ASIA testing

Today, we did ASIA testing on my Spinal Cord patient.. The PT had done a couple ASIA testings on other patients but me and my supervisor had never done one before so it was really neat to participate...and I got to test his legs :)
This is the form that is used...

The dots on the body to the right of the form are the areas that you test sensation using the cotton or the pin prick..the pt has to tell you what they feel, and where they feel it. It wasn't as complicated as I was originally thinking! The pt came it diagnosed as a t12  SCI but we found out that he is more like a t10 SCI with his motor movement and sensation.

Today, I used a reacher, cones and a ring toss activity to work with him on seated balance activities, I wrote a short term goal for him to be able to sit on the edge of the mat table for up to 1 minute with min assist...this will be important for transfers to the bedside commode, and especially when he goes home. I'm looking forward to monday bc we are going to get on the mat with him and do some fun things! I can't wait to learn so much about SCI and how to treat and teach them different techniques! Keep ya posted :)

Have a great weekend :)

week 6

Hello all (all 1 or 2 people that actually read this haha)
I'm not in my 6th week of this fieldwork. ONLY 6 MORE !!!

So far I have had pt's with hip replacements, knee replacements, multi trauma,  and stroke. Today I got my first SCI patient. He is a t12 paraplegic and it is OVERWHELMING..there is just soo much different stuff between the ortho patients and a cord patient. I did his eval today and it took 4 of us to get him sitting EOB and then to do a sliding board transfer to the w/c. He is going to be a great learning experience and I'm excited to see how far he comes!! Tomorrow we are doing ASIA testing on him bc he isn't really presenting like a T12 SCI...so that will be really interesting!

Man I am sooo over my multi-trauma patient- he has a long history of back pain, and then was in a car accident and pretty much shattered his leg from the knee cap down. He is seriously addicted to pain medications. He knows exactly what time of day he gets which pain medicine and if you ask his pain level, he will just be sitting there saying he is a "high 9" or "oh its about a 10 right now"...when a 10 is the WORST PAIN EVER you would not be able to sit there without screaming bc its so bad!! And he is just getting on my nerves- he talks badly about his wife EVERY day- today he called her "the pitbull" and he has been inappropriate with me - calling me 'sweet cheeks' and saying "i cant afford a divorce but if i could, youd be worth it"...so we had to have a little talking too and he's straightened up some now thankfully! He is scheduled to go home on the 18th but we are trying to get him out sooner!

My other pt now is a double hip replacement. Hes a real nice guy and easy to work with. Its challenging bc of his size- he's very large- if he was going down there is absolutely nothing I could do to stop it!

I really need to start on my graduate project and my inservice ASAP- maybe this weekend? I am making a vision assessment kit for my facility, and doing my inservice on spinal cord injury. Should be a good learning experience but I am NOT looking forward to the presentation that's for sure!

Alright, well that's about it for now :)

week 4 already??

Well here we are, already in week 4, almost 1/3 of he way done =)
Right now I am seeing 3 patients, adding a 4th tomorrow and an eval tomorrow. I will be doing my first eval on a pt with CVA. I am a little nervous about it but I know it will go okay, and my supervisor will be there to help if I need it. I read a little bit of information on him today and he has significant global aphasia (problems with receptive and expressive communication) and he only understands about 1/2 of what we say to him! So this should be a little tricky.

The past two weeks, I have been a little board with my patients so I have asked for some different diagnoses as they come in, I am getting the CVA pt tomorrow, will hopefully had a TBI and SCI before its over. Census has been low still so there just isn't much going on-most of the pt's are gen debil, amputees or joint replacements. I'm kind of at a standstill with my patients right now.

I have also been slowly realizing that its OKAY to not know the answer to something, my supervisor likes to ask me random- well not really random as far as content goes but timing wise- questions and sometimes i just have to say "i don't know". Interesting fact I learned today: A metronome is used for pt's with parkinson's in order to work on gait training and their rhythm when walker. Yeah, I didn't know that and was asked today.

Oh, last week, since the census is so low on our floor, we have been going to help out on the LTAC floor (i may have mentioned this already) but I am certain that acute care is NOT for me, I cannot handle the smells, the tubes/lines coming out of everywhere on the pt...it just makes me nervous and slightly nauseous. I thought I was going to have to leave the room the other day.


