31 Mar 2009

CELIA!!!!!!!!!!!!!!!!!!!!!!!!

I'm in Asheville, NC. Very nice. Tomorrow I get to see Celia for the first time in years…she lives nearby. Celia is the reason I am about to have my master's in occupational therapy. I did play therapy with her for YEARS while in undergrad. She was 5 when we started I think. I LOVE her and she always called me “Karen Dobyns my best friend” like that was my title, lol
 
Anyway…let's hope this video embeds right…this is like a 5 year old video, but you can at least kinda see her adorableness
 
http://video.google.com/googleplayer.swf?docid=-3505095904688492456&hl=en&fs=true” style=”width:400px;height:326px” allowFullScreen=”true” allowScriptAccess=”always” type=”application/x-shockwave-flash”>
Category: Occupational Therapy | Comments: none

28 Mar 2009

The end of fieldwork…

Well, I've finished my last rotation EVER…and turned in all my projects and PDEs….so while graduation isn't until May, I pretty much have my master's. Pretty exciting, a little scary too.

My last day had some great ups because of the staff although overall, it otherwise would have been a pretty crappy day. There were around 10 on the unit but only 3 of them were really mine…would be 4 but one was on hold for agressive behaviors. Of those three, only one was REALLY okay for OT…the other two were both obsessed with going home and so anxious about that that they weren't much for OT. Of course I don't blame them, but it makes it hard to be productive when you've only got one patient willing to cooperate.

The day started out with me getting to watch my OT do a craniosacral session on a lady with bad TMJ, pretty interesting. Also so relaxing I had trouble staying awake.
Then I went up to the unit and I could hear the screams before I even walked in. It was one of those days – like Thursday – where you really felt like you were in an insane asylum because several of the patients were nonstop screamers/yellers/criers. And any time you have a paranoid schizophrenic on the unit, you know it. Groups were a struggles since like I said, I only had one high-functioning patient. Also, I watched yet another patient throw her cup of ice water into the face/clothes of a staff member, this time a housekeeper. Poor lady. So two days in a row I watched this happen. Nothing you can do but shrug it off.

The rehab director (?) and my OT took me to a Thai restaurant for lunch which was so kind of them. They blocked off two sessions so we could do so. I enjoyed it a lot. I also got a card from the director, and the OT's husband (I've enjoyed getting to chat with him, a very nice guy!). Came back for a while longer on the unit. One of my favorite nurses walked in with cupcakes she had baked herself, for my departure!! A nurse and tech that weren't on my unit came down to say goodbye and the nurse gave me a card with several peoples writing in it. I also got a card from other nurses with signatures from nurses, the social worker, and even a case worker I didn't even know knew who I was, praising me. One of the phlebotomists and the housekeeper also came and hugged me and said goodbye, so I felt really loved to have gotten four cards, a lunch, and cupcakes, and tons of hugs and kind words. My OT said that the director had never taken any other student out for lunch and that the nurses/techs had never done something for an OT student before, so that made me really happy. She commented that I have a way of connecting with people. And yep, I have a LOT LOT LOT LOT LOT of flaws and I may not be so hot at OT, but my gift is (sometimes) connecting with people, which makes up for  a lot of my flaws. If my OT classmates read this most of them would probably laugh since I'm not alway so great at connecting with my own age group, they'll be like wha-wha-WHAT.

Oh! And the husband of one of the ladies with severe dementia, who I've spent some time with daily for the last few days during visiting hours, giving him handouts and stuff on caregiver stress, tips, etc, and even just sitting with him. He almost cried saying goodbye today, saying that even though he hadn't known me long I had made a big difference to him and that while he may not see me on this Earth again (he knows I'm maybe moving away), he knows he'll see me in Heaven. It sounds so GOOEY and DRAMATIC when I write it here, but it was sincere and sweet.

ANYWAY……….I was really pleased with how kind everyone was on my last day, and I was glad I didn't have to worry about units so much, I spent over an hour just chillin' with my highest functioning patient, she and I have become quite close over the last 3 weeks (most don't stay that long).

