Last entry for my level one fieldwork and overall it was a great experience. I feel very blessed and fortunate that I had such a great site and great people surrounding me. I hope that I have a good experience on my level two fieldwork also.

            I wanted to share with you all an experience that I had on my last two days. We were dealing with a patient that was schizophrenic, Alzheimer’s, and some major arm, neck, and leg contractions. (Don’t know how it happened, couldn’t get much information on a diagnosis)

            The last 15 minutes of my shift we were to go into this person’s room and stretch her arms. It was sooooooo sad!!! I was told that this person couldn’t tell what was going on around her. We walked right in, moved her bed out, and grabbed her arms and started to stretch.

            I was really disturbed by this and I know my supervisor could tell that it bothered me. (I think that’s why she told me the pt. didn’t know what was going on around her.)  There was no talking to the pt. Just do what you gotta do and go.

            I couldn’t believe how this affected me and how upset that I got. I went home that evening and shared with my husband about it. I told him that no matter what the circumstance is, I will talk to my pt. and let them know what was going on.

Discontinuation Note:

Stacy will continue to work on her OT documentation and muscles twice a week throughout the summer.  She will attend summer classes to finish her business degree.

Stacy Wintgens S/OTA

This week I am opting to write a narrative because I was able to do some interesting things and I wanted to share them with you all.

First off, at my facility we have a resident (MRDD/AIDS) who is not at all cooperative with going to therapy everyday. She is always too tired, sick, or her hip hurts. Well, on this particular day I got to go to her room at 9am and ask her if she was ready to go to therapy. Of course she gave me the same song and dance that she always does but I managed to get her smiling and put her at ease. I told her if she came to therapy and cooperated with me, that I had a special surprise for her. One of the ladies had brought in her puppy and I was going to let her hold it. Needless to say…… that brought her right out of bed. I didn’t hear her complain at all. She even walked all the way to the therapy room with her walker!

So once we got down there, I told her that I needed her to take off her shoes and socks for me. Once again she started to buck and resort back to her old ways. I asked her again and she tried argued with me. I told her to look over there and see what was in that cage. Her face lite up and she kicked off her shoes immediately. She had a hard time dressing her left foot because of her hip replacement. So I let her do what she could do and then I helped her. When we were finished, I told her great job, nice attempt, and I gave her a high five. She really likes that.

After that I got to take her out to the court yard and we planted a vegetable garden. She did a good job and was in a great mood. She liked the high five thing and it made her feel more at ease with me. Since she did what I asked her to do and she didn’t give me too much grief ……. I let her hold the puppy!!! She was sooooo happy!!! It was wonderful to see her with a smile on her face. She told everyone that she saw on this day about planting the garden and holding the puppy.

What I got out of this day is………some patients just need that extra positive reinforcement, encouragement, and sometimes a little enticement.

Progress Note:

Got to see “pet therapy” , planted veggie garden with residents, cleaned therapy room, served lunches and cleaned up mess, worked on UE strenthing activites with resident, and reviewed more documentation.

Stacy Wintgens S/OTA

This week I got to sit in on a department meeting. It was really interesting. Everyone involved (physical therapy, occupational therapy, and speech therapy) went around the room and discussed the patients that are currently being treated. They talked about their progress, declines, dismissals and family concerns. They also discussed any department concerns and possible new residents coming to the facility.

S: Am I ever going to understand all of this documentation?

O: Client participated in a 1 hour meeting discussing patient’s progress, declines, and family’s request. Also client observed multiple residents files to review documentation methods.

A: Stacy has not yet achieved proper documentation methods. During meeting she maintained full attention and was able to focus on discussions.  

P: Encourage client to practice documenting.

Stacy Wintgens S/OTA

This week was a slow one for me at my work site. The one day, I spent my time sewing splints. The next day, I got more interaction with the patients. On this day I got to again work on UE strengthening like lifting weights. I also got to work on a patient with balance, so I had her stand and cut coupons.

The next patient is in our short term care unit. Her family said that she needed to be able to take care of her own bills. So I got to work with her on budgeting. I also had her pay bills and write out checks for me. (She really had difficulty with this)

On Fridays the therapy department supplies lunch for all of the employees and if they want it, they pay 3$ per meal. This is to raise money so the therapy department can get a kitchen. I think this is a great idea and I love the fact that everyone in the facility is working together to achieve this.