So that's what's been going on with me.
Oh and I also picked up my NBCOT book for the first time last weekend =\ YIKES i got a lot to review and learn still before taking that!  #wakeupcall

Level 2 number 2 weeks 1-2

Well here I am, in the middle of week two of my second (AND LAST) fieldwork placement! I Arrived in Newport News almost two weeks ago- on a thursday morning- and spent all day thursday and friday organizing and unpacking. It was a little rough thursday night after my mom left bc I was just so sad and nervous about being over 4 hours from home but things are getting much better now and I'm settling in pretty good.

That monday I had to be at the facility at 8:30 for orientation most of the day. The lady that did my orientation was nice, but kindof odd and I didn't really feel that comfortable around her. She had way too many awkward pauses and gave me some odd looks. Then I met my supervisor and the other people on the 3rd floor around lunch time. That just wasn't a good day for me. I sat with them all during lunch and no one said anything to me the entire 30min lunch break...i mean NOT ONE WORD. I was just sitting there wondering why they are so unfriendly?? oh and that day, the doctor's bought them a few papa john's pizzas and they were all digging in right in front of me and didn't even offer a piece.... i just thought that was extremely rude.

Luckily, things have gotten better and people are much more friendly now, BUT you only get one chance at a first impression...and that wasn't a good one.

Anyways, the place I am at is an Inpatient Rehab Hospital. I am on the 3rd floor which is mainly Ortho, General Debilitation and SCI. The 2nd floor is the Neuro floor (CVA, TBI) and then there is a 4th floor that is a long-term acute care unit.  The patients on the 2nd and 3rd floor get 3 hours of therapy a day meaning they get 1 1/2 hr each of OT and PT (if speech isn't involved). They usually break it up and see each patient 3x a day for 30 minutes at a time. So it makes scheduling kindof weird.

Last week on Wednesday, I got my first patient to treat. He had a R BKA (below the knee amputation) We have been working on transfers, dressing, bathing, core strength/stability, balance, and upper body strengthening. On Friday I got a second patient- she has back surgery and ended up leaving today to prepare for her son's wedding on friday. Today, I got a third patient and actually did her eval. She is the cutest old lady and so tiny. She fell at home and fractured her patella (knee cap).

But, there are only 6 patients on the floor right now which is just RIDICULOUS. So they are possibly going to close the floor and send the rehab staff to a different facility until they get more admissions.

So that has been my week and a half in a nutshell.

DONE!

Well as of Friday, I have successfully completed my first Level 2 Fieldwork!! I never would have imagined that i would have loved it as much as I did. I am truly blessed to have been placed at Springtree and to have met the wonderful people that I met. On thursday, my supervisor and the other OT staff threw me a surprise party with yummy food and a cookie cake! It was so nice of them and I was completely surprised. Also on Friday, I gave them each a small thank you gift and card.  This is what I made for each of the OT's and COTA's:

Luckily I pinned this idea on Pinterest a while back and was able to use it! I had originally thought I was going to use vinyl and my friends Cricut machine to put each of their initials on a mug. But because her Cricut was being used by a family member out of town- this was plan B! I actually liked it a lot better than just their initials anyways and they seemed to really like them too! All you need is a mug (I found these at TJ Maxx for $2/each) and sharpees. Once you write on the mug, they go in the oven for 30min at 350 degrees to make it 'permanent'. They do need to be handwashed after they have been used tho- apparently the dishwasher messes up the writing/drawing.

Anyways, that was on Thursday. On Friday I saw my final patients, said my 'Goodbyes' and my supervisor and I had our final meeting to go over how she evaluated me and my eval of the fieldwork site. I honestly couldn't believe how high she rated me on the AOTA form. I was shocked to see the final percentage, especially when the form itself says that 4's are very rare, and here she is giving me all 4's and two 3's.  She said she didn't think she has ever rated a student that high...which makes me feel pretty proud.
She also took me to speak with the HR person about working there doing PRN work (unless a full time OT spot opens up) when I get back from my next placement. Will definitely look into that because I just loved the facility and everyone so much, and by the end of the placement it felt like I worked there already anyways.