I got a comment recently from “BuckEyeBrit” that pointed out something I hadn't thought about. I had written about how a lot of patients see me as a granddaughter and hug me, are affectionate, etc, in ways they aren't with other staff. She pointed out that is a good use of therapeutic use of self – while a lot of times older patients see younger therapists as not possibly having a lot to offer due to lack of experience, coming across as a granddaughter fills them with some love and patience, lol.  Woo!

I really came to love my rotation…even when things were tough or stressful or a wee-bit scary…it turned into a wonderful experience. I learned a lot about mental health OT, a lot of assessments/evaluations, a lot about myself, a lot about interacting with all sorts of different people, etc. I stayed really late yesterday on my final day because I had procrastinated so much I still needed to finish a few things. I got there at 745am and left around 610pm. I got home with kind of an achey feeling. Glad to be done with school and fieldwork as it is a rite of passage, but sad to leave that place with all its wonderful people. I told them I have abandonment issues and would stay in touch, though, LOL.

I didn't end up going out dancing last night because I was so tired.. .it was my friend's ten year anniversary of her husband dying, and her current husband had a really hard day at work, so all 3 of us were sort of in a funk…a blah night. Oh well.

I'm just chillin' today…slept in late of course, did a tiny bit of errands…hanging on the sofa with my kitty now. I definitely feel like doing SOMETHING tonight, so maybe depending on their plans I'll go dancing tonight instead, or who knows what.

I need to get some stuff in preparation for going to a wedding Saturday of an OT classmate (congrats Kim) and also for being a bridesmaid in an upcoming OT classmates wedding (yay Allison)…and prep for some upcoming mini trips, looking at where I may end up…..who knows.

This got long so quickly, oops. Oh well. Anyway……….school as I know it is over….time to face boards, interviews, a real job, etc.

THE REAL WORLD BECKONS!!!

Category: Occupational Therapy | Comments: 2

27 Mar 2009

One day of final fieldwork remaining….nine months over!!

I HIT ONE HUNDRED THOUSAND PAGE VIEWS YESTERDAY……it only took me two years to do so 😡 Right now I'm getting anywhere from 4 to 6,000 page views a month, roughly.

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Today was “off”. I spent an ENTIRE HOUR in traffic this morning (instead of typical twenty minute trip) because of a big accident/diversion. The two nurses on staff in my unit were both not normal nurses for that unit so they weren't entirely sure of what they were doing with the geri psych patients. (Well trained, well versed in psych, but not typically on geri psych and each unit runs a little differently) The sole tech was the only one I sometimes have trouble with. And there were lots of problem patients. Screamer/yeller/criers, agressive ones, etc. Today was one of the few times I really felt surrounded by crazy people.

I tried to do group and in the middle of the room were our two criers/screamers with bad dementia. I attempted to remove them from group as it was almost impossible to focus, but the tech refused, saying she had to watch them and the men. So I moved them to her side of the room and my OT patients to the other side, but it was still really bad. Then my supervisor comes up and is not pleased with what she sees. The tech tries to get her to keep them there too but she overrode the tech and took them out. I appreciated that but I know she probably wasn't happy with me. In hindsight I should have taken my own pts to the other room, but I guess it didn't just occur to me. When I had walked in for group I was overwhelmed by the high density of poorly functioning patients that were going to make group hard for me, and I guess I just didn't want to rock the boat with trying to move my patients out. I should have though, it was a stupid rookie mistake on my part and I should have known better by now.

We did my final evaluation today, I passed, and she said some nice things.

Tomorrow my OT supervisor and Rehab boss-dude are going to get Thai for lunch if it works out time-wise. Won't surprise me if it doesn't but it's a very nice thought and gesture.

