Vicki D.’s Wanderings

JOURNAL IX

I am sad to see my time at Beckett House end. The whole staff has been friendly and helpful! The therapy department shared a special lunch to celebrate my end of clinical hours on Thursday.

Wednesday was a very slow day. I worked on studying ‘R’ notes to try to broaden my understanding of documentation. Two new ‘R’ were added to the OT case load and they are two very sick individuals. The one ‘R’ can hardly do any activity at all and he is struggling for his breath. It is very difficult to get the ‘R’ out of bed, so it has taken some planning between therapy departments to treat him. He is on oxygen and his breathing gets quite shallow with exertion. The second ‘R’ was involved in an accident and has a metal apparatus fastened to his hips; it is the OT departments job to find away to adapt his lower dressing.His pain is intense, so his therapy is slow getting started.

Thursday two more ‘R’s were added to OT’s case load. The male ‘R’ is 82 and fell while fishing. He had to have a screw inserted into his hip. He is very cheerful, but very slow to move and that takes a lot of therapies time with him. He seems to be very cautious of his hip. When OT got their time with him he was very cooperative and was able to complete a set of thera bar exercises. The female resident also participated in the thera bar exercises. She has arthritis and was one week post hip surgery. She is only in her early sixties, but has been battling arthritis for several years.

Kendra asked me to go to the outside storage area to find a set of w/c foot rests. She gave me the description and I brought a set back that fit.YEA! I still am impressed at the amount of work they do to the wheel chairs to make they a proper fit for each individual ‘R’. Misty worked to add padding to a w/c that they thought was causing a sore on a ‘R’s scapular area.  They have special foam padding that sticks right to the w/c; this is covered with lambs’ wool for protection.

This w/c also had three bolts out of the back rest, so we added the bolts to secure the back. She also adjusted the head piece to fit her height to a better angle. Hopefully this will ease the pressure on her scapula.

Well, I only have ½ hour left to complete my level I clinical hours. We have made arrangements for me to donate my clinical project to the facility, so Wednesday, June 3^rd, I will finish out my time when I take the project to them.

PROGRESS NOTE: S/OTA has nearly completed her level I clinical hours. Student has 99.5 hours to date. Student has participated in many activities in the past nine weeks; such as, thera bar exercises, thera putty activities, clothespin tree activities, nuts and bolts, puzzles, cones, hand bike exercises, pulley exercises, thera band exercises to name a few. Student was allowed to observe a home evaluation visit, a staff meeting, a family consultation, morning therapy meetings, and on two occasions Modified Barium Swallowing Testing. Student was allowed to review different documentations to try to make writing notes more understandable. Student states that it has been a very rewarding, educational, and enjoyable experience!

Vicki Dawson, S/OTA 05-29-09

Journal VIII

This was a short week at level I clinical hours. I had planned ahead and worked extra hours to cover one of my days this week. I knew in advance of a prior commitment and the facility was willing to adjust my hours.

Thursday, May 21, I continued on my regular schedule. Mary Arnold came to my clinical hours today. I was impressed with the professionalism she showed toward her formal students. Kendra and Misty, the COTA’s at Beckett House, graduated from the Zane State Occupational Assistant Therapy program. It was rewarding to hear three professionals talk about OT, such as, the changes in OT, continuing education, ‘R’ holistic care, and how the profession can be more effective toward patient care. Mary was very encouraging that with hard work and application we can succeed in the OTA program.

