READING ADIVSORY….BLOG BLIZZARD APPROACHING…STRONG HEADACHE POSSIBLE….POSSIBILITIES OF BLURRED EYESIGHT…
.I woke up at 6am something after my cat, sleeping near my head, decided to attack me because I moved and he thought my hair was a fun toy. A big ol scratch in my finger later, I was up. I have cleaned out about 120 emails…only 80 something to go, plus about 50 facebook msgs….almost ALL related to OT. But hey it's a start.
I'm getting some good and interesting job advice…will be posting a lot of stuff soon – another blizzard – since I'm catching up.
Gave a few showers today. Did a few LACLS. Did a driving screen with one guy in my OT's day program, did a quasi-OPPM (occupational performance process model) with another. Got a few refusals. Did a few ADM placemats. Dealt with some tears, some toileting, etc
I was doing something with one patient when his psychiatrist came in to check on him, that psychiatrist said to me “You must be the famous student Dr. X [another main psychiatrist] is always talking about. It's nice you have such an interest” or something like that.
Tommorrow I'm going to do another driving screen, another OPPM, TRY and do groups – I haven't done a single one this week as of yet.
I had my first “real” private dance lesson today after work…we worked a lot on foxtrot and waltz, one movement of the tango, but overall mostly focusing on the “poise, posture, and carriage”…also identifying what dances to what music. Some push pull swing too. My next lesson is Monday…I only paid for 3 total so I'll be done by next week…and I may go to the Mardi Gras dance tomorrow night. Hmmm.
Alright, I'm going to head to bed I think…this weekend I need to clean up my messy room and make some plans for my future!!!!!!!!!!
I would ideally like to work as an occupational therapist in an inpatient infant/toddler unit in a children's hospital. I'm looking into:
California, San Diego or Bay Area
North Carolina: Asheville, maybe other areas
Tennessee: Nashville. Probably not Memphis
Anybody know of awesome inpatient infant/toddler units in those areas or others? I'm definitely overwhelmed trying to figure it all out.
A social worker intern wanted to do a group today (WHAT? someone WANTING to lead a group? What is this?!).
I danced a patient down the entire long hallway today, to get that particular patient to the intern's group…a form of redirection…lol…it worked…we did a pseudo waltz/skipping kinda thing. It was fun 🙂 I wouldn't have thought of it if I hadn't just had a dance lesson, ahahahahaha
PS: I need to remember to buy peanut butter, I want it!!
Tommorow I have a nerve-wracking morning because I'm starting by doing the OPPM on one of my OT's patients, then I'm doing a driving screen (on paper) on her next patient. Being observed for several hours, augh!! lol Then gotta try and do a bunch with my normal patients.
I had to go to a unit today that I hear is scarier than the scariest unit (at times)…luckily it was calm at the moment…I guess I've gotten used to my relatively sedate and relatively slow-moving geriatric patients.
I hardly got any units today…I did two showers this morning, two evals in the afternoon. Oh and I watched myofascial release today, my OT let me watch her session since I've been curious. I got to help and man, it's hard..I'm not strong!!
Tommorrow after work I have another dance lesson.
So….better pick out dance clothes, better look over the driving screen and OPPM stuff.
No group AGAIN…44 to go. Hope it works out tomorrow, I am not being productive with only 13 or so units a day (need 20)…but it just doesn't happen when census is this low…so many refusals. I think and hope tomorrow it will work.
I just glanced through e-mail….I have a TON of comments and/or OT blog related e-mails to deal with….some with questions from prospective students, some from current OTs in mental health wanting to discuss some things, some from OT students with assessment questions/comments… I'm literally more than a month behind on dealing with a lot of those blog emails/comments…so please don't give up hope. I *ALWAYS* respond and it gives me hope and happiness to hear from people. 🙂
I think OTConnections is an AWESOME idea although I wish my blog would automatically show up over in my account instead of me having to copy paste! Boo! Because I'm lazy and hardly ever remember to do it!! But Penelope Moyers DID ask me to be her friend over there, so I feel special. 😉 I saw in a magazine today that singer Taylor Swift has like a million friends on MySpace. Maybe Penelope Moyers is going to be the Taylor Swift of OTConnections, befriending all! Smart move! Who doesn't love a message saying the president wants to be your friend! LOL
Did two evaluations today – one behind a mask so I'm glad the patient wasn't also hard of hearing (since my lips were covered/muffled).
Busted out the new cards/markers etc that were donated from a friend…the stuff was popular. My favorite part was when I gave this low-functioning patient two markers, a green one and pink one, she sat there and colored, and then the next time I glanced at her, she was using the pink marker as lipstick and had perfectly put it on. Good thing the markers were non-toxic and washable. My OT, upon hearing that story, told me of patients who would think the stain used in crafts was chocolate sauce and try to lick it up.
I also put some pretty pink rubber bangles on that same lady's wrist…I said Miss X, you want some pretty bracelets? She stuck out her hand in “put on bracelet” pose and I slipped them on. This particular lady isn't my patient, but she is “babied” by staff in a good way…
I did an informal family visit today….went well as we more or less agreed on proper placement for patient after discharge, and I gave the family some literature to read on her approximate cognitive level, for them to get a better feel. They were complimentary and it was a successful first family visit 🙂
I also found the MADRS (Montgomery Asberger Depression Rating Scale I think) and the Hamilton something. One of the psychiatrists had recommended them to me because he was curious as to what depression assessments we did besides the Geriatric Depression Scale. It turns out the psychiatrist didn't have copies (I printed them off the Internet) and he was happy to have them.
