20 Jul 2012

Anxiety over graduate school/rotations…You can do it :) If I can do it, anybody can…

I’ve had quite a few people now e-mail me to let me know their favorite posts are the more personal ones dealing with anxiety, etc. Let me tell y’all, I’m a walking DSM-IV-TR of issues. 🙂 Always functional for work though, hello bosses and insurance companies (:::waves::…seriously though. I LOVED LOVED LOVED OT school, but the parts I loved most were with my butt in a chair – I love learning and I can memorize things and take tests really well. I was valedictorian with Virginia (who I am seeing Saturday!) as we both had 4.0 GPAs. After an undergrad dealing with neuroscience, OT school was super easy compared to my undergrad…the hardest parts were time management and dealing with being in like fifty small groups at once. 🙂 Every time we had labs or rotations or anything hands-on, I got anxious. I hate to look stupid or not know what I am doing, and I get nervous and uncoordinated and forget everything I know, so even though most everyone else liked labs and real-world stuff most, that just wasn’t my personality. I had three, three month Level II fieldwork rotations. My graduate school makes us do 9 months rather than the more typical 6 months because it requires us to have a mental health rotation, which is relatively unusual. ALL THREE of my fieldworks fell through, so my plans changed last minute. So I ended up starting with an outpatient pediatric setting (in Mississippi) and that was a pretty good starting rotation for me as it was in pediatrics which I felt strong in, and the kids we were seeing were semi high-functioning, ie we weren’t seeing kids that were super complicated from a physical standpoint. My second rotation was in a hospital and IT NEARLY KILLED ME. Thank goodness it was a smaller hospital and we didn’t get the super complicated stuff. I loved my supervisor and we are still friends, but, not kidding, I was taking quite a lot of anti-anxiety medications just to get through each day, even with semi-un-complicated patients, because the hospital setting was so stressful to me. Nobody really knew as I am pretty good at hiding it and I did very well apparently, but to me, I was a mess. I felt so awkward and stupid trying to maneuver people in and out of bed. The easiest, most foundational skills of an OT, were the hardest for me. They still are. I was so relieved to be done with that rotation even though I liked the people. It wasn’t that it wasn’t interesting, I just felt soo incompetent, even if I apparently seemed competent to the rest of the world, haha. That’s a common feeling, to feel like a fraud or imposter, when first learning a healthcare trade, by the way. My third rotation was my mental health one (so my first was a specialty – I chose pediatrics, my second was physical dysfunction which was mandatory, and third was mental health, also mandatory for my school). Anyways, I spent 3 months in a locked psychiatric ward, specifically a geriatric one, so a lot of aggressive dementia. That was another one where I was sooo nervous each day entering the locked ward. We had to take a course that was basically self-defense, but with the defense being only to get yourself out of a tight spot, not to hurt the person. IE, if a person with dementia grabbed onto your wrists as you walked past, how could you get out of that without hurting anyone. Once I was on the ward I was usually ok, and had a hard time leaving it in the afternoon, but each day I was nervous. And each night I went home and slept for hours (I was staying with friends as this one was out of town). IE, get home at say, 5, sleep till like 8…get up for an hour or two, then go back to bed. It wasn’t the rotation’s fault, but my own psychological issues. Nobody knew that at work because I paid for it on my own time, so to speak. I was determined to get through the rotations. I’m not saying this to scare anybody, because again, the rotations were fine – it was me and my problems with depression and anxiety, etc, that made it a challenge. But I *still* got through all three of them with flying colors and was praised to the skies, so I wish I could have relaxed and enjoyed them more, as clearly I was doing okay…And am still in touch and friends with all the supervisors I had, and they all offered me jobs or would have if they were available. 🙂