The occupational therapy case load is low. Misty only had one ‘R’ and she treated that ‘R’ while I was observing the Modified Barium Swallowing Test (MBST). The testing was done on two ‘R’s. The male ‘R’ had suffered a CVA and is progressively declining in all areas. I have observed him in the therapy room and his deficits include difficulty speaking, sitting up straight without assistance (he uses a special tilted w/c), restricted movement of all of his limbs, and cognition. The staff had documented his difficulty in swallowing; once it was documented an order was put through for the MBST. Different thicknesses of liquids were offered the ‘R’; how he swallowed these liquids and where they went as he swallowed them determined if he was aspirating his food. It was determined by this testing that his deficit was bad enough to end food intake by mouth. Now the family will have to decide whether to put a peg tube in to give him nourishment or to let him go. The female ‘R’, 92 years old, has had reoccurring pneumonia. The MBST was given to see if she was aspirating into her lungs. The ‘R’ was tested on liquids and then solids; the speech therapist administrating the test stated that the ‘R’ had better swallowing reflexes than herself. The conclusion was that she talks while eating and that she then aspirates her intake. She was upgraded on the textures of her food. She had been on pureed food and now upgraded to soft foods and bread. She will be coached not to talk while eating.

Oh, encountered my first inappropriate ‘R’. The ‘R’ was being treated by PT; he was vulgar in his language and made distasteful comments and jokes. The therapist all tried to ignore him and steer the conversation away from his comments. If he thought he was getting any encouragement his behavior would start all over again. Most ‘R’ receive encouragement, but the therapists have stated before that he is a very negative person and needs a firmer manner taken to control his behavior.

I was very encouraged to see the progress of the ‘R’s D/C from occupational therapy. Some ‘R’ went home last week and others are either done with all therapies or continuing with PT. I have been at the facility long enough to witness the changes OT can make. I have also been at the facility long enough to realize sometimes people are just not going to be able to be helped. Insurance only wants treatment to be continued if there is progress. The maintaining part of OT seems to be harder for the insurance companies to justify. The facility I am at then turns those people over to the restorative aides. They continue a POC documentated by the OT department. Then there are the ’R’ such as the gentleman from the MBST where hard decisions must be made; to chose life or quality of life. Another example of that is one of the first ‘R’ I wrote about on BB; he is being put on a feeding tube this week. He had said he was not going to do anything else to prolong his life and now he has changed his mind and chosen the peg tube

S. S/OTA states that life is not easy and death may be even harder.

O. S/OTA student was off on Wednesday, but made plans with staff to work extra hours to have time covered. S/OTA has 86.5 as of May21, 2009. S/OTA will finish hours ahead of schedule if she continues to attend and pace herself at this set POC.

A. S/OTA witnessed many types of DX and different types of ends these DX bring to the individual based on different health issues, age,  and the ability to maintain or improve their well being. S/OTA maintains regular hours and continues her education to be able to assimilate enough knowledge to graduate and to be able to pass the boards. S/OTA was observed at level I clinical hours by Mary Arnold.

 P. S/OTA will continue clinical hours for two more weeks, continue her OT courses in the fall, continue to learn by observing, and studying.

Vicki Dawson, SOTA 05-22-09

It is hard to believe this is week seven of level I clinical hours! This week was very slow; several residents have been D/C from therapy. The whole therapy room takes the down time to catch up on paper work and reorganize the therapy area.

Wednesday we worked with two residents who fell at home and needed OT on their shoulders. We had them do a routine of basic stretches to start therapy, then moved on to the therabar. Each ‘R’ used a different weight determined by their deficit in muscle strength. Two sets of fifteen repetitions were done for each activity. Both ‘R’ put nuts and bolts together and worked on the clothesline tree. Misty, my supervisor, went over notes with me and looked at the paper she needs to fill out for Mary’s class. I helped the PT’s when I was not helping Misty. Interacting with the PT’s is giving me a greater understanding of the differences in OT and PT. We do some of the same activities, but PT. will have the ‘R’ perform them while standing. The activities I have been doing for them include playing catch with a ball and kicking the ball back and forth. I also have been pushing the w/c behind the ‘R’ while two PTA’s assist the ‘R’ in walking.