Now that I'm on a two week break, I have just been relaxing and getting prepared for my next affiliation. I'm moving down to Newport News next Thursday- eeek it's SO soon!!! Will keep you posted on how that goes!!

week 11

I've just finished by 11th week at fieldwork! SO crazy. only 1 more to go!
This has been a weird (but good) week- Two of the ladies I have been treating were discharged. One of them was just my favorite patient, I always looked forward to our sessions and we just had a great relationship. she really trusted me and let me push her a little past her comfort zone...we laughed a lot during every session and just had such a good time together. She taught me some good recipes and made copies of her fave ones for me when she left. As she was leaving yesterday she came to the rehab gym with tears in her eyes telling me just how much she enjoyed working with me and told me she loved me! Which of course made me tear up- I'm such a sap! Its hard to see these people for so long, build a relationship with them, and then they get better and go home. That's the hardest and the best part of this job.
I was SO proud of her for how far she had come. When she first got there, my supervisor and I were reading the eval and it said she was a danger to her self and staff, and that she required max A x5 people to get out of bed. We went to perform her eval and she was just anxious and explained how difficult her hospital stay had been, how she didn't trust the CNA's at the hospital and that's why they had put that stuff in her paper work. She just cam out of her shell so much within those first couple weeks, It was amazing to see her progress to where she was yesterday. That's what makes all of this worth it and I am so thankful that I get to help people like her get back to living their lives.

Its time like that where I know I chose the right profession! I hope everyone feels that way about their job/future job.


This week I have really been on my own with treating pt's and doing about 1 eval a day- one day I had to do 2 evals. One lady was just so feisty, and not nice to me! which was a first. but I made it through the eval and then got to pass her tx session to one of the COTA's. She was just frustrated and confused...I think she will start on the upswing soon.

Anyways, that's about how my week went.
I'm SO sad that next week is my last week, but then again I know it's time to move on. I will miss everyone there so much and I hope I'm lucky enough to have such great co-workers at my future job site. I'm going out this evening to get thank you gifts for my supervisor and the other OT's there. Hopefully I have luck finding the kind of things I am looking for!

Week 9 down

Wow, I can't believe I only have three weeks left!!! I am starting to realize how much I will miss everyone I have met at the facility.
I'm seeing 5 patients now but this week was kind of weird because the case loads were a little low so we had to pass some of our patients to the COTA's so I had 3-4 patients all week.

I did 2 evaluations by myself this past week. One was a man that has stage 4 melanoma and the other had abdominal surgery (very confusing PMH).
The man who had abdominal surgery is now on my caseload. During the evaluation he was so inappropriate and his son/his sons friend were in the room/hallway just laughing at everything he was saying. I was a little hesitant to take him on as a pt for my caseload but he has been completely different than that first day. My supervisor and I think that his son probably liquored him up (he has a hx of drug/alcohol abuse) before they brought him it. Because of that his notes show a drastic improvement in just the week he has been there and I think he will be d/c'ed next week. I just really do not feel he is appropriate for OT now. This week he refused me 3x in one day and 2x the next day but he finally came down after speaking with the doctor and my supervisor. I just don't know what to do with him anymore so I am crossing my fingers he gets to go home soon.

The man with stage 4 melanoma that I eval'ed just reading his background info made me sad. He noticed a lump under his arm and then let it grow bigger and bigger for 6 months before getting it checked. He was taking care of his mother who was dying and said he just put his own health on the back burner. Makes me so sad because they could have prob caught it before it spread to his spine and sternum.  He said he is real hopeful and has a lot of people praying for him.

My pt with the TKA finallllly got an upgrade in her weight bearing status thank goodness!! She was an independent as possible at w/c level so I really needed her to get weight bearing as tolerated (WBAT) when she went to her appointment this past week. She has been doing so good standing =) She is prob my favorite patients right now because we have really formed the therapeutic relationship and she trusts me and lets me push her a little more than she is comfortable with because I just know she can do it! I'm going to be sad when she leaves next week (that's the plan at least).

My pt who had a stroke is still doing really well. I'm concerned he may be getting depressed though. This week we started working more on his L neglect. He is always looking straight ahead and doesn't really acknowledge anything to the L or R really. I attached a timer to his L forearm and set it to beep every 10 minutes to get him to turn his head to the L side. The first time it took him 11 seconds to find and turn off the timer.  By the end of the session it only took him 3 seconds so that showed a good improvement!

Anyways, that pretty much sums up whats been going on so far... Can't wait to see what these next three weeks bring!