For the most part, any of you who have read my blog since the beginning, have followed me through my schooling and fieldwork journeys, first job, etc…but I guess I am kind of summarizing it here with a focus on the personal part. Just feel like it tonight, lol. 
I did not get the dream job I wanted once I graduated/passed boards because of a long story, and I was devastated, but ended up in Warm Springs, Georgia, at the Roosevelt Institute, because I wanted a place similar to my dream job in terms of a “culture of excellence” where I felt I could be proud to work there. It was in physical dysfunction, and I would be the sole OT in a satellite clinic, which is EXACTLY what I do NOT and never did recommend to new practitioners, but I was escaping some demons so to speak, so I didn’t listen to myself. It was a challenging year as adult physical dysfunction is my least favorite area, primarily because I feel the least confident (and you also don’t get to use as much creativity). I did my absolute best and spent so much time researching, asking questions, etc, because I wanted to be the best OT I could be. But I still went home each night wishing I were better. I decided I could last a year so that I wouldn’t burn bridges, etc, but it was a hard year. I loved (most of) my co-workers and they felt I was doing a good job, but each day was a struggle, filled with hidden anxiety. 
When I moved back to CA, a school job wasn’t even on my radar, but over time, as I was job searching (plenty of jobs available, but I’m super picky), I realized how brilliant a school job could be, because it would allow a lot of breaks. When I first started the school job I was SO FREAKING STRESSED OUT because I started near the end of the year, during IEP season, with a lot of high profile cases. I cried a lot. But as I got more confident and knew what I was doing, I began to like it more and more….I ended up LOVING – still do – LOVING! My job. Of course it has its moments of stress ,but overall I love my coworkers, love my kids, etc. So I am doing much better because my environment is now a good fit. (By the way, I had decided always that I would do my first year in my worst area, physical dysfunction, because I knew if I started elsewhere, I would never go back to it!). 
My best friend, who I am staying with right now, in Alabama, is a physical therapist in a Level I trauma area, in acute care, and when she tells me some of her stories, it makes me sick, and so grateful I don’t work in a hospital with all the associated stress. Every OT/PT/whoever has their own level of comfort, own level of interest, etc. I find it all fascinating and interesting, but I know that personality wise, I have to be careful where I work as I am easily stressed in certain aspects. I guess technically many people would find my current job intensely stressful, but I’m good at the things my job most requires, so I’m content. It’s all about finding your niche. It’s okay if you don’t love or enjoy everything you encounter in OT school, it’s okay if some of it you find super hard or boring or scary. You can get through your rotations with your support systems in place, and then you can choose a job that fits your personality and whatever strengths/weaknesses you bring to the table.
I know, for example, that I don’t like manipulating people’s bodies because I get scared I am hurting them. As an elementary school OT working with reasonably high functioning kids, I pretty much never have to touch them, and I certainly never have to cause pain. I know that I am very creative and silly, so working with little kids is great as they find me pretty hilarious. 🙂 I know I can keep up with writing lots of big repor
ts, because I’m a fast typist, fast reader, fast thinker, etc. And I mostly work with teachers, speech therapists, parents, kids, etc…not high-pressure nurses, doctors….I just don’t have a hospital personality, although I still think I could handle a specialty pediatric hospital, ahem, which is still my ultimate dream job, but I’m many years away from even considering it. Also still plan on an eventual PhD 🙂 
I wish I could lay EVERYTHING out on the line in terms of diagnoses, medications, all my stories in details, but as we have all encountered, social media can get you in trouble. Like maybe a future place won’t hire me, or an insurance company won’t cover me, or whatever, because of things I write here. I’ve shared a lot, but as you can see still relatively vague.
Basically….becoming an OT is hard work, but soooo worth it in the end, and even if you have challenges, whether physically or mentally, the chances are, with support, you can still get through just fine. It’s okay if you are scared that you are anxious and socially introverted and that it will affect OT school…I get a lot of e-mails like that. You will face challenges, but you can always overcome them, and you will get through them, and one day end up in a perfect job environment. Just have faith in yourself, use your support systems (including your own internal ones), don’t be scared to get help, and MOST IMPORTANTLY – BE KIND TO YOURSELF! 🙂 
Category: Occupational Therapy | Comments: 3

19 Jul 2012

Sexuality, personal care attendants, OT??

I totally recommend checking out this PDF (link below) if sexuality in OT is something that interests you at all. Well, you know. Not practicing sexuality. But how OT can play a role in it, or at the very least, needs to be aware that sexuality is potentially an important component to a person. Often times, whether or not the client mentions it is directly related to how “open” they think the OT will be in regards to discussing it. Some brave OTs flat out ask about it. I remember that when I was a student, I was giving a hand-out on sex positions to a man having a hip surgery (how to have sex with hip precautions), and he pointed to one of the positions and said to his wife “Remember this one?” AHAHAHAHAHA

 I skimmed this PDF and I was impressed with some of the things it covers, that you don’t typically see in print. A lot of it had to do with personal care attendants and whether or not they were comfortable with helping with sexuality, ranging from masturbation to positioning the person for sex, clean-up before and after, etc. Very intriguing. This PDF isn’t specifically meant for OTs, but I think has a lot of relevant points that OTs should be aware of.

This document (see link) came out in 2011 on attendant services and sexuality and I thought you would find it useful …(edited for brevity) But this document covers a real issue and is based on research in Sudbury and Toronto.


http://www.crncc.ca/knowledge/related_reports/pdf/Sexuality%20and%20Access%20Survey%20Summary.pdf

Category: Occupational Therapy | Comments: none

19 Jul 2012

Challenging worksheets …

Worksheets like this can be challenging for young children with fine motor and/or visual motor issues. In this particular case, the child has difficulty staying in lines but also being able to copy words from a box in one corner to the various lines. Often, because it is so hard for them, they end up giving up and doing an even poorer job…I chide my little guy (in a KIND, silly voice)….Did a troll do this? Because it looks like a troll did this. Was it you or a troll?  He knows to say it was a troll if it's extra messy. So then we erase the writing of the troll (a little at a time) and replace it with HIS nicest writing, not a troll's. 🙂 Yay! No more troll writing!! This is amazing!! So much better!! Silly troll trying to take over your worksheets!!! 