Thursday was, again, slow. The ‘R’s from the day before came to therapy at different times. I had the first ‘R’ do a series of exercises with the therabar and then work with the nuts and bolts, while Misty attended a meeting. The ‘R’ thought her shoulder was sore from the day before activities; so I used theraputty for the next activity. When Misty came back she instructed me on the proper technique for shoulder hot packs.  I retrieved 6 towels which I folded in fourths; Misty then showed me how to get the hot packs out of the hot bath. They are placed in shoulder holsters, which lie on top of the folded towels. She applied one and I applied the other to the top of the ‘R’ shoulders. The hot pack treatment lasts for 20 minutes; after the first 10 minutes you check to make sure the ‘R’ skin is not turning pick or red. Instruction is given to the ‘R’ to let you know if the heat is too much. The hot pack needs to be put back in the hot bath within 30 minutes of being taken out or they will be ruined.

I went to get the second ‘R’ after lunch and she was in the bathroom; she was a little agitated because she had been setting in the restroom for 10 minutes trying to get someone to help her. She said her light must not be working. I told her I would be right back with someone to help her. I found an aide and she was really sorry she had forgotten about her! BUT in all fairness the ‘R’ DID NOT have her light on! AND it was working she just did work it properly. I was glad I had gone to get her when I did! She was especially willing to do her activities when we finally got to the therapy room! They all made fun of me in the therapy room thinking I HAD gotten lost! Misty let me do all the activities with the ‘R’. I had her fold and stack towels, and then she worked on a puzzle. In the morning I had watched this ‘R’ practice on the steps in another therapy room. The ‘R’ will be going home soon. The ‘R’ has a lift already installed at her home and has all kinds of help to assist in her care.

A new resident has refused his therapy. The therapy department has gone everyday to offer him different activities as prescribed by his doctor. Today the social worker sent a note that the family does not wish for him to have therapy!  The whole department was in agreement that the family usually encourages participation in activities to improve their family member. I thought that was interesting.

Narrative note:

S/OTA participated in the treatments of two ‘R’. S/OTA helped prepare and apply hot packs to ‘R’ shoulders. S/OTA assisted PTA’s in activities and walking ‘R’s. S/OTA has accumulated 81 hours for level I clinical hours. S/OTA has made prior arrangements for making up hours for May 20^th. S/OTA provided supervisor with the evaluation assignment.

Vicki Dawson, S/OTA 05-13-09

Wednesday when I arrived for hours I was told that my supervisor had been in the hospital, so I followed, Kendra, the other COTA around. The day started with a family care meeting. This involved the OT and PT staff and their recommendations for the ‘R’ on being D/C. A home visit was recommended, but they were having difficulty in arranging a time period. The family was given the safety recommendations for ADL’s (bathtub transfer chair, extra rails around the tub, a raised toilet seat, no lose throw rugs, a chair high enough to allow ease in standing, etc.) . These meetings allow everyone to have the same information at the same time and that way everyone is on the same page about the ‘R’ D/C. Everyone involved had to sign the POC.

The level II student was also sick, so that put all of the OT duties on Kendra. I was her gofer for the day and it felt good to be able to save her steps. I located several of the ‘R’ and brought them to the therapy room and returned them to their rooms after therapy. I led a series of repetitive therapeutic (preparatory) exercises for a group of ‘R’. I also set up several exercises such as theraputty with beads in the putty. I had the ‘R’ find all the beads. Then roll the putty into a long snake, and then pull the putty apart and make into small balls to be placed back into the container. Kendra was working on a w/c, so I went to another building to retrieve a new back for the w/c. I then sorted out new bolts and washers for the new back.

A’R’ that I have worked with several times was on the phone when I went to bring him to therapy. He told the person on the phone he had to go because HIS therapist was there to take him to therapy. That was a very funny feeling; I wanted to correct him, but at the same time I wanted to hug him! Even though I am not A therapist, yet; I will always remember the FIRST time I was called ONE! A very rewarding day! AND SO MUCH TO LEARN!!

Thursday was a slow day; which was good since Kendra only stayed half- a- day do to her illness. I led a couple of the ‘R’ in their ROM exercises and  set up their  therabar exercises, theraputty, hand bike, theraband exercises, pulley exercises, and a pegboard activity. Misty went over notes with me before she went home. Several ‘R’ are either being D/C from therapy or being D/C from the facility. It is always a good thing when they can improve their functions to be able to return home.

