Tuesday, May 31, 2011

Week Three!

I'm always amazed at how one day I look up and BAM! It's been weeks since I've posted. Time is flying and it's a little scary.

Week three of my first Level I Fieldwork is coming along well, I think. I'm always amazed at how little I actually know. Just when you think school has stuffed you chock full of info you go on Fieldwork and realize it wasn't enough. I'm learning diagnosis I didn't even know existed and sometimes there are 2 and 3 variations of one diagnosis.

I'm also learning that every OT and every facility has their own way of writing notes and writing goals. So, just when you get used to doing it one way, you go to another facility and their protocol is slightly different.

Please know that to date I've had 2 clients kind of tick me off by saying inappropriate things to me, however, I smiled each time and kept my cool. I can take a client being rude because they are tired or mentally impaired or don't want to do therapy, that just comes with the territory and doesn't bother me much. But when people make personal assaults, well, that ticks me off. I am a professional AND I am a student, so that puts in the position where unless they call me something really outrageous or do something to threaten my safety then I just nod my head and move on. But you future occupational therapists need to be prepared for the fact that patients say crazy things, even though they themselves are not crazy. They may catch you off guard and, as a student and future employee, it's not in your best interest to give them a piece of your mind. Sometimes you have to just smile and let the patient think they are right or let them think they know more than you. The way I see it, they are not an integral or fixed part of my life; I'll only be working with them for a short time and then it's over.

Wednesday, May 18, 2011

First day of Fieldwork - 10 tips

Before I go to bed, I want to share some brief tips with you on making your first day go along as smooth as possible:

1. Call your clinical instructor AT LEAST 2 weeks before your start date to introduce yourself.

2. Ask about appropriate attire and BE SPECIFIC. At one hospital and another pediatric site, I wore corduroy pants and both sites said it was fine. At a different hospital, the administrator had a HUGE problem with it and said corduroy's are actually jeans and are inappropriate. At some place, khaki's are okay and others they are not okay. So, ask specific questions.

3. Find out if your site requires a background check. They may ask you to pay for it and these things can be expensive so save your money and be prepared.

4. Your site may require vaccinations or titers. FIND OUT! Once you find out, DO IT immediately, assuming you don't object or have personal convictions against being vaccinated. Be sure you read the paperwork carefully. My current site requires tither/vaccinations against Rubella AND Rubeola, and YES, THEY ARE TWO DIFFERENT FORMS OF MEASLES. Only after triple-checking and calling the site did I clarify they needed both. It would have been tragic to show up and be unprepared for this. These injections and titers can get expensive so if you feel comfortable, go to a clinic, it's generally cheaper. Or, if you're at a hospital, they can do it for you--this option may be more expensive but at least you'll know you'll have everything you need and it will be done correctly.

5. Your site may require a urine/drug test. Find out how many 'panels' they require. If they require a 9-10 panel test this is more expensive so be prepared.

6. Ask your CI if there is anything you can study to prepare for the upcoming weeks. Express how eager you are to start and how much you appreciate them taking you on.

7. Review the FIM and your Manual Muscle Testing grades! Many sites use these and it comes in handy to know it!

8. If you can, submit your paperwork, titer/vaccination paperwork early so you don't have to take care of all that on the first day. If you need an ID, see if you can come in early and complete that process.

9. Do a trial run to your site! Drive, walk, bike, take the bus, whatever your mode of transportation will be during your fieldwork, take the time to do it and time yourself. It will prevent you from being late, finding/paying for parking on the first day, or getting lost. Trust me, I do this and IT IS SO HELPFUL. I even go INSIDE the site and find the occupational therapy room. This way I know EXACTLY where I am going on the first day.

10. Go to bed early the night before and get up early enough to take your time and eat a good breakfast. Many sites have set times for lunch, which can easily be 4 hours from your arrival. You may not have time for snacks because you're so busy. If you ate a skimpy breakfast you will starve and this may affect your concentration and performance. I wake up 1.5 hours before I need to leave so I can do my hair, cook and eat a huge breakfast and take my time to get ready. I don't like feeling rushed before leaving out the door for fieldwork. Also, be sure to pack your bag with everything you need so that you can just zip the bag and go!

BONUS--When it's all over-- Send a thank-you card or buy a small, but useful, gift when your fieldwork is done. Remember, taking a student is a both a burden and a blessing. Be respectful of CIs and sites that agree to take you. I ALWAYS send thank-you cards. At one site, they needed clothing for their girls so my classmates and I got together and send clothes for about a month. One girl got her Old Navy co-workers to chip in and buy LOTS of Old Navy clothes. At another site, I noticed my CI was carrying everything in plastic bags so I bought her a sturdy plastic carrying case to make things easier (only $5) and I wrote a thank-you note for good measure. At another site, I wrote about 10 thank -you cards, one for EACH PERSON that took me under their wing, even if it was only for an hour. The point is, show your appreciation in a form that is NOT email. People will remember that and they will remember you.