Category: Occupational Therapy | Comments: none

19 Jul 2012

Weighted Pencil DIY

I loved this tip about weighted pencils off of TherapyFunZone.Com’s comments…

I have had luck with wrapping a rubberband around the end of a pencil, then place nut, and pull rubberband to other side of nut and wrap around pencil again.  This way the nut can be moved up or down on the  pencil.”


Category: Occupational Therapy | Comments: none

19 Jul 2012

Some new OT blogs…

I like these tips at this blog: http://www.golden-reflections.com/p/occupational-therapy-tips.html

Some more blogs you may want to check out…I believe they are all either OT students or hope to start their OT journey soon. Will be adding some to my blog roll later today. 
http://immamakeot.blogspot.com/  by a pre OT student! 

 http://occupationaltherapyjourney.blogspot.com/ by Sarah! (only wrote like a post or two last year)
http://otebby.blogspot.com/ by Ebby! (Travel award)
http://emmajasminspink.com/ by Emma! (Psych student going into OT)
Category: Occupational Therapy | Comments: none

19 Jul 2012

Bill's Journey, Becoming an OT, Part 3 of 3.

Search my blog for Part 1 and 2 if you missed those, I will link shortly.

Part 3-

 

August 19, 2010- the very day I learned of the results.  On my ride to go to the neuropsychiatrist’s office, I had a couple conflicting thoughts.  On one hand, I wished my hunches were right because it would have explained a lot of my struggles in fieldwork.  On the other hand, I didn’t want to be right because I would not know how to face my OT peers, as well as accepting the identity of being a differently able individual.  Two hours or so later, it was the moment of truth- I indeed do have autism, as I was diagnosed with Asperger’s Syndrome.

 

I was relieved for a second.  But, that sense of relief turned into sadness really quickly.  When I came home, I told what my parents what happened.  Then, I quickly went retreated to my room.  All I thought about were- how would I tell my classmates that I failed my first level 2 fieldwork, and how would I tell my classmates that I have Asperger’s?

 

A few days later, my second year of occupational therapy school officially began.  As I expected, almost every classmates were beaming with joy.  But, I was feeling miserable and sad.  Because they were too overjoyed of seeing each other, almost all of them didn’t realize that I was desperately in need of someone to talk to me.  Making matters worse, there wasn’t any good spots to tell people privately about what had transpired with me.

 

Knowing that I need to get the depressed feeling off my chest, I told some of my classmates what had happened to me through Facebook.  All the classmates I talked to were shocked of the diagnosis.  After all, they all had seen the strides I made socially when I was with them.  Moreover, they realized how much fortitude I showed just to attend class with them during the early weeks of our second year of OT school.

 

At the meantime, I was planning my own recovery, as my parents left me in charge because they felt that I know a lot more about autism than they do.  So, I first decided to seek occupational therapy services, which I had been getting prior to the diagnosis through the Lifestyle Redesign for College Students Program at USC.  Then, the occupational therapist I was seeing at USC suggested me to go to a social confidence group that was offered by the counseling services also at USC.

 

Initially, I felt ashamed of the idea of going to a social confidence group.  After all, I felt that others in the group might have wondered why an occupational therapy school student would ever be a member of a social confidence group.  But knowing that I had to do whatever I can to be a competent OT, I reluctantly accepted the idea eventually.  Fortunately, the other participants in the group never judged me.  In fact, because I have relatively less anxiety compared to them, where I was at baseline (before I started with the group) actually was a point where these participants wanted to be.

 

Then, two key things happened proved to be pivotal for my recovery.  First, I stumbled upon a song called The Story Song by a former childhood cancer survivor named Paige Armstrong.  After listening to that song several times, I realized how lucky I am comparing to a lot of individuals with autism when they first learned the diagnosis.  I had some tools to help manage my symptoms (through my OT training).  I had a great support system (with my OT classmates and folks at my church).  I accomplished a lot (I got to OT school without needing any accommodations).  My symptoms are not as severe as others.  All that adds up to the fact that I have an opportunity to make a difference for the autism community.  So, I started to broaden my horizons in trying to understand the best I could about what individuals with autism are going through, as well as their caregivers.

