Week One: complete

Well I have officially completed my first week of fieldwork :) I feel really great about how the first week went and I'm starting to get a hand of the schedule there and get to know the other therapists too :) They are all so nice and willing to help me out so I def appreciate that!

I saw my patient today and we were going to do a ADL session in her room so she could get a shower today and I could try out the long handled sponge, and teach her about using a reacher for LB dressing but she was already dressed and didn't feel like getting a shower...which is totally understandable bc I see her at 1:00! So we headed on down to the rehab gym and did some strengthening exercises and worked on standing at a table to fold laundry. My supervisor did her eval and wrote the goals for her with are: to perform all UB dressing and bathing independently, LB dressing and bathing, using AE as needed, adhering to sternal precautions, performing simple meal prep while standing and perform laundry tasks while standing. On Monday I think I'm goin to try and get her to make something in the kitchen and try to stand for a few minutes at a time, she was complaining about her foot being swollen and numb today so the doctor was going to look at it this afternoon- hopefully its okay! Also we are going to staple papers for the department, I think she will really like doing that because its something 'productive' and useful, instead of doing hand weights, the stapler will help strengthen her hands even if she doesn't realize it!
Please let me know if you have worked with a pt with a CABG and what types of treatment activities you have done!
I think she is doing really well and I'm not sure how much longer I will be seeing her- we set goals for 4 and 8 weeks but I'm not sure she will be there for that long. 
I was glad to get more good feedback on my daily note today too- its good to know that I'm doing it right when I seemed to have difficulty in class with my notes and getting all the right info in it. Notes in 'real life' are different, we don't write SOAP notes at the facility, we just write a narrative that includes 1. what activity we did 2. why we did it (relate to d/c, goals, occupation...) 3. What the OT did (level of A, client education, family education, verbal cues...etc) and 4. How the treatment you did affected the client's performance, did they improve their skills from the beginning of the tx to the end, did they respond to your education, were they successful with the level of A provided...)
I think its a pretty easy way to write a note and not worry about what goes into each section..I still find myself jotting down quotes from the patient to put in the note (like the S part of a SOAP note).

We also saw the lady that had a CVA and she was looking much better today, I can tell such a difference in her head control in just the past couple of days. She seems to be in the 'anger' stage of recovery and she has every right to feel that way- I know I would if I were in her situation...I just hope she can work through it and face whats going on so she can really work on getting better. While she can't speak to us, she really knows what we are saying and can follow simple commands. Today we took her out on the porch to look at the flowers and then put her in the stander so she can engage her trunk muscles. She did really well with that and did well holding her head up on her own and looking out the window. I can't wait to see how much progress she makes in the next couple months.


Next week my supervisor said that I will get more exposure and practice doing the evaluations on new patients. I feel like there is a new patient admitted to the facility everyday, well multiple patients admitted every day...my supervisor did 2 evals today! The evals they do at the facility seem pretty straight forward, they don't seem to use any standardized assessments like we had used in classes. They have a form they fill out and rate the patient in areas like self care, mobility etc..and then you rate them again at time of discharge and hopefully their scores are higher at d/c than during the evaluation. I'm looking forward to doing one but I DEF need to review manual muscle testing and the rating scale.


I'm super glad its the weekend, its taking a bit to get used to this 'real world' working schedule and the weekends now have a whole new meaning! :)