This is my second post in 2 weeks! Such productivity! But, if I'm completely honest, this post probably wouldn't have happened had it not been an important milestone. Well, important to me, anyway. Important to my career as a grad student.
So, here's the thing, you may remember me mentioning that my first semester of graduate school was the summer of 2015. As a summer semester, it was 10 weeks as opposed to the typical 15-week semester during the regular school year. 10 weeks filled with gross anatomy, mostly. Hanging out in the lab with the cadavers. And by hanging out, I mean furiously working to memorize the origin, insertion, actions, blood supply, and innervation of every muscle of the body, in addition to being able to actually recognize them in a real body. Of course, we had other classes that summer, but gross anatomy is the one that really stuck out, probably because it was the most time consuming. But, it was lots of fun! Really!
But I have shamefully digressed. So, first semester of OT school = 10 weeks. Well, this week, I will be beginning the final 10 weeks of OT school. Where has the time gone? One never knows. So, in my mind, as someone who likes to memorialize and place significance on various dates, this week marks the beginning of the end of my career as an OT student. Yikes. But also, yay!
In addition to going off on long sentimental digressions, I also want to say a few words (haha, a few words) on my second fieldwork experience thus far. Two weeks in, and I am quite enjoying it! It's definitely been an adjustment, though. Going from the school setting where I worked with kids on academic occupations, to skilled nursing facilities where I'm working with older adults on ADLs.
I think the most difficult part has been adjusting to the documentation style, and the concept of productivity and having to balance treatments and interventions with evals, progress notes, and discharges. I'm finding that it's really easy to get caught up in the paperwork side of things (while it does require detail and attention, because insurance), and forget about the occupation-based foundations of our profession, especially because of the rehab-heavy nature of the setting. However, I am determined to keep all my treatments as occupation-based as possible, because, as we know, nothing really beats actually doing the occupation to improve safety and independence in that area.
And, really, I've done mostly evaluations and discharges thus far, because both SNF's that I am at have certified OT Assistants (COTA's), who carry out the majority of the treatment interventions. But I think I'll address COTA's in my next post, as it could take a while, and they are an important part of our profession, and I want to do them justice!
But, for now, just a little bit about my typical day and the patients I have been working with. I start my day at a SNF that's a bit of a drive from my house. So I generally get up at 5:30 and am on the road by 6, to make it there by 7. Which, despite feeling less-than-thrilled at 5:30 am, I do really enjoy. First of all because I'd rather start early and end early at 3, and second because I enjoy seeing the sunrise. Third, because the drive is a beautiful journey through the countryside, and there are lots of baby cows. We see patients at that location, and then we drive back in the direction of my house about 25 minutes to another SNF, where we also see patients. And we're usually finished around 3.
A skilled nursing facility (SNF) is kind of a step-down setting for people who have undergone recent hospitalization and are not yet ready to return to their prior residence because they require therapy to get them back to their prior level of functioning. Most of our patients have things like joint replacements (hips, knees), strokes, falls, etc., and most of them are in the older adult population. And, they are lots of fun! I had one lady offer me a can of V8 juice when we were doing her evaluation, "Honey, could you pass me a V8 juice? Would you like one? Let's all have some V8 juice!". I declined, of course, not being a particular fan of V8 juice, but it was a kind thought all the same.
I imagine I'll have plenty more stories to tell in the coming weeks, but for now, I must bid you adieu! I have to go study for the certification exam (so much fun.). Haha.
Sunday, April 23, 2017
Friday, April 7, 2017
Entry-level school OT
I am happy to report that I passed my first 12-week fieldwork placement. Which means I have the competency, when I pass the OT licensing exam, to be an entry level school-based OT practitioner. Whew.
It blows my mind how quickly the past 12 weeks have gone. I do wish I had published a few more posts during that time, but what with the busy-ness of fieldwork itself, and unforeseen family circumstances, it just didn't happen. Ah well, I can just write a lot right now to make up for it (I can almost hear your gasp of dismay, and while I'm tempted to be merciful, the writer's egotistical need to write all the words is stronger). Haha.
