Day 7/60, Geriatric Mental Health, Level II OT fieldwork student

Yesterday. I don't remember much, that's why I should blog each night while it's fresh. I do remember doing a CPT with someone who scored pretty low. On the medicine subtask, I was like augh! One of the pills says “this is as needed, not to exceed 8 in 24 hours” and she was like hmmm….I guess I'll put a few in each. On all the medications, she made some mistakes. Glad her daughter helps her still.

What else. Oh yeah, the big event of the day. I was doing group and one member with dementia was monpolizing things big time – I kept trying to redirect him, tell him to stop, but he is hard of hearing and adamant, so it's a bad combo. Another member, who has had multiple strokes and is not very physically functional and has trouble speaking, got really angry at this monopolizing member, and started yelling, banging the table, and cursing, etc, telling him to shut up. Some nurses/aides came in and calmed down the angry guy. The monopolozing guy kept apologizing but kept talking at the same time about his rough life. They kept trying to get monopolizing guy to be quiet so that angry guy would clam down. One of the aides said something along the lines of “Stop talking sir, we've all had a rough life, we don't want to hear it.” I was like UM. Not to say I have a better way of dealing with it, but that doesn't seem like something you say to people in a psych hospital or who are getting therapy!! Angry guy left and so did another little lady with dementia who always dissapears during such events. So group was a bust more or less. Oh well. It kind of freaked me out when he was getting so angry. Good thing I have behavioral training tomorrow, lol.

I checked in with the angry guy later, he had calmed down, he was angry about the monopilizing (how many ways can I spell this wrong in one post?) not only for himself but also for my sake. I think I'll learn some assertiveness over the next few months, since I'm supposed to be doing two groups a day!!!!! Augh!!!!!!!!

Do you know the scenes in the movie Superstar where Mary Katherine Gallagher is like flirting with a stop sign/flagpole/tree? I think Lester is flirting with a table pole. He just stuck his nose against it.

Today and yesterday my OT has been more with me, watching me do evals to point out stuff, helping me with the single cordovan stitch on ACLS (I still freeze but I'm almost there!!)…we started out the morning with bathing I've never seen shower ADLs before. There is a special bathroom with a shower chair, hand held shower attachment, etc.

My OT basically holds the shower attachment to minimize how wet she gets, and then the person gets scored via ACL scoring and FIM scores for their bathing and undressing/dressing. You think, how do you score a person on bathing?!! But think about all the tiny steps involved in bathing – soaping up hidden areas, remembering a washcloth, being safe, washing off soup, using enough soup, etc.

I did a few MMSEs, a few ADM placemats ….

You learn to just nod and go along with things. Like on the MMSE when you ask orientation questions and they tell you it's February, Fall, Thursday, etc, you just keep going with the poker face…Today's MMSE sentence by a lady with COPD who was very gravvelly sounding: “I wish I had a cigarette”. I added some exclamation points to that one for her 😉

I'm still a little conflicted sometimes regarding “getting the productivity units” versus whether I think the person is genuinely going to benefit from my intervention. Also, because I all too familiarly know the overwhelming desire to crawl back into bed with depression/anxiety, I feel bad for the ones who want to go back to bed because the nurses/aides/doctors want them up out of bed as much as possible. I know in reality it's best for them to stay up, not be isolated, etc, but I really “feel” their desire to just be alone/go to bed!! One lady today was having an anxiety attack and begged me to stay with her  (I had gone in to chek to see if she would come to group, she was in bed crying). In retrospect I wish really bad I had stayed with her and worked on some relaxation techniques, but my other patients were waiting for group to start, so I couldn't. Ugh!

Tomorrow morning and Thursday morning I have behavioral health related training – I don't know how long it will last but I'm hoping a long time – anything to keep me out of the ward!

It's only day 7…I sincerely hope I'll eventually get the hang of things to the point I no longer dread each day. I'm really quite a passive person even in all my activity – I'd much prefer to be a zombie rather than do things like literally JOG to the ward for an eval (my supervisor has long legs!!!). She LOVES her productivity units with a passion, lol. She has the sin of productivity gluttony. She never stops for a break, and I think she's had an actual 30 minute lunch like once.

Today she had to go off premises for a while and it was like time for lunch and she was going to be back in say 45 minutes, and she wanted to make sure I had plenty to do, and I was like yeah and rattled off a bunch of stuff, and then I was thinking…if I'm lucky I've been taking a 20 minute lunch, and there is no such thing as a “break” for her. So I did take like 20 minutes for lunch and felt guilty lol.

I guess it sounds like the above is complaining, but it's more a combination of sharing/awe. She's certainly energetic. I just have my winter zombie blues so her level of energy is pretty amazing to me. Oh and today I got off on time!! Wow!!!!!!!

Okay, this is really long…oh well, I don't care. If you got this far, you are way too nice.

Jan 14, 2009 | Category: Occupational Therapy | Comments: 2

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