Thursday, October 30, 2008
"that stinks....I am sorry you got your car broken in to. I just thought I would try and cheer you up by letting you know how much I APPRECIATE your blog. It is AWESOME. I read it all the time (have been for the past year) I am an OT student in "Smithland". just wanting to say thank you so much for all your hard work! You have helped so many of us and have been a great inspiration to your fellow national students! (I have sent out your blog link to all 48 in my class!!)MUch THANKS!!"
-"Jane Doe" 2nd year OTS
I'm packing for a trip to Nashville to see some friends, one of them is performing in a band on Halloween....leaving Friday right after work (hope hospital census drops dramatically over night lol) and coming back Sunday. Poor Lester the Lion Kitty will be so lonely but I'm having a friend check up on him.
Today went rather smoothly - I wasn't alone much - I think we're slightly backtracking to where I'm with my supervisor a little more but doing a lot more of the work - because I was feeling pretty puny on things like bed mobility and all that!! I think I'm more or less still on schedule with objectives, though.
I might write a little bit more in a few minutes, about a few of the things I never thought I'd be doing!!
Wednesday, October 29, 2008
At least I'm not crying hysterically, I'm dealing with it. More later.
Tuesday, October 28, 2008
Monday, October 27, 2008
This is a TOTAL copy/paste of an ad for Student Conclave.I have failed miserably in my duties of keeping y'all abreast of information. Don't drink hater-ade, I take full blame. So if you are interested, sign up like, ASAP. I went last year and it was COOL and this year it will be even COOLER!!!!!!!!!!!!!!!!!!!!!!!!!! PS: I'm not sure the formatting will stay put, but I'm sure the vital information will stay intact....okay this is too long. I'm stopping now. GO TO CONCLAVE, STUDENTS!!! THE OT GODS WILL SMILE UPON YOU!
Sunday, October 26, 2008
This is the quote that is going to help me get through the next week...
"Our greatest glory is not in never falling, but in rising every time we fall."
The two pictures included were a gift...my friend re-did a figurine to make it me and Lester...down to my glasses and mole on my cheek, a little "OT" band, and cutting off the kitty's face/re-painting it to make it look more like Lester!
Wednesday, October 22, 2008
I do however have a ton of OT-related posts I want to do - like OT being a great recession-proof job, about Student Conclave, about Obama's grandmother's broken hip and how AOTA should jump on it, blah blah blah - but maybe I'll feel more like it later on.
Our census raised dramatically and we went from like, eight patients in a day, to right now having a minimum of 4 evals tomorrow plus sixteen treatments...for me, the main OT, and a COTA (who is there until 2pm I think?)....and I am pretty limited in my ability to handle treatments...augh!!!!!!! Ooh and it is the COTA's birthday tomorrow :) And we are going out to eat lunch - OTs and STs - yay.
And TOTA conference is this Friday - a few OT students from my class and a bunch from class below are going. :)
Anyway....I'm going to try and function for a few hours! I'm supposed to meet some friends for dinner - but it will probably be a short affair if so since I'm so wiped out!
Tuesday, October 21, 2008
Speaking of work, today was my first truly good day as an OT student. For one thing my OT and COTA gave me a present!! Which was so sweet of them. A beautiful bracelet with earrings. :) I definitely didn't expect it, it was quite kind of them.
My day Of course was helped by the fact I got all the easiest patients, but still! I did my chart reviews of the new evaluations, discussed with my supervisor the three knee replacement (day after surgery) evals I'd be doing, one of which was a bizarre case involving patellar fractures and leg immobilizations, and discussed a courtesy consult I'd be checking out. I did all three evaluations in the total joint unit and didn't skip any major steps, spoke slowly/clearly, was personable, got needed information relatively quickly, asked the nurses for permission, kept track of time, etc etc. Then did my courtesy consult, and got done 11ish, and then went down and did evaluation paperwork until lunch. After lunch I went to go see a patient who had a stroke, and we did a thirty minute cognition session - he had improved DRAMATICALLY overnight - yesterday he couldn't retain more than 3 numbers, today he could retain phone numbers, perform 3-step commands, name objects, write his name, etc - all things he couldn't do yesterday. Pretty awesome. Then I went to go see a lady who was deconditioned but she got discharged right then. So today, all by myself, I did three evaluations, a courtesy consult, and a cognitive treatment. Of course I got some advice and discussion with my supervisor so I don't mean to make it sound like I was in a bubble, but it was a big deal that I was so independent! It's Week 4 so it's time, but because I've struggled with anxiety and have so much weakness in the phys dys arena, it's taking me a while to hit my stride. All my patients today were relatively high level - the low-level patients who need help with transfers are still way beyond me, I don't feel comfortable with them at all. Which I need to be. When it's slow I like to follow the PTs around for the lower-level patients because it involves a lot of bed mobility and basic sit-stand, things like that, which overlaps with OT, and I can pick up more tricks/tips.
