My OT World @iloveot-blog - Tumblr Blog

The Evolve Project

By Erin Niland:

The Evolve Project aims to prepare and enable students aged sixteen to eighteen years to take on leadership roles by exposing them to outdoor activities, business pursuits related to outdoor wilderness, and outdoor employment opportunities in the Salt Lake City area. The Evolve Project has partnered with local businesses, the University of Utah, and the Salt Lake City School District to ensure that students exiting the program are better equipped to master the skills necessary post high school graduation.

The occupational therapist’s role should be to identify group needs and apply appropriate interventions to facilitate independence at the group and individual level. Examples include employment and educational exploration, skills related to seeking out and acquiring a job, and communication skill building to maximize safety in an outdoor recreational activity.

This experience was a great example of understanding our scope of practice and whether or not we can provide skilled occupational therapy services :)

Perseverance. Accountability. Resilience. Fellowship. Opportunity. Respect. Empowerment.

PAR FORE is an integrated occupation-based gang prevention mentor program. PAR FORE was developed utilizing current and best evidence practice in occupational therapy, cognitive behaviorism, social justice and psychology. The program incorporates concepts in environmental adaptability, delinquent resiliency, self-esteem building, and self-determination, civic engagement, and community service learning.

Program objectives

Empower youths to develop a sense of self and resilience

Develop productive social networks

Develop skills necessary for anger management and conflict resolution

Develop respect for self, family, and community members

Develop a moral and ethical character, pride, and virtues

Develop a sense of civic-mindfulness

Develop constructive behavior – yielding positive attitudes, healthy lifestyles, and engagement in healthy occupations

Occupational therapy students from the University of Utah and Colorado State University provided life skills lessons before the start of every session. Social work students from the University of Utah also helped to support the success of this program by working in mentorship roles with the participants. Life skills training topics included activities and discussions about the core values of the program, teamwork, the importance of education, verbal and non-verbal communication, managing stress, as well as golf etiquette. After each life skills activity, the Rose Park golf staff provided a one- hour lesson at the driving range or on the golf course. The kids participating in the program had no prior experience with golf and were thrilled to get a chance to learn new skills in an outdoor setting away from the urban environment where they generally spend their time. Over the course, the participants not only learned a great deal about the game of golf, they learned to work in cooperation and support of each other and had a really great time. Many lessons were learned but what everyone remembers best is how much fun we had!

All information above is from: http://www.parfore.org/

I enjoyed working with these youth :) They were so much fun and I learned so much. Sometimes we focus so much on physical or cognitive barriers and not so much on other risk factors like environment or socio-economic status. Some youth are at-risk for joining gangs or getting incarcerated. This program gives this population an activity to get involved in and indirectly prevents them from joining gangs or getting involved in other activities (i.e. stealing, drugs, etc.) They learn life skills from the program that they can apply wherever they go and at the same time have so much fun (like kids should) playing golf :)

Goodbye Utah. Hello "Life-long inspired journey"

This experience was really life-changing. It sounds corny, but it was. I learned so much in this setting and saw how valuable OT is. We are so skilled in task-analysis and are client centered that we empower people of refugee status become independent and self-sufficient. It definitely takes patience, compassion and a strong belief in occupation and doing that our clients are successful.

There were various organizations that I worked with:

1. UHHR (Utah Health and Human Rights) is "a direct service and advocacy agency that promotes the health, dignity, and self-sufficiency of refugees, immigrants, asylum seekers, and asylees who have endured severe human rights abuses, including torture and severe war-related trauma." http://www.uhhr.org/

2. Hser Ner Moo Community Center: "one of the 9 neighborhood sites of Promise South Salt Lake, serving the community in South Salt Lake. It was created after the tragedy that happened in March 2008. A little refugee girl from Burma named Hser Ner Moo was found dead near her apartment after she went missing. The Center was dedicated and is carrying her legacy to keep kids safe when they are out of school and to help refugee and immigrant families integrate in their new society. The Hser Ner Moo Community & Welcome Center empowers immigrants and refugees through the process of successful integration by facilitating access to resources, expanding networks and layers of service, creating opportunities for leadership, and by providing relevant, responsive services and support." http://hsernermoo.blogspot.com/

