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I'm known to geek over anything anatomy or adaptive sports. You’ll find me stopping to pick flowers for my hair, living waist deep in my studies or spending the weekend cooking up a storm. My favorites are fruit, artsy things, wearing aprons and sprawling down on the ground instead of actual chairs.
This is my place of inspirations, thoughts, and daily occurences. Enjoy.
I spoke a question out loud to my CI. I answered it immediately, but she just gave me a face and I knew immediately I shouldn’t have done that. I would have gotten the answer if I just stopped and thought. This is really hard for me since I process with hearing my own questions and thoughts said outloud. I haven’t done this is the last week, and I’m kicking myself that I did it today since my CI will be grading me on this particular area and discussing so with my school.
In general, my 1-3pm schedule today left my flustered. My CI noticed my mistakes and inconsistencies and asked why multiple things went wrong. It may be simply because I don’t normally see patients in the afternoon time frame. However, I think the big reason is because I have 1. Been stressed (about completing an abstract, my school being a pain in the ass to complete my state license application, not getting ‘enough’ things done) and 2. Not taking care of myself. My nutrition has fumbled this week, I’ve gone back to eating only ‘healthy snacks’ such as vegetables or popcorn and lacking to eat a substantially rich in nutrients meal (with proteins, fats, etc.) that is necessary to keep both my mind and body fueled. I know I did it slightly wrong in the last 2-3 days, but I often have a hard time allowing myself to ‘indulge’ in a protein packed snack after the gym or anything else other than regular meals. It has been worse with the stress.
I’m trying to come up with some solutions at least stop, and hopefully eliminate, having these incidences of being ‘flustered’ and asking questions in this rotation. I will try my best to:
I had a meeting with my CCCE (basically the ‘supervisor’ of clinical education at the hospital, but also a fellow PT). It is week 6 of 16, but my CI was struggling to find out I learn best. It was slightly intimidating to get ‘sent to the office’ for a meeting about my learning, but what calmed my nerves is when my CI said it was "definitely not from a lack of effort." Phew. What I got out of multiple lunch discussions with my CI and the meeting with the CCCE is that this is just early intervention to make sure I’m on the right path, finding my niche to running the in’s and out’s of a fast paced rehab environment. Mainly, I need to work on scheduling out days and times for completing documentation (to avoid any time efficiency due times) as well as increasing my confidence in sessions and CI communication (For ex: making statements rather than asking questions, and directing them to my patient instead of my CI).
I also took this as I simply need to up my game!
Below are notes from my CCCE on our meeting:
Angela committed to:
1. Really working on paying more attention to details (for both patient safety and efficiency of work)
2. Taking initiative including strategies such as
a. She will keep a copy of her own team meeting schedule so that she has a better understanding of when re-evals are due (by 1 pm day before the patient is up in team meeting). She will tell Kristi which re-evals she is planning to do and will start in advance (so tonight she can start re-evals for a patient up in team on Wed)
b. She will take more initiative in treatment sessions realizing that if Kristi already said okay with her treatment plan then she is good to go and can proceed realizing that Kristi may interject to show her different facilitation, handling skills, a better way to do something to allow for continued growth and learning. This will also allow the patients to really see her as the person running the session and as their therapist.
c. She will time sessions using her stopwatch to make sure she is efficient and on time for treatment sessions
d. She will write notes to herself regarding how processes work (ex. RA scheduling, Carol/Kylie schedule, etc) and then refer to these notes for recall before immediately asking a question. However, she has informed us that sometimes she needs repeat experience to learn new processes so she may need to verbally discuss the process but will utilize her notes so that she can recall what she knows and what she still needs to review.
in Acute Care you give basic exercises - but most therapists I followed never really get into technique. Using basic tactile/verbal cueing or demonstration can really make the world of a difference in correct performance of them. Interestingly, my two acute care CI’s says ther ex was one of my strengths. That’s my past experience of two outpatient orthopedic rotations kicking in haha! An added plus was I got patient buy in for completioncompliance of a Home Exercise Program (HEP) when I told them I worked heavily in orthopedics before.
