Sunday, April 22, 2012

AOTA Conference 2012 – Indianapolis, Indiana

I am leaving for conference this Tuesday!  I can’t believe it is already here…
I am going early because I am the ASD rep for my school, so I have to attend meetings Tuesday afternoon and all day Wednesday.  Luckily, OT student Brooke is the ASD alternate and she will be going with me! Also – OT student Kristin Davis, who was recently elected to be the ASD Steering Committee Student Representative to the RA, will be there early for the meetings as well.
Kristin, Brooke, and I are presenting a poster together on Friday from 3:00-5:00, so come check us out if you are going to be there!  Our poster is titled “Utilizing the Center on the Developing Child to Promote Evidenced-Based Occupational Therapy in Early Childhood.”
I am excited to attend my blog guru, Karen’s educational session on OT and social media!  I wish I had had more time to look at other sessions I want to go to beforehand, but I guess I will just have to plan as I go with the packet they handout when I get there.  I tried looking at the website a few times, but just got overwhelmed by the sheer volume of information and figured I would just play it by ear.  At least this year I know a little bit more about what I am interested in. 
I am also planning to attend students un-conferenced – didn’t even know this existed last year!
I got most of my packing done today – it was tough… I hate packing.  The weather there is supposed to be in the 30s-60s which means I had to find all of my winter clothing again… I have been enjoying nice, sunny, 85 degree weather here Nola for quite some time. 
Looking forward to the next week – will share more info when I get back!
In the meantime, please enjoy this image that OT student E shared with our class awhile back… I think it ties in nicely with the cover of OT Practice this month on being an OT superhero!


Advocacy Project

For my health and disability class, we had to do a semester project around advocacy.  My groups choose to do it around aging in place.  My original idea was to talk to local architect students about home modification and universal design because I have heard about a PT doing this in the Baton Rouge area (a little out of the PT realm in my opinion as a second year student that definitely does not know everything).  Our instructor liked this idea, but the very next day she got an e-mail about AARP’s Home Fit program.  The Home Fit Guide by AARP consist of tips and tricks to make homes more accessible, checklists to determine the accessibility of a home, and resources for OTs and contractors.  The program has been budgeted into 14 states AARP program and Louisiana was one of them.  We had several people from AARP come to our school so we could give them a presentation about what OT is, what the OT role is for various problems in the older adult population, and OTs role in home mods, universal design, and livable communities.  I learned a lot about aging in place, home modifications, falls prevention, and livable communities through this project.  This has increased by interest in working with the geriatric population and OTs expanding role in productive aging! 

Meal Prep Group

Last week I participated in a meal prep group at school.  I was the “therapist” and because we are an odd numbered class, I was the only “therapist” with 2 clients.  I had one other “therapist” with me and she had a client of her own, who had a stroke and left neglect.  One of my clients had a TBI (traumatic brain injury) and the other had a broken left tibia (lower leg) and a right scaphoid fracture (bone in the wrist).  My client with a TBI had impaired safety awareness, decreased FM coordination, and weakness on her right side that impaired her balance.  This required me to have a gait belt on her and be by her side the entire time.  My other client was a self-proclaimed over-zealous individual that did not want to listen to safety precautions, so I had to keep my eyes on her at all times too.  Needless to say I didn’t worry about the other client too much because my hands were full… literally full the entire hour.
The other “therapist” and I had to write an activity analysis of the meal prep and client descriptions of what they would do during the activity as well as their goals.  We also had to document in SOAP format a treatment note from the session.


