2nd Adult Day Center Experience

You will have to bear with me through this post because although it's not late, I'm extremely tired. So, anyways, in a previous post entitled "Looking Beyond Conditions & Physical Interactions" I mentioned that my last experience at the adult day center (ADC) was a hot mess and highly frustrating. I felt very incompetent and my weaknesses were definitely highlighted within the 3 hours that I was there.

I told you guys that if I had time I would let ya'll know how it went this time around. So, my partner and I had 2 "clients" -- the same 2 as last time. Prior to going to the ADC, I texted her and asked which client she wanted to be primarily over. After talking with my professor, I felt that this would be a good idea since I didn't get to participate much in the questioning or interact much with either client. She texted me back her choice and I told her I would take care of the one left. Because I was very anxious about going to the ADC out of fear of messing up or making a fool of myself again, I felt the need to prepare, prepare, prepare. Since this time around we would actually be performing assessments with the clients, I practiced the assessments by recording myself talking to space (my imaginary person). I also took the time to make some reference sheets that I could take with me to help guide my assessments. It was much of the same information in the manual but without all the unnecessary fluff and with a much bigger font size. Here are a few examples of the sheets I made: (you may have to click on the picture to see it better)

Digit Span Test: Forward Span 

Cognitive Performance Test: Shopping

Cut this paper in half and used it to help guide Activity Card Sort

Toggle Category Assessment 

I was so glad that I took the time to make these because it helped my assessments go pretty smooth! The only assessment that I did not make a sheet for was the ACLS-5 (Allen Cognitive Level  Screen - 5). My experience at the ADC was MUCH MUCH MUCH better this time around. I also got 2 hugs from two other members of the ADC. Another two people asked me to come sit with them. I told them that I would after I met with one more person (I didn't see a reason not too). Unfortunately, after I finished writing up all my notes, they were heading home :(. Oh well! The lady that I was working with had me write in her notebook what we did with the Activity Card Sort so that she could show her house parents. I'm not even sure if what I wrote many any sense! lol I was focused so much on getting through the assessments that I'm sure it ended up being gibberish. Plus, she made me sign it, so there is no denying that...yup that was me...and yeah I know what I wrote probably made no sense. 

Well i'm going to go ahead and get to bed. I'm going to a CEU from 8:30am - 5pm. Obviously I can't get CEU's but I like when going when I can because you get good information!

Ttyl <3

City of Binders

So in OT school we get A LOOTTTT of papers, handouts, and everything in between. Trying to organize it all has been a CHALLENGE. At first, I thought about just putting all the papers for a semester in a 4 inch binder -- and I did. However, it was heavy and not the easiest to navigate. Plus, our classes often overlap in material, especially when it comes to documentation, interviewing patients, and various conditions. Therefore, organizing by class isn't the best idea either.

So, instead, I decided that I would buy a crap load of binders and organize them by topic. It has been time consuming since I've had to rummage through my chaos of papers from all my classes pulling things out and putting them together with their mates. However, it's been well worth it. So far I have used 8 of the 13 binders I bought. Pictured to the right is a few examples of some of the binder topics I chose to group together (I have small hands so I could only hold so many lol). I'm still not done organizing everything. I still have a lot of papers to go through and I want to add a table of contents as well as some labeled dividers. When I finish organizing all the papers I haven't gotten thus far in my program I will share the completed "project." 

My next biggest challenge will be finding space for all of these binders. On top of all these binders, I also have a ton of OT related books. I have the ones that were required by my program, but I also bought other resources that I thought would be helpful throughout my career (I'll share all of them in a later post). Space won't be as big of an issue when I get my own place, but for now, I must deal with the space I have -- which isn't much. 

I'm also sure as the semesters go along I may have to either buy bigger binders, or group them differently, etc. etc. So, that will be interesting as it goes along. My ultimate goal is that all my papers (from May 2014 - May 2016) are well organized by the time Fieldwork II starts (June 2016). If I have all these resources but can't access them quickly then it's really pointless, in my opinion. 

Well, that about wraps up this blog post. Just wanted to fill ya'll in on my latest and greatest! lol :) 

Looking Beyond Conditions & Physical Interactions

Last year I posted a blog called "Note Taking during Observation & Bridge Burning!" Great blog, in my opinion, but it's missing something - something important. Something I did not realize it was missing until this semester (Spring 2015).

