challenges galore as new OT :)

Today was inventory day and it sucked a lot of monkeys! It was harder than I would have guessed, so sweet teas and a small cookies n cream milkshake that spawned 3 baby milkshakes (split with my two co-workers) made things go a little easier. We had to figure out all sorts of wound care items, splinting items, office supplies, etc! Soo tedious.

I can't remember if I posted about fitting for custom garments….a lot of measurements, I was very fatigued by end of it! I need to brush up on paraplegia and visual impairments, my next two challenges to accompany burns and my fibro/arthritis/other issues person. I'm enjoying the challenges but at the same time I wish I had another OT by my side making sure I was doing things correctly! I don't know why in the world (or okay, I do know why but I was wrong) I thought it would be a good idea as a new grad to go off and be the sole outpatient OT within an entire community. I have some good resources but still, as a new grad, you ideally really need to end up somewhere where you have some ON SITE mentorship more or less all the time.

I think I'm doing a pretty good job overall, I try very hard to provide patients with best possible care, but still….I don't always know what I don't know, ya know what I'm sayin' yo?

I take a modalities course this weekend so hopefully soon I will FINALLY be certified in modalities! I'm looking forward to the certification but not so much the weekend of class! I've been completing online modules. It's through PAMPCA and seems pretty cool. One of my co-workrs used them. Time for bed – good night!!

Two new OT student blogs to keep an eye on :)

I SO need to update my blog list. Two more I just became aware of.

http://lauratheot.wordpress.com/
http://otsweetpea.blogspot.com/

How to Make Instant Grits in 40 Minutes

Working in occupational therapy in field of Vocational Rehabilitation is an interesting job….we do a lot of basic kitchen work – minimal ingredients/directions, to try and prepare students for more independence as desired by them [said so anti-rehab people don't jump on me!]. I think of making instant grits as an easy thing of course – but I take so much for granted, being (more or less) physically and cognitively intact. Making grits could be difficult physically, or difficult cognitively, and especially difficult with both physical and cognitive difficulties. In cases such as below, as the therapist I try to give the student a chance at every single step to come up with their own solution or answer; only cuing when it's clear they are uncertain of how to proceed. It may take 40 minutes the first time as it may be a brand-new experience, but ultimately it should clearly take a lot less time…I think in the case of someone who needs as much cuing as below, their kitchen abilities will be limited to several VERY LIMITED recipes such as this one and possibly require supervision to make sure things don't go awry in the microwaving process! [ie pressing 11 minutes instead of 1 by accident and then walking off and not being able to problem-solve what happens next.

Working in Voc Rehab has taught me I TAKE SO MUCH FOR GRANTED – we all do. We don't think twice about making instant grits when really we should be thankful we can do it so easily! 

How to Make Instant Grits in 40 Minutes
1. Discuss with therapist on making Instant grits (single serving packets, water, 1+ minute in microwave)
2. Try to find bowl, spoon, and grits within kitchen. Get cues to find each item.
3. Try to find directions on boxes of grits. Get cues to find instructions.
4. Read directions for non-microwave directions. Get cues to read microwave directions.
5. Struggle to tear top off packet.
6. Struggle to empty packet. Ask if entire packet needs to be emptied.
6.5 Throw away empty packet then forget instructions are on it as well
7. Get new packet to read instructions on.
7. Read [incorrectly] amount of water needed. Get cued.
8. Try to measure out water; ask if “this is enough” [no concept of measurement]
9. Put in water; read instructions again. Cues to stir.
10. Stir minimally with large clumps left; get cued to stir further
11. Struggle to figure out how to open microwave; cued
12. Place bowl in microwave
13. Read [incorrectly] amount of time to put in microwave. Cued
14. Translate [incorrectly] number to punch in microwave. Cued
15. Try to figure out how to turn on microwave Cued
16. Try to pick up hot bowl immediately. Cued
17. Eat.
18. Cues to use soap, hot water, on bowl; cues to remove all clumps; cues to place in drying rack.

Some days I'm an awesome OT, some days not so much…but it's all in my head

I think I was meant to do talk-OT and not hands-on OT! Once I start touching them I'm so scared! Yesterday I had hands-on session: stressed out. Today I had talk session about energy conservation, joint protection, chronic pain management, basic adaptive equipment: AWESOME session with patient saying things like 'This is EXACTLY what I've been needing!” So yesterday's feelings of “I'm so incompetent” were replaced with “I'm so awesomely competent”. Until next time when it may flip flop again. Ah the joys and fears of new practitioner-hood!!

Tommorow is an all day meeting for outpatient! These days I'm outpatient 3 days a week, vocational rehab two mornings a week, and inpatient two afternoons a week….with occasional small changes here/there. So I'm learning a lot of diversity definitely!

