What a week it has been! I can hardly believe it's Friday tomorrow! What I really can't believe is that tomorrow marks the end of week four...I will be half way done with my first site!!!
I've been treating a lot of patients this past week; especially the last two days. Up until this week I've never felt overly stressed about getting my daily notes done. Today hit and I walked into the office with a stack of charts waiting for me on my desk (yes...I have my "own" desk). It's not like someone else put them there for me to do, I left them there on Wednesday night because I did not have time to finish them before I left. Each time I sat down to work on notes, one of the OTR's would ask me to go work with another patient. I did a total of 6.5 sessions today. That's the most patient's I've personally treated in one day. I wrote notes for 5 of these sessions, plus I had 3 notes to finish from yesterday. I wasn't able to sit and catch up on notes until after my second to last patient around 3pm.
Despite being slightly overwhelmed, I've walked away from work each day this week feeling better and better about what I'm doing. I feel like I am getting a pretty good grip on what I'll be doing for the rest of my life. It's kind of funny to me that the one thing that I hated in school is what I'm the most comfortable doing at the clinic. Passive range of motion (PROM) is the most basic way to make a huge difference in a patient's overall ability to function (at least that's how I am viewing it). I've been hesitant to do PROM with a couple different patient's because of the complexity of the condition, but my OTR has been pushing me to do more and it's helping me build skills and confidence.
The other thing that I struggled with for a bit at school was doing transfers (to and from wheelchairs). I thought I had mastered the technique at school so I wasn't too worried about it--until I had to do it in real life! Transferring someone who is fully capable of walking and has normal muscle tone (even if they try to act differently) is not even close to transferring someone with high (or low) muscle tone with limited walking ability. I'm struggling quite a bit with it and I'm really having to work on it so that I don't drop a patient! My height continues to be a bit of a battle, but I'm learning to adjust how I do the transfers to make it work for my height. I am sure my program director would be happy to know that while I may not always have proper body mechanics, I am at least thinking about what I should do before I start the transfer!
Tomorrow I will be going over my midterm evaluation with my supervisor. I'm rather nervous/anxious to find out from the professional(s) how I'm really doing in the field! :)
Thursday, October 27, 2011
Wednesday, October 19, 2011
Loving This!
I'm not sure I've said this or not...but I am LOVING this fieldwork experience!
I've been doing more treatment sessions this week. Along with continuing treatment with the patients from last week, I've conducted sessions for a few other kiddos, mostly with Autism. Some of the sessions have been better than others, though "challenging" is probably the best word to describe how I feel about these sessions. You make all these wonderful plans for the treatment session, and then the patient is having an off day so your plans go awry. I guess if I've learned anything in the last few days, it's that my teachers were right when they said we will have to think on the fly!
As stated last week, I've been working on my catching/throwing and balloon hitting skills. It's turned into a bit of a joke with the staff at my clinic that I'm being graded on these skills so I really do need to work on them! This morning was an opportune time to do this very thing. I saw a patient with Ehler's Danlos Syndrome (EDS) (super interesting diagnosis that I already know a ton about thanks to my old roommate who also has this somewhat rare condition). He was full of energy so we played bowling, then basketball, followed by baseball. He wore me out, but I had so much fun!
An update on my shoulder in regards to treating the 22 year old that has CP--I've done much better this week with finding better ways to help support him so that I am not injuring myself. So, thankfully my shoulder is no longer in so much pain. So that's the good news of the week! I think I'll end on that positive note!
I've been doing more treatment sessions this week. Along with continuing treatment with the patients from last week, I've conducted sessions for a few other kiddos, mostly with Autism. Some of the sessions have been better than others, though "challenging" is probably the best word to describe how I feel about these sessions. You make all these wonderful plans for the treatment session, and then the patient is having an off day so your plans go awry. I guess if I've learned anything in the last few days, it's that my teachers were right when they said we will have to think on the fly!
As stated last week, I've been working on my catching/throwing and balloon hitting skills. It's turned into a bit of a joke with the staff at my clinic that I'm being graded on these skills so I really do need to work on them! This morning was an opportune time to do this very thing. I saw a patient with Ehler's Danlos Syndrome (EDS) (super interesting diagnosis that I already know a ton about thanks to my old roommate who also has this somewhat rare condition). He was full of energy so we played bowling, then basketball, followed by baseball. He wore me out, but I had so much fun!
