Pulmonary Rehabilitation: Where do OTs stand?

Pulmonary rehab is not an everyday field in the world of OT in Malaysia. Although it has been pretty established in countries like UK and Hong Kong, little or almost nothing is known about it in Malaysia. Very often I find myself trying to explain to OTs what our role in pulmonary rehab is. Come on, even the physiatrists in my hospital does not know our role - the housemen of a ward accidentally referred a pulmonary rehab case to the physiatrist and his plan only involved chest physio. Pretty sad when your boss doesn't know what you can do - not that they know much of what we do really (and neither do I know what the purpose of a physiatrist is).

Anyway, without further ado, let's talk about the background of me and the pulmonary rehab program (PRP) I'm currently involved in. I'm a locally trained OT who graduated in 2013. I spent my first year working in neuro rehab, and this is the second field I've worked in. Luckily enough, I joined the chest ward at a very nice time, just as they were kicking off the inpatient pulmonary rehab program for COPD clients. So basically, it's safe to say that I'm the pioneer of pulmonary rehab in my hospital. OTs have been posted to the chest ward in my hospitals for quite some time already, but things weren't so serious in the past. Due to pulmonary rehab not being in our college syllabus, it was a pretty foreign field for OTs who worked in there, and most of the services offered by OTs there were swallowing tests, prescription of compression garments, and ADL and motor retraining for clients with secondary complications. Nothing really focused on chest problems.

Our primary PRP team involves 5 disciplines: physicians, pharmacists, physios and occupational therapists. But due to the lack of man power, it's only 1 specialist, 1 pharmacists, 2 physios and me (the sole OT). Our specialist has also involved other disciplines, like dieticians and psychiatrists (for depression), but they only come in on demand. Then finally, there are also the nurses as well. They usually play the part of ensuring that the client's home program gets carried out, and the right medicine is given at the right time, and other basic nursing care needs. So basically, every Thursday, our specialist will have a pulmonary rehab ward round to discuss the condition of the clients, giving us input on the medical condition of the clients, the pharmacist will give input on the client's MDI technique and other pharmacology stuff, while the physio gives an input of the client's physical condition, like ambulation ability, cough effort etc. And finally, down to us. So what do OTs do?

Just for some suspense, I'll slowly let the roles of OT unfold one by one in future post. The next post would be a brief introduction about COPD, which is the main condition addressed in our PRP.