I start my day looking at my patient list. Every day I will have new patients added and they can be in the cardiac nicu, pcicu, cardiac floor and outpatient. There are set times to see the cardiac babies for care times and those times are set up first. After that, I set up session times for the other patients and factor in any trainings I will be providing for the day- such as orienting new staff to infant development and the functional implications with cardiac diagnoses, co-treating with staff for VAD and ECMO patients and assorted other team meetings. If any of the patients need a second clinician or just physical assistance, I would also coordinate with our rehab aide. For each patient, I text the nurse to set up the time and ideally coordinate with Speech, PT and timing of pain and sedation medications as well as line removal and procedures. Mornings are busier than afternoons however always subject to change due to medical acuity or children napping.
Professionally, I am most proud of putting OT on the map in the Cardiac and Heart Failure world. As therapists, we feel strongly about our role with these patients, but we are constantly educating clinicians, patients, and families about our role. Heart failure and transplant impacts every aspect of life and I really hope to continue highlighting our role and what we have to offer these patients.
OT is an incredibly rewarding profession. Working with acute pediatric heart failure patients is not for the faint of heart. It will both bring you incredible joy but also at times truly break you. It is vital to have a supportive and collaborative team to make sure that you take care of your mental health as well as provide great patient care. If you do your job well, you will have a remarkable impact on children’s functional status and the quality with which they are able to complete their daily living skills.
A lot of my job involves interdisciplinary communication and collaboration. There is a lot of time spent educating about the OT role and clearly highlighting why we matter and what we bring to the table. I love working with so many disciplines and working to provide the best holistic care we can provide. Instead of working in silos, interdisciplinary care makes things run smoother and better for everyone involved
So much goes into functional outcomes that isn’t necessarily obvious to the untrained eye. Also when we are discussing acute medical needs, many aspects are not viewed as a priority due to the overall acuity. Examples are the use of diapers for continence on an already toilet trained child and the impact this has on their pelvic floor and interoception, or a line placement impacting either an infant learning to crawl or be able to self sooth; or the impact of a post-operative phrenic nerve involvement on their posture, cardiopulmonary status and ability to dress themselves. But as the patients switch to survivors, we want to think about if they survive- now what? What will they be able to do? Are they going to be able to do the things that are important to them? How can we set the stage for all the ins and outs of daily life that we all take for granted to be able to complete. Normalizing a child’s environment and incorporating their and their caregivers’ priorities is vital to succeeding at this job.