About to start Week 3

Friday I only got 14 units instead of 20. I got 12 in the morning but only two in the afternoon!

I went back in the afternoon thinking I'd fill up, but two people were leaving, a few I had already seen in the morning or had an issue, one was heavily sedated, one was a paranoid schizophrenic who was having issues, and three were heavily asleep. I feel like waking up a strange lady to say, hey, I have some questions about depression for you, is kinda counter-productive. Yeah, if it's a depressed person sleeping the day away, that's one thing. But if it's a 92 year old taking an afternoon nap, I hate to disturb the person. Anyway.

The paranoid schizophrenic (look at my poor, poor use of person first language) was sitting in the hallway in a disheveled gown and as I'd walk by she would look at me until I got near, then she'd very blatantly snap her head away. At one point, having exhausted other options, I tried to talk to her (since she is one of our OT patients) and she snapped “I don't want to talk to you”. I said “Okay, just checking in” and kept walking, lol. Her behavior was odd enough that it wasn't her being irritable, it was her having active symptoms, so I wasn't going to mess with her.

Joanne Cash (Johnny Cash's sister) came in to sing again. She does gospelly stuff. One of my men with dementia came in and was like Wow, is that a wig!? (she has black and white crazy hair). She said no, it's all mine, do you want to feel it? Or something along those lines. He ran his hands all through her hair and commented “That's more than a handful.” After she was done singing, he asked again if he could touch her hair. She said no, once was enough. LOL. She was pretty cool in how she dealt with him. It's really nice of her to sing to them. I like watching the patients sing and immerse themselves into the experience.

I did group afterward – 4 in first group, 5 in second. One was on compensating for memory deficits….

Me: What would you do if somebody gave you a phone number and you didn't have a pen? (thinking they'd say repeat it a lot)
Lady: I'd say call back or tell me later after I get a pen!
Me: ::asks same question to man in wheelchair::
Him: “I'd say, go get me a pen so I can write that down!”


The second was supposed to be on anger management, but I made a split-second decision to do it on support systems/discharge planning instead, based on the group and that multiple patients in it were leaving that day.

The shining moment of the day, though, had to do with a one-on-one session.
That morning, I spoke with a man who was leaving that day after being there about a week. He said he was feeling anxious and he didn't know why really. We discussed how change can be scary, even if it's good change, because it means a change in routine, and some unknown factors. He acknowledged he was going to have a new room at his old nursing home and how that was a little disconcerting as well, etc. I think he hadn't been able to fully “get” his anxiety considering it's supposedly a good thing to leave a hospital, until we talked. We also spoke a little about relaxation – deep breaths, calming the mind etc, and he mentioned he wanted to try yoga. ANYWAY, I wasn't sure if what I had just done was billable or not since all we did was chat, but my OT confirmed it was, as long as the outcome is measurable, ie, identify 1-2 coping strategies for anxiety. So….I haven't been fond of what I've been doing in the ward (seems like I do very little therapeutically, mostly just evals and/or confirmatory diagnostic tools), BUT, one-on-one discussions of how to cope with anxiety, depression, etc, is right up my alley, so that might be the one thing that helps me like the rotation.

The way I know (or at least strongly suspect) I actually made a difference for him? He was in my group on discharge planning a few hours later. He basically said word for word what we had discussed earlier about change being hard whether it was good or bad, but he had made it his “own” words.

ANYWAY…those were the highlights of Friday.

I had a fun weekend – details later – but I was bummed tonight knowing I have the start of a new week tomorrow! Oh well, I guess I'll get through Week 3. I'm going to try and go to the gym 4 out of the 5 days, wish me luck.

Lester is curled up next to me with his little tongue protruding, sooo cute.

Jan 19, 2009 | Category: Occupational Therapy | Comments: none