The truth is that it's rather sad to have to say goodbye to the students, teachers, and staff that I have met, worked with, and befriended these past three months. Willy Shakes (William Shakespeare, to clarify) really hit the nail on the head with "parting is such sweet sorrow". Because it's also true that I have had a blast these past three months, and I've learned loads and loads of new information and new skills, and learned things about myself that I didn't even know existed. And, additionally, I am incredibly excited to move on to my next fieldwork site (you'll have to keep reading until the end to find out more about that, I'm afraid).
What have I learned? What haven't I learned? The list on the latter is quite a bit smaller than the former. But I would like to focus on a few things. The first is something modest and unassuming, and, to be honest, something I wasn't so hot on in school. And that is activity and task analysis. As one of my professors was so fond of saying, "It is the bread and butter of OT." And we (my classmates and I) were all like, "Yeah, sure, whatever. Moving on." But, as much as I hate to admit that I was wrong, I was wrong. I was completely wrong to discount activity analysis. There. I've said it.
Activity analysis is a special skill/superpower that OT's have that enable use to look at any activity or task and break it down into individual steps to facilitate identification of the strengths, weaknesses, issues, challenges, and basically develop a target area for creating goals and interventions for treatment. Back in school, we we were like, "Why are you making us write a list of all the steps that make up filling your car with gas?" But it's real! If you're not able to fill your car up with gas, you could just say, "I can't do it", or you could identify exactly which parts of the task you are struggling with, and then figure out a way to fix it.
In my experience, we'll have parents who come to us and say, "My kid can't tie their shoes. My kid can't write a sentence." etc. What information can you glean from that? Not much. As OT's, we observe the performance, or attempted performance of these tasks, and we can identify exactly where they are having struggles. When one of my students was struggling with filling out a crossword puzzle, I was watching him, so I knew that it was the vertical vs. horizontal aspect that was tripping him up. While this was something I wanted him to work on, I also wanted him to be successful in the activity. Instead of only having him write the horizontal words, I provided him with the correct words. So he didn't have to worry about figuring out the answers to the clues, he just had to worry about writing them in the correct orientation. Which was totally fine, because I wasn't working on answering clues, I was working on visual-spatial perception and reasoning.
Which brings me to Thing Number Two that I learned. The importance of grading activities. Grading refers to adapting the activity to make it easier or more difficult, depending on the student's skills and abilities, and success with the activity. Like my student with the crossword, I realized that I needed to grade it down (make it simpler) for him to be successful, while still being challenging. Some of my other students needed things to be made more difficult to challenge their skills. That's where the whole concept of the "just right challenge", that is so integral to the OT profession, comes into play. We want to challenge our clients just enough so that they become more skilled, knowledgeable, strong, etc. But we also don't want to make it so hard that it's impossible, or just very demoralizing to attempt to attain success. Thus, we want the challenge to be "just right". Difficult enough that it's a challenge, while not being impossible.
The third thing that I have learned is the value of a cool head and calm demeanor. Now, these are not attributes that, if you asked my family to describe me, they would use. But that's just because in my non-professional life I tend to be dramatic and sometimes go into long tirades of righteous anger towards some systematic injustice or other. And I most certainly do have a flair for drama, but that's something I indulge in for fun. Not part of my daily life. Just a personality quirk that many would label as obnoxious. But yes, I believe I am a fairly level-headed individual. And I never really realized it or thought about it until I began working with a student on my caseload that is quite physically aggressive. Keeping a cool head was absolutely necessary, both to redirect the student, and prevent any lasting effects of the behaviors on my confidence as a practitioner. All in all, I realized I could deal with a lot more than I thought I could. Which was quite gratifying.
Another thing I learned was to appreciate the baby steps. Each client, or, in this case, student, has their own unique skills, needs, and background. And, consequently they all progress through OT at different speeds and levels. So, I found myself getting super excited when one of my students made a perfect uppercase "B". Like, really excited. All the enthusiasm and cheering (but quiet cheering, because we share our OT room with the resource teacher, so we have to contain the noise level). And I was equally enthusiastic when another of my students figured out a really complex jumbled-picture puzzle. It's all relative. And it's all good.
