I am not an expert about getting jobs, but I have been through a few successful interviews recently. Here are some tips that I recently wrote out for a friend. This is not comprehensive, any of these topics could be significantly expanded.
Basic Interviewing Tips- I'm not going to really cover these since most OT students have probably gone through at least one interview in their lifetime, if only the one to get into school. Wear something nice, conservative, that you are comfortable in. Bring extra copies of your resume. Learn about the company before you go. Use positive body language. Etc.
Rule #1- You are interviewing THEM as much or more than they are interviewing you. So the questioning should be a 2 way street. You have questions, you deserve to get them answered before you make a decision. Make a list- If there's anything clinical that you really liked or didn't like at your fieldworks, you can form a question to devise whether a similar situation exists at the new place. You should get information about what they offer for 401K, health insurance, days off and other benefits from the HR department, and they should get you that information before you leave that day.
Questions they will probably ask you:
- about the experience and interest you have in their population
- about your goals for professional development/ what you want to get out of the job
- your strengths/weaknesses
- might ask you to describe a situation when you overcame an obstacle at work or resolved a conflict with a coworker
(Here are some more interview questions, I'd say the ones about coworkers and goals are most likely to appear in your future)
Be honest in your appraisal of your abilities. A recent job candidate rated herself "10/10" in dealing with all types of diagnoses, therapy techniques, and practice locations- despite only having a year of experience. Also, it can be good to pause briefly before answering a question, especially if you find yourself often making foot in mouth statements. If you're nervous about how you'll react to questions and handle things on-the-spot, many college campuses have a career center that will offer to do free mock interviews or resume workshops. Check it out, you're paying for it anyway. If that's not available, have a trusted friend or adult interview you and offer constructive criticism.
Another question that will definitely come up is what you expect to be paid. (this might even be on the job application) I'd encourage you to discuss this with your professors, but there are also other good resources. Enter your state into this page on the Career InfoNet and see the wage table for your target state and compare it to the nation as a whole. You can also look for your city or metro area on the left sidebar. This gives you a good idea of the range, although I don't know anybody getting paid in that 90th percentile area. Advance also has a salary calculator, but you have to sign up to play with that. In my experience, their sample size has been too low to be truly helpful. Don't get dazzled by the money though- you're looking for the best overall place, the money will come. Also, FYI- sign on bonuses are taxed VERY high.
You should also take time to point out anything awesome on your resume or portfolio and explain how you got the honor and why it's special. For example, "I wanted you to know that I was elected to the office of Grand Poohbah of the Water Buffalo by a group of my peers to coordinate volunteer efforts in our community." Nobody knows why you were honored or what the title means until you explain it.
In the post on searching for a job, I mentioned that you should look at several sites and try to do multiple interviews in a near time frame. You'll want to keep detailed notes of what you liked and disliked about each site, what their typical day was like, anything important that they told you. Keep the names of everyone you talk to- try to get business cards as that will make it easier. And remember that you should send a follow up thank you note after the interview- email is acceptable.
If you feel like the interview went well and the facility looks promising, you can ask to have a shadow day. I strongly recommend doing that. See what a normal day is like, what the expectations are for productivity, get a feel for the balance of the caseload. Among other things, you can ask your future coworkers what they really think about everything, see what kind of people they are.
You want to take your time to consider any and all positions that are offered you, but you should be timely and polite about it- your interviewers are trying to fill their positions quickly and will appreciate your honesty. Nobody is asking you to commit to a position on the interview day, but be timely.
After all that, if you decide to accept, you'll have to pick a start date and all that. So if you come out of the initial interview feeling positive about the place, or if you are definitely living/practicing in a certain state, you will want to start investigating the licensure procedure there. Figure out the timing, how long it will take to get a license. Consider whether you need to start work right away with a temporary, or if you want to take the NBCOT exam first. I didn't want to try to balance studying and working, but it depends on what you want. All that plays into the potential start date.
Bottom line- be honest, be you, and try to find the best fit for your personality and for your skills to grow. Good luck everyone!
4.30.2009
Search for an OT Job
Spring is in the air, as signified by the inch thick of pollen on my car each day. That means that there will be more folks w/ respiratory issues in the hospital and more new OTs starting their first job search!! I'm not a career counselor, but I survived my first searches, and here are some tips to hopefully make your search more fruitful.