Today, like I said, it was two nurses rather unused to the floor, me, a social worker and a tech. Of course maintenance workers, cafeteria workers, nursing supervisors, housekeepers, etc, are also coming through.
One of the patients was getting agressive and kept cornering me (and any staff) every time we walked into the hall. The nurse tried to give him something to calm him down, while he was standing next to me, and he threw the cup of water right into her face, over the nurse's station. She got covered in water of course. I guess better water than chocolate pudding or juice, but still. The nurses didn't do anything, just let him stalk off. I guess it was the best way to keep from him escalating, but wow. It was a little scary. Had he gotten really combative, it would have sucked. A lot.

ANYWAY……I just turned in my professional development evaluations and I have two projects to complete tonight. I don't want to but I have no choice lol, considering tomorrow is my last day of fieldwork. Hard to believe. 5 years of college, almost 3 years of a master's program, plus a semester off here and there, and now I'm 26 and a half and just now starting a career.

Someone emailed me recently saying they looked forward to hearing about dealing with NBCOT, interviews, job searchs, etc…and I was like yeah…wow…I'm transitioning from student to practitioner and that's a whole nuther journey!! Kinda silly to make it sound like thats a revelation, but it is!
Hmm, guess my address “otstudents” is about to be a misgnomer.

Category: Occupational Therapy | Comments: none

26 Mar 2009

I'll get you, my pretty…

Conversation of the Day:

Patient: “You're a very pretty girl.”
Me: Why thanks! ::smiles::
Patient, indignantly: Do you think you'd be as pretty if your head was cut off?!
Me, smile fading: No, probably not.

Category: Occupational Therapy | Comments: none

25 Mar 2009

I love you I love you I love you

Today, three different patients told me they love me!  Awww!!

Can't think of too much special about today besides the love fest. Things were a little chaotic this morning- we have several patients with pretty severe dementia who were agitated and calling out and “responding to internal stimuli”, so that made life kinda difficult.

I told my supervisor today – you know, I am sorry I always come back to the office late from the unit. I know it messes you up having to sign them the next day, and it messes me up too since I have to stay late, but I have a REALLY HARD time leaving my patients in the afternoon. So it's not that I can't manage my time effectively, it's that I choose not to.

AAHAHAHA It's true…I look at my watch and I know I should go soon, but there is always one last thing to help a patient with…then another last thing…then a family member to speak to…then another thing…and then OOPS…and what is probably the worst is that I'm typically there about 30+ minutes after my last billable unit…so it's not even that it's counted towards productivity!!

Oh well. If I'm going to suck at managing my time, I guess it's good that it's by choice and for the reason of wanting to help patients, and not just because I sit around twiddling my thumbs.

I'm working on my professional development evaluations right now, I'm maybe half-ish finished. They are due Friday. I also finished my final fieldwork questions. I have a big ol' long form of questions to fill out though, and still need to work on a few other projects for my supervisor!!

Category: Occupational Therapy | Comments: 1

24 Mar 2009

Four days left to go of my psychosocial OT Level II fieldwork…then DONE, baby

Gonna be quick. Lots to do in next four days, project wise…then lots to do after that for other things, ie finding a cool job. LOL.

Still working on professional development evaluations, OPPM grid, nursing cheat sheet, therapeutic exercises, functional maintenance, observation of ACL levels, final questions, and a few other random things due by end of this week.

My back is really hurting this afternoon…it could be for several interesting reasons…from standing up in church for several hours on Sunday (an Antioch orthodox church, very interesting experience), but possibly from dealing with an angry patient today…I was running on adrenaline and didn't use proper lifting technique I bet when assisting staff with stuff related to him.

Today was the closest I've seen to being in person live at the start of a possible combative patient code (where its announced overhead throughout the hospital so we can get more people for backup/help). The patient was already being supervised quite closely but he bam, got angry. I was in a patient's room, prepping her for a shower, when I heard lots of commotion in the hall, yells and thuds and all that. I told her I'd be right back, closed her door, and flew out to the hall to see how I could help. I helped with moving some of the things out of the way and re-righting a wheelchair, but it was heavier than normal ones and I think I bent way badly and didn't start feeling it until later when the adrenaline wore off.

