Day 9/10 of Adult Physical Dysfunction Level I Occupational Therapy Fieldwork!

Day 9/10 of Adult Physical Dysfunction Level I Occupational Therapy Fieldwork!

Today started out a little rocky but ended smoothly. We got several new patients to eval, and they were all low-level, so there was going to be triple-booking and times when I would ideally treat a patient alone, which isn't technically allowed. I was nervous because I do not feel confident in my ability to handle transfers or anything alone. It ended up working out. I helped one of our “regular” patients with ADLs,  and assisted with evals as needed. One of the patients was in a motorcycle crash and VERY low level, so it was exhausting for the OT, PT, and PT student to deal with that patient. During that hour I was treating my patient, with another OT in the gym keeping an eye on me. We stuck mostly to arm exercises and didn't do a lot of standing so that the potential for problems was minimized. I used an idea that Merrolee gave me, about trying to be more occupation-based, to work with my patient. He is working on standing balance and endurance, and I've been having him do tabletop fine motor activities to distract him while he stands. I knew he liked to travel, and Merrolee suggested pulling out maps and letting him trace where he has been, or something along those lines. I searched around my house but apparently didn't have a US map. I did have a US state-puzzle from the dollar store, though. I brought it with me and had him stand up, then pick up the state puzzle pieces and make a pile of states he had been to, states he wanted to go to, and states he had no interest in. It got him thinking about his past and his adventures, and he stood up longer than he ever has before. It pretty much rocked. I didn't make him do anything crazy with theraputty today, although tomorrow I plan for him to make slugs and porcupines. Slugs meaning he will make long skinny rolls of putty, then stick pegs in for eyes. Porcupines – round balls with tons of pegs. Good for hand strength and endurance and also slightly more amusing than just rolling it back and forth forever.

I also got this great idea for getting mini armadillos and stuff and throwing them around the hall, then letting him run over them with his roller, to make roadkill, just like he would in a RV. Am I amusing or what? I'm totally kidding. But the thought did cross my mind.

I ALSO had this great idea that perhaps tons of other people already know, but I thought about putting some bubble wrap (on some dysem so he won't slip) underneath his non-weight-bearing foot, for sit-to-stand transitions. The point is to NOT pop any bubbles while standing up, with that foot. Many people have a tendency to put weight on the affected foot when standing up, so this would provide some feedback. Maybe it won't work, or maybe it's been done. Whatever, I'm proud of my idea.

I've been trying really hard to make sure the patients know I respect them, I will be gentle with them, and I won't treat them like a piece of meat. I will also be respectful of their feelings and not just randomly start wheeling them backwards or something without giving them some feedback on what I'm doing/why. I also look them in the eyes and smile. I think it is paying off. Today I took an older woman back to her room, who has a ton of problems. She speaks very slowly and haltingly, with exaggerated yet imprecise mouth movements. She can be hard to understand. I put her back in her room and made sure she was ok, and she said “I…like….you.” I was like awww! I like you too! That REALLY made my day.

Overall, I'm enjoying this rotation now. I don't know if I'd want a job in such a place, and in fact I'm pretty sure I wouldn't, but I am getting to appreciate my patients a lot more now.

One patient today, who we were evaluating, had no teeth and tardive dyskinesia, and she was VERY hard to understand. My OT asked her to repeat herself and she said “You…have…hearing…problems.” AHAHAHHAAH

I also got to see pitting edema today! The patient had nicked herself somehow and edematous fluid was steadily dripping out, TONS of it. It was gross but cool to see!

Hmm…that's about it for today. Tomorrow is my final day of fieldwork! And Sunday is my birthday! I'll be 25! Wow! That is crrrrazzzzzzzzzzzzyyyyyyy.

Oct 18, 2007 | Category: Occupational Therapy | Comments: 1

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