I'm REALLY starting to think about getting back into the blogging routine of reflecting on daily work…..except with lots of safeguards in place to make sure things stay HIPPA/employment safe. I feel compelled to reflect!

I missed early registration for conference even though I do plan on going. I couldn''t sign up for AOTA membership without having to submit my NBCOT certification and fill out a real application, since I am a new practitioner. which is SO INCREDIBLY ANNOYING. It WAS willing to let me re-sign up as a student and I pondered this heavily as it was tempting to do that, sign up for conference, then fix the mistake, so that I could have gotten the early registration fee….but ethics won over I so I didn't. But man was it tempting. Ugh.  So….guess I have to go spend a bunch of time digging up NBCOT file etc, then pay full price for conference, BLAH BLAH BLAH!!!!! If I didn't want to go so bad I'd just be like screw it, it's so not worth the hassle!! But AOTA needs support, support AOTA and be a member, but bug them to change the new practitioner sign up method!

Financial Aid Options for Future Occupational Therapists

an invaluable (literally) article with a list of financial aid options for those hoping to enter the field of occupational therapy, compiled by an awesome dude named Richard.

http://blog.onlinecollegeguru.com/health-care/financial-aid-for-occupational-therapists/

Post Polio Syndrome

Interesting article on Post Polio Syndrome, too bad Roosevelt Warm Springs wasn't mentioned!! I've treated two people with it now and it's pretty interesting. Of course I have at least one PT friend who doesn't believe it exists.

http://www.nytimes.com/2010/02/03/health/03polio.html?src=twt&twt=nytimes

lol therapists in bikinis, I think not….

I have a patient who is active on some Internet boards who gave me enough information to find him! He's talked about Karen the therapist and how he likes her, blah blah blah, and allllll of his friends are suggesting that he get a picture of me – in a bikini. For anyone who knows me, yes it's okay if that made you throw up a little. Me too.

But there are like PAGES of them suggesting the therapist/nurse (because we all know that is the same thing ::heavy sarcasm::) in the bikini with all sorts of ideas on how to make it happen! Of course they are all just dreaming men who know better but it CRACKS ME UP! Men!

Clothes irritating your wound? Nudist colony

So I posted on Twitter something along the lines of “If a patient complains of clothes irritating a wound and I suggest a nudist colony, is that a bad thing?”   A few minutes later I get an e-mail that NudistClubhouse is now following me on Twitter, and then I get a response of “Sounds great to us!” from them. AHAHAHAHHAAHA

hmmm ot ot ot ot

I've learned more about burns in the past week than in many years combined. The key word of burn rehab as far as I can tell is officially ELONGATION. Want to do my patients right!

I feel really guilty for being so um…..deliquent with updating. Honestly I am truly exhausted almost all the time. It's all I can do to handle work most days in terms of staying awake….I nap way too much or sit passively and read articles in downtime instead of being active and updating blogs etc. And my gmail box is up to about 700 mails I haven't dealt with yet (and 50 I havent even looked at)…so I'm just uh, yeah……well….

I do love OT but I don't love insurance companies. One bit!

I'd say I have a new leaf to turn over of updating blog more often, but I am so freaking tired most of the time that it is unlikely. I constantly think about things I want to write about and just need to start writing them all out in private emial….then go back and change things around enough to eventually be able to discuss them without HIPAA violations. Instead I just am like “man, can't write about it on my blog” and then it's gone out of my brain. : Boooo.

So anyway………tomorrow is vocational rehab and maybe some outpatient. Right now I'm working 4 areas sometimes within the same week! Inpatient, voc rehab, outpatient two clinics….so lots of interesting experiences. I guess I'll stop rambling now. Love hearing from readers and if you want to write in about something, if it's appropriate I'd post it for you, re OT of course.

Loooove
Karen

hmm

Today was such a weird day. The morning was filled with students learning new skills – vocational rehab – things as basic as mixing grits and water together in the microwave, putting on a sock, or making a bed independently, etc. Takes a LOT of patience and is very frustrating – but if I find it insanely frustrating I am sure its a million times harder for the students. The afternoon was evals. I read five different chapters on burns last night trying to figure out the blueprint for treating a pt with burns – unfortunately all the chapters give ideas but it's no blueprint or substitute for hands-on. I'll be talking to a burns expert, Sandy in Memphis, in next few days. Driving home today I saw a bad wreck that had just happened – I had been mad at myself for being late getting home but the accident had just happened and you always have to wonder what would ahve happened if you HADNT spent that extra few minutes doing something. My thought as I passed the wreck (it was before even emergency vehicles got there, at least 10 came flying by within about 2 minutes – but there were SO many people already pulled over there is nothing more I could have offered) – was how sad I was for whoever was in that vehicle, and the drastic changes their lives wold probably have. It's crazy how just a SECOND can change everything…..today it hit me harder than normal, after a day filled with people learning or re-learning skills or navigating a changed life……that could be me.