Chicken Soup for the Occupational Therapy Soul

I'm mad at Deborah R. Labovitz, because she already wrote a book about stuff *I* wanted to write one day, called “Ordinary Miracles: True Stories About Overcoming Obstacles and Surviving Catastrophes”  and all having an occupational therapist contributing to the miracles in some way, small or big! It's kinda like Chicken Soup for the Occupational Therapy Soul.

I plan to bring it with me on the plane to Pittsburgh, PA this weekend…I'm looking forward to reading it

And now it is 720am and I need to go finish getting ready!! AUGH!

PS: I found out through my stat counter that if you just type in “augh”, my site will eventually come up! I guess I say it too much!

"The Occupational Therapy Address" by Abraotham Lincotln

Approximately four score and seven years ago, our OT founders brought forth, upon this nation, a new OT nation, conceived in occupation, and dedicated to the proposition that all men can find meaning.
Now we are engaged in a great health-care crisis, testing whether this occupational therapy career, or any career, so conceived and so dedicated, can long endure. We are met on a great insurance battle field of the Medicare cap war. We have come to dedicate a portion of this ongoing battle field, as a hopeful not final resting place for those who have dedicated their careers so that this profession might survive and not get minimized by insurance issues.  It is altogether fitting and proper that we should do this.

But, in a larger sense, we can not dedicate – we cannot consecrate – we can not hallow – this insurance battlefield. The brave occupational therapists, living and dead (and especially Ora Ruggles, GO ORA WOO!), who struggled here, have consecrated it, far above our poor power (muscle strength 2+ or so) to add or detract. The world will little note, nor long remember what we say here, but it can never forget what these occupational therapists did here. It is for us the current OTs, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced in the name of occupational therapy. It is rather for us to be here dedicated to the great Centennial Vision task remaining before us – that from these honored OTs like Eleanor Clark Slagle, we take increased devotion to that cause for which they gave us the last measure of devotion – that we here highly resolve that these therapists shall not have fought in vain – that this nation, under the OTPF, shall have a new birth of freedom and diversity and evidence-basedness and client-centeredness, and that government of the therapists (AOTA), by the OTs (State Associations), for the OTs(AOTPAC), shall not perish from this earth just because of Medicare!

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So…to address my exuberance…no, it's not caffeine….I promise in real life I'm a (somewhat) calm person. I just have lots of wacky ideas. Years ago, I was playing in some chat room and I encountered this lady who talked like THIS!!! YAY!! LOL!! EVERYTHING IS SO FUNNY!!!! YAY!!! LOLOLOL!! ROFL!! YAY!!! I found her hilarious. She made me laugh. And I decided that while I'm not quite THAT extreme, there is no harm in being a little overly enthusiastic and yay-ish at times…we all need some smiles in our lives. Speaking of which – the above “Address” is not meant to offend or make light of veterans – it's just a great speech to use! GO OCCUPATIONAL THERAPY!! YAY!! LOL!!! YAY!!

Rehab hospital from a consumer perspective…

My good friend wrote this up for me after his mom ended up staying in a rehab hospital in Alabama. Here was his experience:

Background
On October 22, my mother fell breaking her left femur below the ball joint. She is a Caucasian female, 88 years old, 65 inches tall and approximately 125 pounds. She does not have osteoporosis. She lives a very active life, and lives independently. The method chosen by the orthopedic surgeon for fixing this was to do a half hip replacement. The top of the femur was cut off and replaced with the artificial ball joint. This was fitted into her natural socket on the pelvis. There was no damage in the fall to the hip itself or any other joint or bone.

Comments
Please realize that to the consumer, health care is one long continuum. Because of the fact that the health care professional is dealing with human life, it is hard for the consumer to accept a “not my job” explanation or or to accept that if a provider sees something that is wrong but not in their field to not address it. The discussion below may be taken as criticism because it is a discussion of areas that frankly fell short or could improvement would greatly benefit the professional image of OTs and PTs.

Stereotyping
Because my mother is 88, the hospital social worker was initially recommending she go to a nursing home for rehab. To their credit, the hospital therapists stood up for her and reommended the more vigorous rehab at the local rehab hospital. However, the whole incident came across as extremely condescending. We both wondered how she would have fared had I not been present and she had been on her own, since these decisions were being made less than a day after surgery. To a lesser degree the same stereotyping occurred at the local rehab hospital. The larger offense there was their greatly underestimating the amount of therapy she was capable of doing, which to a point discouraged her. I was present for one visit to The Orthopedic Center. It was like night and day. The therapist there seemed to work harder to connect and address Mom as an individual.

