warning, blog blizzard ahead, READING ADVISORY!!!!!!!!!!!!

READING ADIVSORY....BLOG BLIZZARD APPROACHING...STRONG HEADACHE POSSIBLE....POSSIBILITIES OF BLURRED EYESIGHT...

.I woke up at 6am something after my cat, sleeping near my head, decided to attack me because I moved and he thought my hair was a fun toy. A big ol scratch in my finger later, I was up. I have cleaned out about 120 emails...only 80 something to go, plus about 50 facebook msgs....almost ALL related to OT.  But hey it's a start.

I'm getting some good and interesting job advice...will be posting a lot of stuff soon - another blizzard - since I'm catching up.

this only has to do with koalas

This has nothing to do with OT, but you have to give me a break - it's been a long time since I've been utterly off-topic.

 

This picture- but mostly the caption to the picture - is awesome, in my opinion, although it involves vulgarity so don't read it if you're

easily offended :)

 

http://www.time.com/time/photogallery/0,29307,1881664_1850307,00.html

 

 

Showers, assessments, blah blah blah

Gave a few showers today. Did a few LACLS. Did a driving screen with one guy in my OT's day program, did a quasi-OPPM (occupational performance process model) with another. Got a few refusals. Did a few ADM placemats. Dealt with some tears, some toileting, etc

I was doing something with one patient when his psychiatrist came in to check on him, that psychiatrist said to me "You must be the famous student Dr. X [another main psychiatrist] is always talking about. It's nice you have such an interest" or something like that.

Cool huh!!!

Tommorrow I'm going to do another driving screen, another OPPM, TRY and do groups - I haven't done a single one this week as of yet.

I had my first "real" private dance lesson today after work...we worked a lot on foxtrot and waltz, one movement of the tango, but overall mostly focusing on the "poise, posture, and carriage"...also identifying what dances to what music. Some push pull swing too. My next lesson is Monday...I only paid for 3 total so I'll be done by next week...and I may go to the Mardi Gras dance tomorrow night. Hmmm.

Alright, I'm going to head to bed I think...this weekend I need to clean up my messy room and make some plans for my future!!!!!!!!!!

Jobs?!!

I would ideally like to work as an occupational therapist in an inpatient infant/toddler unit in a children's hospital. I'm looking into:

California, San Diego or Bay Area
North Carolina: Asheville, maybe other areas
Tennessee: Nashville. Probably not Memphis


Anybody know of awesome inpatient infant/toddler units in those areas or others? I'm definitely overwhelmed trying to figure it all out.

Dancing down the hall

A social worker intern wanted to do a group today (WHAT? someone WANTING to lead a group? What is this?!).

I danced a patient down the entire long hallway today, to get that particular patient to the intern's group...a form of redirection...lol...it worked...we did a pseudo waltz/skipping kinda thing. It was fun :)  I wouldn't have thought of it if I hadn't just had a dance lesson, ahahahahaha

PS: I need to remember to buy peanut butter, I want it!!

A quiet day

Tommorow I have a nerve-wracking morning because I'm starting by doing the OPPM on one of my OT's patients, then I'm doing a driving screen (on paper) on her next patient. Being observed for several hours, augh!! lol Then gotta try and do a bunch with my normal patients.

I had to go to a unit today that I hear is scarier than the scariest unit (at times)...luckily it was calm at the moment...I guess I've gotten used to my relatively sedate and relatively slow-moving geriatric patients.

I hardly got any units today...I did two showers this morning, two evals in the afternoon. Oh and I watched  myofascial release today, my OT let me watch her session since I've been curious. I got to help and man, it's hard..I'm not strong!!

Tommorrow after work I have another dance lesson.

So....better pick out dance clothes, better look over the driving screen and OPPM stuff.

No group AGAIN...44 to go. Hope it works out tomorrow, I am not being productive with only 13 or so units a day (need 20)...but it just doesn't happen when census is this low...so many refusals. I think and hope tomorrow it will work.

by the way, sorry...lol

I just glanced through e-mail....I have a TON of comments and/or OT blog related e-mails to deal with....some with questions from prospective students, some from current OTs in mental health wanting to discuss some things, some from OT students with assessment questions/comments... I'm literally more than a month behind on dealing with a lot of those blog emails/comments...so please don't give up hope. I *ALWAYS* respond and it gives me hope and happiness to hear from people. :)

I think OTConnections is an AWESOME idea although I wish my blog would automatically show up over in my account instead of me having to copy paste! Boo! Because I'm lazy and hardly ever remember to do it!! But Penelope Moyers DID ask me to be her friend over there, so I feel special.  ;) I saw in a magazine today that singer Taylor Swift has like a million friends on MySpace. Maybe Penelope Moyers is going to be the Taylor Swift of OTConnections, befriending all! Smart move! Who doesn't love a message saying the president wants to be your friend! LOL

Hmmm...no good title springs to mind.

Did two evaluations today - one behind a mask so I'm glad the patient wasn't also hard of hearing (since my lips were covered/muffled).

Busted out the new cards/markers etc that were donated from a friend...the stuff was popular. My favorite part was when I gave this low-functioning patient two markers, a green one and pink one, she sat there and colored, and then the next time I glanced at her, she was using the pink marker as lipstick and had perfectly put it on. Good thing the markers were non-toxic and washable. My OT, upon hearing that story, told me of patients who would think the stain used in crafts was chocolate sauce and try to lick it up.

I also put some pretty pink rubber bangles on that same lady's wrist...I said Miss X, you want some pretty bracelets? She stuck out her hand in "put on bracelet" pose and I slipped them on. This particular lady isn't my patient, but she is "babied" by staff in a good way...

I did an informal family visit today....went well as we more or less agreed on proper placement for patient after discharge, and I gave the family some literature to read on her approximate cognitive level, for them to get a better feel. They were complimentary and it was a successful first family visit :)

I also found the MADRS (Montgomery Asberger Depression Rating Scale I think) and the Hamilton something. One of the psychiatrists had recommended them to me because he was curious as to what depression assessments we did besides the Geriatric Depression Scale. It turns out the psychiatrist didn't have copies (I printed them off the Internet) and he was happy to have them.

The MADRS is a scale that, in my understanding, is done by the health professional, but I looked at it and decided I'd rather do it in conjunction with the patient. We discussed each question together and I think it was much more helpful done as a joint process, at least from the OT perspective.

So I did the MADRS for the first time, albeit modified, and I also got to do the Rosenberg Self-Esteem Scale for the first time...