Good luck!

Level II Fieldwork - Day 2

So, today was my first REAL day of Level II Fieldwork. Yesterday, I took care of all the 'new person' logistic things, like meeting my CI, getting to know the building, taking a HIPAA course (which was about 2 hours!), getting keys and access to the electronic system, getting a locker, signing papers, going over expectations, meeting the other clinicians and taking a 3-hour course on using the electronic documentation system. By the time I did all of this it was about 4pm and so they sent me home.

Well, today, that was not the case! Haha! I had a FULL day. I did some ICU (Intensive Care Unit) treatments, evaluations and inpatient treatment. I did not actually DO the treatment, that comes in the next 3-4 weeks. Rather, I observed and assisted and asked a gazillion questions. I probably won't be posting much detail, due to privacy and discretion and all that good stuff, but I'll try to post the most interesting things that I see or experience so that all of you can share this wonderful Level II experience with me.

One thing I must say is that this particular fieldwork is INTENSE. At my last fieldwork, I would hear a diagnosis and it would be familiar. At this location, however, there are diagnosis that are so rare or uncommon that many times the only way to know is to ask the doctor, use the online medical database or Google it. I can definitely say I will be trained very well by the end of this fieldwork because I am learning diagnoses that I didn't even know existed. My CI confirmed that they tend to get a lot of special cases...which is good for me.

Another thing I must say is that I have been blessed with some AWESOME CIs, at this location and all my fieldwork locations prior to this one. God is really looking out for me because I have not had some of the horror or boring experiences that others have shared with me. Taking on a student is a HUGE responsibility, and in a way, a big pain in the buttocks. Taking on a student definitely slows the therapist down due to all the questions, having someone follow you EVERYWHERE you go like a shadow, explaining all the steps in the treatment process when you would normally zip right through it and then the biggee--documentation. Showing a new student how to use the system and then how to write in OT language is a huge challenge and not everyone can teach this well. My CI stayed behind an hour today just to show me how to document, to assess my clinical reasoning and to ensure that I understood what we saw, how we treated the patient and how to translate that information in a way that OTs and other medical professionals can use it for further treatment and discharge.

At the site prior to this one, my CIs were the same way. They were soooo patient and were very good and pushing me to jump right in and do it. I learned so much from them and they gave me an excellent baseline for this fieldwork.

I probably won't get to go out with my friends as often because I'm realizing all that I don't know. I'll be one Googling sister. Seriously. There's not much time for me to Google while I'm on site but when I come home I have to make the most of my time, and there's not much time in the day. I'll probably be in the bed by 9 tonight. Right now, it's 8.30 and I'm exhausted--and it's just the first day! Lol. After work, I had to run some errands, eat dinner, prepare everything for tomorrow and update this blog.

I also have all these blog notes I wrote from the last fieldwork, notes on things I observed or participated in and wanted to share with you on this blog. However, I rarely had time to log on, as you can see from my limited activity last month. Additionally, I have notes from things I learned months ago while in class, along with a ton of pictures I took of adaptive aids and devices and other interesting occupational therapy items. As you can see, none of that has been posted yet! I'm so busy. But I promise I will get it posted, slowly but surely. It's really important to me that this blog is a resource for those pursuing occupational therapy or interested in more information about occupational therapy.

I'm so sleepy and there are probably all kinds of typos and grammar errors and words missing in this post. If so, I truly apologize!

Tuesday, May 17, 2011

First Level II

I started my first Level II today! Whooooooo...scaaaaaary. But, so far, l'm loving it! It's only been one day, but still...

All day, I kept thing that this is it. This is LEVEL II. I finish this fieldwork in August and then I start the second Level II and then...graduation...and then real life. I'm a second career occupational therapist, I don't know why I treat this as if it's my first job.

More importantly, this is Level II and this is the real thing. My last three Level I's were more like practice. I observed and I asked questions. I performed some evaluations, planning and interventions but not every day and not with every patient. This time, however, it's a bit different. The first 2-3 week will be observing, asking questions and working with a few patients. But, by week 6, both my school and my CI (clinical instructor) will expect me to have a caseload, as in a minimum of 8 patients that are my own. My CI reviews everything I do, of course, but for the most part there will be many, many, many times when I am alone with the patient and need to use my professionalism, knowledge and clinical reasoning/judgment.

Thankfully, this will be an interesting and fun experience. I can't wait to get into the groove of things. I'm really looking forward to it.