Starting Week 4...

So I have not been good about writing much...likely due to being pretty exhausted, but overall things are going well. I rarely get to see patients more than once, such is acute care.  My CI is a manager/team leader, so she gets a variety of patient cases...leads to some very interesting days for me.  I am learning a lot, and at times things can get a bit overwhelming.  Yet I am adjusting and finding a groove, getting down the computer system and how things are done at the hospital.

Not seeing pt's very much has been an adjustment - time management/efficiency is still a working progress. I apparently do one of the best chart reviews out of any one there (which takes more time than others, but hey, I am making sure I know my pt's pretty well before I enter that room).  I've been teaching some of the therapists a thing or two which has been cool.

I do really like that my CI isn't afraid to admit when she doesn't know something...very realistic and refreshing.

So overall, doing alright and it's been a fast 3weeks in already. Not looking forward to working this weekend but who knows, all this cold icy weather is making me make-up hours :-/

Week 1 of Acute Care

So I survived week 1 in the hospital! haha.

Monday: Orientation all day. My brain was fried with all the tests and forms to fill out...then went on a tour of the hospital -I really am hoping to not get lost, haha. Something amazing about the hospital? Dunkin Doughnuts coffee in their cafeteria!!! :-) The little things that make me happy... O, met my CI and I did not know how to take her since she's somewhat sarcastic but very nice.  Got done "early" and with the next day off (surprise!), I went out to dinner and chilled with my friend, Nick, who had me laughing hysterically with Monty Python - just what I needed after hours of Orientation :-)

Tuesday: Off since my CI was out at a Continuing Education Course that was about Disney's Customer Service approach and how to apply that to Health care...sounds like a good time :-)

Wednesday: Arrived for my first day with my CI...went through the computer system and chart review for some patients - they have mainly electronic records but also some paper chart stuff at the patient's rooms so you have to check both. The first patient (pt) we saw had her Nurse in to take blood...and I nearly passed out since the Nurse had to keep poking her to try to get a vein; luckily I stood closer to the door with a chair nearby, looking to the window and listening to my CI ask questions of the pt. And just as I was recovering from my face starting to feel numb, hearing and vision not doing well, and feeling awfully hot - my CI calls me over to the pt just as the Nurse had decided to try again later, whew.  We only had a few pts on our schedule, only half were appropriate to eval...and it's very hard to keep smiling/a good face while you have to help clean up pts or those pts that are really sad or depressed.  But my CI is amazing and really does a great job with pts, family members, and other staff...so I know I'm in good hands :-)

Thursday: My CI had meetings and classes to teach to the volunteers at the hospital so I went around with other therapists.  Got to go to the NICU to see 2 babies - very cute little ones who luckily at this time were not as sick as the babies I saw at Mt Washington's NICU.  Got to observe more co-treatments with OT/PT which was good...and it's nice to see the variety of styles of all the different therapists.  O, and had to go back to a pt's room to get a pillow for the chair since we had them out walking in the halls...surprisingly I did NOT get lost!! Was very proud of myself and the therapists I was with were happy to see me so happy, haha. All the therapists and aides are really nice to me - even the physicians, nurses, and other staff seem very nice.  I have a lot of names to learn in the Rehab Dept- 30some so it's a good thing I am good with names.

Friday: My CI had me come in a little later and start chart reviews to prep her when she was coming in. Of course, my log-in screen is different and try to navigate the 3-4pts I have to review in the hour and a half...I get through the first 2 pretty thoroughly since they are pretty sick people coming to the hospital and have some fairly extensive past medical histories...and getting through the 3rd when my CI comes in but then the last one gets taken off our schedule so that was good. So gave my chart review reviews to my CI, called an Assisted Living Facility (ALF - new abbreviation I learned, haha), then went to see pts.  Evaluated my first pt who turned out to be somewhat confused with new onset of CHF (Congestive Heart Failure) - I did fairly well but was glad a nurse from the ALF came in to give my CI and I some more info while she visited the pt.  The other pts on our schedule my CI took the lead since I'd still have to do documentation after lunch. Some of the things you see are really sad and makes you question family/people's intentions but I guess some people are just in denial, some people just don't care, and some people just don't understand or know.  I get to practice a lot of good body mechanics since I am apparently tall...taller than my CI and most of my pts so far.  Documentation took awhile (surprise) at the end of treating; still attempting to figure out the computer system with all these different things.  Yet I had some good descriptions and goals for my pt that my CI liked - so not worried. 

Traffic in general isn't bad - not any in the morning until I actually get to Frederick so a nice 45-50min drive; I make sure to have coffee for my drive :-)  The drive home there is some more traffic especially closer to 695 but it isn't bad at all - but maybe my views are skewed based on DC/Baltimore traffic, haha. 

I think overall, a good week. I know I am going to learn a lot and have had some good conversations with my CI along with some other therapists/staff :-) Plus I am getting everyone's names down which makes my life easier when I need help and they all appreciate it.  Enjoying my weekend and getting to rest up some, get organized, and prepared for Week 2 in the hospital!

Prep for Int III

So...it's been a good long while since I updated. Yea, sorry :-/

Anywho, Internships I and II went well; I learned a lot and had the opportunity to work with a variety of patients on land and in the pool :-) Then had 6weeks of classes...which was not fun after being in clinic for 20weeks.  Yet I made it through and am now done all of my classes at GW!! :-)

I've been chilling and enjoying the holidays during these 3weeks off...it's been super nice but kinda weird to be off this long.  So living it up!!

Monday morning I start Internship III out in Frederick, MD at the hospital...I did a trial commute Tuesday morning this week and it wasn't bad; 45min drive out Rt70 but I will have to leave my house around 6:30am.  My friend from High School that went to Hood College made a great suggestion for this coffee place :-)

So I am looking forward to getting back into clinic even though I haven't had much time in the acute side of care...should be a good experience :-)  Hopefully I can be better about blogging for this clinical...Monday is Orientation day so shouldn't be too bad as long as the snow isn't terrible and the Ravens win this weekend :-)

Halfway Finished Int I

So I've been slacking on this whole blogging thing for the past 2weeks or so now...sorry.  Clinic has been a bit crazy especially leading up to the 4th of July holiday weekend. 13hour days (even 10hrs) = not fun, but I am pretty comical by the end of those days.
Anywho...I am doing well and have finished up my midterm evaluations, with my CI rating me pretty well in all categories (nothing below intermediate and a few at beyond-entry level!!).  Not surprising that I have lower grades from myself and more in the comment/explanation area than my CI...haha.

Slightly bummed that the patients I typically like working with are all steadily being discharged which is awesome, don't get me wrong, but leaves those less likeable on the schedule still. Still have the patient with a shoulder hemiarthroplasty (she's awesome and doing so well!!), the grumpy man who loves the Yankees and has a herniated disc has turned out to not be so bad once you engage him in conversation (topics he likes, of course) - he's actually thanked me and shook my hand the last two times I've treated him...shocking, I know. Let's see...had an older Egyptian man with a herniated disc who had absolutely no body awareness...made doing exercises ever so interesting especially when he was one of the last patients of the day; some favorite quotes (all when speaking to me): "You ask me to use my stomach muscles; I have none, it is 50lbs of fat there, no muscles", "You weigh 25lbs and I could be your father or grandfather...", "In the real world, we do things just once; one and done - none of these repetitions"...and I could go on, but sadly he stopped coming to therapy last week until "he is ready" via his wife.

There seems to be an influx of patients with vestibular dysfunction/disorders at this clinic...Dr. Blatt would be proud and probably saying "I told you so" when we said there'd be no way we'd be seeing a lot of those patients...up to 5patients now (1 AN, 4 BPPV).

Let's see...o, had my midterm site visit from DeLeo Wednesday which went well.  And Becca came to visit on Friday :-) It was nice seeing some friendly faces...a quiet week off from Tim (the tech who is like an annoying little brother) was short-lived and he was back in full-force this past week.