We decided to make French toast and I would say it was mostly a success.  The thing I took away from this more than anything else was that it is incredibly hard to divide your attention between two very needy clients.  We had several students watching to document, so I frequently used them as “techs” since I couldn’t be holding on to client 1 at the counter while assisting client 2 at the stove.  Even with “tech” assistance, it was really hard to keep up with what both clients were doing at the same time. I don’t think this was supposed to be the take-away message from this activity, but as I was the only person with 2 clients, my unique perspective on this activity changed it a bit for me.
Some other things I learned while doing this activity
It was really hard to put things in regular terms again, especially for my classmates.  Now that we have become fluent in the OT vernacular, it takes work to think how to say things to people in a different way.
Likewise, telling a person the actual steps to the activity in the most effective manor was difficult and clearly needs to be rehearsed beforehand. 
It was also tough to try and talk to clients about depression and anxiety issues while in the middle of actually doing an activity… especially when I had two of them!  I am somewhat well versed in this particular topic because I have many family members with either one of both of these conditions, but talking to a client about this in action of cooking over a hot stove and trying to multi-task with another client was ridiculously hard.  We ended the session at the table, where I could discuss these matters, but when they were brought up by each client during the session it was almost impossible for me to productively address. 
Even though it was tough, I had a lot of fun and learned some great things.  I also learned how to make French toast, which I had never even tried before.  I get pretty excited about new foods, so I made it for me and the boyfriend the very next weekend! 

Older Adult Activity Bag

I love the activity bags we do in school.  This semester we had to design one with 5 activities meant for older adults.  Everything had to fit in a 1 gallon zip-lock bag and each activity had to have 2 cards: one to treat a social or independence deficit and one to aid in wellness.  I have listed below my activities.  I am particularly fond of my re-invention of the children’s game “Story Cube.” I invented “Story Dice” which is meant for older adults and helps initiate real life story telling. 
Item: Dinner Set: Fork, Knife, Spoon, Plate, and Dycem

Deficit: Independence

Activity: Many older adults have diseases or conditions that inhibit their FM coordination and activities that require FM coordination such as eating.  A utensil set could be used to help show alternative ways to hold and use the utensils for more successful self-feeding.  The client can also be instructed to use Dycem underneath their plates and bowls to prevent sliding.  Using an adaptive way of holding utensils specific to the individual’s needs as well as the adaptive equipment of Dycem can help promote independence in self-feeding which is an important area of occupation to many older adults. 

Upgrade:  Rather than instructing the client on how they should best perform the task of feeding, have them problem solve and offer solutions themselves which will further promote independence.   

Item: Dinner Set: Fork, Knife, Spoon, Plate, Dycem

Deficit: Occupational Wellness

Activity:  Many older adults have diseases or conditions that inhibit their FM coordination and activities that require FM coordination such as eating.  A utensil set could be used to help show alternative ways to hold and use the utensils for more successful self-feeding.  The client can also be instructed to use Dycem underneath their plates and bowls to prevent sliding.  Eating and feeding are two very important areas of occupation and being able to do these activities independently will promote occupational wellness. 

Upgrade:  Rather than instructing the client on how they should best perform the task of feeding, have them problem solve and offer solutions themselves which will further promote independence and increase occupational wellness.



Item: Story Dice

Deficit:  Social - Isolation

Activity: This activity involves two dice covered with various words on each surface.  One dice is the “family” dice: each surface contains a word representing a family member (i.e. spouse, sibling, parent, or pet). The second dice is a “life” dice: each surface is contains a word representing some life occurrence (i.e. marriage, birth, or party).  The player roles both dice and must choose one picture or word from either the family or life dice and tell a story about it.  Many older adults like to share stories about their younger years and this will be a way for them to connect with their pasts as well as with other group members to decrease isolation.

Upgrade:  Have the client tell two stories: one about each word or picture shown on both the life and family dice. 

Item: Story Dice

Deficit: Emotional Wellness

Activity: This activity involves two dice covered with various words on each surface.  One dice is the “family” dice: each surface contains a word representing a family member (i.e. spouse, sibling, parent, or pet). The second dice is a “life” dice: each surface is contains a word representing some life occurrence (i.e. marriage, birth, or party).  The player roles both dice and must choose one picture or word from either the family or life dice and tell a story about it.  Many older adults like to share stories about their younger years and this will be a way for them to focus on positive experiences of their past and feel emotionally well. 

Downgrade:  The clients can be given up to two turn “passes” if the dice do not roll on a picture or word that brings back particularly positive memories or stories that they do not want to share. 




