Ethical Dilemmas in OT activity

You are overwhelmed at home and struggle every day with maintaining your productivity and working the full day. You come in today are scheduled for an 8 hour day but must leave in 7 hours. You decide that to alleviate the problem, you could bill as scheduled and shorten the treatment time of one of your patients - Ms. Jones. You would then come in early to make up the time with her tomorrow without anyone knowing.

Speak to your director and inform them that you have to leave early, despite possible administrative repercussions

You have received 2 write ups in your employee file for having consistently low productivity. You try really hard but cannot seem to master time management. You decide to clock out for lunch but complete your documentation during your break so that your productivity will not suffer. Your rehab company has made it clear that therapists are not permitted to work while off the clock.

Be sure that you do not clock out for lunch if you will be working during that time

You come in and are disgusted to see that you have Mr. Williams on your caseload, again. You try to like him, but really do not care for this patient. You decide to switch him for another patient on your coworker’s schedule. After all, your coworker comes in later than you and would never know

Speak to your rehab director and request to have this patient removed from your caseload

You are on your way to get your last patient for therapy and a CNA asks you to help herget a patient off the toilet. You want to inform her of your productivity standard but do not want to come across as if you do not want to help. You decide to help. What should have been a 2 minute process has since turned into a 10 minute process. The worst part is, you cannot bill for this patient because she is not actively on caseload. You want to help the CNA but decide that you also need to maintain your productivity and caseload

Try to help the CNA efficiently and quickly while being mindful of your productivity

Your mother is strugging with a wrist contracture after having a TIA at home. You have been helping her with exercises, TheraPutty, etc. Your work is helping, but she really needs a RHS. You know that your facility has ordered two splints recently, and one did not fit the patient and remains unused and thrown in a cabinet. You are sure that it will fit your mom. Your mom is struggling financially, and you cannot help her due to your own expenses. You take the splint when no one is looking and give it to your mom. The facility never notices that it is gone.

Search for community resources that may assist your mom with obtaining a splint

You have been working with Ms. Smith for over 3 months, and she is pending D/C this Friday. You have been in constant communication with her daughterm and she has assured you that she is ready for her mom’s return home. On Thursday morning, the daughter stops by to see you and informs you that she is having financial troubles and has so electricity at home. She would like you to change your recommendation for D/C to keep Ms. Smoth at the SNF for another week to allow her time to have the electricity re-connected. The daughter also asks that you not tell anyone about the electricity situation at home, as she is sure that they will call the Department of Children and Families due to her having young children at home. You speak to the Social Services Director, who informs you that she will change the D/C to allow for the extra week if you feel it is necessary. You also update your progress note to indicate a slight decline despite your stating previously that she has met all TO goals.

Speak to the Social Services Director about the daughter’s financial situation and attempt to obtain community based resources to help the patient

You have a group of 4 patients that you need to see for 60 minutes. One group member is not ready for the group. They arrive 15 minutes late for your group

You should bill 60 minutes of group treatment for 3 patients and 45 minutes for the individual that is late; then see the fourth individual that was late for 15 minutes of individual treatment

You need to get out of work earlier than you had scheduled. You have a personal doctor’s appointment that you forgot to alert the schedular and management about. You have a full schedule, and it does not look like you are going to be able to get out of work to make it to your personal doctor’s appointment on time

You should call and reschedule your personal doctor’s appointment considering that it is your fault that you neglected to notify your manager and scheduler that you needed to be out early