And now I've come to the most important part. And that is the amount of gratitude that I have, for the experience itself, but most of all for the students, staff, and teachers that I have gotten to know and learned from these past 12 weeks. I can't imagine a better Level II experience in a school setting. I was very blessed to have had an extremely knowledgeable fieldwork supervisor who, while being an excellent OT practitioner, also cares boundlessly for the students she works with. She was flexible and adaptive with her supervision style-- as the weeks progressed and I became more competent, I was given more responsibility and expectations were increased. Because of her, I have the confidence in my own competence as an entry-level school-based OT practitioner. The rest of the staff and teachers at my school(s) were equally welcoming and supportive throughout my time there, and I am forever grateful for that. And, of course, the students. It is perhaps from them that I learned the most. I will never forget them.
Enough soppiness for the present. Now comes the next adventure. The next 12 weeks of my life, I will be a Level II OT student at two different skilled nursing facilities. "Working with grandma's and grandpa's" is what I have been telling my students, since it's very difficult for them to understand why I'm leaving. (One of the kindergartners was like, "So, you're retiring, Miss Fiudo?"). But yes, for the next 12 weeks I will be dividing my time between two different skilled nursing facilities (SNF). This Monday, I will be arriving at one location at 7 am. It is a 50-minute drive from my house. Yay for long commutes! The great thing is that my school fieldwork was a good 30-40 minutes away, so I'll just be slightly extending that time for this one. I am a little nervous because I haven't done hard-core physical medical stuff in a while. But I'm planning on reviewing my course material over the weekend! I'll try and post again in the next 2 weeks to give a first-impressions-rundown. Cheers!
It blows my mind how quickly the past 12 weeks have gone. I do wish I had published a few more posts during that time, but what with the busy-ness of fieldwork itself, and unforeseen family circumstances, it just didn't happen. Ah well, I can just write a lot right now to make up for it (I can almost hear your gasp of dismay, and while I'm tempted to be merciful, the writer's egotistical need to write all the words is stronger). Haha.
The truth is that it's rather sad to have to say goodbye to the students, teachers, and staff that I have met, worked with, and befriended these past three months. Willy Shakes (William Shakespeare, to clarify) really hit the nail on the head with "parting is such sweet sorrow". Because it's also true that I have had a blast these past three months, and I've learned loads and loads of new information and new skills, and learned things about myself that I didn't even know existed. And, additionally, I am incredibly excited to move on to my next fieldwork site (you'll have to keep reading until the end to find out more about that, I'm afraid).
What have I learned? What haven't I learned? The list on the latter is quite a bit smaller than the former. But I would like to focus on a few things. The first is something modest and unassuming, and, to be honest, something I wasn't so hot on in school. And that is activity and task analysis. As one of my professors was so fond of saying, "It is the bread and butter of OT." And we (my classmates and I) were all like, "Yeah, sure, whatever. Moving on." But, as much as I hate to admit that I was wrong, I was wrong. I was completely wrong to discount activity analysis. There. I've said it.
Activity analysis is a special skill/superpower that OT's have that enable use to look at any activity or task and break it down into individual steps to facilitate identification of the strengths, weaknesses, issues, challenges, and basically develop a target area for creating goals and interventions for treatment. Back in school, we we were like, "Why are you making us write a list of all the steps that make up filling your car with gas?" But it's real! If you're not able to fill your car up with gas, you could just say, "I can't do it", or you could identify exactly which parts of the task you are struggling with, and then figure out a way to fix it.