My schedule today was quiet again for most of the day...although always when it does get busy, it gets busy quickly. Sometimes I end up helping two different patients in two differently ludicrous situations, at the same time, because of their proximity to each other (ie roommates both in need)...obviously not billable time at that point, depending on what's going on, but hey, sometimes ya gotta do what you gotta do...if that involves ludicrous tasks x 2, then that's what you do, if at all possible.

I didn't get to do group yet AGAIN - only like one of my patients in the room - but I think probably tomorrow I should have 3+ finally. Gonna do discharge planning/leisure activity. Not that I miss group or anything, but my productivity is so low now that I need the units, yo! Only 46 groups to go, lol.

AFTER work, I went and had a dance lesson...basically a modern ballroom dance!! Yes, laugh all you want, I'm awkward as can be. It was actually really good - it works on poise and posture and positioning and all that good stuff. I signed up for a few more...it's a stretch for me, out of my comfort zone, but I believe it's a helpful thing...the instructor kinda got annoyed with me because I was all ADDish, my eyes darting everywhere to see the other dancers...he finally turned me around so I couldn't see anything but him. He also had to deal with my huge "trust" issues - I don't like being led backwards where I have to trust him as leader - I kept glancing back and at one point completely froze because I knew people were near, he was like TRUST ME! lol. I'm one of those people who could never just fall back trusting people to catch me, in those trust-building games you play. We worked on very basic components of foxtrot, waltz, and rumba (sp).

Okay, The END.

Census down...

Well the census dropped precipitously....all of a sudden we were down to 9, and only 5 of them are my patients...the rest are too low functioning for what our intervention is there. Because of multiple refusals and various reasons, I didn't get any productivity at all until 10am something! I ended up not having group because only two of my patients could come to group, at which point you might as well just do individual treatments...I did a lot of Mini Mental State Exams, a few leather lacing, a few ADM tile trivet tasks, and several ADLs.

I *REALLY* am starting to dislike the LACLS more and more...it frustrates almost all of my patients. And therefore frustrates me.

Tomorrow I have an informal meeting with the family of a patient that used to live alone pre-admission. My first! Let's hope it goes ok, they won't like what I have to say. :(

I got to spend some time - a lot of time - today - just hanging out in the ward, talking to techs, student nurses, patients, etc...there was literally nothing for me to do at times. Especially when rec therapy was going on. If rec therapy has just a small group and it's the only fun they get to have all day, I'm not taking them out of it.

But I felt guilty just sitting down. It was my first time in basically 7 weeks that I've just been able to SIT for a while. It was kinda nice although I'll try not to get used to it. :) Actually, I ended up losing track of time, I was up in the unit until 3:45pm and then I was like OH MAN I forgot about notes. So I didn't get off work until 5pmish today. I guess 745 to 5pm is a normal day for a lot of people.

I only got EIGHT units today...I had several different sessions that were exactly 22 minutes...ie 1 minute short of two units...so I probably would have had at least 10 units if I had just one more minute on those units. I gotta say, ethically, IT IS SO HARD not to just rationalize the minute away and charge two units....like you're at 22 minutes and you think "I forgot to look at the watch until a few minutes into it, so I am sure it's okay..." but that's a slippery slope. Ugh. Luckily my OT had a very very busy day with 27 units, so she carried me through. There were days I had like 26 units and she had like 10, so I guess I don't feel too guilty just yet. I know I have at least one eval tomorrow, although several are being discharged...I may end up with like 3-4 patients only!! I'm gonna have to be creative to figure out what to do with them all.

You know what sucked today - is I had to clean up poo, multiple times, from the shower, and it wasn't even my patients or my issue. But two different times the techs left the shower with poop in it (a lot of low functioning patients poop in the shower, maybe because they are sat on a shower chair with a hole and it triggers toileting?), and I was like um....are y'all gonna clean it? They were like, housekeeping can do it. And I was like nuh huh. Housekeeping might not show up for hours and people need their showers...and I need to do them for ADLs/meeting goals. If it happens again I'll say something (it was a tech who isn't that familar with this unit which requires more um, dirty work than most)...but that's ridiculous...you take a patient in there and they make a mess, you clean it up. Don't make the next person do it. Not fair at all.

I am going to go look for some self-esteem/self-worth worksheets for a particular patient....and my groups tomorrow will be on discharge planning/leisure activities. Hmm, what else.

Oh...and cool thing...a friend sent me a box and I was like what is this...open it up and it was DECKS OF CARDS! CRAYONS! MARKERS! SQUISHY BALLS! Awesome stuff!! So I'm taking it in tomorrow as a donation...I am excited!

By the way, I forgot to share this awesome story from about a month ago, I had a black female pt who looked at the flimsy little comb the hospital provides, (no match for a black woman's hair) and said, "What am I supposed to use this for? To comb the hair on my tinklebox?" and then she burst out laughing and so did I.  It was pretty awesome.

Lester the Lion Kitty learns the LACLS

Lester is NOT a 3.2, as it turns out.

Lester the Lion Kitty: Prairie dog at heart

I LOVE LESTER THE LION KITTY!!!!!!!! He loves his treats so much he is willing to stand for them!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! And sneeze. At least not in my face this time.

Centennial Vision Moment, Dum Dum Dum

Pt = patient, shorthand, in documentation. I keep forgetting to write out patient. Sorry.

Today was a relatively normal day, plus an extra special Centennial moment.

A friend jogged my memory about the COPM, which reminded me of the Occupational Performance Process Model (OPPM)...I remembered a case study in our book "Individuals in Context" that I really liked, as it detailed the steps of the OPPM used to help a lady with major depression after the birth of her second child, and ended up inpatient. I have a patient with severe depression so I decided to use that case study to help me use the steps. I had to do my own modified version because I have a much shorter timeline and limited resources, but it still was AWESOME, and I really felt like it was therapeutic and functional.

Today I wrote myself a skeleton of OPPM, then met with the pt. The pt and I came up with occupational performance issues (OPIs), based on me asking pointed questions about typical days, both before depression and during depression. (People with severe depression can have a hard time coming up with own ideas, concentrating, etc) We discussed importance, performance, satisfaction, of these performance issues, with some trouble, so I did not use that part, even though I know it's key if the OPPM is used properly. Since there isn't a way to follow up with pt after discharge,  I didn't worry.