Item:  Large Plastic Jacks

Deficit:  Social – Participation

Activity: “Eggs in a Basket Jacks” can be played in a group setting.  To play, the player uses a throwing hand to bounce the ball and a non-throwing hand is used as the “basket”  Each time the ball is bounced, the player must pick up a jack with the throwing hand and transfer it to the “basket” hand and catch the ball with the throwing hand before it bounces more than once.  Each time a jack is correctly picked up placed in to the “basket” hand, the player can continue their turn until the “basket” hand holds all ten jacks.  If at any time the jacks fall from the “basket” hand the players turn is over.  .  The large plastic jacks are used rather than the small metal ones for ease of grabbing with decreased FM coordination.  A larger ball with a longer bounce time is also used in this set for the same reason.  Also, it is an activity that is popular with older adults as they may have played these games as children.  This activity is played in group settings to promote social participation

Downgrade:  Instead of doing this activity in a group setting, have clients pair off in twos so that they only have to socially participate with one other person. 

Item:  Large Plastic Jacks

Deficit: Intellectual Wellness

Activity”: “Eggs in a Basket Jacks” can be played in a group setting.  To play, the player uses a throwing hand to bounce the ball and a non-throwing hand is used as the “basket”  Each time the ball is bounced, the player must pick up a jack with the throwing hand and transfer it to the “basket” hand and catch the ball with the throwing hand before it bounces more than once.  Each time a jack is correctly picked up placed in to the “basket” hand, the player can continue their turn until the “basket” hand holds all ten jacks.  If at any time the jacks fall from the “basket” hand the players turn is over.  The large plastic jacks are used rather than the small metal ones for ease of grabbing with decreased FM coordination.  A larger ball with a longer bounce time is also used in this set for the same reason.  Also, it is an activity that is popular with older adults as they may have played these games as children.  During the game, each person must pay attention and keep score of everyone’s turn each time they play.  This activity can promote intellectual wellness because each player must pay attention to the person playing, count the number of jacks their get, and keep score for every other player throughout the game. 

Downgrade:  Have the client only keep score for themselves and all of their turns.


Item: iPhone – Downloaded Music and Pandora

Deficit: Social - Communication

Activity:  Have the clients take turn selecting a specific song downloaded on the iPhone or a station on the Pandora radio application and explain their choice.  After the song is over, have each person respond to the song explaining either why they liked/disliked it or sharing a particular memory that the song evoked.  Downloaded songs and Pandora stations should be tailored to the genre of music that the older adults grew up with.   This activity will promote social communicate through sharing and interacting with other group members.

Downgrade:  Have clients only respond or share after only one other group members choice of song rather than responding to every single group members choice of song. 

Item: iPhone – Downloaded Music and Pandora

Deficit: Spiritual Wellness

Activity: Have the clients take turn selecting a specific song downloaded on the iPhone or a station on the Pandora radio application and explain their choice.  After the song is over, have each person respond to the song explaining either why they liked/disliked it or sharing a particular memory that the song evoked.  Downloaded songs and Pandora stations should be tailored to the genre of music that the older adults grew up with.   This activity will promote spiritual wellness because music is a common way to evoke positive emotions and increase a persons’ spirits. 

Upgrade:  Extend the time of the group session and give each member two turns.



Item: Gentle Yoga Routine Handout

Deficit: Mobility

Activity: Instruct client through gentle yoga routine aimed to increase flexibility and restore muscular alignment and function.  Increased flexibility will enable individuals to have increased movement in various joints and muscling increasing range of motion and overall mobility. 

Downgrade:  Instruct client through two poses rather than the entire series.

Item:  Gentle Yoga Routine Handout

Deficit:  Physical Wellness

Activity:  Instruct client through gentle yoga routine aimed to increase flexibility and restore muscular alignment and function.  Increased flexibility and muscular function will promote physical wellness by creating a better functioning physical body. 


Upgrade: Instruct client through entire routine twice. 