3. UNP - Hartland is "a comprehensive capacity-building project co-created by University members and residents that brings a set of resources—family financial fitness, home buyer education, health access, English-as-a-Second Language classes, and early childhood programs—together in a rental complex for its 800 residents, 75% of whom are non‑native English speaking immigrants or refugees."http://refugee.utah.gov/volunteer/unphc.html

5. IRC (International Rescue Committee) "responds to the world’s worst humanitarian crises and helps people to survive and rebuild their lives. At work in over 40 countries and 22 U.S. cities to restore safety, dignity and hope, the IRC leads the way from harm to home." http://www.rescue.org/us-program/us-salt-lake-city-ut

6. Making Meaningful movement class is a class that our fieldwork educator started for individuals experiencing hemiplegia that incorporates pilates. Students are there to assist the individuals achieve various exercises by providing support such as holding an individual's hand flat on floor if they are working on full finger extension.

This type of placement takes place in non-traditional OT settings, so we are getting a taste of how OTs can play a role in the various programs and activities. It allowed me to use task analysis and forced me to have a clear understanding of the OT framework, so that I could be effective in each setting. We were exposed to and focused on many different occupations other than ADLs such as job employment, pre-driving, transportation (using the buses/trains), home management, financial management, education, etc), communication, goal setting. We were forced to be creative and think outside of the box. I am realizing the vital role we play in the success of at-risk populations and using our skills to help them function independently and thrive in our society.

Why was this experience life changing?

My classmate/roommate/partner in crime are inspired to start working with people of refugee status here in the Bay Area. I say this will be a life-long journey because it will take time to really solidify what we want to do.

-Teach a class or guest lecture on working in non-traditional OT settings

-create partnerships with various organizations and other OT programs in the bay area

-start a fieldwork I where students will complete their hours at organizations that we partner with and eventually this will lead to a fieldwork II placement

and the list goes on...

It is time to show the world the effectiveness of OT in mental health settings and non-traditional settings! We focus on occupation and what is meaningful to an individual...what can be more empowering than that?

WELCOME TO UTAH.

I'll be doing my last 3 month internship here. 12 hour drive away from home, so this will definitely be an adventure. I'm excited to see what this internship has in store for me and I"m sure I will love it :)

End of chapter 1: 'First stop, Skilled Nursing Facility'

Today was my last day of my first 3 month internship, at a skilled nursing facility (SNF) where the emphasis was on physical disabilities. I can still remember how nervous I was before starting and how scared I was that I wouldn't like this setting or this area of OT, but of course I was wrong. When you find a career you love, you may not be open at first but your passion for the field just takes over.

I have seriously learned so much and words can't express how grateful I am for having been placed in a facility that had an amazing rehab team who taught me so much. I expected to only learn from my fieldwork educator, but I learned from seriously everyone there...from the OTs to the PTs to the PTA to the ST to the CNAs to the patients and the list goes on. It was incredible to be a part of an effective team that was filled with constant communication, constructive feedback and a genuine respect and understanding of each other's craft. There was never a moment where I felt otherwise. Each therapist had something to offer, but what they all had in common was their focus on patient-centered care filled with compassion and advocacy. It was admirable. I have high expectations of what I will look for in any team I work on.

My FE was the best. We were each other's first and it worked out so well. She has so many strengths and is just a great OT! I encouraged her to continue taking on students because she has so much to offer and more great OTs will come out of it. Although she wasn't actually treating a lot of clients, I feel that she used her OT expertise on me. My occupation right now is my education and she definitely enhanced the quality of my learning experience. According to her, I basically went from a Max A to a Mod I for my OT skills :) hehe I could not have asked for a better FE because she had great communication, was patient and supportive, tried to maximize my learning experience with every situation that came up, she threw me in from week 1, she challenged me to be creative and think outside of the box and the list goes on and she knows it haha

This first stop has opened my eyes to so many possibilities. I have always loved the geriatric population and this solidified my love for it. It also broadened where I could possibly work in the future. In the beginning, I thought I wasn't going to like physical disabilities and working on ADLs all day, but seriously with my OT glasses on I think I will enjoy and be open to so many different settings and populations. If I could come back and work there for a couple of years, I definitely wouldn't mind it :)

I could seriously go on forever about how amazing this experience was, but i'm glad that I've documented most of it along the way. This blog has been a reflection of my journey in becoming an OT and now I've made my first stop.

