What do Occupational Therapists do in neurology departments…

I am a Certified Occupational Therapy Assistant (COTA) and I currently work in the neurology department of a hospital in Houston, Texas, and I love my job. 

During the pandemic, I have alternated shifts with a fellow COTA – about biweekly – in the areas designated for patients with COVID-19. On a normal “neuro” day I would review my list of patients, then don my face mask and face shield, and set off to provide the best treatment I can. Now I have been assigned to cover the COVID-19 areas, the day runs a little differently with extra steps along the way. I take time to gather a set of hospital scrubs, an N-95 mask, and my heavy-duty face shield, and additional time is required before/after each session to don/doff all the additional PPE (insert superhero emoji). It seems like I wouldn’t be able to see as many patients due to all these extra processes taking up time, but I am also not interacting as much with my co-workers – people get a little uneasy when you stroll into the documenting area wearing your “COVID scrubs” – so it evens out.
The most distinct difference in my sessions with patients with COVID – aside from the extra attention given to their oxygen levels, activity tolerance, and mental status – is the time spent with each patient. In the more serious cases, they require more time to acclimate to the physiological effects of even minimal exertion. It can take 30 minutes for a patient to sit up at the bedside and wash their face, simply to ensure that their O2 levels remain adequate.
I find myself spending more time in their rooms, not only to provide therapy, but because they do not receive much social interaction. Nurses, doctors, etc. come in far less frequently, and there is a strict “no visitors” policy in place due to the isolation precautions. The only way to see their family is through a video chat – if the patient is lucky enough to have family and they have access to appropriate technology and it can become quite lonely. One patient said, “I feel like I’m in a zoo, and everyone keeps staring at me from the window.” I, along with some other therapists, arranged for donations from the community; we received hairbrushes, lotions, coloring books, word puzzles, dry-erase boards, phone chargers, and tons of other things that might aid in lifting their mental/emotional state. Most of the patients have been exceedingly grateful for some of those little things, just to make them feel “more normal” and give them something better to do than watch TV.
It has been a challenge to alter my routines and how I address my patients, in response to the pandemic, but it’s also been somewhat refreshing. The fast pace of an acute setting often makes me feel like I have to rush through sessions in order to see all of my patients; but the need to address the mental effects of long-term hospitalisation and isolation has allowed me to build a deeper rapport with patients and truly provide them some comfort in addition to therapy. Something as small as a hairbrush and a little extra time to chat has caused such a major shift in my patients’ affect, that I can literally see their eyes brighten. It has been extremely humbling but has also made the aforementioned superhero pose feel a tiny bit earned.

This blog is part of our ‘What do Occupational Therapists do…’ series to celebrate OT month.

Author: Virginia L. Dismukes, COTA

Bio: I have been a COTA for four years, and currently work at a Level I trauma center. I am also working toward my master’s degree to become an OTR. I live in Houston, Texas with my spouse, two cats, and a 6-month old puppy who has more energy than I’ve ever witnessed in a living thing.

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