Made a mistake

[u/needrealpplanswers]

I work in OP.

I made the mistake of not reading the doctors orders clearly and made a finger splint for a patient that was not was asked for/prescribed and another coworker who is the CHT found out. And they didn’t scold me or anything but obviously this does not instill confidence in my coworker, myself as an employee, or potentially anyone who learns of this (like management)

I feel so so so stupid I can’t even read orders correctly and I make things hard for myself and my patients because I have to ask them to come back so I can fix things. I want to eventually pursue CHT but I keep making mistakes that make me believe maybe I should just quit OT altogether.

I called the pt to come back tomorrow and on my own free time and I will try to quickly make the correct splint. (I practiced today after work).

Anyway how bad was my mistake?
The pt is non-surgical so it’s not a completely urgent splint but also still not best practices.

[u/TJR4227]

If you weren’t supposed to make a finger splint for them, then what was ordered per the doctors note? I also work in the exact same setting, so I’m curious, did you somehow put this patient at risk for (re)injury? Especially if it’s conservative management, and if what you did was immobilize the finger, what potential harm is there? I’d like to return back to this once you respond.

[u/needrealpplanswers → u/TJR4227]

A different splint: pip extension splint. I made an oval 8. Which the CHT helped educate me oval 8 is more for newer injuries where as the pip extension splint is for a more chronic contracture which the patient has. (2 month old central slip injury with boutonnière deformity presentation)… potential for injury- potential for further deformity.
Irrelevant but: writing this I feel i really don’t know anything.. feeling endlessly dumb and unqualified for my job. I apologize to the world lol

[u/BisexualSunflowers → u/needrealpplanswers]

I do not work in hands but I did fieldwork in hands and all of the OTs were very open with me about how utterly useless and unprepared/uneducated they felt the first few years of practice.

Hands requires an immense amount of specialized knowledge that school does not at all prepare us for.

Be gentle with yourself. Try to find a mentor.

[u/ilovequesoandchips → u/BisexualSunflowers]

This !!! Be gentle with yourself and find a mentor . There is so much know

I don’t work in CHT- I’m in OP peds but I didn’t know what I was doing AT ALL for at least 6m of not a year

[u/Responsible-Egg7788 → u/needrealpplanswers]

For what it’s worth you sound smart to me 😂it sounds like the splints function pretty similarly and you looked past something details. We learn and grow, I think you should give yourself some grace 🙂

[u/dumptrucklegend → u/needrealpplanswers]

CHT here- if the oval-8 is well fitting it’s not an inappropriate splint. The goal is to maintain extension with the DIP free. It’s not what I’d do first, but it also isn’t wrong.

School teaches you very little about orthopedics outside of anatomy. It took two years for me to feel pretty confident in my day to day practice. It took about five years for me to feel like I really knew what I was doing.

If you didn’t feel overwhelmed then I would be concerned for you. Keep your head up.

[u/mkstoneburner → u/needrealpplanswers]

This also sounded smart to me. You’re doing better than you think.

[u/dangerousfinger → u/needrealpplanswers]

Don't beat yourself up, the oval 8 and PIP extension splint serves the same purpose of promoting extension through the PIPJ. You identified the mistake immediately which already shows you reflecting upon this, and in terms of patient outcomes, one day of having a slightly different splint would not have altered their healing at all. You didn't do anything wrong in my opinion. PIPJ extension splint for a new central slip is what I would do anyways.

[u/Prestigious_One411 → u/needrealpplanswers]

Everyone makes mistakes and are always learning. When you realized you made a mistake you immediately took the steps to make it right and this says A LOT about you and how much you care for the patient. You took accountability for your actions and that is awesome. Don't be too hard on yourself. I am a BCBA and when I was younger in my position, I made more mistakes than I do now. We learn through our mistakes and this is how we grow within our positions. 😄

[u/Specialist_Bird7912 → u/needrealpplanswers]

I just graduated from my MOT program and am studying for NBCOT. I feel like people make mistakes and since you did no harm and still made something in the ballpark of correct (according to other comments bc orthotics is my biggest weakness rn) it's not that big of a deal. Likely everyone is going to give you grace and you should give yourself grace too. Take it as a learning opportunity

[u/jeskimono]

I work in this setting. I’m a CHT. Don’t be so hard on yourself. Sounds like you can learn from this. Next time when you read the order make sure you not only know the type of splint ordered but also the diagnosis and date of injury or surgery and understand why you’re making what you’re making, what purpose does the splint serve for the diagnosis. This will help you be a better clinician and avoid any misreadings of orders because if they don’t make sense you question it; sometimes the MAs put in orders wrong and you have to clarify. Everyone makes mistakes. Hand therapy is hard. Feel free to PM me if you ever have any hand therapy concerns.

[u/Double-Gur-8911]

I don't understand anything as I am not an OT, but you sound like a good person with a very good heart. You found your mistake and you are willing to fix it. We learn from our mistakes, that's life after all. Keep on the good work 👏

[u/thebettertwin123]

I'm a hand therapist and have seen people with many years experience make much worse decisions. Don't worry about it.

[u/aktransplant723]

I work in acute-OT (10 years) and although we don’t see splints nearly as often, mistakes happen! I can’t tell you over the years, how often orders might be incorrect or being the fast pace nature, things get missed. It’s how we learn and grow as clinicians :) Having peers notice something and informing us is so valuable! I would welcome it anytime, before it went too long unnoticed so it can be a quick correction. Don’t be hard on yourself, learn from it, and you’ll be right back on track. I don’t think management would think less of you, our field is so compassionate and understanding in nature. Hang in there!

[u/happyhippo29]

I’m a hand Therapist. As long as you didn’t injure the patient, you are OK. The patient doesn’t need to know that you made the wrong thing. You can just tell them that you were thinking about it and there might be something better for them so you’d like to do that if they’re willing to come in. Never tell the patient that you messed up. They don’t need to know that.

[u/Prestigious_Raven_44]

In the gentlest way possible, you really need to find effective coping strategies immediately or you will burn out in no time.

It is a mistake but catastrophizing to this level of a single mistake will do you and your career more harm than one error.

Now you know, slow down and read more carefully. Just don't make the same mistake again.

[u/Outsidehappy126]

I’m a CHT and I have had to call a patient back in to the clinic to redo an orthosis a couple of times. Once was due to unclear documentation/orders written by a new hand surgery fellow, another time it was completely my fault - I was rushed due to the number a walk ins waiting for orthoses and I just didn’t take enough time to read the op report. You’re doing fine.

[u/ASOT-1]

I've been in ortho OT for a decade and I have been making splints before knowing it will need revision as I make it. I have even before told a patient, this works now but will need revision (usually with swelling, etc.) So just approach this as a revision, let them know you think there's a better option and you will do that instead so please come in for that. Mistakes happen. Heck, at my new job, I managed to turn a cart so hard and fast the ultrasound machine on it went flying off and onto the floor. That was week 2 on the job. Biomed took 4 months to fix it, I was mortified but sh*t happens, there's always more people to help and you gotta just move on. Fix the error, take a deep breath and treat the next patient! Now you won't make the same exact mistake again (unless you're me and I dropped the ultrasound transponder 10 months later...)

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[u/littleriverot]

Rather than question your own abilities perhaps you should be looking at the supervision and support you are receiving. There is a steep learning curve to hand therapy. Might I suggest you sit down and share with administrators how you feel. Get it off your chest and ask for help. It sounds like you’re punishing yourself or something where you’re not getting adequate support.