It doesn’t hurt that I also am a perfectionist and very much about structure.
Interestingly, I’ve missed implementing a full hour of a specialized exercise/balance regimen for patients while in acute care. It was very functional with little (if any) time spent on exercises (I always tried to implement them after walking in the hallways but I can’t say the same for some others I shadowed under). I’m hoping acute rehab will be a good mix of utilizing specialized exercise/activity while still maintaining the functional goals.
While home, I’ve found my love for correct exercises towards areas of weakness (not for ‘making yourself look better’). This includes things like:
Man, for somebody that is in no way a body builder, I sure love the structure of kinesiology that creates a good foundation for creativity of individualized exercises!
(surprisingly not so many ‘factual’ things because I was stressed about simply performing up to par)
MPD Syndrome = Multiple Personality Disorder
Evaluations in the ICU are really not that bad. In fact, despite all the lines and cords, they’re pretty quite simple and straight foward?
When you are less stressed about guarding and performing for others, it opens up room for growing in other area! (AKA: I feel less ‘under the microscope’ with my new CI and now am working on efficiency and time management)
Acute Viral Syndrome
*It is hard to take criticism at first. Don’t be defensive when it is given on the spot. If you need time to fully digest it, take it. Then take the time to understand it, thank the critque-er or discuss, and then try implementing it into practice.
*As much as things may seem frustrating, hard or bad at times - there are still people who cheer for your success and others who know your genuine strengths.
TKA Revision & Implant
IDA (Iron Deficiency Anemia)
Yesterday I shadowed at an inpatient rehab facility (actually I was working under my old Neuro Rehab professor and Clinical Education advisor – someone I truly admire and kind of ‘idolize’..it was quite funny to see her in scrubs).
It was so nice to work inpatient again after having so much ortho experience in the past year. We got to work with a lovely 80 year old lady with some balance and cognitive problems. Later we had a more involved case of a 70 year old who had fallen after a history of alcoholism and suffered multiple neck injuries (most notable a C2 fracture and iSCI). He was on a large vent machine, required two person assists (+ use of over head lifts) and constantly needed to be ‘orally suctioned’ as we caused ‘things to come up and out’ as he did some exercises. We had to work hard to keep his anxiety down and simply keep him awake!
After reviewing notes with my professor over lunch, she looked over to me and asked “Do you have any questions?” I smiled and said no. I surprisingly didn’t have any. Not having questions is new for me. Sure there were some topics from that day I’d like to brainstorm, but knowing and embracing that I was smart and able enough to figure out the ‘unknown’ new situation at hand and treat accordingly? That was new and meaningful.
It is down to two options
1. Mom & 2 Kids
2. In a house a Doctor at CHOP rents out rooms to students
Oh decisions. I am hoping to have this decided and done with by this Saturday.
I always am the organizer and the outreacher. I’ve been told this can come as the personality of an overachiever - but to me, it honestly feels like everybody else just doesn’t care.
Result = Me doing 99% of the work upfront and feeling it is ‘more work’ to delegate and supervise…
One of my patients is a 59 year old woman who got injured both her knees from a fall at work. She also speaks only Spanish. She had her 10th visit today (so I’ve treated her 3 times a week, for just 4 weeks) and in the past, has had consistent knee pain, edema and range of deficits. Her first week I made sure she was always wearing a knee stabilizer and using a single point cane.
Today, she reported to me having NO pain. Her knee range of motion was back to normal limits, and she completed all her functional goals (treadmill, stairclimbing, box carries)! We both think she’s ready for discharge tomorrow and I couldn’t be happy about her sudden improvement. I’ve treated her all in Spanish on top of all this. She’s a sweetheart and we’ve worked so hard (but well!) together. I’m excited for her and grateful for moments like this where my job really means something.
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