Day 8/10 of Adult Physical Dysfunction Level I Occupational Therapy Fieldwork!

I've been hearing some hilarious stuff lately! I had one patient (CVA) tell me she was brought to the hospital just because she was extremely constipated! I had another one tell me that me and my OT supervisor were “twins”. I've also been hearing stuff broadcast over the nurse station speaker from the call button – things like “I need to go Number Two Extremely Urgently!” – or “I need help! I need EVERYTHING!” – okay, that's not funny from a patient perspective, but it's funny to overhear it! Another patient asked my OT supervisor to “unimpact her”. And it seems that, almost universally, patients call us “Nurse” or refer to themselves as being in “physical” therapy.

I would actually say I had fun today! I'm officially retracting my soul-sucking statement from last week! I was able to help with transfers, assist with multiple patients, treat my own patient with some different things, etc. I left a note on one patient's bed who was being discharged today that said “Hi Mrs. ___, we'll miss you! – The Twins, Karen and Supervisor” with a really bad picture of us playing balloon volley and the kitty puzzle with a missing piece. She appreciated it! LOL.

Today I got there a little bit early (around 6:50am) to do some brainstorming. I flipped through my ENTIRE textbook of “Occupational Therapy for Physical Dysfunction” by Trombly this morning, to try and see if I could find anything that would be helpful..nothing screamed out to me though as a treatment activity for a patient who has a hip replacement, touch down weight bearing status, bilateral shoulder arthritis causing limited range of motion, and hand arthritis. I'm tired of therabands and arm bike and arm pulleys! It seems like such a cop-out! I know it is necessary but still! So today we did the arm rickshaw which works triceps, shoulder flexion stretches using a bolster on an inclined table, standing up four different times and doing a nut-bolt activity and a wooden colorful puzzle activity, and then doing some theraputty exercises. I made him pick little objects out of the theraputty, which is pretty typical, but then I forced him to make little balls and stick pegs in it, ie cupcakes with candles…he thought I was crazy but he was a good sport and went along with it! I just am trying hard to think outside the box! I definitely don't know what I'll do tomorrow! Guess I'll get there early and brainstorm again by staring at the shelves of random stuff!

My favorite thing in the world right now is smiling at a patient and having them smile back! Sometimes it is a sympathetic smile, sometimes it is an ironic smile, sometimes it's a genuinely happy smile…whatever the reason, I LOVE having that smiley connection! I think a lot of these patients don't get smiled at enough!

Another huge thing to me right now is learning that phys dys is NOT magic! It all is starting to make sense! Even things like changing out catheter bags doesn't seem so crazy anymore. I'm figuring out how to charge insurance, do chart reviews, do evaluations, write progress notes, etc! I'm not as scared about my Level II three-month rotation at a rehab hospital anymore! Also….here is a tip to all you current/incoming students….it might seem a little bit overwhelming when you are learning little nitpicky details about how to do manual muscle testing or goniometry on tiny areas, while in school…but it is very likely you will never do any of that in a normal rehab hospital or job! Insurance typically just wants to know, grossly, how that patient is functioning. You can typically eyeball range of motion, and just do huge muscles for manual muscle testing. It's easy! So learn it just in case you get a job in hand therapy or orthopedics, but probably you won't have to memorize nearly as much as you think! Don't be scared!

I will be glad to get back into my “normal” school routine, crazy as it is…but I plan to enjoy my last two days of fieldwork!