TOTA Conference 2007

I attended the Tennessee Occupational Therapy Association (TOTA) Conference in Nashville this past weekend! It started at 8am with some basic election information and scholarship announcements! Haley (a fellow student on the Chattanooga campus) and I each won a mini scholarship! It was very exciting and very much appreciated!

We then started educational sessions! You could either do the 9-5 Sensory Integration session, or do two shorter sessions – one on AgrAbility (farming) and one on spirituality! I chose to do the two shorter ones. There were also many vendors there with information and free stuff (YAY MY FIRST GAIT BELT YAY!), as well as lots of opportunities for networking, and yummy food! The next one is in Dickson, TN and y’all better go if you are in Tennessee! Or I’ll hunt you down and beat you with a stick. Moving on.

The three-hour session on farming was really interesting. It talked about how farming is one of the most hazardous occupations, and that many Tennessee farmers experience injuries or illnesses each year that can affect their ability to continue farming. Seeing as how there are so few farmers left, it is in our vested interest to keep them healthy and productive!
The Tennessee AgrAbility Project is the state version of a national project, aimed at helping keep disabled farmers leading productive lives! Occupational therapists can help by helping farmers modify equipment (or at least making suggestions), figuring out ways to make the task easier, figuring out ways for others to contribute, etc. Basic problem-solving, typical of an OT, only geared at farmers! www.agrAbility.org for more information! (Quick side-note: My friends are members of Slow Foods Memphis, and this organization is all about supporting local farmers! I am suggesting the two organizations do some hooking up! Also, I’m now a famous chicken – Karen, the eponymous (?)) Dorking chicken, had her debut in Edible Memphis Magazine! With a picture and everything!)

The second, four-hour session, was in the afternoon. It was called “Spirituality in the Clinical Context” and it was run by Chaplain Patrick Whiteford, who works at the local VA here in Memphis, TN. I learned some pretty neat stuff in that session as well! We discussed the differences between spirituality and religion (my own definition: religion is spirituality with boundaries), and how as clinicians we should be willing to discuss spirituality with our clients, if we truly want to be as holistic as we say we are.

We talked about the seven core spiritual needs: dignity, power, freedom, meaning, love, rest, and celebration.

We talked about “loss of the assumed world”, where everything you knew and trusted to be true, is shattered in an instant – loss of a limb in a car accident, etc. We also discussed the “ministry of presence”, which is essentially how it can be therapeutic for someone if you are just sitting there, listening – being actively present.

My own tangent: Do you know how sometimes you are on a long road trip with someone close to you, and you will say things to that person while staring ahead at the road and driving, that you would not otherwise be willing to reveal? I feel like OTs are sitting in that car – you are occupying the patient and distracting him/her, and he/she is able to bounce things around in their head and reveal things to you that he/she wouldn’t reveal to a family member, doctor, or even a psychologist. Probably the most important thing we OTs can do is listen – not be judgmental or offer advice, but just listen. Usually the patient will figure out their own storyline based on their own spiritual/religious beliefs.

We also discussed three spiritual assessments – F -I – C – A, HOPE, and 7 x 7. The Hope is probably the easiest/most relevant to OT. It asks questions such as “What sustains you and keeps you going?” “What are the sources of hope, strength, comfort, and peace?” Etc.

The main point was, OTs should be willing to discuss spirituality/religion with their patients, in a nonjudgmental or controversial manner. It may make a difference in that patient’s treatment. Be client-centered and holistic like a good OT!

Hopefully pictures will come soon! I am waiting on friends to e-mail me some!

I half-won a TOTA scholarship!!!

Guess what!!!!!!

I half-won a TOTA scholarship! I guess I technically won a full TOTA scholarship, but two of us students got one, which I think is unusual, so we each got $550 to go towards our tuitition! So I am calling it a half one! I am really excited and happy and pleased about that!

Conference was great and I want to give you all details. Unfortunately I am sooo exhausted. I drove to Nashville Friday afternoon, got up early Saturday and had conference all day, got home 6ish, dozed from 7pm to 9pm on my friend's couch, slept 9pm to 11am…so almost 14 hours of sleep…but am still exhausted from this past week.  I fatigue ridiculously easily! I have chronic fatigue without the syndrome!