Progress Note:

Worked Tuesday and Friday, worked on how to sew and repair splints, worked on cognitive skills with resident, and cleaned therapy room.  

Stacy Wintgens S/OTA

This week was a really good learning week for me. I got involved in a few different things.

I got to assist giving a resident a shower, I helped a patient practice paying her bills,  I got to take residents outside for therapy, and I had to come up with some purposeful ADL’s & occupation based activities for  residents .   

Here is an example of a purposeful activity that I did. I took some close pins of different strengths and placed them on a table on both sides of her. Then I had the resident take the close pins from one side and pin them on the pulley cord in front of her.  I had her place 10 at the top and 10 at the bottom of the cord. This worked on her ROM, UBS, fine motor, coordination, manipulation, and most importantly her balance since that was my goal. I did stand by assist. By doing this activity I was wanting to simulate putting groceries away.

Here is an example of a occupation-based activity that I did. I took pegs of different sizes and shapes and threw them all over the floor. They went everywhere… under the tables, beds, and chairs. I gave the patient a broom and dust pan and told her to sweep them up for me. This activity worked on her balance and her right side visual impairment. This lady was a good sport. She told me that I was a slob!!! 

(I also had a different patient clean off the pegs that I dropped all over the floor for another occupation-based activity)

Progress Note:

 I got to plan activities for the patients to do and work on a one on one basis with them, I am reviewing more patients records, and I am trying to pick up more on OT terms.   

Stacy Wintgens S/OTA

Week three was an interesting one…… so let me tell you about it?

I feel that my supervisor is realizing I am there to help, sooooo she has started to take full advantage of me. (In a good way) I am now getting more comfortable with the facility and all of the residents that we see on a day to day basis.

They now have me going and getting certain patients from their rooms and bringing them down to do therapy. Some are more eager to come than others and that was an experience in itself. J

I have one lady that I went to get, I introduced myself to her, told her what I was going to do and she said to me, “So I am going to be your guinea pig”. I then took her down to therapy and went through her routine with her. She told me when I took her back to her room, “You did alright honey”. It was also funny because she told me exactly what I needed to do for her. For example I needed her water, call light, wheelchair legs down, remote, and phone by her side. So for my first patient, she was a good one to have and I am sure that Mandy (my supervisor) knew that.

I also got to go get my AIDS/MRDD patient. She is a pickle. J I told her that I was going to get her ready and take her down to therapy. Well she told me adamantly that she did not want to do therapy today! I told her I would give her 15 minutes to finish her lunch and I would be back to get her. (She already had her tray for over an hour)  Well needless to say, she wasn’t ready to come. What I did to handle that situation…. I went and got the professionals and let them take care of it.

Another thing I got to do was a beside commode transfer. This lady had a hip replacement on her right side and has dementia. My supervisor and I worked simultaneously as she lifted her upper body up and I moved her legs to the ground. We then pulled over the commode and assisted her with pulling her clothes down and helping her onto the commode. It made me realize that I am sure vanity is the first thing that goes when you are in this situation like that. Up until now, I have left the room when the OTA was doing this, but I realize that I am going to have to do this, so I might as well try and learn from it now. I was a little embarrassed at first, not for me, but for the patient. I didn’t want them to feel uncomfortable with me.

Then I got to “supervise” therapy sessions with some patients on an individual basis. What I mean by that is, my supervisor gave me a list of activities/exercises for particularly patients and I got to work the entire time with them to do the exercises.  My supervisor was close by of course to make sure that everything was going smoothly, but she did not step in much. I got to lift a patient from the wheelchair (using a gait belt) with her walker in front of her while she was doing a puzzle. (I used CGA) I also got to go to a patient’s room and go through her entire routine with her. (My supervisor would stop in every few minutes and check on us) It was really different to see this particularly patient in her room than down in the therapy room. Her personality really came out when it was just her and I. When she is in the group therapy, she is very quiet and reserved.

Overall, I had a great third week. The residents seem to like me and always tell me that I have a smile on my face.