We discussed patient's strengths, pt's resources, and came up with targeted outcomes and an action plan, with very simple, basic goals, that she agreed were reasonable...after lunch I put it all into the computer and typed the goals/all of it up, with extra spaces for pt to add more strengths/goals. I put one copy into the chart and gave the pt a copy. The psychiatrist showed up right as I was putting it in her chart and I showed it to him and he was like "This is GREAT! This is what OT is all about! Does OT work on the other units?" I said yes, if the doctor orders it....I forget his exact response, but it was along the lines of "You may regret telling me that", ie he was going to start using us more often on other units.

It turns out this is a reimbursement problem for various reasons I don't fully understand, but if a doctor orders it, we do it regardless of reimbursement? I guess if we get this huge deluge of orders we'll have to narrow it down, but it was clear the psychiatrist was enthusiastic and pleased with the specific, detailed functional goals made to promote pt's success in participating in activities of daily life, after discharge.

I enjoyed the process - I spend most of my day doing things I don't find very therapeutic, as it is mostly cognitive assessments. This was one of the first times I felt like a real OT (student). I've said I don't particularly care for the rotation in general as I don't like the unpredictability...but working with people with depression/anxiety for mental health OT, is kinda cool. Too bad it's hard to find a job that lets you only work with that specific population.  ANYWAY....it was an awesome CentenniallyVisionish moment and I'm proud. Considering I didn't even use the model properly (mostly used its skeleton, missing a few ribs and a leg bone) and it was still powerful, I can only imagine its power when used right!!

Random "Stand out" moments of day:

1) Rescuing a lady in a wheelchair being pushed unwillingly by a pt wandering aimlessly. I've noticed patients with Alzheimers at the stage of wandering in the hall, will push wheelchairs, whether people are in them or not. Of course typically the pt in a wheelchair doesn't appreciate this, especially if the pt is pushing them into closed doors. Luckily typically the staff catch this early and stop it.

2) Patients being extra demanding/needy/restless/fidgety all at once - which started around my group time, lol. I didn't do anything special or different, but by 1035ish I had only 2 of my own patients left, so I stopped there at the end of the first group (on self-esteem), instead of doing another one. If this had happened earlier on in my rotation I might have felt like I did something wrong, but now I know that some days are better than others, and sometimes it seems like patients feed off each other and all end up wanting things at the same time...either they're all calm or all upset.

The rec therapy student had a flop group this afternoon too...she was frustrated and asked me advice...I told her not to feel bad because that's just the nature of it...some groups work, some don't...it might not work one day, but work a few days later...

3) A nurse and I did a rather complicated toileting ADL for a woman who requires a lot of assistance...I was proud because I did a good job with the transfer helping, yay...and also, that nurse afterward, who doesn't normally work the floor and doesn't know me, told me randomly, "You're sweet. You have a good heart, I can tell." and then walked off.

4) Did an ADM placemat task (copying shapes/colors of a placemat, onto a blank one, using felt pieces) with a lady who did it slowly and steadily and perfectly - except for the upper right quadrant. Probably a visual impairment rather than a cognitive one.

One last thing...

an achievement...I saw on the nursing/social worker notes that often accompany a chart, that the social worker had mentioned to a particular patient's family that OT would be assessing patient for safety returning back to living alone.

Six weeks ago, the social worker didn't use OT at ALL for anything, and now she comes to me for any patient that may be making a change of living situation, asking me to do the Cognitive Performance test, etc. We talk almost daily for a few brief minutes about patient statuses...

I hadn't really thought about it because it's become a norm, but when talking to my friend tonight, I realized what a change that is from when I first started there, and I'm proud to say it's 100% because of me going to her and letting her know we can assist her. She hadn't realized. It helps her a lot to not have to make the decisions quite as blindly so she is happy to utilize OT now, and it's just become commonplace.

Talk about Centennial Vision! Woot! Alright, no more bragging...just realized how things have changed.

Week 7, Day 3...

Today was a catch-up day. A few people had been discharged, and no evals. So I made a list of all the assessments I needed to catch up on. Mostly a ton of ADM placemat tasks (a task where you have a patterned placemat and a blank placemat with felt shapes, and have them make their placemat match yours. Helps you gauge cognitive level up to a certain level...many of my patients are around a 4.4 level...don't have the form to remember what that corresponds to, but they definitely require quite a bit of cognitive assistance).

Also caught up on the geriatric depression scale and mini mental state.

My depression scale lady scored off the charts for depression :( I gave her a Tangle to hold while she answered questions because she was restless. I think she liked it.

I don't tend to push patients who do poorly on placemat...like I give them a chance or two to see if they can make theirs like mine, but if it is clear they can't, I'll be like "That's a pretty pattern you're making, I like it"...no point in frustrating them in my opinion, if they are nursing home level anyway especially. One man today made a beautiful design that looked like a big flower made of hearts. Very artistic. It surprised me. I wish we had more supplies so the patients could keep what they make instead of it being taken back part - which I know isn't how it's supposed to happen, it's supposed to be used therapeutically and fully, but with this economy and understaffing, that's not possible. Let's say it's been 8 minutes and it's clear what their score is. Technically I could be like "Okay that's it and move on, since I've gotten the billable unit. But if they're enjoying the task, I'll give them the extra 5 minutes or so to play with it, before I stop them, so that it's at least SLIGHTLY therapeutic in the sense they are immersed in the activity.

I get frustrated with lack of supplies in unit - again, economy, short-staffed, and tendency of patients to destroy/lose things, makes it hard. But still - some magazines, a bunch of playing cards, a bunch of crayons and adult coloring book pages - not that hard. Anything. They have NOTHING besides TV and a few groups a day. Lucky ones get magazines or books brought to them. Some of them get restless and bored and cause nurses/techs issues because they have NOTHING TO DO.

I wonder if foam dominoes exist, so they can play without it being dangerous if someone gets angry.

Today I did one group on orientation in multiple planes - a little easy for most of them. Can I be embarassed to admit that one of the questions asked what century we are in, and none of them knew, and I was like...ummm....I THINK 21st? It's one of those things you hear but don't think about it until an embarassing moment like that where it's like I AM TOO IGNORANT TO LIVE! EGGPLANTS ARE SMARTER THAN ME! None of them were too perturbed though, lol. If they don't know the answer, they don't seem to think it shocking that I don't either...thank goodness, lol.

This one lady who wanders around really agitates some of the other patients - apparently she has smacked some of them. One patient in particular, who is my patient, gets really restless and slightly agitated when she is around him. She got really close to him several times and one time started to really get in his face. I had to PHYSICALLY maneuver my body in between hers and him, and with gentle pressure got her to move back. I didn't hurt her or be physically aggressive at all - just needed to get between them as I was worried either or both of them would hit each other.