It's 9:20pm – I got back in town mid-afternoon, unpacked, met friends for dinner, came home and unpacked some more…and I haven't taken out the trash, done the dishes, prepped for tomorrow, washed my hair, put together my new laptop tray, finished unpacking at all, dealt with my ten thousand e-mails and online things to do, etc etc. And I just realized a few minutes ago that I had not done my treatment plan for my patient for the week – so I have to do that now. That makes me almost want to cry because I am so tired that I just want to sleep! I'm going to work on it until 10pm then go to bed. Ugh. So…I did have a fun time at conference, and I have enjoyed getting so many e-mails from OTs and OT students recently…and I will post more details about conference, hopefully tomorrow night. My wish for the night is that tomorrow afternoon I will have the energy to do all the things I did not do tonight! And my other wish is that I'll be a little bit more coherent tomorrow since I just reread what I wrote and I sound like I need some Ritalin!

So…YAY on the scholarship!!!!!! More tomorrow!!

Day 5 of Phys Dys Level I OT Fieldwork + TOTA

I am writing this from Nashville! I left the hospital at noon to get here at a reasonable time for tomorrow's Tennessee Occupational Therapy Association conference – avoiding Friday rush hour traffic, and no night driving, since my night vision is NOT good! I am exhausted so I hope I can go to bed really early tonight! I am staying with some good friends of mine so that helps, money-wise!

Yesterday, I said this rotation was sucking out my soul. I also got a really interesting comment on that from an OT who used to work with a geriatric population. I'd share it but I am on a guest computer which is awkward/frustrating, so I'm only doing a bare minimum the next few days! Well, today was a much better today. All our patients were in good moods, and our slowest patient was already dressed and funky when we checked on her. I walked in on my OT wiping the bottom of one of the patients and it didn't even faze me. I got to semi-treat several patients with my OT standing right there. Also, one of my favorite patients had several visitors (her son and daughter-in-law) – I got to encourage them to watch her therapy, and explain to them why we were doing what we were doing. Unfortunately we were doing therapeutic exercises like thera-band and arm bike (“upper extremity physical therapists”, so I couldn't really brag about the whole occupation-based part. I really felt like the patients were okay with me and that they could see I was trying to be gentle and respectful with them. I try really hard to warn them when I'm about to wheel them backwards, because I know it is disorienting to not see how you are being moved. Not to say I don't fumble with their wheelchair leg rests or bump their foot against something a little, or say something correctly, but in GENERAL, I did not feel like my soul was being sucked out, and I felt like I could maybe actually get good at this eventually! I feel like I have already learned a TON in just a single week. It's amazing how much you can learn, so quick.

I'm learning an easy way to put compression stockings on patients with serious edema next week, and I'm going to try and continue to become more wheelchair proficient. I've gotten good at putting on/off the leg rests and stuff – simple to so many, but for me it was hard!  I know how to re-connect oxygen tanks and swap them out as needed. I know how to help patients push off from their chair and not their walker. I also can handle a basic occupational profile and/or evaluation, where you do some basic gross manual muscle testing, proprioception testing, sensation testing, etc. Well, bragging about it here, I realize it all sounds really simple and easy, but those are skills I hadn't practiced much, and I'm proud of them! I just did an OT evaluation on my friend! Because I'm a dork! Woot!

I am excited about conference tomorrow, and I am also not as scared about next week of my phys dys rotation! Like I said earlier, I'm at a friend's house on a guest computer, so it's hard to maneuver…I really want to update several posts but it will have to wait until at least Sunday! AOTPAC gave me permission to print their letter in entirety, plus I got a ton of e-mails recently from new students with various questions, so I want to deal with all that Sunday too!

Thanks to all the kind comments I've gotten recently – they really mean a lot to me and boost my spirits, and it is encouraging as well! Please don't be shy to e-mail me anytime!!! I am not always quick to respond though, depending on how projects are going at school!

I'll probably post tomorrow about how TOTA conference went and if I got a scholarship or not! Don't forget those good vibes!

Day 4/10 of Adult Phys Dys Level I Fieldwork

Day 3/10 of Adult Phys Dys Level I Fieldwork

Today was a tiring day! It started at 7am with the ADL rounds…helping people get up, brush their teeth, hair, bathe, etc. I saw more private parts this morning than I think I've seen in my entire life! It seemed like many of our patients were anxious/depressed/agitated today. It really hurts my heart to not be able to help with the cause of their agitation, because typically it is not something alleviated by occupational therapy! In fact, it is often something that can't be helped, period.