So as this chapter ends, another one begins titled 'Second stop, Welcome to Utah'

#iloveot

The 'ten commandments' of rehab

The DOR had given me her 10 commandments of rehab aka how to survive being a therapist and still die laughing :)

if it wasn't written, it wasn't done

complete daily documentation in a timely manner aka on the day of treatment whenever possible (you may get hit by a bus on the way home and not be able to document the following day :p)

when in doubt about handling a patient safely, ask for help from another therapist or CNA

when faced with a difficult patient encounter, smile, excuse yourself and then call you supervisor stat

be pragmatic when setting goals and remember to ask your patient what he or she wants to accomplish. Remember, it's their goals, not just yours, to achieve.

make every treatment encounter a fun encounter with your patient

laugh a lot

smile a lot

remind yourself daily why you decided to become a therapist

go home at the end of each day and pat yourself for doing your best for you patients.

This was a blast to read, but really good words of wisdom for this field and I think it can apply for any setting and if you tweak it a little bit try following these rules for your career :) #iloveot

2 days left: "right when im getting the hang of all this"

Each day this week, I've been discharging one patient at a time and not getting any new ones. It has felt amazing to see patients go home especially when I've witnessed a lot of the progress that they have made during their time at the facility.

It's mid week and I've realized that I have a rhythm and a routine going. I get there around 8:30-8:45 write down who I have, how long their treatment time is and if I have specific documentation that is due that day. Once that's settled, I start checking on clients who have their shower day and what not, definitely ADLs in the morning because the therapy/activities is more natural and in the moment. Depending on which patients are up and ready, I start bringing them or they meet me in the therapy room. From there I can decide who I will save for the afternoon I mean there's only so many minutes in the day. Today, I would finish a client and do my documentation right away and continue that cycle throughout the day, which felt so natural. Then after 4 hours, it's lunch time. In the meantime, I'm thinking about what my plans are for my patients in the afternoon. Next bring in my clients then end the day with documentation. Of course this type of schedule varies day to day depending on when I get to work, the patient's mood, who is ready, meetings that are taking place, etc.

Today, the DOR asked me if I feel like I've learned all that I can there and if I feel like I could just start working in a SNF tomorrow and surprisingly my answer was yes (definitely could have said it with more confidence though) She says I think you are definitely ready, which was very nice to hear. I thought to myself, yea I could see myself continuing this for a while. Was this the thought I had in my mind when I firsted started? of course not. I feel like I just started to really get the hang of everything and now it's almost time to say goodbye. As much as I've learned here about OT, there is so much more to continue learning especially with a whole different population. There are so many opportunities for OTs (population, location, etc) that I'm looking forward to learning as much as I can now and taking challenges too, so I can be the best OT I can be. #iloveot

3 days left: Inservice

I did my inservice today on the Tri Pull Method (shoulder taping) invented by one of my professors from SMU. It was fun to present something created by someone that I know :) The staff was impressed. I went over the purpose (reduce pain, reduce shoulder sublaxation and correct misalignment of the joint), the assessment, materials, preparation and steps on how to put on the tape. Let's just say I was not prepared to answer all of the questions that the staff had, but I assured them that I would find the answers to their questions as soon as I can.

I really appreciated all of the questions that they had for me because it showed their interest and what was even better is they want to continue to see more evidence around this method before bringing it to the facility (FYI - the evidence based article will be in the Nov/Dec issue in AJOT). It's nice to see that the therapists there look for evidenced based practice. What helped too was being able to demonstrate on my FE using the materials because she could feel the pull that the tape had on her shoulder. Of course it came to mind again how important inservices are for staff to learn new techniques and methods that are out there. When we are out of school and not exposed to all of the new research out there; so it's refreshing to learn about new practices when you can. I think that facilities should require/recommend this out of their therapists such as when they get their continuing education units especially if it will benefit the facility and the rehab staff. Sharing is caring :p #iloveot

4 days left: letting go

This is my last week of my first physdys 3 month internship and time flew by so fast. I just can’t believe it or soak it all in.