During my observation, I focused soooooo much on the condition the client had, what the therapist did with the client, tips and tricks, all that...but the one thing I forgot to pay attention to was the interpersonal interaction between the client and therapist, the therapist and parents, and the therapist and his/her team. I have over 45 pages of notes outlining my clinical observations and NOT ONE talks about anything of the such UNLESS there was something that the therapist did that I did not agree with.

I did not take the time to note any of the positive, beneficial, or key interactions. Nothing that the therapist said to motivate their client, nothing that the therapist did to support their client when they burst into tears, nothing that the therapist asked to try to understand their patient better, nothing that the therapist did when they could tell their patient was getting hostile, nothing about how the therapist approached his/her colleagues (e.g., other OTs, PTs, nurses, doctors) when he/she had questions, nothing that the therapist expressed when interacting with caregivers...just NOTHING I tell you and that's so unfortunate.

Taking note of the conditions you see and of the specific therapy techniques and activities the therapist does with the client is important, but the interpersonal interactions that occur within the setting is just as important and it's something I failed to attend to during my observation. I won't say I was focusing on all the wrong things, because I wasn't...I actually learned a lot...but what I will say is that the lens I had on was too narrow to see the big picture at the time. And now, as my first year of OT school is coming to a close it is something I regret. But why?, you may ask.

Well, interacting with others on certain levels is not something that comes natural to me and it's a long story as to why. I communicate well with others when it just happens and I'm not putting to much thought into and also when I'm one-on-one with someone. However, lately, I feel like I have to be so much more intentional and when I'm intentional it's just so unnatural, especially if I'm with another person and especially if I have to follow a specific protocol (i.e., that required by an assessment). For example, we have been going to an adult day center to interview some of the members there so we can fill out case maps, do some assessments, and eventually create a treatment plan. When I tell you it's like I couldn't improvise, I couldn't think, I didn't know what to say, it was awkward, and I couldn't play off the dynamics of my group member...I am not joking nor exaggerating. I got so frustrated that day. Plus, the way our seats were positioned was conducive for my group member to interact with the client, but not for me because I was off to the side (not that I wanted to be, it just happened with how my partner sat). Long story short, it was a mess. I think it would have helped if my partner and I would have met prior to discuss how we were going to execute obtaining the information we needed to, but with our schedules so hectic it just wasn't possible. We should be able to meet before we go back again (this coming Thursday) so hopefully my experience will be much better this time around. I talked to my professor about it and she was able to give me some advice so we will see. If I have time, I'll let ya'll know how it goes.

Anyways, back to the point. The point is that I wish I would have took the time to acknowledge how the therapists interacted with others, how they improvised etc. etc. because now I'm faced with situations that are unnatural for me and I have nothing really to go off of but words. Words are great, but I learn best by seeing firsthand. So all-in-all, my advice to anyone who may struggle with interpersonal interactions, are introverted, or just want to see the bigger picture is...don't just focus on conditions and physical interactions, also take notice of how the therapist is interacting with those around them. Hopefully, this will help you not to struggle as much as I have been. I only gave you one example, but I have encountered a handful of situations that were just a big fat mess.

Anatomy & Cadaver Lab Tips & Tricks!

Alright, so it's about to be that time of year again. I promised I would get this out to you last year and I never did...my bad! It's here now! Hope these tips are helpful to you. Don't forget to checkout free printables at the bottom of the post! If you have tips of your own, feel free to leave a comment!

1. Wear clothes you don't care about. The smell of the cadaver lab has a tendency to linger on your clothes. 

2. If the smell is too much for you too handle try rubbing a SMALL amount of Vicks on your upper lip and nose. Some people have suggested cinnamon flavored gum (e.g., big red), but Vicks works much better, some labs don't allow gum, and do you really want to be smacking on gum with cadaver juice flying all around?

3. Don't buy an expensive tool kit. Many of your tools will possibly fall in the tank or get mixed up with your group member's so you don't want to spend too much money on a tool kit. Plus, unless you are going into the cadaver dissecting field you will probably never use the items inside the kit ever again. I will, however, say that you will need a lot of blades because they can get dull pretty fast. My suggestion is that you split the cost with your group to buy a box of 100. 