Hmmm what else. I got my windshield replaced today - it had a massive crack - which is structurally dangerous, who knew. They came to my work, phew.

Oh...we have a patient who was very demanding and needy and needed a lot of physical assistance. I spent a long time helping her with various unrelated things before we finally got the ADM placemat task done. She got really mad at another pt in the room who was just sitting there quietly. She mentioned her higher degree and told the other pt accusingly "I bet you never even finished high school". This was quite offensive to this other lady, who prides herself on learning, even though her learning opportunities have been limited by socioeconomic status and other issues. I told my lady that the pt was allowed to be in there and that that wasn't very nice, etc. I think she was mad about the other pt because she likes all the attention.

Some of our needier patients have left...I don't feel like I'm going to be ambushed every time I leave the nurse's station or enter the unit...although of course every time we loose a few needy patients, we quickly gain some new ones. I hope the census stays slightly lower for a while so I can catch up and breathe and do some ADLs and such. I'd love if it got REALLY low so I could do a lot more one-on-work, but the nurses/techs like it busy so they can make money, of course, lol.

I stopped and spoke to one of my patients who has been not feeling well lately. Sat with her about 5 minutes and held her hand and helped her rinse out her mouth and stuff. I try really hard to look them in the eyes, show them I'm paying attention, sit with them a few minutes, just show them I care. Sometimes I'm so busy I have to just flit around, but when I get a chance, I like to spend a minute here, a minute there, interacting with a patient, just for fun. I do like that pretty much ALL of our groups involve some laughter - no matter what it is about - I especially like it when patients make each other laugh (because of humor, not the mean kind).

Today in group a pt was describing a picture that involved a little child peering into a birds nest with eggs. The pt elaborated, saying "And then the momma bird pops up and says DONT EAT MY BABIES!" and another pt thought that was funny and went with it further. I love stuff like that. I'm trying to figure out how to do a group entirely on humor - jokes of varoius types - and relate it to life skills. Like, maybe focusing on laughter/humor as a coping skill for stress/depression. Hmm. Wonder if that would fly.

I am trying to come up with new groups and not just do old ones - most of them are too dry in my opinion. I end up feeling nervous because I know the topics are boring, and that never flies well because the patients can sense it.

Recently, a patient described a war memory. He has lost most of his words so he is rather Alice in Wonderland like when he describes things in vague terms, but it was clear in the line of duty he had seen some horrible things. He described a story and it was possible to get the gist of it. He wiped tears away. The poor man...some memories never go away.

Alright, this is way too long as normal...

Week 7, Day 2...over

Today was a day of assessments.

Started with watching my OT do the KELS on a patient in adult acute who can't leave the unit (hence no CPT), I didn't much like the assessment. The pt decided to pull up her shirt/down her pants to show us fire burns.

I did two groups - very small groups today - one on "Noodle Boosters" and one on Healthy Lifestyle Habits.

Then I went to Dual Diagnosis and brought the patient to the rehab area, did the CPT on the patient.

After lunch I did an eval on a very confused lady who said her dad could hear the sound of a "pea dropping off a dog"....she later changed it to flea. LOL.

I have a HUGE list of patients to do ADMs on, I'm only a little behind on LACLS, and a tiny bit behind on MMSEs and GDS.

Gotta think about groups tomorrow, hmm. Hmmmmmmmmmmmm. Hmmmmmmmmmmmmmmmmmmmmmm.

Went to gym after work....took a "nap" which was mostly me lying there thinking about patients and who needs what in the unit.

I need to try and remember to stop at a Dollar General or something and get some cheap cards. I'm tired of patients asking for them and there not being any. I'm sure they've had cards on and off and they always get destroyed or something, but still. Costco, sell giant things of cheap playing cards, all with different color backs to keep decks separate, to stock up rehab units and stuff.

Wow, this was an almost short post, how is that possible.

Didn't get anything helpful done this afternoon, but tomorrow is a new day with new opportunities, right?

The Healthcare Cake

My recipe for "Best Patient Care"

1 cup enthusiasm
3/4th cup compassion
1/2 cup respect and dignity
1/4 cup sweetness
3 tablespoons creativity
2 tablespoons patience
4 tablespoons teamwork
2 teaspoons empathy
1 dash of passion
2 pinches of hope

Gather ingredients. Stir together in one large bowl until well-blended. Bake for 30 minutes at 350 degrees. Let cool. Share with others. Enjoy.

Week SEVEN

Did a group on stress (identification of symptoms, stress reduction) and one on relaxation. The tables in the day room - typically in one long arrangement like a feast - have been changed to more cafe style, so instead of sitting at head of table, I walked around the room. One of my patients asked if I used to be a schoolteacher and said I'd be good at it. That was really sweet I thought, since I definitely don't feel like I have any group skills.

One of my patients was in rare form today - bright and bushy tailed - one of her ideas for stress reduction was doing something fun - like catching a fish with your bare hands. And then she told us about how she did that once, lol.

I attempted two more times to do an evaluation on a man with serious aggression, but I didn't try too hard to rouse him because he gets aggressive quickly. I just needed to be able to document the attempt. I'm sure he won't get picked up, but have to keep documenting that I've tried.

I have two patients in another unit that need the KELS done - neither can or should be taken off the units for various reasons such as elopement risk so the CPT is out...so my OT suggested the KELS. She has a free spot in the morning so she'll do the first one and I can go off and do the second after...I'm sure I saw it done once in an OT school lab but it's been a long time, I've forgotten. I've now been in the Mood & Stress, Acute Adult, and Dual Diagnosis, beyond just the geriatric psych unit...so branching out, woot.

I have about 16 patients right now...not enough hours in the day to get all their short term goals met, let alone long term goals. I am hoping a few got discharged or will be discharged asap...about 5 of them apparently are all waiting placement but are otherwise stable.

Alright....tomorrow...two KELS...attempt eval again...hope there are no other evals lol...and then try to catch up on LACLS and MMSEs and ADMs....ADLs would be nice but take a lot of time so unlikely. And of course groups.....as a friend pointed out, only 58 to go....

Ummmmmmm...........maybe I'll do one on an AARP article about boosting "noodle" (brain) power...haven't done that one in a long time. And maybe a lifestyle habit one using bingo chips...asking wellness questions and if they answer yes they get a bingo chip...ie accumulation.......something along those lines. I don't hardly prepare for my groups anymore - most of them are repeats. I remember when I first started there I could not fathom just grabbing something in 2 seconds and then doing a group...but it's not that hard.

Rereading that paragraph it sounds like I don't try. I do spend a LOT of time looking up ideas/topics for groups...but in terms of sitting down and plotting it out, that hasn't been necessary...once I have the topic in mind - that is the hardest part - the rest is not hard. I've gotten books from the library on art therapy, spent hours searching the Internet, used some guided meditations, brought in my own relaxation CDs, etc. So I do try to think outside the box.

I saw the doctor today and changed medications. I'm weaning off one and starting two others...a little bit (okay a lot) more medication than I'd like. I think that when I swallowed my new pills this afternoon, I also swallowed some hope. This evening for the first time in a long time, I felt some mild energy/motivation. I got some paperwork done and cleaned out about 70+ emails...although of course have 220 to go. Not counting being about 100 Facebook msgs behind (many of which have to do with OT).  If this feeling of hope and motivation continues, I may actually get those Christmas thank you cards done this month...wow. lol.

Hey I had my midterm today. A lot of 2-s for need improvement, some 3s for good work, lol. I passed, that's all that matters. I don't think I've done any worse on this rotation than my others, this OT is just a tougher scorer!

Apparently there is an OT blogging carnival coming up...read about it today after seeing a comment about it. Will post on it later. And other stuff.

All y'all need to keep your fingers crossed that my hope, energy, and motivation, stay strong, so that I can get through this next 6 weeks with courage and grace, giving my best to my patients, my best to myself, my best to family and friends.

BLAH!!! BLAH!! BLAH!!!

Um....I've been hit by a little old lady, watched the smearing of feces, watched the spontaneous public disrobings of patients, dealt with auditory and visual hallucinations, and delusions, and aggression,
etc. I don't think I've written up my day for a while, I forget when I last did it. Seems the last few days haven't had massively big issues - just more typical stuff. Seems like there were a few things I wanted to share but my mind is blank right now. Just wanted to post so that people knew I didn't fall off the face of the earth.

Have a doc appt tomorrow afternoon - need a medication adjustment I think - feeling very zombie-ish. Makes work very very challenging as its very VERY busy - much higher census than normal - so there is VERY RARELY downtime. If you feel like a zombie, running around all day long is a very daunting task. I need to do my midterm questions by the end of this week. And start working on professional development evaluation stuff. And register for class on taking the boards/get review book. And deal with the over 300+ emails and such. And start planning trips/what happens after this final six weeks are up. I'm on month 8 of 9 months of fieldwork - my fieldwork baby is about to be born, ha ha ha. I crack me up. Anyway, it's pretty freaky to try and figure out what is next....ooooh.

Lester the Lion Kitty is soooo cute/sweet....

If anyone I see regularly has some extra decks of cards, please donate to me.....I'd like to take them to my geri unit.

Ok...hmm tomorrow's groups....maybe one on relaxation and one on boring nutrition. boo. lol. Hmm...

I guess I'm going to try and go to bed...if you've emailed me asking me to answer questions re OT school....I promise I ALWAYS answer....its just sometimes a very, very delayed answer. Like I'll probably send out my Christmas thank you cards in March....seriously. :X

Week Six.

Today was neutral. Not great, not bad. I admit every weekday morning I wake up feeling slightly nauseated and anxious as I realize I have a full workday ahead of me. I try and give myself pep thoughts, think positive, breathe deeply, try to relax, etc. But it's a yucky feeling. I know it's going to stick around probably the rest of this fieldwork as well as a while longer, as I figure out where I'm going to be settling down for work...I steel myself each time I enter the unit because I never know what to expect...

I heard my first Code 100 today....which means combative patient.....it was around 4pm and my supervisor had just left (early for the first time in like forever), so I couldn't go as a student without a supervisor around, but my heart still raced!! (Technically anyone with training who can go, should go...I've had the training...although I'm forgetting it!). It's probably my fault it happened, lol, because I saw the HELP training guy today and we chatted briefly and he mentioned there hadn't been a code in a few months. Tempted fate, oops.

Today the chaplain came in and over-ran my time....I couldn't exactly hover over her shoulder while she sang about Jesus but I did lose quite a bit of productivity. But I just hovered in another room and didn't disturb - I think the patients need that time for praise and reflection and relaxation and song and I wish she came every day. I was glad she was there, just wish her time didn't affect mine! I lost about 8-9 units because I could only run one group instead of two...I made an executive decision to run one longer group instead of two overly
short groups. Especially because the rec group had involved exercise and one of mine involved some exercise, so I crossed that one out...I did one on self-awareness...using advice...ie, what advice would you give someone younger/less experienced than you, regarding various themes like friendship, relationships, education...one person said "Don't get married at age 14 like I did"...yep, good advice. We discussed briefly at the start the importance of reflecting on the past, good and bad, and thinking about own experiences and satisfaction, and what you've learned from your experiences you'd want to share with others. There were 11 patients in the room + 1 who wandered in and out. 9/11 were my patients - two I had discharged due to lower levels and/or refusals, but they were there today. Two others slept the entire time and didn't participate so although they were at the table of my group, I didn't charge for them obviously.  I think some of the techs think of my group time as a "break" which frustrates me - if there are 16 people on the unit and 11-12 of them are in a single room with me doing a group, how about one of y'all techs stick around in the room in case a pt needs something, which is inevitable?

I guess I've come a long way that 12 people in a room with me the leader, wasn't too stressful.

One lady kept wandering around dropping her pants...not sexually, just randomly... I was in a room with a more or less bed-bound man, and this lady wandered by, and he hollered YOU KEEP YOUR CLOTHES ON! I DON'T WANT TO GO BLIND! And he explained to me she walked into his room the other day and got buck naked. AHAHAHAHAHAHA Yikes. I bet he was like noooooooooooooo!!!!!!! noooooooooooooooo!!!!! Poor lady....

Ummmmmm.......I'm way behind on lather lacing. I really don't like the LACLS....and I'm still not so hot at the single cordovan stitch. :x But it's a goal for pretty much all my patients so I better get crackalackin. I think my OT would have a heart attack if she realized that I have like eight more people to do it on...:X I'm pretty caught up on ADM/MMSEs....need to try and deal with some ADLs. Have two people on another unit to deal with. I'm just thinking out loud here, lol

I got a really nice e-mail from a guy from India who is also switching to OT from a computer-tech-ie oriented career. He was interested in thoughts on OT as a second career as well as cultural differences in OT...I'll have to think about what to write about it. My last supervisor was British and my current one is Australian....wow so cosmopolitan...lol. Gotta think about who else.

Ummmmmmmmmmmmmmmmm..............ummmmmmmm..........gotta think about tomorrow's groups.....

Lester the Lion Kitty and Roger the Cowardly Kitty are messing with each other....Lester has Asperger's I'm pretty sure. No real social skills, but the desire to be social. He needs social skills training.

Ummmmmmm UMMMMMMMMMMMMMMMMMMMMM I feel like there is more to say......what what what..........oh.......an ethical thing.........let's just say I'm doing an eval with a guy in his room..and then at 917 another patient comes in and tries to get into his bed and generally causes a mini ruckus that takes, oh, 5ish minutes to resolve...and then he and I finish up. And then when it's time to bill...do I count that time? Technically I was in the middle of an eval, didn't leave the room, was still with him, but was forced to deal with another patient. Do I try and glance at my watch and subtract the few minutes of chaos? If I can even remember to do so in the midst of chaos? Do I just bill for the time from start to finish and ignore a 3-5 minute interruption, even if it makes the difference between billing for one unit or two? What's most ethical/fair/feasible/realistic? These are the days of our OT lives.

Ok I'm going to stop my vegetable typing...I'm practically comatose. Hmmmmmmmmm, what does tomorrow's groups bring with probably 10ish patients and most of them with dementia? Hmmmmmmmmmmm

RIP Orange Kitty

]
Orange kitty/black kitty aka cat, my beloved La Jolla kitties....enjoying a rare inside visit while I'm home for Christmas. RIP Orange kitty!!

my poor orange kitty in california has passed away

My mom just wrote my family to tell us Orange Kitty passed away....orange kitty was about 15...we got orange kitty and black cat when we were in 6th grade.....even though i only see orange kitty about twice a year these days when I go home to California, and even though she's been a skinny minnie a long time, it still hurts my heart to know my beloved orange kitty is gone. At least she passed away peacefully inside.... And now poor black cat has to fend for himself....oooh my poor orange kitty...I'll put pictures up tonight. 

 

I'm saaad :(

 

I've got to focus on finishing these two evaluations and a discharge...I've already written up three evaluations...we had SEVEN evaluations today...and an even higher census. Craziness. I only did five because #6 went to the main hospital for medical reasons and #7 I just couldn't fit into the day.

 

Yes I'm sitting here blogging at 230pm but its just a quick 5 minute grief break. MY POOR KITTY!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

 

And now, a moment of modesty...and by modesty I mean "bragging"

My blog was created 4/19/2007...I'm at about 91,000 page views right now....my two-year blog anniversary is in a few months...I'll be (based on statistical trends) probably hovering at around 100,000 page views by then...and well over 1,000 blog posts.  Wow. Just sayin.

Midterm week coming up...and I survived last Thursday....

Friday was better than Thursday...the patient I was worried about was okay (ie the incident report thing). Plus, I felt better when the awesomely experienced beefy man tech admitted he practically cried too that Thursday afternoon, because things WERE so insane. He thought about quitting! So it validated my intense stress levels to know I wasn't the only one way overwhelmed. Poor guy.

Hmmmmmm, I'm trying to think of Friday, but honestly it's blurring up on me...I was kind of in a daze. I was really gun-shy about going back to that unit after Thursday's experience. Luckily we were more fully staffed and with good workers and so it wasn't so bad. Plus the hardest (for me) to handle patient, group-wise, had gone to a "real" hospital for medical reasons, so it was a little quieter. I did make a few documentation mistakes in the computer so I had to write the same note THREE TIMES - ugh, lol. My OT let me go a little early -
I left 45ish minutes early (I stayed an hour late Thursday). My OT warned me she grades low - she gives mostly a score of 2, Needs Improvement, at Mid-term, and usually a 3 at Final....yay. Low scores, just what I need to boost my confidence lol. No, I guess it's good. And I do need a lot of improvement. Although I think OVERALL - considering how crazy things are - so understaffed, her running the neuro day program and me running a currently high-census area - that I'm doing a pretty good job for the most part!!!!

My patient who scored sooo low - in way severe dementia range - scored almost three times higher - now in moderate dementia range - and was much more in it. I'm getting deja vu, I feel like I must have already written this all up? She is in a different unit...another patient came up to me and asked me something utterly outlandish...I was like....ummmmmm.....lol.

This is midterm week coming up.....week 6....six more weeks of rotation...wow. I need to start figuring out what next, SOON, huh....:x

Soon to come: My cat and the ACLS...a perfect match.

AUUUUUUUUUUUUUUUUUGHHHHHHHHHHHHHHHHHHHHHHHHHHHh

This afternoon SUCKED. SUCKED. SUCKED.

This morning I got to see the CAM done - did a group on discharge planning/leisure activities (9 in first group!!). Did a few ADM placemats. Tried to do an eval with a really nasty (ie mean) lady who refused...

Went back after lunch to do an eval etc.. AND IT WAS CHAOS AUGHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. AUGHHHHHHHHHHHHHHHHHHH
AUGHHHHHHHHHHHHHHHHHHHHHHHH
AUGHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH
AUGHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHh
AUGHHHHHHHHHHHHHHHHHHHHHHHHHHH

The worst part of the day I can't share ...let's just say an incident report was filed and it was partially my fault. My OT was really understanding though....and I learned an important lesson.

So....the census is almost double as high as normal....and this afternoon we were short a tech for whatever reason, and it was just overly busy...I coulda been like "No I can't help you...or you...or you...or you..." because none of it was billable, but it was a conscience thing. In good conscience I couldn't turn my back on these people....like the restless fall-prone guy who was getting out of bed by himself...but just needed his jacket off because he was hot...and then another lady was so restless and jumpy-out-of-her-skin because she was desperate for a sense of control and wanted her clothes...which were lost...blah blah blah...we finally found them in her OLD room...but I spent easily 30ish minutes with her...she was NOT doing well and I knew she really needed someone to give her some attention and at least a modicum of sense of control and that finding her clothes wasn't high priority, obviously, to busy nurses/techs. But I know her well enough as my patient to know she really needed this. This poor lady needs a lot more than meds to keep her from coming back - she needs a lot more coping skills/strategies. While I could have turned into a treatment, I was stressed and busy and trying to do a thousand things, so it wasn't a treatment, lol. Then I was helping a mean lady's diaper get changed, stuff like that. Then a wheelchair seat belt alarm went off and I went to the guy who had taken it off, he was cursing and tried to hit me when I went to try and re-do it so the alarm would go off. I turned it off a second to spare us all the high-pitched screech. I tried again slowly but he was still mean and angry and swiping/cursing. I had to get the insanely busy man-tech to help me. Then there is the lady spitting out her meds onto the floor next to me, the lady stopping me to ask this, the man wanting this, blah blah blah. It sounds like it wasn't a big deal, but it was REALLY stressful to see so many of my patients having issues...these people have so little control, so when the techs/nurses are too busy to listen to them or help them with low priority things (high priority being injuries, medicines, admissions, discharges, etc), that the people get upset.....and that incident I can't discuss in detail (just for self/hospital protection) REALLY stressed me out...I was sure I'd be in soooo much trouble...luckily I think it's all going to be okay...did I mention AUGH?