Halfway through my internship, I was assigned a client that had got a stroke while visiting his family from another state. He has been here for the last 6-7 weeks and I’ve worked very closely with him from when he needed max-total assistance for everything to min-SBA. He has made excellent progress and will continue to make progress when he goes back home. Last week, we started car transfer training with the family and during our session when we got back into the building, he tells me in English (he speaks Minh and broken english) “you good, number 1” with a huge smile on his face. It definitely made me feel great! Today was his last treatment day with us and during our session his daughter started crying and we didn’t know exactly why, but when I see someone in tears, it makes me very teary. Good thing I needed to go out and grab something because it gave me a moment to get myself together. At the end of the day, I went in and asked his grandson to translate for me to his grandfather: ”It was nice meeting you and working with you. Good luck with everything.” His grandson said thank you for everything you've done for my grandfather. My family really appreciates you guys :)

It’s so hard when you work with a client for such a long time and see the progress they are making because of the skills you and the team bring to his treatment. I’m learning that it’s okay to say goodbye and to let go. Of course, he will be on my mind when I get there tomorrow but I know that he is on his way to get more intense rehab where he is from. Plus it’s time to use the skills I’ve learned and bring forth my effort, empathy, patience and compassion to the next client. the joys of rehab #iloveot

What's more awkward?

a. cleaning up your parents when they're older?

b. cleaning up your partner when they can't anymore?

c. cleaning up your sibling (esp of the opposite gender) when they can't anymore?

Obviously, none of these scenarios are comfortable at first. But this came to mind because one of my client's sister is his primary caregiver and since he has had his second stroke he needs total assistance especially with going to the bathroom. Along with the PT, we've been doing caregiver training with her and the other day I had asked her if she wanted training on toileting. She asked "why, what do you mean?" I told her that her brother now has to wear a diaper, is incontinent and doesn't have the motor skills or balance to go to the restroom or transfer to a commode, then turned away. She then asked her brother, "is that okay with you that I clean you down there?" He said, "sure." When she turned back, I could see her eyes were watery. It is definitely difficult to accept that your loved one won't function the way they did before and that they need more assistance than ever. When I put myself in her shoes, I thought to myself, I would do anything for my brothers and take care of them; but taking care of their private areas is something that is awkward that will get done but for me will be awkward for a while.

Being in the health field, I am seeing the various changes that people have to go through when they have a disability and the changes that their loved ones go through as well as life changing decisions that they make as well. I have started to see both sides where people are either selfish but more so selfless esp where families are making so many sacrifices especially life style changes for their loved ones. When all is busy and crazy during the day and through all of the chaos, I try and reflect on the beautiful things that I see like a sister's love for her brother. #iloveot

The messenger.

How do you relay "bad" news to a client and their loved ones?

In the last week, I've had to explain to families that their loved ones have reached their maximum potential and that they may not go back to the level they were at before going to the hospital. It definitely leaves a bad taste in my mouth. I've heard "this is how my mom was before..." and I have to say, "I'm sorry but that was your mom before she went to the hospital, but this is her abilities now..." Some families are in denial and need some education and time to understand the full extent of their loved ones change in function physically and mentally. Today, I was the first to tell a family member that their loved one will be discharged in the next couple of days and we want to do caregiver training with her, so she will be prepared; however, she had no idea that this was happening and became very defensive because of the short notice. I felt myself freeze on the phone and literally didn't know how to console her because I assumed that she knew already. I felt in her voice disappointment, frustration and anger. All I could say is that I would find out more for her and will make sure someone will get back to her :/ I still feel uneasy and my FE told me I did what I was supposed to do since we are preparing a client and his family for his discharge.

I'm hoping that in time becoming a messenger will get a little easier because I will have more knowledge about the disease process, recovery and policies and more experience under my belt. This I would say is not the sunny side of therapy, but these are things that have to be done :) #iloveot

reunited.

