The carnival is up!!! With an update

The blog carnival went up today…time got away from me so I didn’t submit in time. I feel bad. Check it out and read all the great OT submissions at

http://e-nableot.blogspot.com/2009/03/occupational-therapy-blog-carnival_09.html

This would have been my submission:

Private Parts & Body Fluids: Things you have to learn the hard way in fieldwork

It is my belief that OT schools should have at least a class or two (maybe a panel with some fieldwork students or new grads) on some of the um, not so much fun, aspects of OT that might come up in practice. Just to be slightly less surprised when those things happen. For example, it turns out a lot of lower-functioning people, once placed on a shower chair (with the hole), often end up having a bowel movement in the shower. Nobody told me this. I had a patient with problems functioning physically and mentally, surprise me by leaving a large mess on the shower floor, at the beginning of the shower. Trying to keep him calm and safe while dealing with the mess, was a little overwhelming. That’s just one of those things you’re never told about! I just wouldn’t have thought about my patients pooping in the shower. Until it happened. Several times.

1) Hopefully by the time you have completed all your observation hours to get into OT school, you realize this, but toileting, depending on the setting, can and does take up quite a bit of time, especially in geriatric settings. You might have to help wipe. You might have to help change diapers, help change soiled clothing from accidents, deal with underwear, incontinence pads, diapers, etc. And if you ever want to think “I’m only going to sit him down for 30 seconds without anything on, surely he won’t have an accident in that 30 seconds” – you are wrong. I speak from recent experience.

2) Women’s issues – menstruation in younger women, urinary incontinence in older women – pads, pads, pads. You might be putting the pads in yourself or helping fix a mistake. I recently had to fix an urinary incontinence pad while the lady was wearing it. It had bunched up while pulling up her underwear. Because standing up/sitting down was so fatiguing for her and we had already done it multiple times, the safest option by far was just for me to fix it while it was on her. With her permission of course. But as I stood there, fixing it, I marveled at the idea that I was doing something like that. I never would have thought that was part of the job description…and/or at least thought, “that will never happen to me”. Guess what, it does.

3) Some people are private – but many are happy to whip out all their bits and do whatever they need to do. You’ll be surprised at how flexible some of those 90 year old women are when it comes to getting clean. You’re going to see it all.

4) You’ll hear every word in the world to refer to private parts. My personal recently-heard favorites are “tinklebox” and “possibles”. Be prepared! (By the way, the other day I discovered me and a geriatric patient had the same pair of Victoria’s Secret underwear…slightly traumatizing, but mostly cool).

5) You will deal with ALL BODY FLUIDS. ALL OF THEM. BE PREPARED!

A few more thoughts on the matter:

1) Gloves. Just stick gloves in your pocket or whatever you carry around all the time. Boxes of gloves have a habit of being empty right at the minute you need them most. Just always have at least a pair on you.

2) Even if it’s tempting to call someone else to deal with a mess – if it isn’t a huge mess and you can take a minute, do what you can. It may take a while for someone to get to the person, and/or they will see you as not being a team player if you never help deal with it. You can argue it’s not your job or it takes away from productivity, but any little bit of help you give will be appreciated by both patient and staff.

3) It really does get easier. If you had told me nine months ago that it would become common-place to give showers, help with toileting, deal with all manners of body fluid, adjust breasts from getting in the way of gait belts, etc – I would have said YEAH RIGHT. NEVER!!!! But it’s true, you get used to it. I don’t blink these days. And I’m not even done with fieldwork yet…so you get used to it pretty quickly, I promise.

Good luck on fieldwork!!

UPDATE: Great comment from a reader:
“I love your blog as always. It’s really too bad that you didn’t make the blog carnival. But on the gloves matter,… latex gloves are a huge issue. You want to be careful about that advice for paediatric settings (yes I use British spellings) or even non-elderly adults (ie gimps) because huge numbers of sb [spina bifida] adults/children have latex allergies.”

Mar 08, 2009 | Category: Occupational Therapy | Comments: 1

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