Tomorrow will be the busiest day we've had since I got here - and the COTA only stays until noon and the outpatient OT may not be there since she had to go home for her sick daughter today. We have at LEAST seven evals plus 9 treatments! I can maybe do 3-4 of those evals and 1-3 of those treatments I guess...the key is that even though we're busy I need to not stress....just take deep breaths and handle it. While being safe.
When I read back on my day you might be like, big deal, but to me, it's a very big deal, because of my anxiety levels having been so high. I hope tomorrow I can handle the challenges.
After work I went to OTS Kerri's and we ignored each other because I had like twenty thousand phone calls to respond to, plus I had just found out Lester the Lion Kitty made Icanhascheezburger.com which is a HUGE deal, HUGE, because I love that site and it's kind of elite - only a few cats a day get put up but they get thousands of submissions. So I was really excited. Then we went to Mexican where we met up with OTS Jason, Minda, Becca, and Brooke....had a lot of fun and of course exchanged some fieldwork stories.
Overall it was a really nice day both at work and afterwards...I appreciate all the phone calls, txts, Facebook messages, emails, postcards, packages, etc....I am blessed to have wonderful friends and family. Thank you all!!
It's not even 10pm but I'm so tired that I think I'm going to quickly prep my OT stuff and then go to bed! I'm 26 now, and that's old, so it's acceptable that I'm so tired, right :)
Monday, October 20, 2008
Then we went in to help a PT do a dependent transfer, and I totally had no clue what I was doing at all and felt like a total dumba** lol. And the pt had on an abduction pillow (a triangular pillow between the legs to keep them separated) and while I've seen them, I had never taken one on/off, so I was like ummmm WHAT DO I DO AUGH?! lol THESE STRAPPIES ARE TOO HARD!
In the afternoon I was going to do an ICU eval by myself and then do a treatment with a little lady with dementia/deconditioning, but the nurse requested that the eval be put on hold because of patient being so drugged/resting, and then the little lady refused and I couldn't convince her otherwise without becoming a bully, so oops. I went back to the office and wrote up discharge summaries and stuff instead.
Tomorrow we have AT LEAST six evals, probably more like 7 or 8...luckily I can do several of the less complicated ones by myself. Probably the COTA will do all treatments tomorrow, of which there are probably only 4. And I'll maybe do 2-3 evals in the morning (?), we'll see...maybe more. Or less. I don't know. I'd kind of like my OT to see me do a straight-forward one tomorrow (ie a knee replacement) so that she sees I'm only utterly incompetent with the more complicated peeps. LOL.
One of the issues that came up today with PT coming to visit OT, is a lady they were seeing who cannot wipe her bottom because she is so large....there are special tools that can be bought to assist with this and IF MY CAT KNOCKS OVER MY FLOWERS I SWEAR HE IS GOING TO BE ONE SORRY KITTY CAT OOOOOOOOOOOOOOOOOOHHHHHHHHHHHHHHHHHHHHHHHHHHHHH BAD KITTTYYYYYYY BAAAAAAAAAAAAAAAAAAAAAAAA ok wow I totally got distracted there.
When I got off work I went to the post office to send my twin a card, I wrote it completely randomly like "I use this color red not only to represent diversity but to symbolize the twinly blood coursing through our veins" because that is totally the kind of stuff she likes, she will send for example a card for an 8 year old boy, to me, because she is amused by the randomness. And I'm getting on a tangent again! Anyway then I went to Curves to work out and then I met up with my utterly bizarre friends (who have two articles in the current Edible Memphis magazine, go pick up a copy), and they gave me pickled ginger, mood-lifting sea salt with lavendar, wasabi, Painfully Hot Popcorn, blue sprinkles, and a bunch of other weird things because they had cleaned out their pantry, ahahahaa, plus a nice monetary gift yay!! plus they took me to Soul Fish and we had HUSH PUPPIES!!!! and other food of course, but the focus must be on HUSH PUPPIES because I love them dearly, the beautiful balls of mush.
I got home late and had a package from Norway waiting for me...perfect timing...with a sweet book of quotes (in Norwegian of course) plus some yummy Norwegian chocolate...and also a book about an Ultra Marathon Runner that I wanted, from my sister...and then Allison called me to inform me there was an AWESOME video of the Lester the Lion Kitty song on Facebook...it's also on Google Video if you type in "Ballad of Lester" at video.google.com....
Speaking of Lester, he is running around like crazy.