Yesterday, I went back to SMU for a summer check in meeting with my classmates and fieldwork coordinator. It was great seeing all of my classmates again and being in a classroom. I did notice though how antsy and restless I was sitting in a chair for a long time because for the last 9 weeks, I hadn't sat down for more than 10 minutes at a time. I do wish that our meeting was on a friday, so we could have really enjoyed each other's company after our meeting instead of preparing for our next work day.

We each went around and said:

where our fieldwork site is (was).

client population

type of setting

what we've learned

It was amazing to hear how many of us were at a skilled nursing facility and others are at a mental health facility or in pediatrics. It was so hard to limit myself to what I've learned because there's just too much to say and the list continues to grow...i've learned to come out of my shell, use my therapeutic use of self to create relationships with my patients and again just being assertive. We are all learning so much and it all just reaffirms how great many of my classmates are and what great OTs they are going to be. I'm looking forward to seeing everyone again in November when we are almost done with our second fieldwork and on our way to studying for the boards. #iloveot

Be more assertive.

Last Friday I had my 8 week eval and it went well.

strengths:

work well on the team

great communication with various members of the team.

areas of improvement:

better communication at care conferences

time management

Basically my lack of time management has come from me "being too nice" My FE said I need to be more assertive. I have clients who just don't want to come to therapy and I check in with them at various times during the day, which affects my treatment time. Plus there are families that want their family member to get better, so they want more treatment time. I've heard this feedback before and I need to work on it because my productivity depends on it. I'm learning to be more creative in doing therapy with my clients and sticking to my treatment time whenever client's families want more. Sometimes I just have to put my foot down, which is difficult for me :/ Hopefully this will get easier as time goes on. There's so much more to learn and I know I'll continuing learning about myself and what I'm capable of throughout my career, this is just the beginning. #iloveot

Surprise!!!

I definitely don't like surprises (most of the time) haha

Last week, I had a new eval to do three days in a row :/ oh the joy of evals. I was discharging some of my patients, so I had to do evals for new patients to keep my caseload the same. Prior to the evals, my FE basically let me know so I can prepare for them. On friday, I knew I was discharging a patient and didn't know in advance that I was going to have a new patient. I was in the rehab gym and my FE tells me to with the PT to see a new patient. I tried not to act shocked (nervous) but I"m pretty sure my eyes got bigger, my jaw dropped a little and my smile slowly faded accompanied with an anxious laugh. I didn't get to review the chart yet and just went straight into the therapy session. It was not a disaster and I did fine.

Man was I nervous! Later, when my FE was checking over my eval with me she asked me how I felt. I told her it was nerve wrecking not being able to prepare as much as I had before. She made me realize that working in a setting like a SNF, you have to be very flexible :/ There are times that patients come in and they need to be evaluated right away and you're expected to go in there and complete your eval and treatment. I must say it was a great experience though because I feel like I should always be prepared for anything. As long as I have my OT GLASSES on, I'll be okay. I'm learning more everyday to be not only flexible, but adaptable as well :) #iloveot

10,000+

Recently, I've been wondering why I come home exhausted, my body aches and my feet/legs hurt the most. Plus, I've had a few comments that I'm slimming down? I've responded with I don't even go to the gym as often as I should anymore, maybe it's what I'm eating?

Then I realized that I'm pretty active and on my feet from 8:30 to 4 and engaging in physical activity. Today I decided to bring my handy dandy pedometer to somewhat measure my activity level. To my surprise, the number came out to.... 11,600!!! I would subtract at least a 1000 from the subtle movements that the pedometer picks up when I'm sitting, but 10,000 plus steps! That's amazing! I couldn't believe it. I'm definitely thankful to be in a career that is physically demanding and where I'm on feet and not at a desk from 8 to 5. Not that having a desk job is bad, it just takes a little more extra effort to stay fit such as working out before or after work. As for OTs and PTs who work in a physical disability setting like a hospital or SNF, you're already getting a workout in while you're at work...what a bonus!!!

I eat a pretty small/healthy breakfast that I burn off in the morning and now I started eating a salad which will get burned off after lunch when I finish up my clients and if I'm really motivated I head to the gym after an early dinner :) I'm just thankful that the career I'm pursuing is also keeping me healthy and in shape (somewhat ;) #iloveot

Take care of yourself first, before you can take care of others.