Progress notes:

Student felt useful in the clinical setting. Student has logged in seventy level I hours to date. Student initiated many therapeutic (preparatory) activities with ‘R’ on Wednesday and Thursday. Student was called a therapist by a ‘R’ for the first time. Student is still working on the jargon and trying to learn how the notes evolve. Student will continue to watch and ask questions to obtain as much knowledge as possible in the remaining clinical hours.

Vicki Dawson, S/OTA 05-07-2009

Week number five of level I clinics was a variance of therapeutic activities. Misty, my supervisor, was away on Wednesday; so my day was spent observing in the therapy room and assisting who ever needed an extra pair of hands or set of legs. I reviewed charts to compare the charting notes to what we are studying in class. I find I am able to understand more of the jargon every time I read a chart.    

Our patient load consists of CVA’s, a CABG, a MI with scar tissue from burns; one CVA also has had basal cell carcinoma removed from her neck and face. We have added two more residents to occupational therapy; so we are about the same since two went home last week. One new ‘R’ fell at home and is here for a few weeks of rehab. She has stiffness in her hip so PT is working on ambulating and OT is building her UB strength. She has a very positive attitude. I am still observing lots of interaction between the staff for the ‘R’ benefit.

I was moved by the love of two residents for each other. The female ‘R’ has given up trying to walk and her partner walks in front of her with his walker, coaxing her to walk, while the therapists assist her. He has nothing but love, concern, and patience for her. She will insist she could do her therapy better if he were with her. They eat lunch together and share a room together; they are inseparable. This is definitely part of the holistic care we are learning about; that they can continue their lives together in a safe, healthy environment.

On Wednesday morning I attended the weekly therapy staff meeting. I was impressed with the thoroughness of each department in documenting each ‘R’ POC. I can see why each department at Beckett House is always on the same page. They collaborated as a group on each individual therapy ‘R’. These were some of the documentation topics: doctors appointments, diets, medicines, transfers, DC  ( from therapy or of ‘R’ from facility), home evaluations, w/c care, insurance, any noticeable changes in ‘R’ (physically or cognitively), any results from tests, motivation, spirits, medicine changes, precautions, safety, functional levels, walking ( changes in status) , screening of ‘R’ and braces.

Thursday morning started out on a sad note. The first ‘R’ I assisted with on my first day passed away early Thursday morning; the ‘R’ had been hospitalized. The whole staff felt her loss.

Thursday morning continued at a fast pace because of a scheduled home evaluation. A hip replacement ‘R’ will be ready for DC in a few days; so OT and PT went to  the ‘R’ home to see if the environment of the ‘R’ home was safe and manageable. It is a thorough process from counting steps, to measuring door ways, to making sure resident can successfully do her ADL’s in her home environment. The house was one level with a ramp to the porch already in place. They had the ‘R’ sit in her usual chair; she broke her hip precautions, so they suggested she sit on the couch, which was higher and aided in her not bending out of the 90 degree angle. They checked the height of her bed (they had her get into and out of the bed), they made suggestions for her bathroom (a tub transfer bench, an elevated toilet seat, grab bars for the tub, a hand held shower wand, and that the toilet paper be moved to the vanity; because she was breaking hip precautions when she leaned forward to reach it on the wall fixture. They also suggested that the kitchen table be moved to allow the ‘R’ more room to ambulate to the kitchen area. They had her go to the refrigerator and pour a glass of water, she was also asked who she would call for help if she needed to; she relied “911”. They were satisfied that with the changes ‘R’ home would be safe and manageable for ADL’s. Her husband is retired, so, he will be with her to aid in her daily routine.

The p.m. was spent in the therapy room working on UB strength with several ‘R’. Misty had me work with a ‘R’, while she worked with another, I set up her theraputty activity, and did therabar exercises with ‘R’. Misty also went over my interview assignment and signed off on it. I shared with her my other finished assignments and she looked over the information I had gathered about The Beckett House. She was especially interested in the state reviews of the facility I had pulled off the internet. They are due for inspection at anytime, since it has been a year.