Okay...I think I am getting delirious because I am so tired...I need to make this one of those tiny posts but I'm writing this in gmail and too lazy to switch over, so maybe I'll fix this post tomorrow. I'm hoping tomorrow goes smoothly at work and then tomorrow evening I'm meeting up with OT girls! And maybe going to the gym if I get off early enough.
And maybe sometime this week I'll become a good OT student and actually spend an evening or two going through all my stuff and re-organizing and looking up some things...seems like I never get home until like 10pm and then I'm too tired to do anything but therapeutically blog and then go to bed!
Sunday, October 19, 2008
PS: A few days ago I went back to my first pediatric clinic to say hello, and a little boy with Asperger's was so glad to see me, but mostly he wanted to know where Mr. Snail was (a puppet). I told him Mr Snail was vacationing in Hawaii with my grandmother.
*I'd like to point out I have an obsession with (fake) snails and I think they are awesome creatures and I mean no offense. Just sayin'.
Overall today was a thousand times better than yesterday...I'm still a little nervous about the upcoming week fieldwork wise, but not too bad...it is the start of Week 4. And it's my birthday week, so I have lots of birthday dinners scheduled! Fun!!
This weekend has been one of extremes. It was one of the "lowest" weekends I've ever had without having a really good reason, but today I'm feeling some HOPE....some much needed HOPE.
The Bad News:
1) Friday evening/Saturday morning/afternoon was one of the lowest times I've ever had. I mostly spent the day in bed feeling dead with the occasional panic flash whenever anybody tried to contact me. It was also the first day back on Wellbutrin. But by evening I was feeling a little better, which is good since I had to babysit for an important occasion. So I got out of bed at 430pm. LOL.
2) I cut myself - again - while doing dishes - this time I was not (stupidly) cleaning a knife like last week when I did it - but a glass cup had broken and I didn't know it since it was obscured by bubbles- so I cut myself good with the broken cup on my left thumb- and once again had to do the dishes one-handed while the other hand spouted blood.
3) I feel "deconditioned" after spending so much time in bed so little things tire me out!
4) Grammar is hardly.
1) Today, Sunday, I feel slightly more "me", like I've swallowed a few teaspoons of hope!
1.5) I cut off a bunch of Lester the Lion Kitty's hair again because I was tired of the random clumps of Persian hair he was leaving around. I'm being more careful though, his skin is so loose that it's easy to cut it, which I learned the hard way last time.So he has his lion ripple again. Ruffles Chips should hire him as their mascot.
2) I cut some flowers in the garden for my house...sounds little, but the small things I can do to cheer me up, accumulate into bigness.
3) My sense of humor is slowly coming back. I have a house plant that I put outside with a stick/flag that says "I'm dying, please help me, <3 Plantie" since my landlord is smart with plants. (BTW, I told a lady the other day I have a "black thumb" because we were discussing plants and she was a black lady and she looked at me blankly, and I was like hmm...oops?)
4) My Biobrite alarm clock is back and making a big difference since it fills my room with light by the time the alarm goes off.
5) I have received several great books from my twin, a GPS system from my friends Suzy & Arnie!!!!, now I can stop getting lost every few days, and then also my serotonin necklace from madewithmolecules.com from my parents! And a beautiful handmade necklace from a good friend!! And a postcard from my Norway host mother's best friend, Hilde! My birthday is Tuesday! I can't believe I'll be 26!
6) I'm not feeling utter panic at the thought of this upcoming week in OT fieldwork. In fact, doh, that's something I really want to share with you guys...later on tonight when it's dark and I'm not burning valuable jewels of sunshine, I'll share the weekly supervisor/OT student meeting comments....but for now I need to go. I'm going to go hold babies at the hospital, then walk in a park or forest or something...let the sunshine melt into my pores and infuse me with vitamin D goodness. More later...
Thursday, October 16, 2008
Tomorrow is his last day since he was only doing a two week rotation! We'll miss him!!
I did two evaluations entirely by myself today - one on a deconditioned woman, one on a recent hip replacement.
I have coined a new diagnostic abbreviation...."TW"....stands for train wreck....and its for those people who have SO many issues going on that train wreck is the best way to describe it...like the person might be in seen by us because of deconditioning but their past medical history may be: GERD, gastroparesis, hypertension, hyperlipidemia, cataracts, hip replacement, diabetes, depression, anxiety, dementia, cardiac stents, CABG, arthritis, back injury, right toe amputation, breast cancer, uterine cancer, RSD, anemia, renal failure, COPD...and more.
Tomorrow I will be following PTs in the morning and Cody will be with the OT. And tomorrow is our weekly supervisor-student meeting to discuss goals of week and goals for next week.