The MADRS is a scale that, in my understanding, is done by the health professional, but I looked at it and decided I'd rather do it in conjunction with the patient. We discussed each question together and I think it was much more helpful done as a joint process, at least from the OT perspective.
So I did the MADRS for the first time, albeit modified, and I also got to do the Rosenberg Self-Esteem Scale for the first time…
My schedule today was quiet again for most of the day…although always when it does get busy, it gets busy quickly. Sometimes I end up helping two different patients in two differently ludicrous situations, at the same time, because of their proximity to each other (ie roommates both in need)…obviously not billable time at that point, depending on what's going on, but hey, sometimes ya gotta do what you gotta do…if that involves ludicrous tasks x 2, then that's what you do, if at all possible.
I didn't get to do group yet AGAIN – only like one of my patients in the room – but I think probably tomorrow I should have 3+ finally. Gonna do discharge planning/leisure activity. Not that I miss group or anything, but my productivity is so low now that I need the units, yo! Only 46 groups to go, lol.
AFTER work, I went and had a dance lesson…basically a modern ballroom dance!! Yes, laugh all you want, I'm awkward as can be. It was actually really good – it works on poise and posture and positioning and all that good stuff. I signed up for a few more…it's a stretch for me, out of my comfort zone, but I believe it's a helpful thing…the instructor kinda got annoyed with me because I was all ADDish, my eyes darting everywhere to see the other dancers…he finally turned me around so I couldn't see anything but him. He also had to deal with my huge “trust” issues – I don't like being led backwards where I have to trust him as leader – I kept glancing back and at one point completely froze because I knew people were near, he was like TRUST ME! lol. I'm one of those people who could never just fall back trusting people to catch me, in those trust-building games you play. We worked on very basic components of foxtrot, waltz, and rumba (sp).
Okay, The END.
Well the census dropped precipitously….all of a sudden we were down to 9, and only 5 of them are my patients…the rest are too low functioning for what our intervention is there. Because of multiple refusals and various reasons, I didn't get any productivity at all until 10am something! I ended up not having group because only two of my patients could come to group, at which point you might as well just do individual treatments…I did a lot of Mini Mental State Exams, a few leather lacing, a few ADM tile trivet tasks, and several ADLs.
I *REALLY* am starting to dislike the LACLS more and more…it frustrates almost all of my patients. And therefore frustrates me.
Tomorrow I have an informal meeting with the family of a patient that used to live alone pre-admission. My first! Let's hope it goes ok, they won't like what I have to say. 🙁
I got to spend some time – a lot of time – today – just hanging out in the ward, talking to techs, student nurses, patients, etc…there was literally nothing for me to do at times. Especially when rec therapy was going on. If rec therapy has just a small group and it's the only fun they get to have all day, I'm not taking them out of it.
But I felt guilty just sitting down. It was my first time in basically 7 weeks that I've just been able to SIT for a while. It was kinda nice although I'll try not to get used to it. 🙂 Actually, I ended up losing track of time, I was up in the unit until 3:45pm and then I was like OH MAN I forgot about notes. So I didn't get off work until 5pmish today. I guess 745 to 5pm is a normal day for a lot of people.
I only got EIGHT units today…I had several different sessions that were exactly 22 minutes…ie 1 minute short of two units…so I probably would have had at least 10 units if I had just one more minute on those units. I gotta say, ethically, IT IS SO HARD not to just rationalize the minute away and charge two units….like you're at 22 minutes and you think “I forgot to look at the watch until a few minutes into it, so I am sure it's okay…” but that's a slippery slope. Ugh. Luckily my OT had a very very busy day with 27 units, so she carried me through. There were days I had like 26 units and she had like 10, so I guess I don't feel too guilty just yet. I know I have at least one eval tomorrow, although several are being discharged…I may end up with like 3-4 patients only!! I'm gonna have to be creative to figure out what to do with them all.
You know what sucked today – is I had to clean up poo, multiple times, from the shower, and it wasn't even my patients or my issue. But two different times the techs left the shower with poop in it (a lot of low functioning patients poop in the shower, maybe because they are sat on a shower chair with a hole and it triggers toileting?), and I was like um….are y'all gonna clean it? They were like, housekeeping can do it. And I was like nuh huh. Housekeeping might not show up for hours and people need their showers…and I need to do them for ADLs/meeting goals. If it happens again I'll say something (it was a tech who isn't that familar with this unit which requires more um, dirty work than most)…but that's ridiculous…you take a patient in there and they make a mess, you clean it up. Don't make the next person do it. Not fair at all.
I am going to go look for some self-esteem/self-worth worksheets for a particular patient….and my groups tomorrow will be on discharge planning/leisure activities. Hmm, what else.
Oh…and cool thing…a friend sent me a box and I was like what is this…open it up and it was DECKS OF CARDS! CRAYONS! MARKERS! SQUISHY BALLS! Awesome stuff!! So I'm taking it in tomorrow as a donation…I am excited!
By the way, I forgot to share this awesome story from about a month ago, I had a black female pt who looked at the flimsy little comb the hospital provides, (no match for a black woman's hair) and said, “What am I supposed to use this for? To comb the hair on my tinklebox?” and then she burst out laughing and so did I. It was pretty awesome.