So hoping the 2nd half of internship I goes even more smoothly and that I can continue to improve.  Biggest things are to work on explaining things with more confidence, more progression with POC/ther ex, more efficient and function-oriented documentation, and more consistent measurements with goniometry (especially cervical).

Start of Week 2

So more and more each day I am with my CI, I can see why he hates one of the other PTs. I am not really a fan of the other PTs there but do love the PTA, Patti. As much as I hate to admit it, I truly appreciate good documentation. The one other PT documents ROM measurements in percentages (yes, percentages) and has a ton of goals (record of 47 for one initial eval) plus she's not the most professional and has that fake-happy attitude...I think the most annoying thing is how she lets the timers run out, beeping for a really long time - silly, I know, but really really is starting to get to me. The other PT does some weird things and her assessments don't say much about what is actually going on with the patient and documents exercises not really well (I have no idea what she does with them but certainly doesn't do any manual therapy is for sure). The PTA, Patti, is pretty cool and really smart. I can see why everyone gets along with her.

Today presented some more unique patients...one initial eval pt is an overweight gentleman who apparently has a herniated disc in his lumbar spine from picking up a groundball since he coaches and plays baseball; he flat out told us that he didn't care what we had to say about the causes of his symptoms and what we were attempting to do with therapy - he just wanted a quick fix and doesn't really care about the exercises. So it'll be interesting to work with grumpy I guess.  He's kinda like another patient we have who refuses to do any real exercises - just wants heat and stim for his neck pain even though he has muscular and joint restrictions in his ROM. 

Had some more patients in aquatic therapy today, however, still learning about the routines they do and where to start patients out. One gentleman started feeling nauseous near the end of his session so that was cut short - very odd but guess we'll see if it happens again, I was so ready to grab the little trashcan for him to throw up in, haha.

I don't think I knew there'd be so many patients with partial menisectomy procedures that were such lazy people...my CI has warned me about being optimistic about them.  And as much as I hate to admit he's right, he probably is...learning a lot about insurances and what (not always, but usually) the type of insurance along with MOI leads you to assume about the patients coming into the clinic.

O, and lumbar disc replacement? Yea, have a pt with that who also happens to be a PT...she's pretty advanced but "has pain still" (MOI was transferring a pt using stand-pivot transfer). She likes me but pretty sure she can do more than what she leads people to believe...plus no real info on her surgery as it's still in clinical trials really. Fun times.

Another interesting patient (there are a couple actually, that I like). A lot of patients with Parkinson's Disease which is cool to use Neuro stuff and a patient with a hemiarthroplasty/total shoulder replacement is another interesting case.  Learning a lot of manual techniques and figuring out the best way for me to do them as my CI is a lot taller and has bigger hands than I do (plus about 60lbs).

Looking forward to doing some marketing with my CI and learning more about the billing/insurance stuff.

Survived Week One of Eight with a Yankees Fan

So I've survived week one of eight in clinic for my first full-time clinical internship/rotation...my CI is a huge Yankees fan but we get along pretty well. I am getting used to being in clinic for 8-10hrs+ a day and more confident in working with patients.  There are some interesting patients coming in the clinic and some pretty fun ones.  It's a good thing I enjoy and like sports, the older gentlemen get a kick out of that and love chatting it up with me (especially about golf) when we're working together.  And I think most of the patients enjoy how smiley and pleasant I am even at 7am...

I am surprised at the number of patients with parkinson's disease or pseudo-parkinsonism at clinic and they are all at different stages. Going to review that section from neuro rehab/CCIV again to maybe incorporate some different things into their treatment sessions.  One patient case of pseudo-parkinsonism in particular is rather difficult since the patient needs a lot more medical and family intervention...it's trying to just keep the older gentleman awake and help him move.

And I think by the end of this affil, I'll be tired of LBP and/or pretty good at it (at least competent if not quite competent or outstanding, haha). I will also have a pretty good grasp on all the psychological issues that come with patients, even in outpatient and in working with others.

And just when I think I am doing pretty decent with my documentation for daily treatment notes, it takes me forever to add exercises to the treatment portion of this computer documentation system. It takes me forever especially when I try to find all the sections (like the other PTs and PTAs do at the clinic) instead of going under "other" and typing out a description (which is what my CI does all the time).

Experienced two sessions of aquatic therapy which was not too bad, but was rather difficult to think of exercises for a patient with chronic pain/fibromyalgia among other things since every (literally every) thing hurt this lady. Pretty sure her like 5 various physicians prescribing like 10 different meds for her doesn't really help either...but I'm just a PT student, so what do I know.

Anywho, will be going over protocols this upcoming week and hopefully get some more aquatic therapy experience.  Need to come up with some more complex lumbar stabilization exercises for this patient that is a PT who hurt her back transferring a patient (she appears pretty fine, but we'll see).  My CI has been showing and teaching me a lot of the business/financial/insurance aspects of the outpatient clinic world...and it's pretty bad/sucks. No wonder health care is messed up.

First few days of clinic...

So Sunday night after semi-freaking out, I talked to Jeremy a little as I was stressing and wasn't able to talk some of the people I wanted to talk to the most (especially those who wouldn't have also been nervous/anxious about starting clinicals like my friends from class). After reassuring me about clinical, we talked about life and two of our favorite people so it was rather nice.  :-)


I survived my first day of my clinical internship and it managed to be a rather interesting day. My CI (clinical instructor) told me the wrong way to get to clinic and the wrong place to park, but managed to make it to clinic only 3min late and before my CI got started for the day. Luckily, Becca (a previous student there and dear friend) was amazing and saved me from panicking about not being able to find the right place. My cell phone died as soon as I got to clinic which was ok since I didn't need it while there, but what did kinda suck was not being able to eat lunch the 8hrs I was there (7am-3pm). We kept busy for the most part even though their network was down and my CI couldn't really show me how to use their documentation system or write notes most of the day.

My CI, he is an interesting guy; probably one of the most sarcastic, brutally honest, and fairly pessimistic... made for an interesting day as I learned a lot of what he does not like/hates, including one of the other therapists who I am met my second day. Haha, I def needed a drink tomorrow after my 10hr day. Steve, my CI, promises day 2 to be one where for the first few hours, he will be a completely different, mean, and somewhat miserable/unbearable person due to the other therapist he hates being there....so if anything I think I will become more tolerant and selective of things based off this experience. Overall it was alright with some nice patients, some kinda crazy patients, some pretty lazy patients, and my CI quizzing me randomly throughout the day on any number of things. O, and there was a patient with bilateral (yes, bilateral) BPPV...very interesting to actually see a patient with vestibular dysfunction like Dr. Blatt said we would. And thank goodness, Big Bang Theory (at least until the fall) is on Monday nights :-) Half hour of amazingness that always gets me in a good mood :-) BAZINGA!!

Day 2 was a long day, my CI is not as grumpy as he made it out to seem like it would be like. He was different although I can see why. The day went by fast and I actually got to have lunch! Was very nice to have that break and I am slowly opening up in clinic - not being so quiet, haha. Got to do more documentation and work with more patients. However, there seems to be quite a bit of patients with: Low Back Pain (LBP), partial menisiectomy, partial knee replacements, shoulder impingement...10hr days are long especially when you're on your feet most of the day and eating/snacks are a low priority of the day.

Day 3 seemed to come too soon after leaving at 8pm and arriving 6:55am. Luckily today was a short day; finished up at noon. Got my badge today so that parking should be easier (at least once it gets activated which will take a day or two apparently). Got to see some of the same patients today that I saw Monday so that was nice and my CI let me be in charge of treating more patients today. Which meant I was doing more documentation, haha. Tomorrow there is supposed to be a good bit of aquatic therapy with patients so I am looking forward to that (although my CI told me not to expect much). Overall, not a bad day as I am feeling more comfortable in clinic and doing things in general.  I visited Towson University HRL staff today since finished up early and then came home for a nice little nap :-)  Going to have to get used to this schedule...but I get to sleep in tomorrow in prep for my 10hr day.