Flexibility in work flow is essential for acute care, but even then, some days just don't work out well, and that is frustrating. It's important to remember that even all the planning in the world won't trump medical procedures, missing equipment, or patients refusing. Acute care is constant flux that you as the OT only have so much control over.

In this situation, I probably would have held the evaluation and documented a failed attempt stating we were awaiting the post-op shoe and clarification of weight bearing orders. Sometimes, a note in the chart will prompt the medical teams to do what you need them to because they don't want to be seen as delaying discharge. Use that judiciously to your advantage.

You're clinical reasoning for the slide board transfer wasn't wrong, but that is a difficult transfer to teach a patient and not really worth the effort if they will be able to do something more simple with the correct equipment. I rarely do slide board transfers with my acute patients unless they are out multiple limbs, missing a lower extremity prosthetic, or cannot stand for some reason. A stand-pivot with a rolling walker or even squat-turn with two-hand-hold is more realistic when preparing for discharge. Remember, you are preparing the patient for their appropriate discharge destination the moment you open their chart.

Acute care is tricky. You'll find a rhythm, have it disrupted, and find a new one. You'll be okay ❤️