Broke down and starting blogging… FW I recap

I wanted to write about my second FW 1 in… March… ah yes, I am one month behind!  I have forgotten A LOT of details, but never fear, I am going back to the exact same facility for my first level II fieldwork in approximately 2 weeks, so there will be an endless amount of detail all summer (as endless as HIPPA allows, anyway).
Why am I going back to the same place twice…
Well what had happened was - I was originally scheduled to go to a different out-patient facility, but there was a booking error and they accidently took two of us. One of us had to go and since my lotto # (we do a random lotto for FW II as to who gets to pick what facility first) was lower than the other girl booked, I had to go and I was fieldwork-less and no spots were left in Nola.  Having just come from an EXCELLENT out-patient clinic for my FW I, my fieldwork coordinator suggested I contact them to see if they would take me for FW II as they currently were not taking students, but have taken many in the past. One short (ok, long) week later and I was in!  Couldn’t be happier about the result because I feel truly blessed to get to go back to this facility and learn from some amazing OTs.
So this setting that I was in for a week and will be in for another twelve, is an out-patient clinic here in New Orleans.   They see mostly ortho, but have a decent mix of neuro and lymphedema, which is something I have never seen and am now very interested in.  I had a great experience and this facility is really unique, but I plan to ask my CI at some point how much I can share before I give out a lot of details. 
Some things I can share --
There are 3 OTs and several more PTs and they have the best interdisciplinary relationships with one another that I have ever seen. 
All of the OTs are CHT’s and therefore, crazy smart.  Two of them are also trained in lymphedema management. 
I saw lots clients that had fractures, nerve injuries, and tendon transfers.  I was almost able to keep up with everything that was going on because of my amazing ortho class this semester (and self-confessed obsession/dedication to anatomy last summer).
I saw a few clients who had had strokes and it was very different from anything I had seen before in an acute or in-patient setting – much higher functioning.
I saw lymphedema management – wrapping, massage, exercises. 
Everyone at the facility was so nice and welcoming – this has not always been my experience! 
All three OTs were great at explaining what they were doing, why they were doing it, what each client’s history was, and where they see them progressing in the future.  They were so helpful! I really felt like I got a picture of what it was like to treat someone start to finish in an out-patient setting with these therapists and I know I will learn so much from them!  One of them even helped with the documentation by letting me document after a session and telling me what she would have done similar and different.  She also looked over some of my documentation assignments which was helpful. 
We had 8 assignments to do during our weeks out in the field---

Documentation
-write a treatment or progress note in SOAP format
-perform a chart review and put the initial eval in framework format
-write a short paper for bonus on the documentation process from referral to discharge
-fill out form of what was seen based on framework concepts
-performance eval by CI

Research
-short paper on how FW experience and research class relate

Principles of Practice II
-Spirituality handout – I did yoga, of course.

Health-Disability Continuum
-Client project – PowerPoint presentation of client interview, disability survey, resources, eco-map, assimilation to class, and review of class.

I start my FW II on May 7th!  At some point in the first few weeks I will be sure to discuss with my CI what I can and can’t put on my blog and give y’all some more details.  This is a great and unique facility in New Orleans and I would love to share. 

Tuesday, April 17, 2012

While studying for my ortho final…



(Hint: look at the last note on the bottom)
I was studying for my ortho final yesterday when I saw this note and found it hysterical.  It was probably so funny because I was going on the 10th hour straight of being extremely busy, but nonetheless, I wanted to share. 
I think it is extremely ominous because I am going to an out-patient ortho setting for my first FW II this summer and therefore, will be treating shoulder quite frequently. 
I believe I meant “Never treat a shoulder without assessing treating scapula as well”  which was said in the note right above it… man I am just with it lately! 
As you probably gathered from my 10 straight hours of busy-ness and lack of blogging, I have not had a ton of time write posts.  I have a few good one coming up including my FW I experience, my adaptive meal prep experience, details on my aging in place advocacy project, older adult activity bag, and a re-cap of my transcendence into an increasingly more balanced school and personal life (which I find quite difficult in graduate school).  Oh and conference!!! Which is in 1 week… which I have not prepared for… and I am also presenting a poster… but that is mostly done :)



Friday, April 6, 2012

OT Ellen Video

What would OT school be without a silly video?!



