Outpatient

Finished third day outpatient, definitely learning a lot every day. Frustrated today because due to miscommunication – no one's fault – I ended up doing multiple forms for single evaluation when only one was needed – based on insurance. IE you do a Medicare 700 form (get used to that term) or you do a private insurance form. I was like ALL THIS DUPLICITY KILL ME NOW so I was relieved to discover it was accidental I did that and not something I'd have to keep doing!

I am enjoying all the learning….trying to get down the phrases about low load long duration stretch, increasing normalization of tone, increasing facilitation to X, inhibiting Y, and all the little things you have to write/do/say to make it very clear the services provided are SKILLED and not just like “He did some theraband, yo, it was awesome'. So I'm learned to be skilled. Can't wait for physical agent modalities course.
By the way, my friend Cookie Gimp wrote me to say he was confused as I said I wasn't certified, but according to him (meaning I didn't go google it or anything since I trust him) I said on my blog I was certified in 2007. If I said that I was confused – I took a several day COURSE in thermal modalities for certification, but never took the hours to receive actual certification (it was a required part of my school program and very generous and good – but I never got the hours in because I was never spending time in phys dys locations that did a lot of modalities). I know I was confused about how that worked originally.
Outpatient and inpatient really are two very different beasts….I like them both but I have a lot lot lot to learn for outpatient – like learning the names and how to do provocation tests for example. And it's not necessarily important I ALWAYS remember, so long as for example if I have a patient with bicipital tendonitis, I look up how to deal with it, how to treat it, the tests for it, etc so that I can treat better and diagnose better.
And – all my professors will roll over in their live graves – I did some minor evidence-based research yesterday, looking at articles in AJOT about sensorimotor versus therapeutic practice for best handwriting treatment as well as what type of underlying problems that slow handwriters tended to have. 
I need to sign up for PAMCA which involves a ton of paperwork since I work for the state department of labor, I need to put in request for a day off to make up for the Labor Holiday I worked, I need to fill out a housing request application (I want to try and get pet-friendly housing), I need to continue doing lots and lots of studying for outpatient….like reviewing the ulnar nerve distribution as to how it starts in the C8/T1 portion of brachial plexus….goes down the arm and into pinkie/ring finger etc….and being reminded of how pain versus paresthesias are in different spinal tracts so need to not lump them together as I tend to think of paresthesias (ie numbness, tingling) as pain. 
Learned some median and ulnar nerve gliding exercises today….learned about bicipital tendonitis and rotator cuff pathologies, about “milking” massage to remove edema from hand, learned ways to prevent people from compensating while doing external rotation exercises (force them to hold a rolled up towel under arm so have to keep elbow by side), etc. 
Today was kind of an “off” day in sense I had that frustrating day of repetitive paperwork and then I came home and vegged out/napped instead of working out/being productive….and I made conscious choice when leaving work today to not take any stuff home to study tonight…..my roommate Christy, a PT, made delicious veggie quesadillas and corn/black bean salsa for me and Jamie SLP and her friend Derrick so that was a nice dinner but also “off” since we don't normally eat dinner together….basically everything about today was abnormal.
Tomorrow will be semi- abnormal as well as after work we are going to a “Taste of Newnan” which is some kind of barbecue or chili cook off, I keep hearing conflicting reports, but sounds fun. Newnan is town about 40 minutes away closer to Atlanta. By “we” I mean like half of Warm Springs population, hahaha. It will be the first time in over a month that I've gone two days in a row without working out :O Maybe if I get off early (I have some overtime so if I can leave early I will to avoid that), I'll work out first…..Ive discovered daily exercise is by FAR the most important way I can handle days with less stress, more energy. 
Tomorrow I get in at 730 to finish writing up an eval, hopefully I learned all my important lessons today (ICD-9 CODES ARE EVIL) so that it won't be such a frustrating exercise. We have patients most of morning and afternoon….
I do love being an occupational therapist…getting to say I am a therapist….getting a paycheck!….wearing a name badge and being part of an awesome institution….writing OTR/L…..getting to help people feel better in diverse ways….being surrounded by fun healthcare workers…..oooh the outpatient techs CRACK ME UP. Love them. 
Blah blah blah. If you read this all you must be really bored. I'm waiting to jump in shower after someone's laundry done. Good night!! 
Oct 01, 2009 | Category: Occupational Therapy | Comments: none

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