4. Don't leave your gloves sitting out, people will use them and they will be gone before you know it. Box of 100? Umm, what box?

5. Don't set your tools on the edge of the tank. They will most likely fall in and be gone FOREVER! lol

6. Don't use the body as a scapel holder. When it comes time to open the body and "play" with their organs there is a high chance that you will have poked into the intestines and there will be poop EVERYWHERE. That happened to the group next to us. It was a stinky stinky mess. 

7. Take your lab coat to a laundromat, you don't want to stink up your washer/dryer. Also, don't try to bleach it - may make the smell settle in more.

8. Read about the dissection procedure prior to dissection. I usually just went with the flow lol, but I wouldn't suggest it. I was the one showing up like "yeah, so umm..what are we supposed to be doing?" Don't be like me, be better! 

9. Use lab time effectively in an effort to finish dissection. Don't spend more than an hour and a half a day outside of lab time trying to finish your dissection (especially if your in a fast paced course). It's usually not worth it and the professors and lab TAs will cut and dig for the structures they want anyway. You need to be using as much of your free time as possible studying or reviewing the structures on the cadaver...not trying to dig through fat to find them. 

10. Speaking of fat, if you get to choose your own body, avoid the big belly bodies :) You will be cutting out and digging through fat for dayssss!

11. Don't just mindlessly dissect your cadaver. You usually spend 2-4 hours in lab for class...take advantage of it. When you identify a structure share it with the group. When your group members find something have them share with the group. Pay attention to the location, what structures it can easily confused with, all that. Let's be real though, sometimes that's hard to do because everything usually looks the same and you have no clue what you have found, if anything.

Another option, is to review lecture material while you are dissecting. Everyday, have a different "leader" at the head of the tank "teaching" that day's lesson. They read you a part of the material emphasizing the important parts, and then they quiz you over what they just covered. Then they cover a little bit more and quiz you again. This worked really well for my group. We were able to remember a lot from being quizzed over class material while dissecting.

12. Make a list of everything you are expected to be able to identify and make sure you locate it and write down the easiest way to locate it. Sometimes the professor will provide you with a list, but it usually has other nonsense on it. You need to make a list with just the structures, free from any unnecessary distraction.

13. Don't just identify a structure on one body. I recommend you see every structure AT LEAST 3 times on 3 different bodies. Sometimes they look very different depending on the body.

14. If you don't work well in groups for studying purposes DON'T do it! I don't usually work well in study groups, but I thought "OMG, everybody is always studying in groups, I need to study in a group too." Yeah, no! The one time I attended a group study session, it was a mess and I felt like so much time was wasted and that I could have learned much more on my own. 

15. Take advantage of tutoring if it's offered. I recommend going once a week every week if you can. I did solo tutoring and just asked the tutor to show me where to find a bunch of structures and then explain to me how I can easily find and identify it, while distinguishing it from similar structures. I wrote this information down and went on about my business. This was discouraged, but it worked amazing for me. They suggested that you have the tutor quiz you over structures that you should have already identified on your own. Yeah right, there was usually too much going on to have already figured out where everything was located. It was my belief that I could quiz myself, but what I couldn't do was locate all these structures on my own, so if the TA just tells me where they are all at first I can figure out my own way to quiz myself later.

The reason I did it this way is because I quickly learned after the first test, that the structures I missed were the ones I had never seen before. Why? because I never identified it to begin with, so when I saw it, "I'm like what in the world!!?? Umm...let me see well it obviously isn't A because A is located somewhere else, but oh is that B?, can be look like that?...crap I only have 10 seconds left... umm shoot i'll just pick D." It was a mess.

After that test, I had my tutor show me every single structure we were responsible for, how to find, how to distinguish it from other similar structures. Next test went 1000x better. lol

Some people did group tutoring, but again, I emphasize if you don't learn well in groups, don't do it just to save a buck or $10. Nine times out of ten you will regret it. 

16. If your lab TA's host practice lab tests GO TO THEM! Pay the money if they charge and go to them. It really helps you to see what areas you are struggling in. Also, some of the questions may pop up on the real test. Also, sometimes going just helps you get your technique down. You have to move quick and you have to think quick! "Jack be nimble, Jack be quick."