This video was created and directed by the lovely OT student Andrea C. (rapper in the video). She is trying to advocate for OT during the month of April by trying to reach Ellen. The idea is, Ellen will see it and want put it on her show so thousands of people can see it and have a better understand of what OT is. Hopefully this is the end result! Watch it, like it, post it on your Facebook, post it on Ellen's Facebook, Tweet it (confession: I don't know how to tweet) and use any other means necessary to spread it around!

PS – I am Ellen in the video and I know that I am awesome : )

PPS - I finally figured out how to make a link you can click on rather than copy/paste - look out world, I am getting tech savy!

http://www.youtube.com/watch?v=E9os4fXb6Ys&feature=share

Tuesday, April 3, 2012

Stroke and Jan Davis Take II

I was so excited to see that I got a comment yesterday from Jan Davis on a blog post I wrote about stroke and her videos last semester! She shared some information about new videos, so I will post it here to share with everyone. Thanks for reading, Jan!


Hi Meredith,

I happened upon your blog and read your post about the stroke videos you watched in class. I'm so glad to hear that you like learning this way!
I think video is a powerful tool and can help students or therapists develop better clinical skills.

I'm working on a new set of videos that can be viewed on iPhones and iPads. If you go to my facebook page and hit 'like', you'll know each time I release a new video! http://www.facebook.com/Jan.Davis.Clinical.Educator

Good luck with school!

Jan Davis, MS, OTR/L

Monday, April 2, 2012

Autism Speaks

April is not only OT month, but also Autism awareness month! We had a "Light it Up Blue" event at school today. Everyone wore blue, we discussed the upcoming Autism walk, and bought the puzzle pieces to support Autism Speaks. Here is a pic of us and a link to the Autsim Speaks website. Happy April everyone, what a great month for OTs!

http://www.autismspeaks.org/

Sunday, April 1, 2012

OT Identity Crisis/ Long Update

Once again, I can explain my absence: I have been having an OT identify crisis. I LOVE LOVE LOVE OT, but lately I have been having a hard time managing/balancing my school life and my personal life and free time. As always, we are really busy in school with many different assignments, lectures, readings, etc., but since I have been on this P90X exploration my free time during the week has been zapped to zero. A typical day has been: get up, go to class for 7ish hours, come home to 1-2 hours of school work, walk dog, P90x, cook dinner, shower, go to bed. Repeat 5x a week . I have had ample free time on the weekend (I cannot lie) but I have reached a point where I am so busy with school work during the week, I don’t want to even think about OT during the weekend. I got to my overwhelmed point with school and assignments a few weeks ago and was in a very bad space for a while, which I am not exactly proud of and why I waited to blog until I was in a more positive mind frame. I really try to promote OT and OT school positively on this blog so I won’t go into the negative details, but it was very similar to my semi-rant last semester (for those that continuously read) regarding the amount of assignments/ group work verses the amount of time I feel I am learning skills directly applicable to OT as a career like how to treat a client with a stroke. Now before anyone gets on a high horse: I know I can take away something from every assignment that I will use in my OT career: how to work with difficult people, flexibility in time management, etc. etc etc. Believe me I see that. I have to see that or I would go nutso, but it doesn’t make it any less frustrating during the actual learning process. So while trying to not complain or sound too negative I thought it was important to both explain my absence and convey a very real part of OT school that, in my opinion, most people experience: burnout!
Now that that is out of the way I can give an overview of some things that have been going on that are pretty cool.

I think this was over a month ago, but nonetheless, here is a pic of OT student B and OT student STC fabricating their thumb spica splint for ortho class. This is our second splint in the program; we made a resting hand splint last semester and in the fall we are going to make a dynamic one.