My goal for tomorrow is as always CONFIDENCE :)
Wednesday, October 15, 2008
Today I did one treatment today for almost an hour, all by myself (she kindly peeked in to check) - it was a VERY VERY VERY tall man with a hip replacement - I showed him how to use the hip kit to do his underwear, pants, socks, and shoes, so that he would be following his hip precautions. He was a very kind, polite, man, and a good learner...then I saw several other patients with help from the great COTA and then she did a few as the primary person. ahahaha. I can only tolerate so much challenge within a day before I feel like I've hit my "I'm going to explode", PLUS I only want to see patients by myself if I feel 100% sure I can handle that person safely and that I am trained enough on the particular intervention as to not be completely worthless when I get into the room. I always have to kind of have a mental self pow-wow before I walk into the room to kind of go over my plan as I don't think well on my feet.
I'm struggling with anxiety - I'm kind of at this new baseline where I feel over-caffeinated almost all of the time (only I'm not on any caffeine) - which is somewhat typical of how I feel in the fall, and this fall is especially difficult because it coincides with my phys dys rotation which in all honesty I have dreaded ever since I started OT school. I used to have nightmares about it. Now that I'm actually on the rotation, I really like my supervisor and the colleagues, and it's not as scary or rocket sciency as it seems, but I can't seem to conquer the anxiety with exercise, herbal supplements, blah blah blah - so I'm going to try to get back on a medication to help. I know some friends who read this will be like too much info Karen, the world doesn't need to know this and that's private informatoin- but to me it's important to share because I like to reflect on my student journey and my level of anxiety is strongly affecting that journey! And it's not private in my opinion, I could care less if the world knows I'm a little psycho. :) Anybody who has been reading this for the last year and a half or so, knows I am high-strung! Luckily in person I do not appear nearly as nervous as I actually feel, so most people don't realize how anxious I am...which is obviously a good thing in a professional setting. But no fun to always feel on edge and it affects my abilities as a fieldwork student because I have a much lower tolerance for challenge. But again I know I am too hard on myself and I'm doing FINE overall in terms of meeting goals and being where I should be at this point.
Today was really not too bad overall - I felt pretty okay about how the day went at fieldwork and thought it was pretty cool my supervisor had read my blog - especially because it meant she discovered my level of anxiety was higher than she realized and she has reassured me I am doing fine - and then I went to the gym after work (we got done somewhat early) and then was at a special dinner event lol - so got home just a while ago. Going to go to bed soon.
Oh! The assisted living facility I volunteer at at times, is close to my fieldwork...and it's such a trip when we open up the Impending evaluations sheet and it's a name I recognize from there! When I hear the particilar person talked about at Bingo or something, as in "Person X is at the hospital", I have to be so mindful of HIPAA to not say anything about the fact I *saw* that person!
Tomorrow I am hopefully going to follow one particular patient in all 3 disciplines (PT, OT, speech), do at least one eval by myself, probably do a treatment or two by myself, and follow the COTA in general...the level I fieldwork student is with the OT supervisor this week...and my goals continue to be to speak loudly, slowly, clearly...to be more confident...ideas for new goals?! I think those are pretty big goals so I'm okay with them. Baby steps!
Tuesday, October 14, 2008
This morning with Anita present I did two evaluations - one on a left total hip arthroplasty, one on a left total knee arthroplasty. Both patients were pleasant and cooperative and I think the evaluation went smoothly. Then I went to write up the evaluations and realized I had not asked them their pain levels or about the functional use of their arms, oopsies. So Anita and I went back to quickly ask just that, after I had written up the evaluations and my supervisor had double-checked them. I also did a few discharge summaries and showed her a few of my SOAP notes! Woot! The questions on clinical reasoning were interesting...I think it would be good for fieldwork supervisors/students to have a chat about the various types of reasoning and sometimes discuss what types of reasoning were used for a specific client, and why.
In the afternoon I saw one patient alone - a 15 minute ADL treatment where in all honesty I felt rather "otiose" OH MY GOSH MY CAT JUST SNEEZED ALL OVER ME THAT WAS DISGUSTING okay anyways OH HE IS DOING IT AGAIN okay but anyway, then it was time for an eval that had come in - on a very involved patient with about a thousand diagnoses - and I will admit I was like (but in more professional language) Yo Supervisor...I've really hit my max ability for the day to handle anything new and challenging...I would really like to not do this eval. Since it was not straight-forward and would take place in the ICU and also with a Level I student present (who is awesome btw), I was just like...this was my first day seeing patients alone...and I saw three of them...plus had my teacher watching for two...in other words, that I was slightly overwhelmed at the prospect of taking on another challenge of a complicated ICU eval with two people watching. My supervisor was actually VERY understanding and sweet about that. I think if I tried to beg off challenges regularly, she would not be thrilled and that would be inappropriate and unprofessional, but the occasional legitimate "I'm overwhelmed at the idea of a new challenge right now", can be okay.
That last eval was a DOOZY - the ICU patient was an "unreliable historian" and SO involved - and it took the OT, two OT students, a PT, and a "Sara Plus" standing machine, to get her from her chair to the bed. Afterwards, the elevators wouldn't come and Cody (the OT student) and I tried two different elevators (because we had this standing machine) and they were all being crazy, so it took us at least 20 minutes just to get downstairs! And also, Cody got poop on his lab coat today! Yikes!
Ok back to seeing patients alone...It seems easy to watch the supervisor do it..then it's my turn and I'm just petrified of forgetting to do something that could be a safety risk or pain risk to the patient...like forgetting to put up the bed rail, or things like that. I'm also really scared of the nurses thinking I'm stupid. I struggled with a tray this morning (getting it pulled up) and I wish the nurse hadn't seen me! I had practiced with a tray, but not this particular type. The nurse helped. But I think nurses - even the awesome ones - are often a therapist's harshest critic - so I only want the nurses to see awesomeness!! Which so far I am not delivering! But it's only two days into Week 3, maybe awesomeness will come.
Overall I think I did well today...even when I'm very nervous I usually mostly look calm...and I think I talked slowly and loudly overall...and was more personable...
For the rest of the week I think my supervisor is mostly going to have Cody, and I'm going to be with the COTA who is great...so I'll be doing treatments...I'm not horribly nervous, but I have several big things to get done this week including getting student health insurance - which looks like it will be costing $573 dollars just for two months?!!! Plus need to get some important prescriptions filled, and a few other things that require phone calls and such, plus getting my twin sister's birthday present together, so I'm like augh! When do I do this?! Tommorrow with any luck we will get off somewhat early so I guess I can make my phone calls and send off my sister's present then.
otiose \OH-shee-ohs; OH-tee-\, adjective:
1. Ineffective; futile.
2. Being at leisure; lazy; indolent; idle.
3. Of no use.
So..... occasionally there are moments where I'm like...is what I am doing of any therapeutic use? Maybe I'm just OT-iose at those times.
Monday, October 13, 2008
So...this lady is an AMAZING "mother warrior"...! It makes me slightly sad that although she had to have a TON of occupational therapy, only rehab generically, and physical therapy, is mentioned in this relatively long article...it should have been the OT that was making the biggest difference to her and allowing her to live her life as fully as possible, in wwhatever way that meant to her. :) Question is...did she not get great OT...or....who knows....anyway, a very cool lady. But this is the kind of thing where AOTA needs to do a follow-up and be like YO! Here are ways OT could have or did help someone like this!
Today was a pretty good day...I helped with several sessions in the afternoon although the morning was odd...including an eval with a man whose chart says he had no plumbing or electricity....tomorrow I do an ortho eval - a hip - by myself, and a treatment, by myself...with one of my UT teachers, Anita, observing...for some research she is doing...scary!!! I then babysat all evening and now I'm going to bed!
A friend sent this on to me. Americans are welcome to contribute!
This link is for the Canadian Disability Studies Association's call for papers. It's the 2009 meeting in Ottawa and papers from occupational therapists that relate to disability studies (i.e. embrace the social model) would be welcome.
OKAY! NEW REMINDER of MONDAY GOALS!
SPEAK LOUDLY, CLEARLY, SLOWLY
UP CONFIDENCE, DOWN INTIMIDATION
ENJOY INSTEAD OF DREAD
Sunday, October 12, 2008
I guess that will be my new big goal for this week...getting student health insurance asap...
I did go from about a 100 emails to 40...and about 25 Facebook mails to like 10.....so I got some stuff done tonight....tomorrow I'm going to try not to stress too much...go to the gym...probably babysit...see some friends...and then prepare for a busy Tuesday with a lot of hip replacement evals (their surgeries are Monday, so Tuesday we should have at least six ortho evals to do)...
I read your blog regularly and I felt compelled to offer you some reassurance. I just finished my last fieldwork and it was at a phys dys site. (acute inpatient rehab on the brain injury unit) Let me tell you....it was very stressful at first and there were plenty of times I was on the brink of tears because I felt so overwhelmed and incomptent! Trust me when I say this....it will get better!!! As you said...you're only in week 2!!! To be honest, I didn't really get in the groove until like week 9 and then for the last few weeks I was flying on my own and it felt great. Phy dys sites are just harder I think than others. Especially in a hospital setting. So don't be so hard on yourself....you are learning and it's expected you'll struggle a bit. If you picked everything up in just 2 weeks what would be the point of a 12 week internship?!? You'll get it...just be patient :)
Hey dude, if you have a computerized documentation system, create a word or text file and keep it either on your public network folder or a jump drive. Every time you write goals for a pt, just copy them into there. It's also great for ROM and other exercises that you do in a similar way each time. Saves you a lot of time to change small parts of your canned text.