17. Now is not the time to experiment with new ways to study or follow someone else's method of studying....unless you are a procrastinator, then you better snap out that quick. Other than that, if you have a particular study method down pat, stick with it! 2nd year MOT students discouraged me from making note cards because they were too time consuming and "not worth it," but I knew that I could memorize information like no other with flash cards. So i went for it! Was it time consuming? HECK YES. Did it pay off? Again, I say, HECK YES! ...If this is your method of choice the key is to not play around. Get them made so you can get to studying. The one section that I didn't make flash cards over...forearm and hand muscles...was the one section that I knew the least well. I tried some else's method and guess what? It didn't stick.

If you take your first test and you realize "OMG, the way I studied was a mess. I thought I was getting it until I took my test and then I was like what????" Then that is the time to go to the drawing board. If you have an advisor, go talk to them...sometimes it's mandatory anyways, but I strongly advise you seek their advice. Most of them have been doing what they have been doing for awhile and have a few suggestions up their sleeves.

If I can find one of my advisor appointment sheets I will scan it and share it with you all!

Resources that I made that helped me and may help you if you are learning similar content! :) 

You have permission to use them ANYWAY you think will be beneficial.

I encourage you to make your own as well!

Disclaimer: Pneumonics may offensive to some viewers. Some pictures were taken from online sources.

SHOW ME THE ORIGIN & INSERTION & LABEL

DRAW ME THE BRACHIAL PLEXUS

MUSCLE DETAILS PRACTICE SHEET

AXILLARY ARTERY BRANCHES

BRACHIAL PLEXUS

CONTENTS OF MEDIASTINUM

CRANIAL NERVES CHART

ERECTOR SPINAE

Panel Lessons to Tuck in a Special Place!

So this is my way of checking in and letting ya'll know that I'm still alive and kicking. This semester has just been a huge roller coaster for me academically and emotionally and I have not had the time nor energy to sit down and type.

Since I have about a 2 day break from school work, I decided to get on here and share what I thought was an amazing and much needed guest lecture. So, on Wednesday for my conditions class my professor invited 4 individuals to participate on a panel where each shared their "disability" experience. Although, in our profession we emphasize person before disability, it is not appropriate for me to disclose the identity of these individuals. However, I can share their conditions for those interested. TBI (ATV accident), Stroke (she had a stroke twice, each time after the birth of her children), T8-T9 SCI (skiing accident), C5-C6 SCI (car accident). As they spoke, my professor occasionally interjected and shared some of her experiences working with patients as well.  

Here is a cumulative list of many of the lessons they each had to share:

"The therapy team acts a connection. They help individuals plug themselves back into their lives."

"It's import to work with a team that can help you in areas that you are weaker in."

"The words you choose and the attitude you have as a clinician are powerful."

"Don't take away their hope. Don't give false hope. Don't lie."

"Allow families to have their faith and support them in it. You don't have to agree with their faith...it's not about you."

The patient is not the only one who can lose their identity. Traumatic events are traumatic to the whole family.

"As an OT you are the nucleus"

"Take the time to listen to caregivers, they may give you information that can enhance your therapy and thus help the patient improve."

"Therapeutic use of self is not just for the patient."

"Things may not become easier, but they can become possible, if you change your mindset."

"You can't feel sorry for your patient and you don't want to become too attached to them. It will hinder you from doing your job and your patient can take advantage of you."

"You never fail until you give up. If you don't give up you can't fail."

A journal may be helpful for patients who don't feel like they are making any progress

"Doesn't matter how bad you feel. Doesn't matter what happened when you woke up, when you drove to work, when you got to work... Leave it at the door!" 

The panel members also shared some of their not so good experiences with the medical team. It was shocking some of the stories they told. The story that stuck out the most to me is the one where the mother of one of the individuals stated that when her son was in his coma, the physician walked in sniffed over his bed and said something along the lines of "Smells like death today." :O Jaw dropper right? Yeessss!! Unbelievable smh. 

Well, that's all I wanted to share. Take care. I will update ya'll on my FWI: MH and Peds rotation soon! :)