fieldwork

This is the last day of my 100 hours I had to complete for my fieldwork. I was once again in the rehab gym with the COTA/L , which I have learned a lot from her, her experience and time in the OT field really shows with the educated, and appropriate tx she applied c the different dx. We were working with TKR and had them practice on the AE they were educated on the tx a to see if there were any issues that needed to be addressed. We also did dowel rod exercises, and I ran the arm group c the therapist observing.

The last hour of the day was once again in the mental health unit, we played dice c the pts which they seemed to enjoy.

I was with the COTA/L and we stayed in the rehab gym area. We worked c pts who had TKR, and CVA. The COTA/L addressed the goals that were in UE drsg, and LE drsg. She showed the patients how to use AE such as the sock aide, drsg stick, reacher, and long handled shoe horn. Some of the patients were receptive to it, but some refused to use the AE. We also did shower/tub transfers c the pts, the goal was to show them the a safe way to get in and out of the tub using a tub bench.

I also attended the rehab team meeting which addresses the pts progression or regression in their therapy tx. It was a good experience for me to see how all of the therapist come together and make a whole team decision in the pts placement, and care.

The last thing we did today was go to the mental health unit. I went with the COTA/L and an OT/R student. The OT/R student was running group therapy, and she had them do paint staining. The pts were all receptive to the tx and enjoyed what they were doing.

Fieldwork was very educational this week, I was with the COTA/L and we treated 4 patients in the 5 hour time frame I was there. We took 2 patients into the kitchen to do light homemaking task, and also address safety issues if any were seen, and educated them on the more safe way to open the refridgerator door or cabinets and how to safely transfer items from one counter to the other. We had a patient make muffins, which she gathered the supplies, mixed the batter, put them in muffin holder, and popped them in the oven. It was educational to observe how the COTA/L addressed unsafe situations and helped the patient adapt to her physical limitations.

Today I was in the rehab gym with the COTA/L. She had a group of patients who was doing arm excerises with a dowel rod. After we took a patient to do some homemaking skills in the rehab kitchen because she was getting ready to be discharged and the therapist wanted to observe her safety awareness and her level of indepedence. The patient also did a shower transfer.

The next patient we worked with she did donning and doffing of her shoes, and socks and also pulled a pair of pajama pants over her pants. She used adapative equipment to perform these ADL’s task. She did a tub transfer using a tub chair to get in and out.  While working the patient the therapy had me look over her chart t see what goals need to meant and what goals to work on.

The next patients I worked with the OTR/L. He had the patients do dynamic standing hitting a balloon back and forth to each other. We did toilet transfers, therapeutic excerises and activities for the remaining of the treatment session.

Lastly, the COTA/L had me fill out a discharge paper, filling out the final FIM scores and also a treatment paper for the treatment team meeting on the patients that we worked with for the day. I also attended a treatment team meeting.

Today at fieldwork I got to to see E-stim on a stroke patient. It is very interesting to see. The therapist placed the E-stim pads on his deltoid, trapezoid, and bicep area, and than she set the amout  of eletricity she thought was appropriate for the patient. After all that was complete and ready to go you could visually see how the eletricity was going through his muscles and would lift his arm about .5 inches. The purpose of doing this is to wake the muscles up and have the brain interpret that movement to hopefully regain the movement back in that arm. The treatment time for that was 15 minutes, with 10 seconds of stimulation, and 20 seconds of rest intervals.

I also got to experience Fluid-o-therapy. This is a therapeutic treatment that helps with edema, decreaing pain, muscles spasms, and musculoskeletal disorders of the extremities. It uses dry heat with solid particles that evenly distribute the extremity. The therapist had me put my arm in the machine while it  was running and it in fact is very relaxing, and therapeutic.

I was with the OTR/L

We were in the rehab gym all day. There were 5 patients seen all together with different levels of functioning. One patient has had CVA to the left side and what we did with her was sit her on the mat and have her kick the ball focusing on using her left leg as much as it will allow, the same with her left arm we used a ballon to hit back and forth, although she is not able to move her left arm the main focus was to hit the balloon as far left as possible so she could scan to the left side. Her sitting balance was also being worked on. The therapist also used a vibrator on the patients left arm and her scapula to wake the muscles up, as she is doing this you can see noticable movement in the patients arm and fingers. The therapist states to be careful that you do not use to much vibration on the muscles as it could do the opposite.

The other patients we saw were high functioning, they needed to increase their endurance and home managing skills so we worked a lot in the kitchen with them and had them doing homemaking task, such as folding towels, picking stuff up off the floor, getting a glass of water, putting stuff away into the cupboards, refridgerator, making small meals, and educating them on safety techniques. We worked on their strength by using the hand bicycle, doing dowel exercises 2 times 20 and also had them do dynamic standing at the table.

I was with the COTA/L and we were it the mental health unit all day.

From 9am to 12pm we did group therapy with the patients and the therapist had them do goal oriented worksheets, not all the patients participated many of them walked in and out during the group therapy. The patients that did participate the therapist had them complete the worksheets and talk out loud to the group what they wrote and why and how they feel. A lot of the session was interacting with the patients talking and listening with them.

From 1pm to 2pm we did another group therapy session but this time we played the game “Jenga” and on each piece they pulled out was a open ended question that they had to answer with a positive statement, if they answered with negativity they were highly motivated to answer again with something positive. The patients seemed to like playing and were all interacting with one another in a postive way. 2pm the therapy session has ended.

My first day at fieldwork was quite an experience. I got to follow along with two well educated Occupational Therapist with years of experience in the field of OT. I observed a patient  utilizing a sit to stand machine which holds the patient in a standing position to strengthen the muscles in the leg, which in the future can aide the patient in becoming independent with furture ADL’s  and goals. I also observed the OTR doing extensive stretching on a patient with increased tone in his left arm secondary to a CVA, the OTR showed me where to place my hands on the patient, and to focus on the muscle belly while stretching.

The mental unit was the last portion that I got to observe, that is a site among itself. There were so many different behaviors I got to observe, which is an experience for me as I have never been around these behaviors. The therapist did a therapeutic activity which involved a group discussion, and than later on in the day did another group therapy activity which involved playing a board game. All of the patients interacted and acted appropriately among one another.

That was my first day a fieldwork!

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