Thursday, May 31, 2012

day 3.

Today was great! I got to run two treatment sessions and do those patients daily notes and I found out that I will take on one of those two as 'my first patient' :)  She had a CABG and is working on getting stronger and being able to dress and bathe herself and perform the IADL's she needs to do when she gets home. Also she has to do these things while adhering to Sternal Precautions because of her surgery.
I have to take her vitals before and after each session and when I went to get her from her room and got set up to take her vitals, the BP cuff kept inflating and popping off her arm! It was a little embarrassing that I couldn't get it to stay on so I went to get my supervisor to help me! Luckily they have the electronic ones so I dont have to depend on listening to the stethoscope to find the blood pressure!  Once we got the vitals taken we headed out to the patio to fold the towels for the department since she said she is the one who does the laundry at her house. And we worked on some hand/grip strength because she had complained about her hands feeling weak after she got out of surgery. Then I had to write up her daily note! :) It was a great session and it went very smoothly :)

The other lady that I led a treatment session with was not as compliant with treatment! we worked on bilateral task- she had a hip replacement and broke her arm so it had been in a cast before this week. She is very nervous to use the arm but it is fine and ready to work! I had to keep redirecting her and keeping her on task which can be exhausting. Then we folded clothes, which is good because it is a task that just naturally facilitates the use of both arms. And we ended the session by making a peanut butter sandwich and working on opening the jar of PB and the bag of bread and using her affected arm during the activity. She complained pretty much the entire session but I just love her anyways- yesterday we saw her and when we said a phrase and it reminded her of a hymn and she just started singing. And when I took her back to her room and went to leave she said "may the blessings of the Lord be with you today" it!

I felt so good about my tx sessions and daily notes based on the feedback I got from my supervisor- she said she was so impressed with my notes and that I did really good leading the Tx sessions with each patient, and esp with the second lady that needed constant verbal cues.

I love that I'm getting more responsibility. I figured it would be another week or more until I got my first patient but I think I am ready to start with one, esp since the eval was done by my supervisor yesterday. :)

Tuesday, May 29, 2012

Level 2: Day 1

Well I have successfully completed day 1 of my first Level 2 :) I am at a Skilled Nursing Facility and it was so nice :) My supervisor is awesome, we just dove right in today and saw 3 patients in the time that I was there (She only worked a half day today so I came in at 1:00).

The first patient we saw was an elderly woman who lives at the facility due to alzheimers/dementia and she needed a resting hand splint because of contractures in the PIP joints of her L hand. She was so cute and her daughter was there visiting and saw my name tag and said that she went to Radford for her schooling! Then she was asking me how much longer I have left and I told her I will be there til Aug then to Newport News and she was just so excited because her family just moved to Roanoke from NN last year and they loved it there! =)

The second patient we saw was an elderly man who had a THA (hip replacement) that had gotten infected (eek!) and he only has 2 weeks left before he is d/c. He was soo cute :) He was telling me that he's been married twice, and has many grandchildren and then asked if i was married and if I wanted to be married and told me that I was a 'lovely young lady'!  We worked on transfers: supine-sit, sit-stand, w/c- arm chair. He is really good at doing a sliding board transfer to get from his bed to his wheelchair. we also worked on UB strengthening because he has gotten weak since being in the nursing home.

The last patient that we saw was an older woman who had a L CVA, pretty severe and has R side neglect- needs lots of cues in order to look to the right. She has some muscle tone returning in her R UE but for the most part the R side is a 0/5 (for manual muscle testing) which means there is no muscle contraction. She seemed like such a sweet lady, even though she was non-verbal and appears to had aphasia, her room was filled with balloons and mother's day cards/flowers. I can't wait to see her progress from now until she is d/c.

The facility is going through a medicare audit of all of their documentation right now so it was a big deal for me to learn their documentation procedures- I spent some time today going over old notes my supervisor had written w/ comments from the rehab manager just so I am familiar with the format and how they write notes there (everywhere is different!)

My assignment tomorrow is to write part of a daily note for a patient that we see. I don't think it will be too difficult.

(Please let me know if you have any questions about anything I write regarding fieldwork, diagnoses, abbreviations....or anything!_

Thursday, May 24, 2012

let's play catch up :)

So here we are, it has been an awful long time since I have updated this blog! Since my last post lots has happened! I am now done with my time on more classroom instruction!! I will be starting my first Level 2 Fieldwork next week (!!) and will be there until the middle of August before moving to Newport News for my second Level 2 placement.

The end of the semester was so busy and stressful, as usual.  This whole semester we have been working in groups of 4 to create a business plan, I am not sure if I have mentioned this before- I think I may have briefly. My group created a Transition Program for students in the three counties around my university. I had never taken a business related class in my life so this was pretty difficult for me, never had heard of a SWOT analysis, or a Market Analysis, or a Break Even Analysis..but it all had to be done and then some. During the last week of class we had to give a 30 min presentation on our business. My group did really well on it and my professor stressed that there is such a need for the services in the area that she hoped we would take the business plan and really put it into action. hmm...we'll see about that ;)

Also, I had two skills competency checkouts for my Musculoskeletal and Neurological courses. They were the same style but different clients. We had to go in an choose a 'client' from a card, spend a few minutes reviewing the case, making a list of evaluations and treatment ideas for that client and then our professor acted as the client and we carried out an evaluation and did a treatment session, and then we had a couple of hours to write up an eval note, daily tx note, and long term/short term goals.

 For Musculoskeletal the client I had was diagnosed with Low Back Pain so that was not too challenging because it is all about client education: no bending arching or twisting, and introducing adaptive equipment to reduce the need to bend/arch/twist the back.
For Neurological, the client I was assigned had a CVA with severe L neglect (meaning she did not attend to anything to the left of mid-line, for instance if i had placed items on the left side, she would not even know they were there, even if they were placed within a normal visual field). I had to do the Letter Cancellation Test for the evaluation, and a bathing task for the tx session.

Other than written finals, those were the main assignments that kept me busy through the end of the semester.

So for my first Level 2, I am at a SNF (skilled nursing facility, aka 'nursing home') in Roanoke and I'm really excited about it. I called my supervisor the other week for the first time and she was SO NICE. She just kept telling me how much fun we will have and that she does not want me to be stressed out at all. She said she had 3 Level 2 fieldworks that were all awful and she promised herself that she would never make a student feel the way that she did. She also said that she wants me to come and be a little sponge and soak up all the information and learn as much as I can, and that if I'm too stressed, I won't be able to learn as well.  I can't wait to meet her on Tuesday :)

Since I am moving to a new area this fall for my fieldwork, a friend/classmate is also placed in Newport News - we went two weeks ago to scope out some apartments that offer short term leases and found one that we both really liked and that is affordable so that takes some of the stress off with that! Now we just need to sign the leases and get it all in order for the fall.

AND last but not least, a friend of mine from highschool, who is an Occupational Therapy student at Colorado State, just started a blog that I think you all will like so go check it out when you get a free minute: