It's over! No more acute care!

Holy cow! My LAST day. At times, this clinical seemed to be dragging, but really, overall it went by so fast. I really can't believe it. I'm done with my second clinical! Only two more to go before graduation! WOW! Today was a really good day. Yesterday, my CI and I started going over my final evaluation and then we finished it up today. I was really happy with all of her comments and suggestions. I really have grown a lot and she definitely recognized my hard work and I definitely feel rewarded for it. I did have a good experience, it was a little hard at different times, but overall it was good. I learned a lot, and the staff at the hospital are so nice and helpful. 

The best part of today was one of my patients was also discharged! Much like my lady who was post-open heart with complications, so was this particular patient, although much worse. He ended up having sepsis and multi-organ failure, including the need to be on continuous dialysis for awhile. It was really sad for quite some time because it appeared he was maybe not going to pull through. But within the last week or so he has been doing so much better medically. He is starting to talk to us a little and today he got his foley cath out, the last line.tube holding him back! So, we went in to see him and I told him it was my last day and we talked a bit and I told him how proud I was of how far he had come, etc. It was a really nice, special "goodbye" (He has been in the hospital since May 9!!!) Well, later in the afternoon when my CI went to check off my progress note for him it came up he had been discharged to the nursing home!!! It was so exciting!! And perfect timing! :)

Well, I guess it's time to put another experience in the books and call it a day. I had a nice experience, but I'm glad to be done and ready for the next step! 

Substitute CI for the day...

Today my CI was off, so I got to be with a different therapist for the day. I got to work with one of the part-time therapists. It was a really good day. She is really nice and kept telling me how impressed she was with my skills/knowledge. It felt good! She even bought me a coffee at lunch time! ;) I was proud of myself because I fought for a patient who hasn't been doing well in the ICU and she wanted to discharge him, but I convinced her not to, since he isn't normally her patient. I keep hoping that he will make a turn and come around the other side, but it seems like every day he is worse. My CI and I had discussed discharging him last week, but we were worried that he may fall through the cracks if he does get better and then he will lose out on therapy he desperately needs. 

I can't believe I'm in week eight. I will be so glad to finish this clinical because it has been a lot of hard work and I've learned a lot! I have been working really hard on my in-service and I think it's going to be really informative for everyone. We've had so many patients (my CI as well as other therapists) with brachial plexus symptoms following open heart and it has been a really long process of researching over everything and I'm currently trying to find some treatment ideas now. I feel like I'm sort of "stuck" but I haven't given up yet! My CI seems like she is pleased that I'll be doing my in-service on this topic and I hope that she enjoys it (as well as everyone else) when I give it. We still need to pick a date to do it, though. 

Well, two more days til the weekend! :) Then, onto week 9!

I made it through the week!

 This whole week ended up being pretty good. I was excited because yesterday and today we randomly were assigned some evaluations on the Transitional Care Facility (it's a short term skilled option for some patients instead of going to a different facility... sort of like a subacute/nursing home setting.) And it just so happened that the two patients we were assigned to evaluate were two patients I had evaluated acutely and recommended for TCF. So, the evaluations were pretty smooth and I actually got to do MORE testing! I did some balance testing and the TUG with both patients. The patient today I did the TUG with and without an AD and you would've thought I won a million dollars. And, I got to do "real therapy"! Real exercises! It was a lot of fun! I think I may like that better than acute, but there are some positives of acute. Regardless, after feeling a little down and tired I had a pretty good week. I am excited that this is the end of week six and I'm working on applying all of the suggestions my CI and I discussed over midterm, so I hope that I continue to grow. We have another patient that is my favorite, she is a sweet older lady who had open heart surgery and then had a questionable stroke. They have yet to determine that she had one but have decided she has had a clinical stroke. She was nonverbal and really low-level for quite some time and in the past few days she is really starting to come around. Today, when we went in her room I asked her how she was and without skipping a beat she answered "ok". I almost fell over! :) They are working on getting her medically stable to go to a nursing home and I am really going to miss her when she goes. She was admitted on April 30th, so I feel like I have been treating her almost the entire time I've been at the hospital. But, it's also exciting to see her finally beginning to make (very slow) progress. Happy Memorial Day weekend!

Well, still going strong...

