My First Job in San Diego

Today was my first day back at work and boy, am I exhausted...and I didn't work a full eight hours of work! Taking a few months off has made me a bit unfit for my physical job as a PT.

My first assignment was at a skilled nursing facility, only a 15 minute drive northeast of our place. It's a typical skilled nursing facility...not that I've been to many of them. It's not the nicest facility, Bethany on Pacific is far more superior in cleanliness and appeal; but I wasn't immediately horrified...a good thing! It took a few adjustments since I am used to working at a subacute care facility, especially ETCS.

ETCS has set a high standard and thus, I'll probably be disappointed in the quality and care, especially when it comes to nurses and nurses' aides (cross my fingers, I find a few excellent ones!). Notable things that are considerably different: the agency orientation. I was given a really quick, like five-ten minute, orientation of the facility which is far bigger than the TCU. I knew the gym (where most of the equipment is stored except for wheelchairs which are stored in a shed outside...if you can find one), general location of the rooms (kept going back to the wall posting after every patient), where the bathroom was located (which I didn't use because I didn't have time), and the computerized documentation (though they failed to mention, until I asked, that I could glean more information in the hard chart for the initial evaluation at the nurses station). I wasn't introduced to the nurses or at least where I could locate them if I had a medical problem with a patient.

I guess I'm use to the thorough orientation the TCU gives agency staff, especially with the initial evaluation! I got a very interrupted introduction to the evaluation paperwork process. Fortunately, the computerized documentation is easy to follow. I guess it would of been nice to be completely oriented to it. They were pretty relaxed about it saying that I could finish the Plan of Care tomorrow....ummm, no! Anyways......it's just different. I guess as a contract therapist, I'll just have to learn to bug people a lot with all my questions. I'll adjust accordingly.

One thing I miss about the TCU is that its focus is not driven by minutes. I guess that's what you get when you work for a non-profit versus for profit. Really, and I mean really, is a 720 minute RUG level appropriate for a patient who has Alzheimer's and only receiving PT/OT....I'm thinking, not so much. And that's one thing I'll have to stick to my guns, the appropriateness of minutes for a patient.

Anyways, I think this will be a good experience for me. Hopefully, I'll be able to find a few facilities I really enjoy (and hope they enjoy me), but it's nice to get exposure to the different kinds of places and people. The good thing about it....if you don't like it, then you can decline to return back there! And I'm still undecided about this place...well, I am there until Friday. Stay tuned!