An update on my shoulder in regards to treating the 22 year old that has CP--I've done much better this week with finding better ways to help support him so that I am not injuring myself. So, thankfully my shoulder is no longer in so much pain. So that's the good news of the week! I think I'll end on that positive note!
Thursday, October 13, 2011
Nearing the End of Week Two
Let's see if I can recap the past few days...
On Tuesday I was able to work with a couple more patients. A young boy with cerebral palsy (CP) was my first patient in the morning. He is a super funny kid to be around. He always has something to tell you, he loves to tickle you, and 90% of the time he has some kind of super power. My first time working with him on my own involved a lot of energy on his behalf! He was so wound up and I was not able to get all my treatment goals completed. It made writing the daily note rather difficult! Which...speaking of note writing, he was the first patient I had to write a note about. My supervisor didn't have me write notes for my patients on Monday. It proved to be more challenging than I expected.
My second patient was a girl around 20 years old that also has CP. She is non-verbal and doesn't seem to like therapy a whole lot. She puts forth little effort and lacks motivation in a big way. Regardless, I've still seen some improvements over the last two weeks. She was kind of another tricky patient for me to see because her range of motion on the right side is so limited and she is non-verbal.
On Wednesday I got to see my very first patient from Monday again. We worked on lot on seated activities which required a lot of physical support from me. I feel like I've thrown my shoulder out from trying to help him maintain his balance on the edge of the mat. At the end of the session, he requested that I transfer him back to his chair. I was really nervous about doing the transfer because of his high muscle tone, but since he requested that I do the transfer, I went for it! My supervisor showed me what to do and it was an overall smooth transfer!
After lunch, I went with my supervisor to do a session at a patient's home. This little girl has a very rare diagnosis of D-bifunctional protein deficiency disorder. She has very low muscle tone so the two main things that OT works on is doing some passive range of motion (PROM) as well as minor weight bearing through the upper extremities. I watched my supervisor (who has worked with this 4 year old since she was 2 months old). I was scared to even touch the precious little thing for fear of hurting her. My supervisor let me finish up the shoulder PROM and just sit with her for a little while. It was a very neat experience and I hope I get to go back and work with her again a few times before my 8 weeks is up.
Today involved another adventure with the two boys that have CP. The younger one that I started with on Tuesday and was full of energy was significantly more mellow today. I accomplished nearly all of the treatment goals during the session (which made note writing MUCH easier)! I also worked with the older one who nearly knocked me to the ground on Monday and Wednesday. I did better with him today and learned a better way to keep him stabilized but my shoulder still feels like it's going to fall apart. We had another smooth transfer back to his chair at the end of the session and I felt pretty good about the session as a whole.
Later in the afternoon I worked with the cute little guy from Monday. We got more accomplished than we did on Monday which made me feel good. He's so easily distracted that he is hard to work with but he's adorable and I love working with him!
While I've only done a few treatment sessions on my own, I've been assisting with many more throughout the course of each day. I have been working on my throwing/catching skills, my balloon hitting skills, and even my soccer skills! I have learned how to play new games and I got to play on the swing a couple times too. I'm absolutely loving this time of learning!!!
On Tuesday I was able to work with a couple more patients. A young boy with cerebral palsy (CP) was my first patient in the morning. He is a super funny kid to be around. He always has something to tell you, he loves to tickle you, and 90% of the time he has some kind of super power. My first time working with him on my own involved a lot of energy on his behalf! He was so wound up and I was not able to get all my treatment goals completed. It made writing the daily note rather difficult! Which...speaking of note writing, he was the first patient I had to write a note about. My supervisor didn't have me write notes for my patients on Monday. It proved to be more challenging than I expected.
My second patient was a girl around 20 years old that also has CP. She is non-verbal and doesn't seem to like therapy a whole lot. She puts forth little effort and lacks motivation in a big way. Regardless, I've still seen some improvements over the last two weeks. She was kind of another tricky patient for me to see because her range of motion on the right side is so limited and she is non-verbal.
On Wednesday I got to see my very first patient from Monday again. We worked on lot on seated activities which required a lot of physical support from me. I feel like I've thrown my shoulder out from trying to help him maintain his balance on the edge of the mat. At the end of the session, he requested that I transfer him back to his chair. I was really nervous about doing the transfer because of his high muscle tone, but since he requested that I do the transfer, I went for it! My supervisor showed me what to do and it was an overall smooth transfer!
