 Hospital personnel are dedicated to healing and caring for the sick and the injured. But there are times when a helping hand is not in the best interest of the patients and in fact may delay their ultimate recovery. Occupational therapy concerns itself with a patient's total performance, his work, leisure, and self-care. This patient, a retired officer, is recovering from a stroke. Immediately after her stroke, she wasn't able to feed, dress, or groom herself unaided. Self-care is usually taught as soon as possible after hospitalization begins. Using many techniques and devices, occupational therapists help patients relearn basic skills. From that beginning, patients will go on to improve leisure and work skills. In a more private area, the Occupational Therapy Clinic, instruction in dressing is provided by the therapist on a one-to-one basis. With instruction, Colonel Simon is slowly regaining her independence. It is difficult to resist the temptation to step in and help, even if not helping, seems to slow you down. But in the long run, when the patient has mastered a useful skill, your job is easier. Everyone who comes in contact with the patient must provide positive reinforcement. It really is part of every treatment plan. You've got that figured out real well. Okay, now the method we're going to use to get your pajama top off is to reach behind your back, take a hold of your collar, and then gather up as much of it as you can. Pull it right over your head. There you go. Now pull it right on over your head. Very good. Now bring it on down, and you have your arm out. That was easy, wasn't it? And you did that real well. This way of dressing is one of many techniques available. The specific method will vary to meet the individual needs of each patient. Pull it on through your sleeve. Very good. Now take the shoulder seam and pull it up high up on your shoulder. That's very important that you always get it right up to the top before you try to do anything else with it. That shoulder seam is right in here. You want to put it right up on top of your shoulder. That's it. Very good. Now reach around and pull it across your back. You're getting it. That's it. Keep pulling it around. It'll come. There now. There it comes. And you'll be able to find your other arm hole in it. That's it. Very good. Now you need to straighten it all up so it looks good and feels comfortable. Doing a fine job. How's that feel? Very good. But what happens to Colonel Simon when she is back on the nursing unit? If the people on the unit aren't aware of her new skills or that she needs to practice them instead of developing self-confidence she develops a sense of helplessness and despair. What can be done to improve this situation? One thing we can all do is to become familiar with the practical techniques patients acquire in occupational therapy. For mealtimes, the occupational therapist have a whole kit of special assistive devices. This is the rocker knife. With it, a patient with only one usable arm can cut his own food. This strange-looking utensil is known as a spork, a combination spoon and fork. By attaching a large handle, it helps those who can't grasp small objects. A large handled fork and a plate guard can be a blessing for patients who are trying to function with less than their normal dexterity. There are many devices to help with a patient's personal hygiene. A strap on an electric shaver, an extended comb, a hand brush that mounts in the washbasin. Find out how much the patients can do for themselves and let them do it. You build their self-confidence and at the same time, the nursing staff gets more time for other patients. In the occupational therapy clinic, patients learn to do a lot of things you might think were beyond them. This man with total hip replacement is learning to put on support hose. It helps to understand the techniques and the devices used to improve patient skills. But the greatest need is to improve communication between therapy and nursing units. Every time you do something for a patient that he could have done for himself, you retard that patient's progress. Every time a patient is deprived of a chance to practice his new self-care skills, it diminishes his independence. What can be done about this problem? What are some of the ways that a patient's progress can be communicated to everyone who works with the patient? One way is with regular entries in the nursing care plan, indicating the level of the patient's ability and the techniques he has learned. The nursing care plan entries can refer to detailed documentation from occupational therapy progress notes in the patient's health care chart. Some hospitals record this information in the nursing notes or in the problem-oriented medical record. Whatever method you are using, it is essential to keep these records up to date. Follow-up conversations will help keep you informed of each patient's progress. I'd like to bring you up to date on the progress Colonel Simons has been making in OT. Oh, good. We've been working with her in getting in and out of her pajamas and her shoes and socks, and she's now able to do that all by herself. Well, that sounds great. We've been working with her on a bed so that people who work with her can just take her fresh pajamas to her and she can do it all in her own bed. Well, that sounds real good. I'll certainly pass this on to the rest of my staff. Nursing personnel going off-duty should always include the patient's progress in the change of shift report. Yes, ma'am. Sounds real good. Certainly will. Yes. Good afternoon. How are you today? Fine, yourself? Oh, just fine. Ready to go home. I was just on the telephone with occupational therapy and they called in regards to Colonel Simon and beginning this evening. Yeah. We would like for her to put her pajamas on herself and also in the morning her socks and shoes. Great. And that's extremely important that we pass this on to the remainder of the staff because we need consistency throughout all shifts. The occupational therapy patient is continually learning new skills. Skills you need to know about to give the patient the opportunity she needs to practice them. With this knowledge, you can arrange schedules to fit the patient's needs and abilities. You must anticipate these situations and allow enough time for dressing, for personal hygiene, and for meals. By letting the patient practice these daily tasks, you also provide another opportunity to build self-esteem and confidence. At the same time, you have more time for the patients who need you with them. When help is needed, it's a question of doing only what's required. This patient cannot open containers, but he can feed himself. Sometimes you can help most by helping the least. We are dedicated to caring for the patient. Yet with occupational therapy patients, too much assistance could delay their rehabilitation. One thing you can do is reinforce instructions where the patient needs it. Sometimes it's very hard not to help, especially when the patient is struggling to do something that's so easy for us. You must be aware of your patient's progress and remind yourself to let him do those things he has learned. Support better communications. Keep your records updated. Be aware of changes in status of your occupational therapy patients. And pass the word on to others. Colonel Simon has been taught in OT to get dressed. Presently she's attempting to get dressed. Will you please go in and check on her and see how she's doing? Colonel Simon has come a long way since she entered the hospital. Every step has taken her closer to her goal of leaving the hospital an independent person. Your occupational therapy patients need your support in their self-care efforts. They need the chance to develop their feelings of self-worth and well-being. It's up to you to give them that chance.