 

My second thing that happened to me was during the 2010 AOTA/NBCOT Student Conclave.  I happened to have a couple one-on-one conversations with then-Assembly of Student Delegates Steering Committee chairperson, Jaclyn Tarloff, not once, but twice!  The first one was before the event started, as we used the time to get to know each other- since we competed against each other for the very position that she was serving.  The second one happened because of a gaffe that I made at the airport as I was trying to go back home to LA, which was a long story in itself.   As I was waiting for my flight home, I saw Jaclyn walking along the gate as she was waiting for her flight.  We ended up chatting for an hour, in which she gave me a pep talk once she learned what I was going through.  At the end of the pep talk, she told me that she respected me a lot than when she first knew me.  Considering Jaclyn had become one of my OT idols after we got to know each other, it was special for her to say that to me.  So, I decided to try to follow what she has been doing since then as a blueprint and adding my own elements.

 

On my flight home back to LA, I spent a good bit of time to think about making my mark in the OT profession.  I then decided to do the following things, which has led me into becoming a starlet in the OT profession.

 

1.     I associated myself with majority of the candidates who were running for the Assembly of Student Delegates steering committee positions in the last two years.  I was able to use my previous campaign experiences as a way to connect with them. 

2.     I began to share my “new found” perspective via OTConnections.  Dr. Clark (current AOTA president) has taken notice of what I did and named me as one of the vibrant pixels in the OT profession in the 2011 Spring edition of the USC Alumni Magazine, as well as constantly putting me on the top of the occupational therapy social scene at the occupational therapy conferences I have been to since I was diagnosed.

3.     After learning that Jaclyn would be doing her share of OT conference presentations, I decided to challenge myself to start doing some, too!  As I attempted to do these presentations, Dr. Clark also took notice, as she knew it probably took a lot of guts on my part to even try something like this, which was true.

 

Behind the glory, however, I was miles from where I wanted to be.  So, I signed up for not one, but two independent “bridge courses” where I could get my feet wet in trying to rebuild my clinical skills.  These “bridge courses” were designed for students who felt they needed additional seasoning before they go on their level 2 fieldwork assignments.

 

Although I have demonstrated good knowledge, anxiety still overwhelmed me when I was trying to lead treatments on my own.  Even though I expected the anxieties to happen, I knew that the anxiety episodes had to be under control when I resumed trying level 2 fieldwork again.  Towards the end of my second “bridge course”, I decided to try anti-anxiety medications out of the urge of a Facebook friend whom I have never met but I happened to know her vicar.  She has dyslexia and ADD.

 

Coming from a family that resists medication, I initially didn’t like the idea of being medicated.  But, considering what was at stake, I reluctantly to give medications a try.  So, the psychologist at USC who gave me the screening for autism prescribed me Lorazepam towards the last 3 weeks of my second “bridge course”, since I would only be at the clinical setting 2 days a week for no more than 8-10 hou
rs total.  I noticed some subtle improvements.  Then, I got a prescription for Lexapro because I would be at the clinical settings for longer period of time and at a more consistent basis. 

 

After getting used to the effects of Lexapro for the first 4 weeks, I have seen my performance at the clinic improved as my anxiety have dramatically reduced.  Although I still showed signs of impulsivity and anxiety at times, it was night and day comparing to me from almost two years ago.  Now, I am proud of the recovery I have made in almost two years since my diagnosis.  Sure, part of the reason for my wonderful transformation was that I started in a better position than a lot of individuals with autism.  But, without the hard work that I put in, the support I have received, and the fact that I tried to understand myself holistically, this transformation wouldn’t have happened.

 

Sure, people may argue that I started in a much better position than a lot of individuals with autism.  But, without the hard work I put in, the support I have received, and my efforts to try to understand myself holistically, this “beautiful transformation” wouldn’t have been as great as it is.

Category: Occupational Therapy | Comments: none

18 Jul 2012

Therapeutic use of silence in OT

http://phillipagrace.blogspot.com/search?q=ot+blog

A few posts on the value of therapeutic silence. I have definitely learned that sometimes, staying silent a few extra seconds causes them to keep talking and tell me things they wouldn’t have said otherwise. Try it. 🙂 
Category: Occupational Therapy | Comments: none

18 Jul 2012

40 best online tools for OTs

I recently got this e-mail from a man named Kenneth who says:
 “I write articles for http://mastersinoccupationaltherapy.org/, a website dedicated to providing students with the information and tools needed in order to pursue their Masters in Occupational Therapy.
I ran across your site, and I thought that your readers might be interested in the latest article I’ve posted ( http://mastersinoccupationaltherapy.org/2011/40-best-online-tools-for-occupational-therapists/ ). It’s called 40 Best Online Tools for Occupational Therapists.
I checked out the first link and it actually looked relatively commercial. The second link of tools was more useful. I I definitely plan to check out some of the apps mentioned in that online tools link. 

Category: Occupational Therapy | Comments: none

17 Jul 2012

Healthcare jargon….

My PT friend who works in acute care told me today that a social worker referred to a patient as probably having a “celestial discharge” ……I love it 🙂 

Category: Occupational Therapy | Comments: none

17 Jul 2012