They got things semi under control so I went back into room to finish helping my lady. Then we hear more commotion, I leave her again. Then come back, we start to leave and then the commotion starts up right outside her door, so we sat on a bed and waited for it to finish up. No way was I taking a lady with a walker into the midst of that. It actually messed up my productivity some since we were kinda trapped!

You know, a person's protective instinct should be taking care of self, but I think it's innate to help the vulnerable first, even when its a stranger. Like, I know its my job to help my patients before myself, in case of a problem, yet technically, if things got bad, I could be like screw this! I'm getting out of here! and bolt, to protect myself. Yet today, even though I'm a big ol' scaredy-cat, when this guy was acting up, had he come into her room, I would have done anything and everything in my power, to keep him away from my patient. That has nothing to do with knowing its my job – just a strong instinct to protect the vulnerable. I guess everyone must have that, maybe its evolutionary…lol.

I had an extra good time with the nurses/techs today…there was random (nonballroom) dancing involved, in the nurses station, lol. Just quickly, I swear patients weren't being ignored. 🙂

Ummmmmmm………nothing else too special. I'm really enjoying my rotation these days…not to say there aren't moments of dread or stress, but in general, I feel empowered to help make a difference in their lives during their stay, and that's a good feeling. Blah blah blah, good night…better go work on my projects.

Category: Occupational Therapy | Comments: 1

21 Mar 2009

Well ma'am, his arm strength looks fine

An evaluation I did yesterday asked for upper arm strength:

“Unable to determine, although since patient was throwing chairs, it appears within functional limits”

Category: Occupational Therapy | Comments: 1

20 Mar 2009

almost done with fieldwork…

So somehow today I ended up doing the sticky chicken dance for some patients.

I spend a lot of time just hanging out with my patients…no billing or productivity, just hanging.

Today I had 3 “with it” patients in the day room at the big table, and one lady with bad Alzheimers at another little table.

One of my patients asked if I'd clean the table they were sitting at, as it was really sticky. I started cleaning it and commenting on how it really was quite sticky. The lady with Alzheimers somehow started bringing up chickens and somehow we ended up on the idea of sticky chickens and how that could be a dance. I got up and hopped around like a chicken, saying that was my chicken dance, and then stuck my feet on the floor and twisted around like a chicken, doing the sticky chicken dance. My three patients were HOWLING with laughter. It was a completely ludicrous thing to do a sticky chicken dance, totally silly…but we had fun!

I was talking to an OT student in the class below me, Shari, on Facebook a few minutes ago. She is rightfully overwhelmed/scared at the prospect of starting fieldwork soon. I was telling her that it's so much less scary than it sounds….it all falls into place. Not to say there is never stress or yuckiness, but that overall its a pretty good experience…and encouraged her, on her upcoming geriatric Level I fieldwork (a two week fieldwork to gain some exposure), to do her best to spend some informal time with patients….ie, go sit in a day room at a table with some of them while they are hanging out or having a snack or whatever. I told her she'd learn a lot just by watching them interact with each other, seeing how staff redirects them, and having conversations with them.

I think my best times with my patients are in the afternoons around 3pm…its quieter and calmer (to some extent) and I end up just chillin' with them in the day room, depending on what's going on…I frequently am bad about losing productivity/billable units, because I feel like just sitting with them and chatting, is more therapeutic than me taking one of them off for some cognitive assessment. But I think those times are the most enjoyable, most bonding, situations.

I think being a young girl helps automatically with bonding because the ladies see me as a granddaughter…a lot of them will kiss my hand or rub my hand against their face, kiss my cheek, or put their arm around me, in a way they wouldn't even attempt with the rest of staff…just affection the way they would give one of their own. I rub their backs a lot, or stroke their hair…or sit and hold their hand a while. It's therapeutic! I'm just rambling. I should go to sleep. Soon.

I did the Cognitive Assessment of Minnesota (CAM) today on a neuro dude for my supervisor (as a competency thing). It's like 45 minutes and it looks at all sort of stuff, like attention span, orientation, memory, sequencing, visual attention, concrete problem solving, abstract reasoning, blah blah. I really enjoyed it! It's not perfect or anything but it can help you kinda target deficits in certain areas, it's not that hard to give, and it makes you feel like a therapist, lol.

