How Can you Progress Patients as a COTA!
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[00:00:00] . Hey there, it's Hoang Tran with Hand Therapy Secrets. I want to come on and talk to you today after doing one of the manual therapy workshops in New Jersey. So I had a really great question when I was there from a coda. So here's what she asked me.
[00:00:19] She's as a coda, how do I progress my patients? And especially with the skills that she was learning, she's like how do I as the coda progress my patients? So today's podcast and video, I'm gonna talk all around that and I want to. Share essentially my perspective. So I know that there's a educational differential, right?
[00:00:44] So as a coda, I can't remember. I think it's an AA degree. And then your scope of practice, quite honestly is very similar to an ot. I think the only thing you cannot do you can't do evaluations. You [00:01:00] cannot do progress notes by yourself. But you, in some states, you are allowed to do progress notes, right?
[00:01:06] And then the OT just essentially signs off on that. You're allowed to do discharges, right? So you're allowed to write that up and then the OT signs up on it. And I believe certain things are state dependent and I'm not the quote unquote expert on the legal aspects and all that good stuff from a treatment perspective.
[00:01:29] I know something about something when it comes to that and where I would, where I encouraged this therapist was I. I asked a question, why are you waiting for permission to be told what to do? Why are you waiting for permission? And the concept of that behind that is like, why are you waiting to be told that you're allowed to do something?
[00:01:53] I think as a coda you need to understand your scope and what you're allowed to do and then just do it [00:02:00] right. So I believe that, as as codas, codas play a really big instrumental part in. In supporting OTs in the hand therapy realm. Now, yes, you are not allowed to sit for the C H T exam, and that's okay cuz that's just the rules that they created, right?
[00:02:20] Because codas cannot formally do evaluations on their own. Just because you cannot do formal evaluations on your own doesn't necessarily mean that you. Don't know how to observe and how to do certain clinical tests as you learn them. For example, if someone comes to you and they have lateral epicondylitis, how do you know the therapist?
[00:02:51] Who does the evaluation is supposed to confirm or deny that, but as you are working with your patient based off of the [00:03:00] framework or based off of the plan of care that the therapist has created, you as the assistant need to observe how they're doing their exercises. Are they getting better or not getting better?
[00:03:12] And if they're not getting better and they're getting, or they're getting better, how to advance and progress them or regress them. And I believe that requires you as the assistant to fortify your skills, right? To know what to do, how to do clinical testing, how to observe and see, okay, what are some of the movement patterns I'm seeing?
[00:03:32] What are the comp compensatory movements? You have to know how to, what I say is prescribe, prescribe the exercises, right? Yes, to a certain extent the OTs are writing out this plan of care, but you as the assistant, you dictate and you can compel that, that process, that treatment process, right?
[00:03:58] And then it's [00:04:00] working together with the team. Of the ot. So if the OT does the evaluation, you're doing majority of the treatment. You as a OT need, you as a OT assistant need to know what to look for. So you can feed back to the OT and say, I'm seeing this. I'm not seeing progress. I suspect X, Y, and Z problems.
[00:04:19] So for example, let's talk about lateral epicondylitis. The latter epicondylitis area has muscles, but it also has a main nerve, which is the radial nerve, right? So what if you're doing all this stuff and they're not getting better? Part of your job is to go back and tell the OT and the OTs job and your job together is to rule in and rule out is it just a lateral epicondylitis?
[00:04:46] Is it just a muscle tendon issue? Or could there be components of a radio nerve type of issue? So you together work as a team to come up with a plan that gives the patient the best [00:05:00] possible results. And I think as a coda, I would encourage you not to wait for permission to speak up and actually do speak up and you can guide where the plan of care is going.
[00:05:13] You might not technically be the person writing it but you can certainly in your documentation, note that you are observing, improvements or you're not. Observing improvements and that you are, working together with the OT to, do whatever to re how do you call, reevaluate the patient or to adjust the plan of care accordingly.
[00:05:39] That's just technicalities in terms of, the writing and the evaluation part. But in the treatment part, you can command What is being done with and to the patient. That's the whole point of taking classes, right? That's the whole point of going to a workshop and learning your skills, and you can take it back and say, Hey, ot, I've [00:06:00] learned these skills.
[00:06:00] And then when they go to a class, they can go and learn their skills. And then between the two of you is share. And that's teamwork. That's teamwork. I've heard so many times, I personally have not worked with codas recently, but way back in the day when I was in the hospital and they had codas working, in a queue and rehab and stuff like that.