Communication
The first day in her room at the local Hospital, the therapist upon leaving told the nurse, “Where’s our stuff? Everything we need is missing.” That was said in our hearing. To me, the therapist now has a responsibility to follow up past asking the nurse. So be careful what you say in front of the patient. By the way, the “stuff” never showed up, but that is another story. Suffice it to say that before we left I had the floor charge nurse and the assistant head of support services standing in front of me.

If you tell patient number one something make damn sure that you tell patient number two who has the same injury the same thing. Two days prior to her discharge from the local rehab hospital, Mom got a new room mate who also had broken her left leg in the same place. I was there when Mom came in and I was there when her new roomie checked in. They gave her a whole rundown about what her rehab would be, her limitations, what she would be expected to do and what they would do. Mom found out stuff as she went along.

When you discuss limitations on movement, please ensure you specify if they are permanent or temporary, such as during a specified recovery period. Prior to discharge at the local rehab hospital, they gave Mom a list of prohibited movements. When I arrived for the discharge interviews, I had a despondent Mom because she thought these were permanent restrictions. I pointedly asked both the OT and the PT (both of whom were “technicians” according to their name tags) about each and every restriction and we found out they were all during the recovery period. We were greatly relieved.

I am not that interested in your personal life. I am especially not interested that when you were in high school your ex-boyfriend loosened the lug nuts on your car, causing the wheel to fall off while you were driving it and your new boyfriend beat the crap out of him. The patient does not need to hear that from the therapist. Keep up on current events. If you know what is going on in the world, it gives you something to talk about with your patients and to possibly connect with them as individuals. It is also a way to avoid or redirect possibly inappropriate personal questions. Your patients come from all walks of life; you can learn from them. However, asking a patient, who has told you he is from Switzerland, where Switzerland is does not inspire patient confidence.

Scheduling
I have not seen so much hurry up and wait since I was a Midshipman on summer training 35 years ago. I do not understand why scheduling can’t be better accomplished. While not an OT/PT issue, I fail to see why a dressing has to be changed at 3:30 a.m. except that someone forgot to do it and the next shift caught the screw up. Also when Mom checked out of the rehab hospital, at precisely the same time as when we were supposed to be meeting with the OT and PT, the medication nurse and the team to remove the surgical staples all showed up. You could not have crammed one more person into her room. Scheduling stunk.

Personal Appearance
Please consider wearing something other than scrubs. Everybody wears scrubs. OTs, as an example, have completed a stringent, horrifically rigorous program. Differentiate yourself. At The Orthopedic Center, the therapists were in knit shirts or sweaters and khaki pants. You may be dealing primarily with an older population or, if you are with children, you want to assure the parents that their offspring is being cared for by a real professional. Like it or not, appearance makes a difference.

Also along that line, avoid visible tattoos or body jewelry. Call me old fashioned, but I have a hard time carrying on a serious conversation with someone who has a nose ring. I frankly do not care if it is part of your cultural heritage or not.

If you are dealing with patients, do not wear clogs or crocs. I watched a person pushing a cart twist and then step out of a croc (it had a heel strap which was useless) and almost fall. If that had been a patient with mobility issues, well i leave that to your imagination. Wear something that is secure to the foot.

Since You Are A Health Care Professional, Do What The Other Health Care Professional Tells You.
This conversation was overheard while I stood outside my mom’s room at the local rehab hospital during the staple removal circus.

Health Are Professional (HCP) Number One, “Hi!”

HCP2, “I knew I couldn’t get past the room without you stopping me.”

HCP1, “What’s wrong? You OK?”

HCP2, “No, I don’t feel good and I have a scratchy, sore throat.”

HCP1, “Taking anything?”

HCP2, “Yeah, I went to the doctor and got a shot and some antibiotics, but I quit taking them.”

HCP1, “You did?!”

HCP2, “Yeah, they were making me (didn’t hear the word) and I was feeling better so I quit taking them. Now I may have to go back.”

Thank you very much for bringing a now drug resistant strain into contact with the elderly. Is this how MRSA got started?

Summary
During Mom’s hospital and rehab stay she was cared for by a lot of talented people – we all realize and are thankful for that. But folks, there is room for improvement and because you are dealing with life here, you have been given a special trust and confidence.