Also interesting for this man to point out that nursing homes are typically much worse than hospitals about such things.
Sent: Mon 6/10/08 10:39 AM
Subject: Fwd: Stop Paying Nursing Homes That Injure Elderly and Disabled People
Stop Paying Nursing Homes That Injure Elderly and Disabled People.
Information Bulletin #264 (10/08)
On October 1, 2008 Medicare announced that it would stop paying hospitals
for injuring patients. The Centers for Medicare and Medicaid Services
listed 10 "reasonably preventable" conditions for which it would no longer
These "preventable" conditions included injuries from patients who fell
in the hospital, catheter-associated infections, stage 3 and 4 pressure
ulcers (aka bed sores).
Why has CMS not addressed "reasonably preventable" conditions and injuries
that nursing homes cause elderly and disabled persons? Why has CMS not
instructed States to stop Medicaid payments to those nursing homes that
cause specific injuries? Why is this standard applied only to hospitals?
Augh! Sundays overwhelm me! A whole new week to be scared! I'm about to start Week 3 of 12 of my phys dys rotation...I dread each and every day and the new challenges. Ugh. I just want to go to sleep and never have to wake up so I don't have to be scared!! Can I just sleep through the next 9 weeks please? Or maybe the next 3 months and 9 weeks so that I can get through all this fieldwork as a frightened student? Every time I see a kid I just want to grab him and be like PLEASE LET ME WORK WITH YOU! NOT ALL THESE ADULTS! THESE FRIGHTENING ADULTS! PLEASE, KID!
Ok that was my melodramatic moment of the day, moving on.
I need to take some deep breaths and remind myself of the attitude readjustment I'm trying to have!! Trying to not be so hard on myself and to not be so scared and to just go with the flow!
Friday I did a treatment session with my supervisor and the Level I OT student watching me, it was a pretty basic session of just getting up and moving and doing ADLs (activities of daily life) like brushing teeth/grooming, working on standing endurance and bed mobility and all of that, with a woman who is deconditioned, but still...ugh. It's hard having someone judge your every move. I want the criticism, I accept and learn from the criticism, but that doesn't make it enjoyable! I have to remember that with each day, I gain new experience and knowledge, and that pretty soon, it won't be so scary. SO REMEMBER THAT KAREN! lol
I do have a lot to share and catch up on from an OT/blogging perspective, some neat stuff I've read on other OT blogs, getting to go to OT student April's wedding, my friend Doug coming back from England, some funny things patients have said, hearing stories about other OT student fieldworks...even some thoughts on some of the special needs remodeling that Extreme Makeover does on houses....... I'm also behind on e-mails and Facebook messages, but when I get this overwhelmed I don't feel like doing any of it! I think I'm going to go shower and breath deep and come back to try and deal with a few of these things!!! And I'm going to go see an attitude chiropractor to adjust me! Ha ha ha I crack me up! Like a chiropractor! Ha ha ha! That was funny too! Ha ha ha ha! Ok I'll stop now.
Ok...So...my goals for this week...which are repeats because they take time and effort and practice.....is....to be calm and confident. To speak slowly, clearly, and loudly. To not be so hard on myself. To try and ENJOY the experience instead of dreading it!!
Thursday, October 9, 2008
This is EXACTLY something I've been pondering the last few weeks in acute care, as we have to ask all our ortho patients (knee, hip replacements) their pain level. Two ladies with the exact same surgery on the same day may have two very different answers. People with low pain tolerance who complain of high levels of pain - like a 7 - always seem to be seen with at least a slight level of disdain. I've noticed in general, people brag about high pain tolerances, as if it's an amazing talent. Or calling people wimps like in the TV show - "His eight is my three".
I guess I'm sensitive to the pain issue because I personally have a low pain tolerance and I get tired of people treating me like I'm just a baby. It's not a choice - nobody WANTS to feel pain acutely. My personal theory is that it is somewhat related to sensory systems - just like some people have sensory processing disorder and/or are hyper or hyposensitive to senses - pain is one of those senses where some people feel it more acutely than others. It's not a choice. It's congenital.
I'm not dealing with the issues surrounding painkiller addicts or anything here - I know some people complain of horrible pain just for painkillers - but in GENERAL - LEGITIMATELY - I think people's perceived level of pain needs to be respected. Who cares if their eight is your three? They have a differently wired nervous system.
