OT Across America: Boulder, CO with Kimberly Kearney + Team

For this OT Across America: Boulder, Colorado edition, we had the chance to meet with Kimberly Kearney, COTA/L in beautiful Boulder, CO, along with her awesome acute care team!

The interview was in a group format at their hospital (Boulder Community Health) and it consisted of Kimberly Kearney, COTA/L, Shelley Tidd, OTR/L, Leslie Sheats, OTR/L, Megan Litwiller, OTR/L and Sarah Beth Thompson, OTA student.

We loved learning about their experiences in acute care as well as the differences in healthcare in Boulder, CO compared to other parts of the US.

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What does a typical day look like for you in acute care?

Shelley: A typical day is you’re coming in and there’s been a scheduler that has already gone through the work list and assigned case loads to each of the therapists. So you’ll get anywhere from 10 to 12 patients assigned to you. Then you go and you do your chart review and see what’s changed since the day before because it’s acute care – things are changing every day. Then you’re figuring out the day by communicating with nursing and fellow therapists and then treating patients as appropriate. If you’re in the ICU, we take turns attending rounds. Documentation, so typically we each have our own different styles, but ideally you’re seeing a patient and sitting down and documenting.

Leslie: I think here we do a really good job of collaborating. So it’s a lot of seeing the patient and then letting the nurse know what’s going on. And then check in with the discharge planner about whether they really need staff or if they’d be a great inpatient rehab candidate. Like this morning a doctor came through saying, “You know, I know her blood pressure is low. We really want to get this going. Can you go back later. Try it again.” Not 100% but I think a lot are very open to our input.

What is your productivity like in acute care?

Shelley: 50%. We just had this productivity standard put in place in the last year. We have some staff that have been here for 25 years, and they’re just floored by the idea of productivity. For those of us that come from the SNF setting, 50% is doable. So it’s really a transition for the people that have been here for a long time.

Leslie: I would say on average we have 5 evaluations out of 10 patients.

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Have you found that it’s been challenging to get that 50% in acute care?

Leslie: It averages out pretty well.

Shelley: You can’t be a slacker. You think, “Oh 50%. That’s not that hard.” But you have to have good time management. You have to be direct to get your questions answered and be able to move on to the next piece.

Megan: I feel like as a new practitioner in this setting I don’t really have any time to chit-chat or anything. I’m really “go go go.” So some days if I’m right on it I’ll get it 50% exactly. If it’s one of those days like it is today where you’re going back several times to see patients and trying to coordinate, it’s difficult. It’s all a really big learning curve time-management-wise.

Leslie: This week I was on the oncology unit and trying to make up 50%, you’re banging your head against the wall. And you have that where people have been here a while and they’re really not that enthusiastic to participate anymore.

Kimberly: I would think – I don’t know because I don’t do evaluations – but I would think that patients are more willing to do evals than they are willing to do treats. So that’s the factor I deal with, and plus I go all over the hospital so I’m running a distance.

How many beds does this facility have?

Leslie: It’s 110 or so. It’s a pain. It does kill some time but not a ton.

Shelley: Because we’re not so big, we’re often on two floors.

How many patients do you typically see in a day?

Leslie: Eight to ten. On a good day. And then you might have a little bit more. Or you might have a day that is less.

Shelley: We haven’t had to do this in a while, but you might get a day where you’re assigned 15 and then we’re still trying to provide those quality treats, but they’re going to be shorter.

Do patients get seen almost every day if they’re a priority?

Shelley: I keep asking that question in other places because that’s what I want to know. We make a care plan, and we really try to stick to it. Neuro patients, orthopedics that are going home, and anybody who’s got trauma that’s going home – we’re trying to see them daily. Cardiac is 5 to 7 [times a week].

Leslie: Unless they’re really very close to independent, then we just need to check on them.

Shelley: Three to five days a week are more patients that came from SNF and maybe broke a leg or something like that and they’re going back to SNF.

Kimberly: It’s really satisfying to have that experience and to have a real collaborative team. We really do collaborate.

Leslie: We’re a free standing community hospital, and there’s talk that we will get bought out by University of Colorado Health. That is the prevailing theory, but who knows.

Leslie: It would bring with it some pluses, some minuses.

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What are the most common diagnoses that you see here?

Leslie: We’re a level 2 trauma hospital. We see some trauma. And because we are such an outdoor community in Boulder we do see a lot of ski accidents, bike wrecks, skateboarding, drunk college students,  and rock climbing accidents.

Shelley: We have a fair homeless population, so alcohol withdrawal as well. We have a great cardiothoracic surgeon so open heart surgeries. He does quite a few of them weekly.

Leslie: A lot of elective orthopedics. And there’s a lot of older ladies with pneumonia.

Do you have a lot of stroke patients or not too many?

Leslie: There are not a ton.

Shelley: And I think our rehab is close to 40% or 50% strokes.

Leslie: I would say we get more head injury than stroke. A lot of TBI.

What do you like most about this setting?

Leslie: I came from Boston where it was bring them in young, burn them out, we’ll replace them. Work a million hours. And here we respect that you have a life and you want to raise a family and do other things – hike, bike, etc. So come to work, work hard. But we’re going to work with you to get the time off you need. Very few people work full-time here which is great. It’s more than just working which I think a lot of hospitals don’t do.

Kimberly: I think that there’s some unique things that are Boulder-ish, like aromatherapy, Reiki, sound baths, yoga for staff, walk with the dog, tubing to work day, bike to work. It’s very Boulder. There’s a sacred Labyrinth. The spiritual care is not like your typical – you don’t see priests. I never see priests here. They’re all Buddhist and non-denominational.

Is there anything else unique about healthcare in Boulder?

Megan: I just think some of our patients are so neat – especially some of the older ones who have either come here from other places or have been here for a while. They’re just really interesting. Boulder draws a unique individual especially because of the spirituality here, and so I just I think some of our patients are really cool.

Shelley: I had a gentlemen today in his 90’s who is a World War II veteran that has done a bunch of triathlons. He decided to become a triathlete in his mid-50’s.

Leslie: Today, I have a nationally ranked cyclist who’s 67 and fell off his bike.

Kimberly: It’s very scientific here too. There’s a whole bunch of engineers and a whole bunch of Ph.D’s. It’s a broad range of people, very diverse.

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We want to again thank the OT team at Boulder Community Health for taking time out of their busy lunch break to talk with us! We had a great time getting to know what working as an acute care OT practitioner in Boulder is like, and we hope to return again soon!

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