We have several max assist stroke patients in there now - which I'm not really able to handle by myself - I guess really they are mod/max assist x 2 - and they would ideally get some therapy for their affected extremity along with everything else - and many of them would benefit from physical therapy - but there just isn't any to offer....ugh. It's frustrating to know some of these patients aren't getting all their needs met....and time is taken up with stupid stuff like finding or ordering more gowns, finding a diaper, waiting for more towels to be brought up, trying to find a pillow (never did find an extra)... to prop against the back of a stroke patient, etc...

I finally left the area ....after having been there an extra hour+ after the final billable piece...basically doing tech duties......to me, a person with major depressive disorder and no coping skills, who is restless and getting agitated and feeling no control, needs some immediate soothing and help, even if its a low priority thing....even if its not billable or productive...but just because it is in the best interest of the patient. Oh and while trying to leave there is the cursing and gesturing man blocking the locked door, bleeding, other elopement-happy patients near the door, etc...even trying to leave was kind of an ordeal.

I went down and called a friend quickly and cried...from all the pent-up stress and from the incident....I'm still kinda shaken up but once I go in tomorrow and see everything's okay, I guess I'll be okay again....learned a sobering lesson. Sorry to be so dire and mysterious, it's not like I massacred fifty patients or anything, just safer not to go into detail.

Ummmmmmmm...........anyway......luckily the friends I am staying with are nice...my friend that I cried to went and got yummy food like guacamole and yummy ice cream, and a few other little gifts, to make me feel better!!!

Gotta steel myself and get through tomorrow...gotta figure out groups....next week is Week 6...midterm evaluation......ummmmm

mini update

It's 510 now, I got here at 745 and had a 15 minute lunch. No breaks unless you count crying, lol.

 

I finally finished notes...spoke to my OT...this afternoon REALLY, REALLY, SUCKED. I'm going to go to Curves gym even though I don't want to because i need to exercise out some stress. AUGH. Chaos.

 

 

Oh my gosh, please kill me

I just had like the most stressful afternoon in the world in the psych unit. I want to cry, really. Yikes. But first i better go write 16 notes and an eval.

 

 

A squirrel in the pants: I've got nothin'

Week 5, Day 3, Complete, of Geriatric Psych Inpatient, Level II OT Student Fieldwork, Third rotation, so Month 8 out of 9!!!

Funniest story of day: Lady convinced there is a squirrel in her pants, causing mischief....when the family called for an update, the nurse had to delicately explain the belief of a squirrel "in the vicinity", leaving out the in her pants, part, lol.

Most yikes story of day: Lady telling me there are men in the cellar doing sexual things with the girls, and to be careful...she brought it up several times.

---------------------------------

Today I only got 24 units (which pales in comparison to my 29 or so, but is better than the 20 I am supposed to aim for as a minimum).

I did one eval, several ADM placemats, several MMSEs, and several groups.

Eval: confused lady sure she was in the wrong place...frustrated with inability to handle questions....felt sorry for her.

ADM placemats: Its amazing how poorly do with copying a relatively basic heart-shape pattern.

MMSEs: this one lady in her 90s counted backwards from 7's from a 100 without trouble, but only got 2/10 basic orientation questions. Impressive.

Groups: Not so inspired today. Everyone was sleepy, and I wasn't overly excited about the topics. By the end it was a little like pulling teeth...not horrible, but not easy and fun...just kinda blah. Plus we had quite a few distractions. But the tech in the room - who I really like - praised the attempt at the end and everybody clapped and I was like awwwww.....lol. I thanked her later for her encouragement and she was really complimentary and sweet...my groups are improving although today was a regression lol. I think *I* have to feel the group has merit/good qualities, or they sense my unease. I really like overall the discharge planning/leisure group, relaxation group, exercise group, and somewhat Social Bingo group, but just about all the rest haven't really been so hot. Think think think lol.

I know I say this like daily, but I can NOT BELIEVE I'm sitting here running multiple groups of 4-9 people a DAY....it's like shocking to me.

There is a dead zone from like 915 to 10am where I don't necessarily see patients but should...but that is rec therapy time and I hate to pull them out of the one or two fun things that happen in a day!!

One lady told me during the ADM Placemat task how sweet I had been and how she was gonna tell the doc and I was like thinking yeah right! You have to remember who I am first! LOL! ahahahaha. I think (most of) the old ladies see me as a grandchild age and treat me accordingly...we finished it awfully quick and then she held my hand and we chatted a while about her passed away husband...her hands were cold and she has arthritis so I stroked her hand and listened to her chat a few minutes...it was nice. Some of them remind me a lot of my grandmother...the good parts of them, at least, lol. I love my grandma. (And my other grandpa, I need to call him!!)

I'm back to struggling with massive fatigue again.....it seems like if I don't sleep for at least an hour-hour and a half after work, I can't make it until even 8 or 9pm...and I'm just so tired the rest of the evening regardless if I sleep or not...it means I get very little done after work because I'm so foggy. Everything piles up...I need to pay bills, start studying for boards, work on final professional development evaluations, respond/handle the hundreds of e-mails I have stacked up, many of them OT related, and start planning for what happens after the rotation!! I've gotten several emails lately with great questions from potential future OT students...I may just ask them to call me. I've talked to several people on the phone who had questions about OT school and had emailed me. I have to be careful when I talk to them though since my calling plan is limited!!

Okay now I'm just rambling........gonna go to bed I think...tomorrow I'm going to force myself to go to the gym after work since I skipped today....

I think there will be at least one eval tomorrow....2 groups....and then I really should do a bunch of LACLS and catch up on ADLs and ADMs and GDSs.....ooh alphabet soup lol.

Ok...um...groups tomorrow...hmmmm.....think, think, think....lol

Ummmmmmmmmmmmmmmmm

Today I did an eval, a CPT, 2 showers, and groups with 8-10 people in them at any time, including one lady coming in and out causing trouble. Got 26 units....