  Today I had a pretty good day, and since I've been feeling blah, I thought I'd write in this journal. Overall, the day was busy. The few consistent patients we have were all out for testing or up for discharge (hurray!) so we did a lot of "checking in" and talking with the nursing staff. One of our regular patients that wasn't at testing fell asleep when we sat him up on the edge of the bed. I didn't know that was possible, but I guess he wasn't kidding when he said he was tired today. We had some evaluations too and most of them went well. We had the first patient with wrist restraints this morning (dementia, combativeness, hitting/biting and trying to pull out lines), but luckily when we got into her room she wasn't using them and was really calm for us. She has a 1:1 staff with her and she will do anything that girl asks her to do, so we just worked through her to see how she was moving around. We ended the day with an interesting evaluation... the patient was asleep when we got there and we tried to wake him up but he never really did wake up the entire time and ended up singing a song that we couldn't understand all of the words in answer to every question we asked him. It was pretty interesting and we decided we would let him go back to sleep and we will try to see him again tomorrow. The day went by pretty fast and I hope that the rest of this week does and the next 5 weeks til it's time to move forward. :)

HALFWAY Through ClinEd Two!!

Yesterday I had my midterm review with my CI. Overall, it went pretty well. We had a really nice discussion about things, but I felt like she rated me much lower than what we talked about as to where I am currently. Oh well. I know I have room to grow and that's always a goal to work on. To be honest, I am getting a little tired this time around with clinical. I am just feeling burnt out and tired. I am trying very hard to stay very positive, because I don't want to be negative, but I'd be lying if I said I wasn't excited every time Friday rolls around. I never felt that way with my first clinical, and it's not that I don't like acute care, I just don't love it...

     Here's to hoping the rest of the clinical goes smoothly and it's week 10 before I know it! 

Could this rotation go any slower?

 Whew. This was a long week! It was a weird one too, lots of running up and down stairs with people wanting us to come back later, being at testing, etc. Nothing really special happened. 

      We have a patient in the ICU that is really having a hard time bouncing back from her CABG and it's been a huge mystery. She is just extremely lethargic and not really responsive other than moaning or occasionally saying one-two words. You have to constantly give her verbal and tactile cuing to stay awake and most of the time when her eyes are open she will focus on you and then all of a sudden lose her focus and have that look of "nobody's home". It's very odd and it has taken all week for the surgeon to finally consult neurology. They had thought it was medication related and so they have taken her off of all her pain meds, she has a UTI (which could be playing into it) and some other issues. But it's just very puzzling. Every day I keep hoping it's medication related and we'll go in and she will be completely awake and alert, but it hasn't happened yet. Her family is questioning the nurses constantly about what has happened and I feel bad because no one really has an answer for her. They finally did a CT scan to check for stroke signs, but it was all negative. I hope when I go on Monday she's made a miraculous recovery!

     I can't believe that this coming week is week five! It is going by fast! I like that it's going by fast because I go up and down about my experience, some of it is good but some of it is just ok so I keep making the best of the situation I'm in! And I'm getting excited for December to get closer and closer, of course! But, I am trying not to wish this experience away because the freedom of what "real life" will be like is great! I am still undecided about acute care. I definitely think that I could like it, but I think I would like it better if I were calling the shots and could do things in the order I'd like too! But, it's nice to see how other therapists work and to get the experience of trying new ways of doing things because I feel like even though I want to resist it (because it's not how I "practiced") I can still learn something from it.

Cardiac Surgery

     This week has been a little bit of a roller coaster ride... At the beginning of the week I was feeling really frustrated, but yesterday and today were better. On Wednesday I got to observe a CABG and aortic valve replacement. Seeing an open heart surgery was probably one of the greatest moments of my life. Being a heart patient myself, I was really looking forward to the experience and it definitely lived up to my expectations (and then some)! Best of all the perfusionist (the person in charge of the heart lung machine) used to work at Children's Hospital in Pittsburgh. We got talking and he asked when I had my surgery (June of 1989) and my surgeon's name... it just so happened I had my surgery during the time that he worked there and I also had my surgery with one of the surgeons he worked with! So, there's a very good chance that he was MY perfusionist long ago! So cool! I told him thank you, just it in case it was him. So neat! 

     Yesterday and today I have been doing more evaluations and treatments and it went a little smoother. She even told me that my notes a really good this afternoon before I left, so that made me feel good! So, overall- up and down and hopefully things will continue to be up and stay up. ;)