Progress note (narrative):

S/OTA had more interaction with ‘R’ in setting up activities.

S/OTA attended her first weekly therapy staff meeting.

S/OTA accompanied OT and PT on a home evaluation.

S/OTA worked with her supervisor on review of her interview assignment.

S/OTA reviewed ‘R’ charts for practice on her note writing, jargon, and documentation skills.

Vicki Dawson,  S/OTA 4-30-09

Week number four of level I clinics are finished. This was a slow week. The OT load is down and I think they are making sure that the level II student is getting the experience that she needs. There is still a lot to pick-up on from observing and by asking questions. Everyone is still very encouraging and helpful.

I mentioned our clinical project that we need to construct so Misty, my COTA/L supervisor, took me to where they store their extra activity equipment. She explained which activities they used the most and why they did not use some of them. They try very hard to come up with activities for each individual; so some of them are only used for someone with a particular interest. They have a spigot board and an electric display that are only used for ‘R’ with those past experiences. They have two boxes that were especially designed for ‘R’ with a mechanical background. These two displays are also used for people who have fidgets.

Speaking of fidgets one ‘R’ room is set up just for that. Her daughter keeps things on every shelf (lots of boxes of different shapes and sizes) so that she can touch them and move them to different spots in the room. She keeps busy all day just fixing and arranging her special things. She has cards on her door and she is constantly rearranging them as well as the pictures on the wall.

She had a napkin with an A on it and she was hunting everywhere for her scissors so that she could cut the napkin into four pieces, so that she could share the pretty pieces with others. Well, we thought why not find her a pair of safety scissors; what harm could that do? On further investigation it was a problem, because she had cut her call button cord in two! She could not understand why she could not have scissors did they think she was going to kill someone! But even at that they were going to get her a special pair that would only cut paper.

One lady has refused 11 out of the last 14 meals; so part of the OT therapy was to get her back to self-feeding. She is a dementia ‘R’ and the past two weeks they have seen a decline in her abilities. They worked for an hour and a half and she took in very little food. They treated her with a kind hand and kind words. This lady has also been a little combative in the therapy room refusing to do her activities

.

But on a more positive note a couple of the ‘R’ have made enough progress that they will be going home this week. One is a hip-replacement and the other had fallen and needed rehabilitation to be able to perform ADL’s. A heart patient is doing very well with her therapy after surgery. They were giving her a test on her standing and bending abilities and she said she would never pass because she never could balance herself on one foot!

On my second day of week four; I got to observe a modified barium swallow test. A speech/language pathologist came from Columbus to do testing on ‘R’ with swallowing difficulties. The MBS test consists of a consumer swallowing different thicknesses of liquids and soft foods; while a camera takes pictures of the actual swallowing of liquids and foods. The ‘R’ I observed has had reoccurring pneumonia and the test was to see if she was swallowing her food properly. The ‘R’ has been insisting on eating in bed; with her swallowing difficulty that has aggravated the problem. Her muscles that involve swallowing work too slowly and the liquid or food ends up in her lungs, causing the pneumonia. The ‘R’ now has to go to the dining room to take her meals with her feet firmly on the floor. She is not allowed to use a straw as that makes her take  in too much liquid at a time. Her meds are to be given in applesauce, because it slips down easier.  The reason for the testing and the results were thoroughly explained to the ‘R’ as soon as the results were gathered.

CASE 1: (S.O.A.P. notes)

S. I am trying very hard to absorb as much occupational therapy information as I can in my level I fieldwork.

O. Student followed Misty, COTA/L like a shadow taking in the various activities of the therapists, staff, and ‘R’. Student participated in a ‘R’ first tub transfer and bath since being admitted to the facility one week prior. Student set up a theraputty activity for a ‘R’. Student assisted in returning ‘R’ to rooms. Student observed a self-feeding therapy session. Student observed a modified barium swallow test given to a ‘R’. Student set up various activities and timed the ‘R’as they performed their activities.