Today I got to help with transporting patients, swapping out oxygen tanks, and standing by as patients did their therapeutic exercises! I also got to see a Modified Barium Swallow Test (the SLP invited me)! It was pretty cool watching food go down a throat in real-time! The SLP and I talked about how school always makes things sound like there is always a black & white answer to ethical/moral dilemnas, when really there is almost always shades of gray!! Rarely is life black and white.

I made an old lady cry today, although it wasn't really my fault. She was pretty crazy and dramatic and I did something minor that caused her to burst into tears. I rubbed her back helplessly a few seconds, but that was about all I could do!!

I went into this fieldwork thinking I'd be tested on manual muscle testing on little joints like the DIPs, spinal cord injury levels, goniometry of every joint imaginable, etc. It turns out that in the real world, insurance doesn't care about such things. Insurance just wants a general idea of how strong the patient is – some muscle testing of major muscles (don't let me push your arm down!), a little bit of sensation (where am I touching you?) and proprioception testing (am I moving your arm up or down?), a little bit of history (do you live in a one-story house? Who lives with you?), bam, there is your occupational therapy evaluation!

I don't really have a lot to share about today, that doesn't possibly violate HIPAA. I know I say to be open-minded, but for me personally, I can tell already that adult phys dys will never be a passion for me! I do enjoy following my OT and I have learned a lot from her, and I am glad I am having this experience. However I'll be glad to get back to my normal school routine, I am a creature of habit.

Friday I get off at noon so I can go to TOTA Conference. I am excited! I think it will be great! I got some “business cards” today at Kinkos, just basic ones with my name, email address, school, website etc, to have handy while networking. It's such a pain to write information down repeatedly on little scraps of paper! Yes, I'm a dork.

Overall fieldwork is fine, not too hard, not too easy!

Ok it is already 9:40 and I spent several hours enjoying dinner outside with some friends, but now it means I need to hurry up and prep for tomorrow and get to bed! Gotta be up extra early!!

Level 1 Fieldwork Adult Phys Dys Day 2!

I started out the day a little scared, after reading Merrolee's comment about how it can get really hot when observing showering and it might make you feel faint!! After my experience with a really hot room for burncare and almost fainting, I didn't want to repeat the experience!

I got there around 6:45am and I was supposed to park in this really far away and empty lot. In the dark. I parked, saw a man walking near by, and went noooooooooo, turned on my car, and parked in the normal parking lot. Around 7 we started our rounds of helping with ADLs (activities of daily life – like brushing teeth, bathing, combing hair, dressing, etc). I was a little bit nervous – I'm not really comfortable around naked people or toileting activities! Plus I couldn't imagine the patients themselves would be thrilled with an extra stranger watching. I tried to be as discrete as possible, like kind of not just staring directly at the person while they were in the middle of more intimate acts!

Then we just had typical patients, most of whom we had seen yesterday. Several of them were complaining of nausea and pain, which my OT said is not that common, actually. Some got out of therapy. Others complained, but were willing to attempt it. I got to help today with things like pushing the wheelchairs, encouraging people during upper extremity exercise group, sitting with patients while they did things like upper arm bike, sanding (pushing) exercises, etc. It was fun, a little scary.

The part that got to me most today was just helping people get dressed! It was torture to watch. It is frustrating to only be able to use one hand/one leg! (Like in the case of a stroke). There are certain tricks to making dressing easier. For example, when putting on the shirt, you put the affected hand in first. When taking off a shirt, you take the unaffected hand out first. When putting on pants, you put the affected leg in first. Etc. You can also cross your affected leg across your unaffected leg to get the pants started. It's still not easy though.

I like to understand everything that is going on, and I maybe ask too many questions. I hope I'm not completely driving my OT crazy!
Day 2 was fine, but exhausting. This 7am to 3:30 stuff with people, nonstop,  is hard to get used to. I know it's the real world, but it is both physically and mentally exhausting. Mostly mentally – dealing with new people, mostly people who don't particularly feel like doing anything, all day long, is hard on an introvert like me!! Yes that's right! I'm actually an introvert! Shocking I know!

Ok…I'm prepped for Day 3. I only need to get through until Friday afternoon…then I get to leave for TOTA Conference in Nashville! Then only one more week. I guess it will fly by, but right now it seems slow!

AOTA, AOTPAC, _OT Associations….jklmnopqrst

Caption: Julie and Anna wearing the OT hoodies they got at AOTA conference in St. Louis!

Some of you may wonder sometimes why I’m so rabid about exposing the wonders of occupational therapy to the masses. Part of it is because I really just think it’s amazing and want everybody to know!! But another reason is that occupational therapy is a threatened profession! Occupational therapists could go extinct if we don’t have people watching out for our interests!

