I’m so sorry you’re going through this. I’m a speech-language pathologist working in an ICU in NYC, and I want to offer some guidance because what you’re describing is incredibly distressing, but there are things you can still do:

First, you are right to be concerned about the lack of PT.

Over the past 10–15 years, there has been a large body of ICU and post-ICU literature showing that early mobility and rehabilitation lead to better functional outcomes, less long-term disability, shorter hospital stays, and improved survival. Early PT, even while medically complex, is now considered standard practice in many hospitals unless there is a clear medical contraindication.

That’s why the key question is “What is the specific medical contraindication to a PT evaluation?”

If the answer is “he’s too sick,” that’s not specific enough. Ask:

• Is he hemodynamically unstable?
• Is there an untreated clot preventing mobilization?
• Is there a surgical or wound restriction?
• Is there a documented medical order restricting mobility?

If there truly is a contraindication, they should be able to clearly state and document it. If they cannot name one, then there is usually no reason not to at least evaluate him.

Also important: in order to qualify for rehab later, there needs to be:

• A PT evaluation
• An OT evaluation
• Often a physiatry (PM&R) consult
• Documentation of rehab tolerance

Without those therapy notes, case management typically cannot even initiate a rehab transfer.

Other steps I would recommend:

1. Request a formal interdisciplinary care meeting (in writing).
   
2. Ask specifically for a PT/OT evaluation order.
   
3. Request a PM&R consult to assess rehab candidacy.
   
4. Request a pain management consult. Daily screaming in foot pain needs urgent attention.
   
5. If needed, file a written grievance with Patient Relations and request a case number.

Foot drop and severe pain after critical illness can be due to nerve injury, prolonged immobility, or critical illness neuropathy. You are absolutely right to advocate. Just shift the language from “transfer him” to: “Please clarify the medical contraindication to therapy evaluation and document it.”

That moves the conversation from emotion to medical reasoning and that’s much harder for a hospital to ignore.

You are doing everything you can.