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. ;)

Observing my first surgeries!

     Last Friday and today I had the opportunity to go and see my first surgeries! Both were total knee replacements, but I got the opportunity to see two different surgeons to see if any of their techniques were different. They worked about the same way, although the surgeon I saw today moved much faster than the surgeon I observed on Friday. I was really glad I got the chance to see both because the surgeon I observed on Friday was a little slower and took the time to explain everything he was doing, which was really helpful. It was even more helpful when I went today since the surgeon today moved much faster, I felt like I had an idea of what was going on. The OR is a really interesting place... I was surprised how many people were present and how they are professional, but it is not stressful. I was explaining everything to my dad and he said, "So it'd be like you coming and talking to me while I'm working on a car!" and that describes it perfectly! They are able to do their job but also are having casual conversation at times during the procedure! It blew my mind! Really awesome! I'm excited because I am also going to get the opportunity to observe a total hip replacement as well as a cardiac surgery. My CI has been really nice about trying to find some times for me to go to observe surgery and so I'm really thankful for that because it's really interesting and it's a nice break from the day.

     

     Today my CI let me take the lead for the whole time for two evals instead of us tag teaming like we had been. Overall, they went ok. I'm sure I'm my own worst critic! It's funny how I had all of these plans for certain things when I was in class but it doesn't really apply and everything can change so quickly in real life. It just makes me nervous because I feel like I know the right things to do, it's just the way the hospital works is so different than I expected.  I feel like if I did the evaluations that I practiced in school I would feel a lot more confident, but trying to adapt to how things are run at this hospital has been stressful for me. I almost wish we would've spent the extra time in neuro to do the write ups after patient sims like we did in musculoskeletal and cardiopulm, especially the deciding where the patient should go next... That's the hardest part, is evaluating someone and having one snapshot and basically having to make a call on where they should be discharged to and if they are a good candidate for therapy. But, I feel like I'm already starting to get a little better and hopefully with more and more practice I will get even better.  I just wish I could feel more confident, but I'm taking it one day at a time and my CI seems to be fine with where I am and where we need to go next. 

Week Two of Acute Care

Well, this week has been a little rough at times for me. Monday was a frustrating day because I got my log-in information, but the documentation program is very tricky and it took me over an hour to document an evaluation. I was so frustrated afterwards at the things that I missed from my subjective information and how long it took me. My CI wasn't upset and told me that I will get the hang of things and not to be too hard on myself. It was still really frustrating! I came home on Monday night and made a note card of all the questions I need to be sure to ask to be able to fill out the correct information on the evaluation form, so hopefully that will help me not to forget. Luckily on Tuesday and today I have done much better with documentation and remembering all the information we need. My CI is currently on the floating rotation so we have been doing a little bit of everything and yesterday we got two total knee replacements. I was excited because I didn't get to deal with any replacements in my first clinical rotation. It's been nice to be able to see the same patients two times a day for the past two days. Most of the patients we have seen are either already discharged or have gone to another facility except for one. We currently have a patient who had a BKA and just had a BKA done on her other side. She has been having good and bad days (she had the surgery last Friday) and they seem to not have her pain medications quite figured out. She was very lethargic on Monday and today, but did really well yesterday. She will be going to a long term care facility when she gets discharged from the hospital but no one is saying when that will be, so I have a feeling we will be working with her for awhile longer. She is a very funny lady and has a pretty good attitude about her situation, which is always helpful.