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).
At the Robert Mondavi Winery in Napa/Sonoma, CA
Saturday, July 10, 2010
Monday, June 21, 2010
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.
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.
Saturday, June 19, 2010
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.
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.
Wednesday, June 16, 2010
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.
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.
Sunday, June 13, 2010
Night before a new beginning...
So tonight as I am getting everything ready for clinic, I am realizing on nervous I am on the inside but how calm I am appearing to every one else. Wished my amazing colleagues good luck on tomorrow especially as many are coming up to Baltimore from DC for clinicals...and it's our first full-time internship in the clinic. Just sitting here trying to mentally prepare for tomorrow but not really knowing what to prepare (content or skill-wise that is, I got this whole papers together business since that is easy). I guess I will start to learn their documentation and billing system which will be just loads of fun...since I already take long enough to write up my notes, haha.
Well as I listen to David Nail and Jason Aldean as I get papers, an outfit, and start to pack a lunch/snacks...I just remember to breathe and think I'll be able to not come off as a complete idiot tomorrow. Probably will be rather quiet but I have no doubt I'll start to warm-up to everyone by the end of the day. Here's hoping I get a good nights rest and make it to clinic safely (and on time) :-)
"They're not tryin' to make it last
Just enjoying each second as they pass..."
Well as I listen to David Nail and Jason Aldean as I get papers, an outfit, and start to pack a lunch/snacks...I just remember to breathe and think I'll be able to not come off as a complete idiot tomorrow. Probably will be rather quiet but I have no doubt I'll start to warm-up to everyone by the end of the day. Here's hoping I get a good nights rest and make it to clinic safely (and on time) :-)
"They're not tryin' to make it last
Just enjoying each second as they pass..."
Thursday, June 10, 2010
Gettin started starts with relaxin...
Preparing for clinic by relaxing during this little under a week off...staying up late, sleeping in, and enjoying time with family and friends :-)
Thinking I might review before clinic starts on Monday...like goni, MMT, and all that fun basic stuff so I don't have to constantly be saying, "O, that's very interesting. I'll have to look up more about that" or "I'll review and look up more information on that tonight/this week".
Thinking I might review before clinic starts on Monday...like goni, MMT, and all that fun basic stuff so I don't have to constantly be saying, "O, that's very interesting. I'll have to look up more about that" or "I'll review and look up more information on that tonight/this week".
Subscribe to:
Posts (Atom)