Oh yeah, before I forget, I got to educate a patient on how to use a sock aide and shoe horn. She was so excited that she is now able to do this small task on her own.

Progress Note:

Took patients to therapy, worked one on one with some patients, experienced more unhappy aggressive residents, assisted with bed side commode transfer, reviewed hard charts of patients, worked with patients in their room, educated patient on how to use sock aide and shoe horn, and final got patient “D” out of his room.

 Stacy Wintgens S/OTA

Week two was good. I got to be more involved just like they told me I would. I was supposed to go to a “sister” faciltiy on Friday, but I did not get to do that. I finally got to meet my original contact person. She seems pretty nice.

My first day with her, she changed my hours. That way I will be on site the days that she is there. Changing my hours was really not a big deal, so I think it will still work out for the best.

Mandy (my supervisor) acually had me going to patients rooms and asking them if they were ready for therapy. If they were ready I was to bring them. I was a little nervous about that because I was afraid of transfering them on my own, however, it worked out for me because all the patients were up and in their wheelchairs ready to roll!

My supervisor also had me working with patients one on one through their therapy. Mandy would tell me what she wanted me to do and I walked them through their excercises. For example, I needed to work on ROM and upper body strentgh with one patient. So I had the patient with 1lbs. weights lift their hands above their head as far as possible. We did 3 sets of 10 and so on. I sat in front of them and did the excercises with them because their cognitive level was low. I gave the patient positive feedback (smiles and verbally) and let them know that they had done a good job.

I also witnessed a patient being defiant. He was doing his PT and was not cooperating with the staff. The PT moved his oxygen about 5ft. from his chair, made him get up with his walker, and told him that they were going to try and walk some. Well, he kept saying that he didn’t want to walk. So the PT stood by him  hanging on to him and made him walk some. Well the patient took maybe 5 extremly small steps and decided he was done and he was going to sit…….. without a wheelchair behind him. So the patient “accordianed” and sat…. not fall. He was done and that was it! The PT yelled at me to help. So I got the wheelchair behind him while she held him up and then another PT came over an helped lift him back onto his chair. I was scared!!! I didn’t really know what to do! Then, the PT that was working with the patient sat right in front of him on eye level and told him that he could have seriously gotten hurt!!! Never to do that again!! If he needed to sit, then we would let him sit. Come to find out, this patient has a history of doing this. If he doesn’t want to do something then he won’t do it.

Progress Note:

Finally met orignial supervisor that I was assigned, got more involed one on one with patients, got to observe other disciplines, set up an activity for a patient (planting flowers in pots), cleaned hot pack equipment, and cleaned other activity equipment.

Stacy Wintgens S/OTA

Well, I started and finished week one of fieldwork! Yeah!!

I am surprised of the things that I saw and the different emotions that I had while on my first day. When I first got there, I was excited and very nervous. Not sure of what I was going to be doing and not sure of what to really expect. As I went around meeting the staff and residents my nervousness started to go away because everyone was so friendly and made me feel very welcomed.

Then as the day went on and I was seeing different residents with different diagnosis, I started feeling sad! Some patients was eager to come to therapy and get better and some…… not so eager. Some patients had a great sense of humor and were able to cut up with us. Some patients were mentally capable of carrying on a conversation and others…… could not speak at all!  It made me sad because I wanted to help them and I want them to get better. I have to realize that the patient has to want to get better and as a therapist I am not going to be able to do it for them.

Some things that I did on my first week:

- Lots of observing, played pass with pt’s.,  played balloon volleyball with pt’s. , learned how to switch out oxygen tanks, went over some pt’s charts, had a complete tour of the facility .

Different diagnosis that I saw:

- Parkinsons Disease, Aids, COPD, CVA, Hip pin, Amputations, Dementia

Overall my first week experience went great!! She told me that I have an assignment to complete for them by the end of the quarter. She  also told me that next week I will be working on how to transport patients (which I have never done before) and be getting more interaction with the patients. I am really excited and really nervous…………… I just want to do well!!

Initial Notes:

Started fieldwork, met with Nancy (original contact person not there), took tour of facility, met staff, talked about fieldwork hours and reviewed syllabus.

Stacy Wintgens S/OTA