Disclaimer:
These are my opinions and observations. If you disagree, please feel free to contact me and we can discuss. Do not beat up on the blog owner.
StroupeJB……at……bellsouth.net
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UPDATE: He wanted to add that it is important that the therapist clearly explain to the client what is going on. For example, his mom couldn’t understand why she had a therapist making her do an arm bike exercise when she was there for her hip.
There is a good reason, but the client needs to understand that reason.

UPDATE 2: I asked him to rate the experience on a scale of 1-10, 10 being amazing. He said it was a 6.

OT isn't perfect, but nothing is!

Today, I received three different e-mails that pointed out problems in OT.

1) A thoughtful letter written from the son of a rehab consumer, which I will be

posting in full, about his experience…but it definitely showed issues with rehab.

2) A letter from an OT who doesn't find it rewarding in any sense and is giving up

the profession and wants to warn me to have a back-up plan.

3) A disability activitist who enjoys bursting my OT-exuberance-bubble because he

thinks it is unrealistic to have such a high opinion of OT (to be fair, he and I have been in e-mail contact a while

and we've both enlightened each other on things.) He also wanted to know how much

coffee I drink. A fair question.

So. How do we address these things.

1) I will be posting his letter as we all have things we can learn from it.

2) I am sorry that this OT has not had experienced good things with this career. Her

advice is good in that no one should have all their little OT eggs in one handmade

basket. I wish her well in finding something that better suits her.

3) I just want the entire world (or ok, the people who read this) to know that I

know perfectly well occupational therapy is not a perfect career, just like ANY

career is not perfect. I get it's not Utopian and many people have not had great

experiences. There are lots of issues in the healthcare professions and OT is not

immune. I get all that. But the purpose of this blog is for me to chart my journey

as an enthusiastic, not yet jaded, OT student, who is doing her best to show people

the FUN and GOOD side of OT. So it's not so much that I'm in a bubble and don't know

it. I just like to focus on the positive. I want to make the Centennial Vision come

true!! One wacky blog post at a time! (I don't like caffeine by the way).

An EASY Day in the life of an OT Student

An easy day in OT school (thank goodness since we have finals and projects to work on):

8am to 10am: Final in Occupation Centered Practice in Adulthood. Only took one hour. Answering a case study with multiple parts
10am to noon: Lecture on Transition Services in the School System with a Chattanooga professor
noon -1pm: Lunch, work on group projects
1-3pm. Three different presentations by 6 different people, on the “Cognitive Performance Test” (video coming once Google Video stops erroring), “The Milwaukee Evaluation of Daily Living Skills”, and the Kingston something….

Updating soon! Just bored and we’re about to start class and figured I’d post! Yay occupational therapy!

A Day in the Life of a Singapore OT Student

Yen May of Singapore wrote to me and generously shared some insight into her life as an OT student there. She gave me permission to copy it to my blog. It wasn’t intended to be a formal document so no judging any grammatical errors. You can e-mail her at yenmayl ….at…hotmail.com (go away spambots).

“I love OT because of its holistic and creative nature. Thinking back, my definition of what Occupational Therapy is has definitely changed as I learned more about the roles of the Occupational therapist.

I completed one block of clinical attachment (4 weeks) last month in Oct. I was at a mental health setting. In my y1 clinicals, I was really attracted to SI and peds but I soon realised that I liked mental health alot as well!

It was a great time working with the clients, I ran artcraft groups, sports (basketball & badminton), and cooking groups! Throughout my whole placement, i worked with male clients so it was challenging but a good experience. I was really sad to see the long stay clients in their wards, they were very institutionalised – years and years ‘imprisoned’ in those wards. Some were never discharged because their family rejected them and didnt wanna be responsible for them.

I will be starting my next attachment for another 4 weeks starting from 19 Nov, but have yet to know my placement. I think I’d most probably get HANDS, NEURO or ORTHO. Perhaps a community setting because I have not been to one yet.

OT school has been very fun and inspiring lately as we began semester 2. Due to our tendency to speak in our own mother tongue or dialects, the OT school instituted a new ‘law’ that requires all of us to speak ‘Queen’s English’! haha. We were supposed to read newspaper and cut out interesting and OT related articles to share with the class in one our modules: Home and community. It was a realy great idea, as we soon realised that there were so many OT related articles! We found stuff on health policies, community services, leisure opportunities, etc. It almost felt like we were having clinical education going on as we (students and lecturer) discussed about our views on those articles.