Wednesday, October 8, 2008
So tonight to amuse myself in non-OT ways I.....A) spent way too much time playing at yearbookyourself.com, B) watched SNL skits online - there's this Lawrence Welk spoof with four sisters that is really funny but I feel bad laughing at it because the funny sister has like deformed hands which I think is mean to make fun of (She's holding baby doll hands in her sleeves or something). But the skit still cracks me up. C) I spent WAY too long recording snippets off iTunes onto my phone to make individualized ringtones. Ringtones are serious business yo - I try to make them match the personality or have personal meaning. I had a little too much fun picking the songs out as it is often my own inside joke...like a needy person getting a ringtone about security, things like that.
Lester the Lion Kitty is snoring on the floor, and I'm going to go shower. I've more or less cleaned the house, prepped for tomorrow, etc, so I feel a little less insane. Once I've showered I'm going to do a few cheat sheeets for tomorrow's patients and then go to bed. I've gotten several e-mails and Facebook comments about being intimidated/stressed by this phys dys rotation and I really appreciate them! I'm going to share some of it in the next few days!!
And we have a Level I fieldwork student (a two-weeker) watching as well because census is so low that the PRN COTA didn't come in (and/or she goes home early because of a baby), so I feel extra inept because he is pretty confident/secure already, watching me fumble around. Not that he is judging me, I'm just projecting my insecurity.
One of my goals for this week is to speak louder and clearer.....people, not just patients, have trouble understanding me. And I need to successfully complete an eval by myself. I have kinda done a stroke one and a deconditioning one but in both cases my supervisor had to jump in a lot.
I think I am being too hard on myself, it's only Week 2, but I just feel so inept. I kind of dread work because I feel I am constantly showing incompetence. This afternoon I got to see a pediatric speech session with a little girl with velocardiofacial syndrome - very cool - we played CandyLand and did B, D, and T articulations, and I was like right at home...pediatric speech and OT have so much overlap and I was like...oh man....it feels good to not be scared.
I'm trying to keep a good attitude - and just need to swallow fear - and realize it's not that hard or scary - just a matter of getting used to adults with physical issues. It's not rocket science. Ok. That's my goal for tommorow. To be less intimidated and just TACKLE the day. To speak louder and clearer. To just do my best.
Tuesday, October 7, 2008
2) One of the speech therapists brought up an interesting point, about how some of the doctors come in in pal-mode, "Hey how are you doing, ::checks patient very briefly:: yeah great to see you we're going to get you out of here okay goodbye!" while others come in "Hello. Here's what is going on. X, Y, Z, and here is what we will do about it. Bye." And that most of the patients seem to relate better to the jokey-schmoozey doctor who gives them no information, rather than the straight-forward doc. It doesn't seem like many of the doctors I've encountered have a good combination of warmth AND straight-forwardness. One or the other.
3) Census is really low...as in, inpatient, there were only SEVEN patients today...yet an OT, a COTA, a Level II student, and a Level I student. I think the rest of the week will be very slow as well.
4) Today I did two evaluations with quite a bit of assistance. The first one was a stroke and I have only seen one stroke eval so far and it was a very minor one. So my supervisor had to show me a lot of the stuff to do because I've primarily seen ortho evaluations which are much more straightforward. The second one was a very deconditioned woman with a lot of problems and depression and again I needed a lot of help. It was somewhat nerve-wracking/scary to do these evaluations, but really they were pretty straight-forward. I just need more experience. This week- well at least Weds, Thurs, Fri - I think I'm primarily the one seeing the patients and just getting help from my supervisor, versus observing. I guess considering it's only my second week I shouldn't feel disheartened - I'm pretty much writing up a lot of notes/evals etc by myself and navigating the computer system well and getting a feel for hospital layout and procedures - but I just want to like, know exactly what to do and when, and I'm not there yet.
5) I went to traffic court this afternoon...for my 10-over speeding ticket I had to pay 61 dollars but it won't go on my record so my insurance won't go up. Yay on insurance, boo on the cost. What a bummer. Oh well.
Ummmm......it's almost 11pm...I've been so tired...I want to go to bed now...even though I'm way behind on e-mail and feel like I've neglected a lot of my friends....but I need to be on my game tomorrow....tomorrow I don't know if we'll have any evaluations, but I know I have to be ready to treat the patient with the stroke, and the patient with depression and deconditioning, plus a few others I'm sure.
Monday, October 6, 2008
Today I followed speech therapy all morning - got to try thickened water - whoah - and watch bedside evals including one lady who probably needed a psych consult more than a swallowing study. Also followed physical therapy all afternoon, in the ICU - a lot of passive range of motion.
Tomorrow morning I do some evals by myself (although with 100% supervision), augh scary!
I have somewhat of a list of things I want to write about from last few days. Just not tonight.