One more day….and then only ONE WEEK LEFT OF FIELDWORK…NINE LONG MONTHS, DONE!

Fieldwork scared me so much…….I worried about it from like day one of school. . I had to cope with the extra struggle of depression/anxiety on and off throughout it…but I made it. And if I can get through it…anyone can. You don't have to be the smartest or the best….just motivated…clearly trying hard.

Okay bedtime.

Category: Occupational Therapy | Comments: 1

19 Mar 2009

The best moment of the day…

A little old man peeking his head out a doorway in the hall, beckoning to me. I come close enough to see he has on his normal shirt but his pants are off, he is only wearing white boxers.

I let him know I'll get some help for him, since he isn't one of my patients and I know he is a handful.

I let the staff know. The next thing I know, I look down the hall and there he is, his head peeking out again, this time twirling white boxers in his extended hand…clearly tantalizing us!

Most staff are in the hallway by this time and three of them snap on their blue gloves and head down the hall to him to work their magic. LOL. I turned around to go find a patient, shaking my head at the absurdity….and love for my job LOL.

Category: Occupational Therapy | Comments: none

19 Mar 2009

Do I look like the kind of girl who carries a knife?

Pt who is pleasant but very garbled (“word salad”) was sitting next to me while I worked with another pt. She likes reading things and was glancing at my clipboard, so I handed her a blank SLUMS (its a one page cognitive assessment that asks basic questions) to look at and write on. She read the question out loud, “How much do you have left?” without reading the line above it which had to do with spending money. She answered, “Well, all of it! They ain't taken nothing!”

I also wrote  “Patient X is so nice” for her to read, she read out loud “Patient X is fifty nice”…apparently I need to work on my handwriting, LOL.

She also said things (without pausing, like it all flows together appropriately) like “The bedtime has the stitching. There were three babies. Bob got shot in the head. Were you there yesterday? You are going to be my daughter in law soon. I saw that the money was there. Let me find the papers. Oh, there were snakes.”

I conversed with her randomly for easily 20+ minutes. Another pt, who is higher functioning and listening, was asking me later if I was telling the truth/understanding, because I'd respond to things she was saying, like “Wow. Really? Yes. I remember.” stuff like that.

Another pt was confused and trying to get off his seat-belt on his wheelchair. We didn't want him to because then he wears himself out walking and ends up needing a sedative to stop since he'll go to the point of falling down from exhaustion (a relatively common problem for some patients with dementia). He couldn't remember how to use the contraption at all and was fiddling with the belt part. He asked me, “Do you have a knife?” I said, “Mr X! Do I look like the kind of girl who carries a knife?” Mr X said “Well, scissors then”. I said “Miss Y [the tech] is looking for some scissors for you.” We had to keep kinda re-directing him by telling him we were checking on it, etc.

I recently had a pt who wasn't able to really follow anything verbal, but would imitate actions (like if I spread my hands out while talking, she'd do it too), and we were having a lull in group due to some interruption, like a nursing giving meds, so I started vogue-ing, and she joined me since she was imitating me, and then the lady with schizophrenia joined in for fun, etc…so we had a little Vogue pause. LOL

I really do crack me up…lol. Not in a way that makes fun of the patients, I just have fun WITH the patients…ya gotta laugh so you don't cry, right?

Well, I just did the CAM on my friend Suzy….a cognitive assessment. It took about 45 minutes. I wanted to practice since I'm doing it tomorrow on a real patient. It's got a lot of components to it, from explaining proverbs to making plans to reading, doing math, sequencing, mental manipulation, memory, etc. She felt stupid on some parts, but honestly it was all I could do to keep up with some of the sequential matching, so I felt stupid too, LOL.

Lester the lion kitty is so cute, I could croak with love. Hey I better go shower. Good night.

Category: Occupational Therapy | Comments: none

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