This has been coming up more so this week than it has any other week. I've noticed that my wrists are starting to hurt, sometimes I have little aches in my back and that I'm just so exhausted :/

I'm going into a field where I am going to take care of people who have physical and mental disabilities, so I feel like I should be at my best as much as I can. As I reflect on it, I've been doing a lot more transfers with my clients since they need more assistance than my previous clients, this is affecting my wrists and my back :/ the other day, I had a sharp pain in my thumb area. I thought if I stretch my thumb tendons out it would get better. I brought my thumb towards the palm of the hand and felt the sharpest pain ever that I wanted to cry :/ I took it easy for the rest of the day, but my wrists are definitely sore and it doesn't help that I already have Dequarvains tenosynovitis (inflammation of my thumb tendons) Plus I also demonstrate many wrist, elbow and shoulder exercises. There have been times when I slept late and still had to get to work by 8:30 in the morning. With all the craziness in the morning, I felt like I couldn't keep up. I felt like I wasn't present and so off that it made me feel horrible. At that point, I decided that I need to be awake and present before I start my day, so that I can be an effective practitioner.

Clients/patients are relying on my skills and expertise to provide them with the best rehabilitation they can get. These skills are compromised when I'm not physically and mentally there. Therefore, I'm definitely more cautious when transferring and showing exercises. I'm getting a little more rest and making sure I get my cup of joe in the am to get me through my day. I feel that if I take these steps and take care of myself, then I'll be able to take care of my clients and have a successful career. Like the rehab team has said, I can't hurt myself since I'm only beginning my career. That definitely hit home and I'm working on it one day at a time :) #iloveot

co-treat

I have had the honor of working with a physical therapist for two of my patients on my caseload and it has been amazing. She also has a very holistic frame of mind as well as believes in let the patient do as much as they can and simulate their environment at the SNF to their home environment, which I am still learning to incorporate into my mindset.

one client we have together had a shoulder replacement and still recovering from a total hip replacement. Today we did a caregiver training for this client, so that she can go home. The PT spoke of transfers, the client's home environment and leg exercises she can do in bed and I was able to add to that how to safely transfer to a commode, the level of assistance she needs when bathing and dressing plus arm exercises. It was so interesting to hear the PT train the family and give me some ideas on additional exercises that I can teach the family as well as training on how to put on and take off the pt's sling.

Our next client together has had a stroke. He does not speak english and his daughter or grandchildren are there to translate for us. I help her during her session with walking since he doesn't have the motor control, postural stability or rhythm to get going. It is interesting to see how the PT uses her feet and hands to guide his moving. She is in front of him in a stool with her hands on his hips and one foot between his feet. I'm in the back supporting his trunk and making sure he is upright and stable as he walks. The PT will rotate his hip forward to prompt him to move his foot and as he moves his foot, she uses her foot to slide his foot further apart for a wider base of support and so on. She has also helped me in using my body in promoting movement out of the patient. Both of us want to work with him on transfers and to start we are focusing on his sit to stand transfer. This is a basic transfer that the client has to do from his wheelchair, from his bed, from the toilet commode and so forth. So far, he has not been leaning forward instead he is leaning himself back and using his pelvis to get himself up. Part of my therapy with him is to sit in front of him while he in on the mat, place one foot in between his to give him a wider base of support, place one hand on his shoulder area and the area hand on the gait belt on the opposite side. We tell him to stand up and in the beginning, I would give him pressure and lean him forward. Now he is initiating that movement on his own, which is incredible to see. We also use a mirror in front of him, so he can see his posture. This forces him to automatically self correct :) sorry so much info, it's just so interesting to see someone start to regain strength and function after a disability.

I can see how much overlap there was between both of our professions, but at the same time I could see why they are two separate professions. As OTs, we focus on the big picture, but PTs focus on specific aspects of that picture. We want a client to be independent in toileting. That's the big picture. From what I've seen with PT, how is their gait? Do they have enough trunk and LE strength to stand when sitting up from the toilet? etc. I've been very fortunate to work with the PT and learn to appreciate both of our professions and why we work hand in hand :) #iloveot

Trending Blogs

Recently Viewed Blogs

My OT World