After lunch, I went with my supervisor to do a session at a patient's home. This little girl has a very rare diagnosis of D-bifunctional protein deficiency disorder. She has very low muscle tone so the two main things that OT works on is doing some passive range of motion (PROM) as well as minor weight bearing through the upper extremities. I watched my supervisor (who has worked with this 4 year old since she was 2 months old). I was scared to even touch the precious little thing for fear of hurting her. My supervisor let me finish up the shoulder PROM and just sit with her for a little while. It was a very neat experience and I hope I get to go back and work with her again a few times before my 8 weeks is up.
Today involved another adventure with the two boys that have CP. The younger one that I started with on Tuesday and was full of energy was significantly more mellow today. I accomplished nearly all of the treatment goals during the session (which made note writing MUCH easier)! I also worked with the older one who nearly knocked me to the ground on Monday and Wednesday. I did better with him today and learned a better way to keep him stabilized but my shoulder still feels like it's going to fall apart. We had another smooth transfer back to his chair at the end of the session and I felt pretty good about the session as a whole.
Later in the afternoon I worked with the cute little guy from Monday. We got more accomplished than we did on Monday which made me feel good. He's so easily distracted that he is hard to work with but he's adorable and I love working with him!
While I've only done a few treatment sessions on my own, I've been assisting with many more throughout the course of each day. I have been working on my throwing/catching skills, my balloon hitting skills, and even my soccer skills! I have learned how to play new games and I got to play on the swing a couple times too. I'm absolutely loving this time of learning!!!
Monday, October 10, 2011
Treatments are Underway
I did my first two treatments today! How did it go? Well...it wasn't terrible, it wasn't great...it was a good learning experience, that's for sure and I'm happy with how it went overall.
My first patient that I saw is around 22 and has athetoid type cerebral palsy. I've spent plenty of type watching the staff at my clinic work with him but he typically has high extensor tone and it made me nervous about how I'd be able to handle him. Luckily when I started with him, physical therapy had already been working with him and they had just started a new activity to work on sitting balance. I then worked on some reaching and core strengthening. I assisted him with sit-ups. Watching my supervisor and the other OT do this--they made it look so easy! I nearly fell over when I tried assisting him!!! I told him I was going to have to start working out at the gym just so I could continue doing his treatment. He's such a good sport about dealing with me as a student. I know that I'm going to learn a lot from working with him!
My second patient was the cutest little boy I've ever met. He is around 6 years old and was diagnosed with agenesis of the corpus callosum (a rare birth defect in which there is a complete or partial absence of the corpus callosum). My supervisor sat back and let me run the session. It went pretty smoothly, all things considered. He loves books and of course that is the first thing he wanted to do. After that we played on the swing for a little bit. Next I had him copy some letters on the chalk board. I realized I need to have a more structured activity if I am going to work on fine motor stuff. The last thing I worked on with him was a three-step obstacle course. Physical therapy had joined me at this point so we had him walk on a balance beam, jump over "stones" and hit a balloon while kneeling. I hit the half way point of the session and that's when I kind of freaked out. I felt like I had NO idea what I was doing and/or that my supervisor probably thought I was dumb for doing the things that I did. I felt a lot like I did when I was doing practicals at school...unprepared and nervous as all get out. I pulled myself back together and finished strong.
I have no idea who I will be seeing tomorrow. I don't think either of the patients I saw today will be there again tomorrow. I'll walk in the door, check the schedule and hopefully not freak out about who my supervisor puts on my case load for the day. I think she's giving me 3 or 4 patients though. Should be an adventure!
My first patient that I saw is around 22 and has athetoid type cerebral palsy. I've spent plenty of type watching the staff at my clinic work with him but he typically has high extensor tone and it made me nervous about how I'd be able to handle him. Luckily when I started with him, physical therapy had already been working with him and they had just started a new activity to work on sitting balance. I then worked on some reaching and core strengthening. I assisted him with sit-ups. Watching my supervisor and the other OT do this--they made it look so easy! I nearly fell over when I tried assisting him!!! I told him I was going to have to start working out at the gym just so I could continue doing his treatment. He's such a good sport about dealing with me as a student. I know that I'm going to learn a lot from working with him!
My second patient was the cutest little boy I've ever met. He is around 6 years old and was diagnosed with agenesis of the corpus callosum (a rare birth defect in which there is a complete or partial absence of the corpus callosum). My supervisor sat back and let me run the session. It went pretty smoothly, all things considered. He loves books and of course that is the first thing he wanted to do. After that we played on the swing for a little bit. Next I had him copy some letters on the chalk board. I realized I need to have a more structured activity if I am going to work on fine motor stuff. The last thing I worked on with him was a three-step obstacle course. Physical therapy had joined me at this point so we had him walk on a balance beam, jump over "stones" and hit a balloon while kneeling. I hit the half way point of the session and that's when I kind of freaked out. I felt like I had NO idea what I was doing and/or that my supervisor probably thought I was dumb for doing the things that I did. I felt a lot like I did when I was doing practicals at school...unprepared and nervous as all get out. I pulled myself back together and finished strong.