[00:06:25] And even in outpatient if you're a cota with a lot of years of experience, you're the one teaching the ot. And so OTs are actually relying on you to know your shit so you can help them get better and then as they get better, they can help you too, right? You together, I think work as a team.
[00:06:46] And then I think if you're a new coda and you go into an environment where the, the OT is there, they can help you kinda, enhance your skills, improve your skills, especially enhance therapy, right? You [00:07:00] codas are allowed to splint. COTAS allowed to do manual therapy. COTAS are allowed to do exercises.
[00:07:07] So I think that was such a important important question in terms of, how do I improve my patients' results? You apply what you know. And you go and you continue your learning, and I think there's a reason why all of us are quote unquote mandated. To update our ce and there are so many different ways in which to do it.
[00:07:34] You can do it from a online perspective, you can do it from an in-person perspective, mix that shit up and have a good time and I think when we work with patients and there's something that we're not able to help them improve on, those are the cases that kind of stick with us and help us to think like, how can we do better as therapists?
[00:07:56] And I think you are n not exempt. [00:08:00] OT assistance. You are not exempt from that from those type of questions, but I would encourage you to, instead of always waiting for permission, instead of waiting to be told what to do, that you go ahead and you take charge. And do the necessary things that you need to do in order to be able to progress your patients in order to get the results that you want.
[00:08:32] And then I think also to be able to work together as a team with your therapist, even though you may not. Be able to sit to become a certified hand therapist. I think you can play a really huge role in the hand therapy realm and and be able to have more choices in your career as well, right?
[00:08:55] You too can have more choices in your career, and [00:09:00] choices really come down to skill If you as a coda want to go into hand therapy, and this is the thing that I hear all the time there's no opportunities. They won't hire me. Why won't they hire you? Ask that question. Why won't they hire you?
[00:09:16] Now, not all companies have positions. Like for myself, I currently don't have positions for a coda. I hope that one day as I grow my clinic, You know that I, I desire that to be true. Like I would like to bring a coda in. But I also wanna bring a coda in that knows what she or he is doing. I wanna bring a coda in that has taken classes before, has Making those efforts, not just online stuff.
[00:09:45] Like you, you say you wanna learn hands on, you wanna learn, skills, like certain things, take a class. I look at that. I look at those things. I look at it from a OT perspective, I look at it from a code perspective. I, it would be the same for me. If you're coming into a [00:10:00] clinic and you're interviewing, you're like, I got no skills.
[00:10:03] I didn't do nothing to learn nothing. I'm not taking no classes. Who do you think is gonna hire you? I'm being really honest here, right? Who's gonna hire you? So part of it is, it's not like people are, don't wait to get the job to then do the thing. Oh, I'll, when I get the job, then I'm going to take the classes and learn.
[00:10:29] But majority of the time, employers are looking for someone who's. Put that effort in. And you almost have to do it back to back. Like you're taking the class, you're learning some of the skills, and then you're already. Sending your resume out, trying again, and going to the interview and saying, these are, I just took this class.
[00:10:49] These are skills that I have. This is what I would be able to do for your patients. These are, this is the way I would be able to work with your team and your therapist, and your staff, and looking for that opportunity [00:11:00] to grow and enhance my skills. Doesn't that sound better? Then I don't know anything and I'm waiting for you to teach me like I'm going somewhere where I want them to teach me and hold my hand and pay me at the same time.
[00:11:15] Like it just sounds ludicrous. Just sounds where are those opportunities? Like it's probably. None or very few people. I'm always looking like in my company, I'm always looking to mentor and to provide coaching and training to my team. But I need to see that they are willing to do it and pass actions speak louder than any words that, that people say to me.
[00:11:42] If you are a coda, And you wanna get into hands and you wanna progress your patients, then I think that's the key thing that, that the concept there is don't wait for, don't ask for permission, just. Take the necessary action [00:12:00] to get yourself better. And then and then you can have more choices.
[00:12:04] You can apply for those roles. You can be that team member that, that you want someone to be for you. So I hope that helps. That was, I thought that was such a, really good question. I've gotten that question before, but but I wanted to definitely talk about it cuz it was really fresh really fresh in my mind after the manual therapy course.
[00:12:25] So yeah. So if If you need my help, my name is Hoang Tran with Hand Therapy Secrets. I have a, an array of programs and you can check it out, hand therapy secrets.com. I'll include the thing links. If you don't get it from me, get it somewhere so that you can keep developing your skills and get more choices in your career as an occupational therapist.
[00:12:47] All right. Thanks for listening or watching. I'll see you the next time. Bye.