This is where AOTA (American Occupational Therapy Association), the AOTPAC (American Occupational Therapy Political Action Committee), and your state OT associations, come in. They protect our investments in the career of occupational therapy. They are constantly monitoring political issues that may affect the future of occupational therapy. They also serve as advocates, and just in general serve as our mother hens of the OT world! They want their little OT babies to stay safe and happy!

AOTA, AOTPAC, and your national state associations (in my case, TOTA), need the support of the occupational therapists as well, however. It’s a two-way street – they can’t support us unless they get some support themselves. That is one huge reason it is important to be a member of your state OT association and national association. The benefits you get from such a membership (networking, access to invaluable resources, etc), more than make up the cost. It’s especially cheap to become a member as a student!

While these associations can always use financial support, it’s just as important, if not more important, that their members stay aware of the political/legal issues affecting OT. For example, it may not seem like a big deal if physical therapists ask for a little change in their scope of practice…well, it IS a big deal if it means that they can encroach into the occupational therapy’s scope of practice!!

Today I received an e-mail from AOTPAC, discussing “Medicare Issues Ignored by Congress!” It includes a possible therapy cap and negative changes in the fee schedule. These two things could seriously handicap OT as a profession.

The following is a quote from the e-mail:

———-

Help your clients get the OT services they deserve, protect your rights to appropriate payment from Medicare, and stand up for your profession!

Contribute to AOTPAC today. It is the legal and authorized way to participate in the political process and support those who support occupational therapy. AOTPAC’s Board of Directors decides how best to use your contribution to have the most impact for occupational therapy legislative issues. Be part of that process! Make your contribution now and defend occupational therapy!

Make your contribution on-line via the secure AOTA Web site at: http://www.aota.org/aotpac or mail the attached form with your check or money order payable to AOTPAC.

————————

They also ask that you visit the AOTA Legislative Action Center and send an e-mail to your Members of Congress about these and other important issues!

Thanks for sticking around for a “heavy” post. I am definitely not the most political person, but I think we need to remember that we owe a lot to our national and state associations and political action committee!

Update: Here is the full e-mail, I got permission to use it, with one caveat. AOTPAC by law is not allowed to solict individuals who are not AOTA members, if you are not a member, please disregard that portion of the e-mail!

Subject: Medicare Issues Ignored by Congress!
Dear Colleague:
Congress cut critical corrections to the Medicare program from legislation in September, posing a serious threat to two issues essential for occupational therapy. Medicare caps on occupational therapy will go back in effect on January 1, 2008 unless Congress acts this year. The Medicare fee schedule will be cut nearly 10 percent in 2008 if no action is taken.

Fixes for the therapy cap and fee schedule were stripped from the State Children’s Health Insurance Program bill. AOTA worked hard and long to get fixes included and now we must continue to make sure Congress takes action NOW. Without your contribution to AOTPAC and your letters to Congress WE CAN’T BE SUCCESSFUL!

Without action, patient care will be restricted and your payment will be reduced significantly. AOTA is working on Capitol Hill to ensure Representatives and Senators know that the Medicare cap on occupational therapy and changes to the fee schedule must be made this year. But we can’t do it alone! Your contribution to AOTPAC increases the impact of the occupational therapy voice! It helps to support friends of occupational therapy and gives us opportunities to educate about the need for a solution to the cap and the fee schedule this year.

Help your clients get the OT services they deserve, protect your rights to appropriate payment from Medicare, and stand up for your profession!

Contribute to AOTPAC today. It is the legal and authorized way to participate in the political process and support those who support occupational therapy. AOTPAC’s Board of Dire
ctors decides how best to use your contribution to have the most impact for occupational therapy legislative issues. Be part of that process! Make your contribution now and defend occupational therapy!

Make your contribution on-line via the secure AOTA Web site at: http://www.aota.org/aotpac or mail the attached form with your check or money order payable to AOTPAC.