Ortho and ortho case study

I have been loving ortho class. We have an amazing instructor who lectures on the various conditions seen in an orthopedic setting, what to expect from them, and how to treat them. I love the design of this class and I really really wish we had a neuro class just like this! (something I have talked to the department head about, who was very receptive)

I recently went on my second FW I (I will write a separate post about that, promise) at an out-patient ortho setting and I was able to keep up with everything the therapists showed me! I noticed an extreme lack of knowledge in regards to clients I saw with a neuro problem. I feel like we were educated on how everything works, brain, spinal cord, various diseases processes, etc but did not get nearly enough on what do with them as OTs.

We also did part 1 of a very long case study for ortho. My group had a client with a total hip replacement and a scaphoid fracture. We had to write about her diagnosis and its medical management, discuss the interview process we would use with her, give an overview of her prior level of functioning, discuss what we would assess during her eval and what assessments we would use to do it, precautions/contraindications, conditions secondary to diagnosis, and the prognosis for her recovery. We then had to list the deficits that we planned to treat, create long and short term goals for edema, pain, and occupational performance, then we discussed the treatment plans for each area as well as activities that we would use.

It was hard, a lot of work, and 18 pages long! It gave a great overview of what we would actually do (though maybe not write it up like that) on a daily, weekly, monthly basis for a client with an ortho injury. Another reason this class makes me feel prepared for actually treating clients!
We are currently working on part 2!



Documentation class

I have learned SO much about documentation this semester.

We have learned how to write functional problem statements, goals, contact notes, treatment notes, and even some pretty long progress notes. We took a midterm a few weeks ago and had to do a timed progress note in SOAP format and also had a regular test format with it as well. We have had various assignments related to practice note writing – all helpful!

Again, this class makes me feel prepared to be a practicing OT especially after seeing and documenting on fieldwork last week!



Principles of Practice Adult II

We had an AMAZING guest lecture on dementia a few weeks back. Again I am partial to this subject because I think I would like to work with older adults one day : )


Health-Disability Class

We had a great class about mothering/ parenting with a disability and had a young mother who had a stroke come in and talk to us. I wish I could share more, but as always I respect the privacy of others!

I also with to a SCI support group for an assignment and had a really good experience and met some cool people.

Advocacy project is in full bloom! I am giving a lecture with my group on aging in place and OT’s role in home modification and universal design this month. I need to check with my instructor to see if I can put the details online, and if so will definitely tell more!



Research I

Not a lot to say here. Class is canceled frequently and we are given outside assignments in its place. Anything I have learned as been straight from the book. Evidenced-based practice is HUGE in the OT profession -I wish I was learning more : (

I have learned how to summarize a journal article in about 20 minutes, which is kind of neat.



Ellen!

Yet another talented OT student is creating a video to send to Ellen to promote OT awareness for OT month, which April for those that don’t know! I will post the video when it is done… I played the part of Ellen!



Conference

Is this month! Going early to for the ASD meetings and staying the whole time. Looking forward to renewing my enthusiasm for OT! Thankfully our schedules have been rearranged so we finish class before we go… how awesome. Looking forward to April 24th! Also may get to meet my long time blog hero/guru in person... pretty neat! If I haven’t explained before (I think maybe the first post-ish?) I write my OT student blog because had I not stumbled upon hers while contemplating how miserable I was in pre-med curriculum my third year in college, I would have never learned about and fallen in love with OT. Paying it forward is what I am all about.


That’s a pretty decent update for now. I will post about fieldwork and the various assignments we had soon. Actually soon and not in a month : ) I have been strategizing how to have more time and last week I started attempting to wake up an hour and a half early to workout rather than doing it in the evening. I was really tired by Friday, but I think this may work in the long run for my lifestyle change and allow me to keep my life balanced. I am 2 weeks away from finishing P90 – down 13 lbs, reached my goal weight, and I can do like a million push-ups! Yay me! And now I am going to do what I do best on weekends: enjoy this beautiful weather in what is perhaps the greatest city in the word, New Orleans, La! Happy Sunday!