In my experience, we'll have parents who come to us and say, "My kid can't tie their shoes. My kid can't write a sentence." etc. What information can you glean from that? Not much. As OT's, we observe the performance, or attempted performance of these tasks, and we can identify exactly where they are having struggles. When one of my students was struggling with filling out a crossword puzzle, I was watching him, so I knew that it was the vertical vs. horizontal aspect that was tripping him up. While this was something I wanted him to work on, I also wanted him to be successful in the activity. Instead of only having him write the horizontal words, I provided him with the correct words. So he didn't have to worry about figuring out the answers to the clues, he just had to worry about writing them in the correct orientation. Which was totally fine, because I wasn't working on answering clues, I was working on visual-spatial perception and reasoning.
Which brings me to Thing Number Two that I learned. The importance of grading activities. Grading refers to adapting the activity to make it easier or more difficult, depending on the student's skills and abilities, and success with the activity. Like my student with the crossword, I realized that I needed to grade it down (make it simpler) for him to be successful, while still being challenging. Some of my other students needed things to be made more difficult to challenge their skills. That's where the whole concept of the "just right challenge", that is so integral to the OT profession, comes into play. We want to challenge our clients just enough so that they become more skilled, knowledgeable, strong, etc. But we also don't want to make it so hard that it's impossible, or just very demoralizing to attempt to attain success. Thus, we want the challenge to be "just right". Difficult enough that it's a challenge, while not being impossible.
The third thing that I have learned is the value of a cool head and calm demeanor. Now, these are not attributes that, if you asked my family to describe me, they would use. But that's just because in my non-professional life I tend to be dramatic and sometimes go into long tirades of righteous anger towards some systematic injustice or other. And I most certainly do have a flair for drama, but that's something I indulge in for fun. Not part of my daily life. Just a personality quirk that many would label as obnoxious. But yes, I believe I am a fairly level-headed individual. And I never really realized it or thought about it until I began working with a student on my caseload that is quite physically aggressive. Keeping a cool head was absolutely necessary, both to redirect the student, and prevent any lasting effects of the behaviors on my confidence as a practitioner. All in all, I realized I could deal with a lot more than I thought I could. Which was quite gratifying.
Another thing I learned was to appreciate the baby steps. Each client, or, in this case, student, has their own unique skills, needs, and background. And, consequently they all progress through OT at different speeds and levels. So, I found myself getting super excited when one of my students made a perfect uppercase "B". Like, really excited. All the enthusiasm and cheering (but quiet cheering, because we share our OT room with the resource teacher, so we have to contain the noise level). And I was equally enthusiastic when another of my students figured out a really complex jumbled-picture puzzle. It's all relative. And it's all good.
And now I've come to the most important part. And that is the amount of gratitude that I have, for the experience itself, but most of all for the students, staff, and teachers that I have gotten to know and learned from these past 12 weeks. I can't imagine a better Level II experience in a school setting. I was very blessed to have had an extremely knowledgeable fieldwork supervisor who, while being an excellent OT practitioner, also cares boundlessly for the students she works with. She was flexible and adaptive with her supervision style-- as the weeks progressed and I became more competent, I was given more responsibility and expectations were increased. Because of her, I have the confidence in my own competence as an entry-level school-based OT practitioner. The rest of the staff and teachers at my school(s) were equally welcoming and supportive throughout my time there, and I am forever grateful for that. And, of course, the students. It is perhaps from them that I learned the most. I will never forget them.
Enough soppiness for the present. Now comes the next adventure. The next 12 weeks of my life, I will be a Level II OT student at two different skilled nursing facilities. "Working with grandma's and grandpa's" is what I have been telling my students, since it's very difficult for them to understand why I'm leaving. (One of the kindergartners was like, "So, you're retiring, Miss Fiudo?"). But yes, for the next 12 weeks I will be dividing my time between two different skilled nursing facilities (SNF). This Monday, I will be arriving at one location at 7 am. It is a 50-minute drive from my house. Yay for long commutes! The great thing is that my school fieldwork was a good 30-40 minutes away, so I'll just be slightly extending that time for this one. I am a little nervous because I haven't done hard-core physical medical stuff in a while. But I'm planning on reviewing my course material over the weekend! I'll try and post again in the next 2 weeks to give a first-impressions-rundown. Cheers!
Subscribe to:
Comments (Atom)