=======

Also, check out this website: http://www.aota.org/Practitioners/Advocacy/AOTPAC.aspx

HIPAAAAAAAAApotamous

I have a question. I want to be able to write client stories, especially as I am now on my 2 weeks of a Level I fieldwork in physical dysfunction at a local rehabilitation hospital. I can't stand writing vague stories, and nobody wants to read a story about a stick figure. But I'm not sure how far I need to take HIPAA. Am I writing a client story so that a normal person can't recognize the client (hypothetical Level 3), or am I writing a client story so that that client's therapists or family couldn't recognize the client (Level 2), or am I writing it so that the actual client couldn't recognize his or her self (Level I)? I have to get progressively vaguer as I go from Level 3 to Level 1, so I would love to know what level I have to write at. I'm unfortunately guessing it's Level 1. I might just have to stick with making up fictional patient stories and only keeping my reflections on the story the same. Anybody familiar enough with HIPAA to answer this question? I did take an online course on HIPAA through my school, but it doesn't exactly touch on how thoroughly it would affect blogging. Ooh the gray areas of the online world!

Thanks!!!!

Laundry lists: Yay or nay?

Too many projects!

I’ve recently received some feedback about this journal. The consensus is that I should stick to one topic within a post (I agree), the shorter the better (I agree but um, yeah right), pictures are always good (I agree), and I should stick to professional/personal experiences that really delve into OT, instead of just my lists of “I have so much to do for OT school, look!”. I’ve thought about it, especially since I do want to improve my writing. My thoughts on the matter are that I enjoy writing streams of consciousness about my day or upcoming projects – it helps me figure out what I need to do and if I’m going to write it up anyway, I might as well share. Do you all agree? Should I stop posting my to do lists or “im stressed out” posts, and just focus on the professional and personal experiences? I would appreciate input. If I were writing this 100% for myself, I’d continue writing them, because it brings me sanity. But since I only do it 90% for myself, I do like hearing what others think!!

My first day of my OT Level 1 Fieldwork in Adult Phys Dys

Today was my first day of my adult physical dysfunction Level 1 Fieldwork, which is two weeks long. I was sooo nervous this morning! Adult phys dys is way outside my comfort zone. I can handle a baby with a ton of tubes, but an adult who needs their shoulder moved? AUGH! Scary! I felt a little unprepared because even though I had made like 6 pages of cheatsheets (cough), I had forgotten to focus on the most important thing, which is neuro!

I am doing this rotation with one other girl in my class, Marla. She is really quiet and really sweet. She and I were each assigned different OTs, but we are in the same little neuro gym, which is a locked unit, so you have to know a code to leave. (Only because patients can be confused, not dangerous.)

My OT is named Denise and she is really nice. She is also an UT alum. I got to see one child and a ton of geriatric patients with her! Just observing, though, obviously. Some of the patients are grumpy (because they are in pain and deconditioned!!), but most of them are so cute you want to eat them up with a spoon! Which is kind of a gruesome expression, when you think about it.

I think my hospital got confused about JCAHO, because they seemed to think Marla & I needed to go through new employee orientation, which is almost a full day and requires about five hours of video watching on stuff like how to dispose of hazardous waste. After we questioned the need for this considering we were primarily observing, never alone, and only there 10 days, the human resources people made some phone calls and it turned out we only needed to fill out a few forms and watch a few videos. I am pretty sure JCAHO is the same anywhere, requirement wise, and I know none of the other hospitals seem to require this for a two week rotation, so I don’t know where the problem really lies!

Beyond that, it was a nice experience. It was good to see that adult phys dys is not magical, and that there is actually the possibility of me learning how to do it. I have two problems. One is that I lack confidence in my ability to handle “hands-on” experiences. The second problem is that I’m a softie. If a patient doesn’t want to get out of bed or finish their exercises, I’m like “Oh. Ok” when really I should be like “IF YOU EVER WANT TO BE INDEPENDENT IN YOUR ACTIVITIES OF DAILY LIFE YOU BETTER GET THIS BOOTIE UP!!!!!!!!!!!” Ok not quite so strongly worded, though.

One thing that really rocked today is that I got to see a patient with no prior knowledge of her medical history, and I could tell she had a left CVA! I knew because the left side of her face and the right side of her body had hemiparesis, and she had aphasia, which is typical of a left CVA. I was really excited to be able to diagnose that.

Overall it was a nice day, not too scary. I will be there 7am to 3:30pm every day, although I have plenty of projects to work on at night unfortunately, and need to get prepared for the Tennessee Occupational Therapy Association annual conference, which will be in Nashville this Friday and Saturday! I’m trying to win a scholarship so I hope anyone who likes me will send good vibes this way. Also, y’all should hope I have the right fashion sense and wear an appropriate outfit to TOTA conference, because I’ll just admit it, I’m even stressing out over what to wear! I’m ashamed. Sorry.

Tomorrow I’ll experience (observing) an OT helping patients with their morning ADLs, so I’m excited! And scared! Again!