Days 6 and 7 of Adult Phys Dys Level I Fieldwork in Occupational Therapy

10/15- Monday

Today went smoothly. I was tired after the weekend conference though! And my patient that I was following, was suddenly discharged this weekend because his family decided to take him home! So I wrote up a week-long treatment plan for nothing! Oh well! You have to roll with the punches! So I got a new patient of my own, who had a total hip revision! I need help thinking of occupation-based, minimal resources needed, ways to work on improving his standing balance, standing endurance, general weakness, etc. It's hard! I forgot to journal this Monday so I'm writing this Tuesday, and it's honestly hard to think of things that happened yesterday! The days run into each other when you see the same patients and do roughly the same things every day.
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10/16 – Day 7/10 of Adult Phys Dys Level I Fieldwork in Occupational Therapy

Today went pretty smoothly. It started out normally. We did ADLs (activities of daily life) with patients from 7am to 9am. Most of our patients were already dressed and ready by the time we got there. That is actually somewhat of a pain, because each patient needs 1.5 hours of OT a day (6,  15 minute, units), and typically two of those units are used for ADLs. If patients don't require assistance, we have to figure out if there is a way to sneak them in later, to get in all their required therapy! However, for me personally, I like it when they are already dressed, because there is less likelihood to see nakedness and potty parts! If you know what I mean! Today I saw a woman empty her colostomy bag and it was REALLY gross looking. She was very casual about it though, and so was the OT, so I was impressed with both of them. I am good at keeping a poker face but it still grosses me out!

At 9am I got to treat the patient I am following. Denise was nearby and would help if needed, but I was in charge. I'm going to admit to y'all, I was NOT occupation-based. I know we are in school right now learning that the whole point of OT is to be occupation-centered and to not be “upper extremity physical therapists”. But guess what – in an inpatient rehab gym with limited resources and limited time, and/or low functioning clients – it's all about the therapeutic exercise, which I guess counts as preporatory methods. We did stuff like the arm pulleys, pulling items out of theraputty, hip precautions education (no internal rotation, no adduction, no bending past 90 degrees, etc), and then some standing, while doing tabletop fine motor activities. It's really nerve-wracking to me, dealing with the patient and the wheelchair maneuvering, and especially taking on and off the leg rests as the patient moans in pain! I think I'm doing okay though! The patient is very patient with me! Haha I kill me. Ok, anyway.

We saw all our normal patients – I did a lot of transporting and a lot of stand-by treating. I wrote the note on my patient and I was so proud. Unfortunately a lot of the medical shorthand isn't transferable to computer, but it's basically stuff like “Patient seen in am for adls. Patient seen in am for approximately 1 hr of therapeutic exercise, standing balance tasks, and education. Patient performed approximately six minutes on the arm bike, with three to four rest breaks. Patient has fair+ endurance. Patient did this. Patient did that. Patient c/o p! 2 B shldr arthritis. (Patient complained of pain secondary to bilateral shoulder arthritis)  It's pretty cool writing notes! And seeing patients! I had slept well last night, but had a lot of bad dreams, including one where I cried constantly, so I was feeling a little bit jittery/nervous today. Luckily everything went okay. One of the patients cracks me up constantly. She literally makes me laugh out loud with the things she says. She and I were working on a 100-count kitty puzzle while working on her standing endurance/balance, and at one point she said “I hate you kitty!” while trying to figure out a certain piece. Also, we finished the puzzle and one piece was missing, and she said, “This kitty is missing a body part. It should come to therapy, that's where they get help”.

Overall it was a normal day. I don't feel like my soul is being sucked out of me anymore, but I do feel regularly nervous. I'm an anxious person and it FREAKS ME OUT to not be in control or know what's happening or not know how to help someone! So I still wait eagerly for the day to end – which I didn't do in my pediatric rotation – but everyone is really nice and helpful!

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