Sunday, October 5, 2008
I have to admit I'm struggling a little bit - Fall is typically a very hard time of year for me and I have my good days and bad days dealing with some seasonal depression. Yesterday was very hard on me, today hasn't been nearly as bad. I'm doing laundry and wrote up this poem - it's a piece of crap but that's okay - because it's basically how I see the seasons. I've been getting daily poetry from the Writer's Almanac (Garrison Keiller sp on NPR) and it's like word candy to me so um, yeah. Anyway. I've got to go finish laundry, run some errands, get ready for tomorrow, blah blah blah, so I better go...I'll probably post again tonight about expectations for this week - scary - when procrastinating. Click the read More to see the poem, don't blame me if your optic nerve shrinks.
Some call her Autumn
She peeks around the corner
embraced with open arms
Come in, come in! Stay!
Pumpkins and turkey and family holidays
Chilly nights, hot cocoa and cider
Rosy apples & crisp cheeks.
Her husband is Fall; Aptly named
He arrives; my sanity departs.
A perfect inverse correlation
Unable to focus on Autumn’s kindly warmth
I am too distracted by his morose accessories
He is Foreboding; Gray
His incessant rain a smothering blanket
An army of red, yellow, purple marching
A flamboyant pride parade
Mocking in their colorful suicide
So does my mood
Panic rises as the sun sets
earlier each day.
It has not been a nice trip
See you next Fall
Banging, banging, banging
Winter barges in
I grudgingly accept; there was no choice
Landscape barren and deeply frigid
Mother Nature with an empty womb
Naked trees in nudist colonies
I am Winter Alice in Wonderland
Bewildered; grimly desperate
But not berries.
Hibernation a constant craving shhhh
Sleeping away the harshness
Has a gentle pulse
Bringing along her favorite 4-letter word:
New beginnings a cliché
But that’s why it’s true
Hey little buds; glad you’re finally arrived
Thawing warming growing
Popping up like prairie dogs
A crocheted blanket of blossoms
Prissily sashaying in the wind
Winter has left the building.
Timorous blossoms fading way
Into Verdant maturity
Says the thesaurus.
Mannerly trees sternly chiding
the riotous kudzu.
Informing Kermit it’s easy to be green
Drinks of sunshine and lemonade
Children and cicadas shrieking with joy
Darkness a distant memory
Baking in the sunshine
Thursday, October 2, 2008
People are so sweet...I was tired when I went but it was energizing once I was there because I think a lot of the older people kind of soak in youth and reflect it back...
I dunno. Ya gotta love them. Ok good night for real now....
We also - and by we I mean my supervisor - lol - gave a mini private crash course on a doctor who will be having a knee replacement and wanted some information.
Tomorrow we only have five patients unless some evals get scheduled overnight which I think is rather unlikely - we also have our first weekly meeting of strengths/areas of improvement/goals for my fieldwork. Hmm. I guess I should write that up quickly LOL.
Got an interesting e-mail I'll end up editing/posting about an OT student with similar fears in her upcoming fieldwork rotation about her confidence levels, not hurting people, etc. Glad to see I'm not alone in my fears. Appreciated her e-mail.
Lester is purring next to me and it's past midnight and I better prepare for tomorrow...which includes leaving work slightly early to go to a health professional networking thing at 3pm where I am representing OT at my undergrad college (homecoming weekend). Hmm, what do I wear?!!!
ANYWAY............ok good night I'll stop chatting now lol
Wednesday, October 1, 2008
She just told me that today during an evaluation, a mother said to the therapists about her son: "You know when he was growing up I always thought I was talking to him.. but I realized I was just talking to him in my head!"
I know people lose their modesty in hospitals and that gowns are rather exposing, but I would almost *swear* this man really was doing it on purpose. It wasn't overt though so there really wasn't anything to do besides ignore it.
Other than that, today was pretty quiet. Got there at 8. My OT and I went through a bunch of paperwork together in the OT student manual. And my OT and I did two evaluations - I wrote up one with her supervision, she wrote up one - and then we treated one guy with a mild stroke and did a bunch of activities with him - and I observed two treatment sessions with the COTA. Got to leave around 330pm today. Went straight to Curves and ran into OTS Kerri there. She is doing her rotation in hand therapy. Then we ran into another friend. Fun! Then Kerri & I walked at Wolf River to get some fresh sunlight and air - very pretty - and she made dinner for us all once her husband got home. I left a little before 8pm and I've just been chilling with Lester, decompressing- need to finish getting ready for tomorrow and then go to bed. Very tired.
I really like my supervisor and am learning a lot from her and don't feel nearly as intimidated overall - hopefully tomorrow will be a smooth day. I help run Bingo tomorrow night at an assisted living facility and have a few other plans but otherwise it shouldn't be too crazy of a day.
I hope all my classmates have had good starts to their new fieldworks...ok no more procrastination. Done with therapeutic blogging for the night.