Group was actually....almost but not quite....fun....the first one was a Social Bingo game and my favorite is when they get a square that requires giving a compliment to someone on one side of them....

The next group was on relaxation....each of them talked briefly on if they relaxed or not easily, and how they currently tried to relax....some ideas better than others, lol. We did one quick guided meditation, some chair yoga, and listened to an native american flute CD with eyes closed/lights dimmed (Canyon Trilogy by R. Carlos Nakai I think)....it was kind of a quick "imagine the possibilities" on relaxation....most of them were pleased with idea of listening to CD. Afterwards we discussed the visualizations, etc, and what each person would consider trying as new form of relaxation. People seemed to enjoy the group, especially the music, and overall it was pretty fun.

I think tomorrow we're going to do one problem-solving group...and hmmm...

Short entry tonight. No very intriguing people today.

Week........FIVE?

Today was very busy...4 evals and a census of 12 + 1...all mine...lol. I had NINE people in my first group....yep, nine. Me and 9 psych patients. In that group was a combination of people with psychotic features, mood disorders, major depressive disorder, and dementia......and two monopolizers. Ack. I keep marveling at the idea that I'm running these groups.

first group on self-awareness, second group on coping skills for depression. What irritated me is some pheblotomist or something came in during group and while I didn't mind that she obviously needed to do her patients, I minded that she ACKNOWLEDGED it was group and that I was doing it, yet stayed and talked to the patients in the room at a normal level. Either take them out of the room or at the very least, talk quietly! I was like WHY LADY WHY. Then she came up with the great idea of us getting a van so we could take the patients to an animal shelter to cuddle them. I was thinking.....these people are here like a WEEK with ACUTE issues....most of them combative/aggressive when confused...no way are group community outings appropriate for this population during this type of hospitalization. Anyway, I was rather surprised at her level of obliviousness in terms of being quiet even though she knew I was doing group and was actively loudly talking over her. My OT told me I should have asked her to be quiet, but I don't think that would have gone over well with her, seeing as how she was an employee.

One patient spoke up and told me I was a great speaker and she enjoyed group and I was like aw, thanks! Then the lady next to her was like "You said that to the last lady too!" and I was like....oh man, deflate my balloon or whatever.

One monopolizing lady with lots of pain issues was like "I have pain, I should go lie down...but I think Satan is the one trying to get me to do this. Satan, I rebuke thee in the name of the Lord! I'm going to stay." .....several times she rebuked Satan. I was like ummmmmmmmmmmmm. lol. She reminded me SO much of the lady on Trading Spouses or whatever, the Christian lady who went crazy and said THE EXACT same thing  (I rebukee thee...) as she screamed at cameramen in her house.

What else.....during an eval today a lady with hallucinations who was perfectly sweet and appropriate said "Oh, there she is waving at me, I hope she realizes I'm busy"....and yet it was just her and me in the room. It was one of those "Am I crazy or did she just say that?" blink-and-you-missed-it kinda moments. You know how we blink and miss it? What happens when we miss it with our ears, since ears don't blink? Hmm, earblinks.

WHAT ELSE........we were listing coping skills for depression and one lady said "eat a lot!" and snickered. Her normal answer is "smoke" so I guess that's a slightly better response. She cracks me up.

Um.....one patient went down on the floor today and they went and got a Hoyer lift to get him back up..at the same time another patient vomited, and another patient who requires 2 people for help, needed to use the bathroom that was currently being mopped...lol. Chaos.

I got 29 units again today....had to write FIFTEEN notes for group alone lol...and have to type out objectives/goals for EACH one since their systems are so old/DOS-based there is no copy/paste!!!!!!!!!

Um, a patient got agitated today and grabbed onto the unit clerk....they verbally took her hands off the clerk, then redirected her verbally....and they casually mentioned she got agitated around this time each day. That is an occupational therapy mystery as to what sets that lady off then. Hmmm. My guess is she had some kind of errand or chore she did around that time previously, and/or that having more than a few hours of down-time with no entertainment, agitates her....since the last group of day is rec therapy from 1 to 130.

Oh....one last backtrack...I did an eval on a lady Friday in another unit than my normal one.....the unit is connected to the acutely psychotic unit. I went into the nursing station which is enclosed in something like Plexiglass and encloses both units. Some guy started banging on the window and yelling and pointing at me. I was like AUGH!!! Luckily my lady was not in that part since no way was I going through there. This lady was WHACKED OUT....young but not a lot of teeth and she got a SIX out of THIRTY, scoring in the SEVERE dementia range...I'd ask her questions like, what month is it? and she'd take like five minutes to ponder it...."Oh...gee whiz....oh....brother....I don't know...."

I think the "What floor are we on?" question is really stupid. If you are in a psych hospital and all messed up, the last thing you remember is what elevator floor button got pushed as you were taken to your floor...."AUGH THE SCORPIONS ARE EATING MY BRAIN OH LOOK FOURTH FLOOR" lol....maybe I don't get the point and I write this in ignorance. It wouldn't be the first time.

Okay....I know this is too long and most people didn't read it all...but now it's all out of my head and I can go to sleep. I gotta figure out my groups for tomorrow though. I'm thinking a social bingo game to work on social interaction, and then maybe a relaxation group....with a mini array of possibilities....I could read one guided meditation, play one flute relaxing music, discuss deep breathing, and maybe do a few basic chair yoga like things. I dunno. Hmm.

Thurs/Fri

So...when I don't write for even a day, I lose it all. Let's recap the very little I remember from Thurs/Friday.

1) Shower with man with dementia, aphasia. Learned the hard way about poo everywhere. And getting wet from the shower. And sweating from transfers. And being cursed at. "G*d-damnG*d-damnG*d-damnG*d-damnG*d-damnG*d-damnG*d-damnG*d-damnG*d-damnG*d-damnG*d-damn". I was WORN out from that experience. But the nurse told me later he won't even shower for most people (and he curses a lot), so I was glad I did it I guess....good experience, but holy cow.

2) Dealing with monopolizers in group....the constant "Oooh let me tell a funny story"......

3) Lady with depression - more alert than most - always present for my groups - who told me at discharge (I walked past as she was waiting for husband to pick her up) that "You are a great occupational therapist. Remember you are not going to get 100% from these people, maybe even not 50%, but it's not you, it's them". I thought that was a very insightful and interesting remark on her part...I really liked her. I tend to really like the older depressed ladies.

[I didn't think that was a good time to reiterate I was a student, lol]

Okay....now on to TODAY.