I have no idea who I will be seeing tomorrow. I don't think either of the patients I saw today will be there again tomorrow. I'll walk in the door, check the schedule and hopefully not freak out about who my supervisor puts on my case load for the day. I think she's giving me 3 or 4 patients though. Should be an adventure!
Thursday, October 6, 2011
Almost the End of Week 1
This week has gone by quickly. It's weird to think that tomorrow is my 5th day at my first site.
So...what have I done this week? My supervisor decided to make this week strictly observations especially since I did not have any experience working with pediatrics in this field. I've seen a ton of different diagnoses...well, that may not be true; I've seen a lot of similar diagnoses with varying symptom extremes. CP, Autism, TBI, PDD, and probably the most intriguing one to me is
So...what have I done this week? My supervisor decided to make this week strictly observations especially since I did not have any experience working with pediatrics in this field. I've seen a ton of different diagnoses...well, that may not be true; I've seen a lot of similar diagnoses with varying symptom extremes. CP, Autism, TBI, PDD, and probably the most intriguing one to me is
Monday, October 3, 2011
The Start of Level Two
Today was my first day of fieldwork 2. I went in feeling decently confident, but that was mostly because I had been in the clinic and met a few patients already. I'm so glad I was able to spend some time at the clinic before starting today because it definitely helped my stress level.
I knew that today was going to be strictly observations. What I didn't know is that my supervisor would be sick! The day was slightly chaotic due to the two person OT staff being cut in half by my supervisor being sick. We had back to back patients starting at 9am through 5pm except for our half hour lunch break and then our first afternoon patient was a few minutes late. I saw a lot of different...stuff! Different diagnoses, different ages, different activities, different assessments/tests, different behaviors...all sorts of stuff. Some of the patients I cannot WAIT to work with. Others, I hope to never have to work with! A couple of them made me pretty nervous, and one of them honestly scared me. It's been a long time since I've been around aggressive children...and it's a whole different story when they are aggressive because that's just their behavior, not because they are mad or in trouble. Seeing an older teen pulling the therapist's hair, slapping her and trying to bite her was hard to deal with! I feel like I need to be trained in some kind of self defense. I guess working in that situation is the only way I'll ever be able to figure out how to handle it.
I'm anxious to go in tomorrow and maybe get to be a little more hands on with some patients. Instead of sitting back and watching, I'd like to jump in and start doing activities with the kids. I also hope that my supervisor is there tomorrow to cut back on the chaos! I felt bad for the OTR I was with today because she was so overwhelmed with the day's caseload that I was just one more stressor to her. I'm so excited to see where the next two months lead me. I may leave a mad woman or I may come out with an even stronger desire to work with the pediatric population.
I knew that today was going to be strictly observations. What I didn't know is that my supervisor would be sick! The day was slightly chaotic due to the two person OT staff being cut in half by my supervisor being sick. We had back to back patients starting at 9am through 5pm except for our half hour lunch break and then our first afternoon patient was a few minutes late. I saw a lot of different...stuff! Different diagnoses, different ages, different activities, different assessments/tests, different behaviors...all sorts of stuff. Some of the patients I cannot WAIT to work with. Others, I hope to never have to work with! A couple of them made me pretty nervous, and one of them honestly scared me. It's been a long time since I've been around aggressive children...and it's a whole different story when they are aggressive because that's just their behavior, not because they are mad or in trouble. Seeing an older teen pulling the therapist's hair, slapping her and trying to bite her was hard to deal with! I feel like I need to be trained in some kind of self defense. I guess working in that situation is the only way I'll ever be able to figure out how to handle it.
I'm anxious to go in tomorrow and maybe get to be a little more hands on with some patients. Instead of sitting back and watching, I'd like to jump in and start doing activities with the kids. I also hope that my supervisor is there tomorrow to cut back on the chaos! I felt bad for the OTR I was with today because she was so overwhelmed with the day's caseload that I was just one more stressor to her. I'm so excited to see where the next two months lead me. I may leave a mad woman or I may come out with an even stronger desire to work with the pediatric population.
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