A. Student has not yet absorbed enough information to be proficient as COTA/L; but is striving to be a good S/OTA.

P. Student will achieve goal of becoming a COTA/L by continuing her education and learning from those around her. Continue studying, attending classes, doing fieldwork and passing her boards as per plan of care.

Vicki Dawson, S/OTA 4-23-09

My third week of therapy started on a sad note. The lady that we had worked with last week on her car transfers became very ill on Sunday; sick to her stomach and throwing up. On Monday when occupational therapy went to get her for therapy they noticed a change in her. When they ask for a blood pressure check it was very low. She was taken to the hospital where they diagnosised her with a heart attack. Women with diabetes seldom have pain just flu like symptoms. So the whole therapy department felt bad; this lady has had one set back after another. She is a cancer survivor plus many other ailments. She was dismissed from the facility because her diagnosis will keep her in the hospital for awhile. When she is able to return she will have to start all over gaining her strength and stamina.

The lady whose wheel chair had to be repaired last week is still insisting it does not fit her comfortably. After trying everything, they think the seat was so stretched on her old chair that it was supporting her legs from where they fit in the grooves in the seat. The new seat seems higher because it is taunt and does not give, making her sit a little higher.

I got a chance to actually set up an exercise and helped the ‘R’ get started on the activity. It is interesting to see how the activities that we are learning are applied to the ‘R’. I played ball with several of the ‘R’.

I am also getting a chance to observe a PTA and a Level II OTA student; it is fun to see the difference between what the two students activities include. It is also interesting to see what we will be expected to do when it is our chance to be in a Level II clinic setting.

PROGRESS NOTE: (NARRATIVE)

I feel very comfortable at my facility. I know which hallway goes where. I feel free to ask any question of any of the therapist when they have a free moment. They are all very encouraging and anxious for me to come away with as much knowledge as possible. I was able to conduct my interview with a VERY talkative gentleman. I even had a chance to talk to the administrator of Beckett House this week and he was very encouraging about our field of occupational therapy.

Vicki Dawson, S/OTA

Journal 2

My second week of Level I fieldwork consisted of a lot w/c accommodations, adjustments, and repairs. Misty and Kendra are the w/c experts at Beckett House. The first “R” needed a w/c to go on a field trip with other residents. The “R’s” everyday w/c was too wide to fit on the bus; so they did a search, locate and gather to provide the “R” with a proper w/c. They were also teaching this “R” to transfer from w/c to car; so that the “R” could safely make a trip to a family member’s house for Easter. That is always a good thing when they are going home or are able to even make a brief trip home. On one of the transfer days they went for ice cream. Ice cream is always a positive, spirit lifting activity on a sunny, spring day. This “R” has had a hip replacement and will be going home when she can manage ADL’s on her own. She did much better on her tub transfers this week.

The second w/c repair job was not so positive. The lady is bed fast and is very disagreeable where changes are concerned. Her w/c had to be sent away for repair and she threw a fit and refused to eat and said to put her back to bed and she would just stay there until her w/c was fixed!! The COTA’s did everything to adjust the chair and her table and she still insisted it just not the same! They had lots of patience with her and talked to her about every possible accommodation and nothing would convince her to try the chair for even a little bit! This was a side of therapy that was very interesting; of course I was not the one doing the battle of wills with her. I also got to see the lift used to put her back to bed; I was impressed with the ease this lady was lifted and put to bed. The therapists felt frustration that they could not get through to the “R”. This is an on going problem with the “R”; she can not tolerate change.

I observed and did my observation project on a lady doing preparatory exercises. This “R” makes her home at Beckett House and was noticeably weaker; so they started her on a round of OT and PT to try to build up her strength.

Misty and Kendra do the basic repairs and adjustments on the w/c and a lot of the two days this week were watching them put new seats in w/c and adjusting them for the “R’s”. They also cleaned out the storage area where w/c and parts are stored.