In this sem, we started to hand therapy, splinting, home modification (which is really cool), groupwork and leisure, and also a module that talks about wellness. So its pretty fun cuz we get to do cool stuff like travelling in a w/c in the community (taking the MRT,bus, catching a show in the cinema, shopping etc), trying out yoga, pilates, aquatherapy and lots of leisure activities! We also have a module that introduces us to the various community settings/ organizations where the OT works in. It is realy interesting as most of us have never been to those settings.

The Singapore Association of OT student commitee (SAOTSC) organizes many talks and events for the students here. These talks range from education advancement, specific clinical specialty,OT in sign language, Visually handicapped and guidedogs… to many other interesting topics as well. There is a HUGE BUZZ on mental health in Singapore lately and the Government will be funding $88million into the area of mental health to set up community centres that provide mental health services and to create awareness. There will be many other projects as well. One of the medical financing policy is currently being re-evaluated to include mental illness in its list of chronic disease so people can get financial help when they go for treatment for a mental condition.

The lecturers are also challenging us to look beyond the traditional roles of OT (working in hospitals). They are challenging us to look into the community setting, to get involved in ministry level (to advocate and be involved in policy making), to do entrepreneurship, set up centres for wellness, to work in the area of providing accessibility (none so far) and whatever we can dream of! There is no limit as to the things that we can venture into! 🙂 Oh btw, im currently working on a project on OT with the visually handicapped/ low vision group of people, its really interesting as ive never worked with a VH client before! 🙂 “

SOAP Notes, Frames of Reference, Treatment approaches…aughhhh

We are in the middle of finals for several different classes and I'm swamped! It's a ton of case studies and it's a lot harder than you would think! I've spent like ten thousand hours on them already – I use a kitchen timer by my side and set like 15 or 30 minute intervals at a time before forcing myself to move on with another question.

I'm a little behind on e-mails and well, everything, while I try and get through the next few days…bear with me! At least there are lots of videos to watch! You can laugh at how badly edited they are!

Student Conclave in PA this weekend!

I am getting excited about the first annual AOTA/NBCOT National (Occupational Therapy) Student Conclave. It’s next week in Pittsburgh, Pennsylvania. (I spelled that right on the first try, go me!). It’s Saturday, November 18th, and Sunday, November 19th, at the Marriott Pittsburgh City Center.

I’m flying out Friday afternoon and coming back Sunday. The program looks amazing, it was hard choosing which sessions to go to! It seems like it will be really helpful/educational, but I’m also really looking forward to meeting OT students from all over the nation!

Here is what I want to go to on Saturday:

“Empower Your Future: Fieldwork Education Strategies for Personal Satisfaction and Professional Success”

“Tools for Transitioning From Student to Entry-Level Practitioner”

And then I’m torn between “Reimbursement and Documentation Primer forthe New Graduate” and “How To Be Part of the Centennial Vision”, since they are going on at the same time!

On Sunday:

Preparing for the NBCOT Certification Examination

(I am interested to know how this goes – I just heard the NBCOT is changing our exam, but couldn’t find any details?)

Then: Advocacy 101: Policy Impacts Practice

Then: The Journey to Lifelong Learning

THEN, I get on a plane!

Here is the blurb on the conclave overall, from the website:

“Attend the first-ever national conclave created exclusively for occupational therapy and occupational therapy assistant students. This is an intense day and a half designed entirely for your unique needs…giving you an insider’s view of your profession; access to, and tips from, some of the nation’s top employers; and a jump on career skills that will last a lifetime.”

I think it’s going to be pretty successful – it was sold out! So be alert next year and get your tickets early!

http://www.aota.org/Students/StudentConclave.aspx

Version 1 of ACL

In case you were just dying to see an alternate version of the ACL, here was our first try…my memory card was full so we kept having “commercial breaks” as it would fill up and I’d have to delete something…..

Amputation Lab, Sensory Integration Lab, Allen's Cognitive Levels, Brain Train Video

Here’s the deal:

I wanted to write individual posts for all of these, and it is still in my plans. Google Video going down and some other video drama means that I have run out of time – I have two finals to complete and so I need to get crackalackin. In the meantime, here are four poorly made videos on some of our occupational therapy labs. Get inspired to go make better ones.