The diagnosis are the same as last week hip replacement, CVA’s, The bed fast “R” has a severe weight problem that has caused her to become unable to do basic ADL’s and she refuses to do anything positive to help herself; it is like she has given up.

OCCUPATIONAL THERAPY EALUATION REPORT AND INITIAL INTERVENTION PLAN

BACKGROUND INFORMATION

Date of report: 4-12-09                                Clients name or initials: Vicki Dawson

Date of birth or age 5-07                              Date of referral: 03-19-09

Primary intervention diagnosis/concern: student to observe occupational therapy practices at facility

Secondary diagnosis/concern: student to learn hands-on methods of treatments and proper transfer techniques as part of weekly  observation

Precautions/contraindications: Safety first for client and student, proper hand-washing to prevent the spread of germs

Reason for referral to observation with OT: To learn as much as possible in the 10 week fieldwork experience

Therapists: Misty Smith COTA/L. Kendra Abbott COTA/L, Vicki Dawson S/OTA

Assessments performed: Completion of OTA classes needed to start Level I fieldwork

FINDINGS

Occupational Profile: student at Zane State College, enrolled in Occupational Therapy Assistant Program, a wife, mother, grandmother, sister, daughter, small business owner, enjoys reading, playing games, gardening, canning and crafts

PLAN

Short term goals: student will practice transfers and positioning of clients

Long term goals: student will become proficient in transfers and positioning

Recommended intervention methods and approaches: student will plan a practice session with other students to work on proper technique for performing transfers and positioning

Expected frequency, duration, and intensity: student will practice each type of positioning 3x, plus bed to w/c transfers 3x, 1 hr. session

Location of intervention: fellow student’s home

Anticipated D/C environment: room with bed, pillows, w/c

Vicki Dawson, S/OTA

Journal I

Hi, week one week of level fieldwork is in the record books.

My field site is Becket House at New Concord, Ohio. Kendra Abbott COTA/L was my supervisor the first day. She gave me a tour of the facility and let me follow her and a Level II student occupational therapy assistant as they did their daily routine. There was a break in the day and I observed the restorative aides in the assisted dining area. I witnessed several of the feeding techniques we were taught last quarter.

Also on day one I reviewed several pieces of documentation and observed several of the preparatory, purposeful, and occupational-based activities we practiced in class ( clothespins on a four sided tree, different sized pegs on a dowel rod tree, ball bouncing and catching different sized rolls on a resistant mat, folding and stacking bath towels, to name a few).

On day two, Misty Smith COTA/L was my supervisor. Misty let me review patient charts and further ways that they document resident care. I interacted with several patients and assisted in resident transfers.

The occupational, speech and physical therapy staff work closely to decide on the best activity for each resident. They have a staff meeting on Tuesdays and a brief meeting each morning to discuss resident care. Everyone is helpful and more than willing to answer questions and explain procedures.

The gait belt was a new experience for me. Each resident who receives any kind of therapy is required to wear a gait belt. I got lots of practice watching transfers and even got to help assist with transfers. I saw my first chair shower. The chairs come in different sizes to accommodate all the residents.

Some of the diagnoses were CVA’s, hip replacement, blood disorders, stomach disorders, and just plain old age.

INTITIAL NOTES

STUDENT: Vicki Dawson

FACILITY: Beckett House at New Concord

SUPERVISOR: Misty Smith

DIAGNOSES: student needs to accomplish 100 hours of fieldwork to meet her needs for her 130 OTA class and to meet her requirements as a student occupational therapy assistant

SHORT TERM GOALS: student will attempt two, five- hour days on Wednesday and Thursdays from 9 a.m. till 2 p.m.

LONG TERM GOALS: student will accumulate a total of 100 hours by week ten to meet her criteria

POC: student will continue hours each week to continue her education

TENATIVE DISMISSAL DATE: May 28, 2009

Vicki Dawson S/OTA

Hello