There are a few questions which frame the whole job search, but I think most people have this under control. You should know the constraints of your search. Are you getting married or otherwise needing to stay within a certain geographical region? Do you have others to support or just need to make enough to cover your own expenses? Do you need to start work immediately or can you take some time off after graduation? Thinking about what you need can help you narrow your focus and concentrate on what's important to you.
I think it's easier looking for a job in a specific geographical area than just looking for random jobs anywhere. And while you can do a good portion of your job search from far away, thanks to the wonders of the internet, it is easier to do after you have moved and settled in the area. Not a luxury everyone has, I didn't. I haven't had very good luck searching on the internet sites that cater to all professions (i.e. Monster) but when I was seriously looking it was in a more rural region. Even now though, searching for OT jobs in Baltimore only pulls up 9 options. What I do find on sites like this is info for contracting companies, services that run nationwide.
So you can use profession-specific search engines to assist the search. If I remember correctly, I found my first job on the AOTA sponsored OT JobLink. Will this get integrated into OT Connections? Don't know, but it remains a reliable source for finding and communicating w/ employers... like monster, it allows you to upload a resume and have it be searchable or not. If you're an AOTA member (and of course you should be!) then there's no reason not to use this tool. OT Practice has nice color ads organized by region and job type and Advance always has hundreds of ads in the print magazine, you can search their listings as well. 2 other sites come up in a google search, but I haven't used either- OTJobs.com and JobsOT.com. I don't have time to give them a full trial, but I suspect that they are likely to have more national staffing companies than location specific jobs.
If you have a location in mind, it's easy to find links to the Chamber of Commerce for the different areas, you can search for hospitals or nursing homes in the area to see if they list on their website that they're hiring. Also finding local newspapers online will often let you search the help wanted ads. I get a lot of emails and mailers w/ job opportunities (that's actually how I found out about my current job), the other way to find a job is to ask your friends and acquaintences what's open in their area(Hello Facebook!). I still get emails to my school email address from classmates who have job openings at their facilities. Going to conferences big or small will also provide you with a time to network and find out about openings.
Even if you don't see an opening on a company's website, don't assume their not hiring. (Unless it's for the feds, they're pretty clear about when there's an opening) You can always call the rehab department or submit a resume without a specific opening, you will probably have more luck with this if you're willing to do prn work.
Not much to say about choosing a setting, except to keep your options open. It is very possible that you could try something different and find out that you really like it. Going into my last job, I thought that I would prefer the SNF floor over the acute care since it would be more like rehab, and I had no expectations of even participating in pediatrics at all. I didn't know the way I would appreciate those different areas. If you can find a site to give you experience in several different populations and diagnosis types, I'd say that is very valuable. It is much easier to learn to be a specialist after getting a firm grasp on being a generalist, I think.
Once you've found a few places that look promising, go ahead and set up interviews. If you can do all your interviews within the same general time frame, that will be helpful, since each place will probably want to pressure you a bit to commit or decline the opportunity quickly. Just make sure you keep good records of the benefits, daily details, and pros/cons of the different jobs so you don't get confused about what facility had what. More details on acing the interview in another post.
Anyone else have tips for finding a job? Feel free to share. One of my professors used to say that you'd be innundated w/ employment offers once you had a job, so even if prospects look bleak, remember that Job 1 could allow you to find Job 2.
There are a few questions which frame the whole job search, but I think most people have this under control. You should know the constraints of your search. Are you getting married or otherwise needing to stay within a certain geographical region? Do you have others to support or just need to make enough to cover your own expenses? Do you need to start work immediately or can you take some time off after graduation? Thinking about what you need can help you narrow your focus and concentrate on what's important to you.
I think it's easier looking for a job in a specific geographical area than just looking for random jobs anywhere. And while you can do a good portion of your job search from far away, thanks to the wonders of the internet, it is easier to do after you have moved and settled in the area. Not a luxury everyone has, I didn't. I haven't had very good luck searching on the internet sites that cater to all professions (i.e. Monster) but when I was seriously looking it was in a more rural region. Even now though, searching for OT jobs in Baltimore only pulls up 9 options. What I do find on sites like this is info for contracting companies, services that run nationwide.
So you can use profession-specific search engines to assist the search. If I remember correctly, I found my first job on the AOTA sponsored OT JobLink. Will this get integrated into OT Connections? Don't know, but it remains a reliable source for finding and communicating w/ employers... like monster, it allows you to upload a resume and have it be searchable or not. If you're an AOTA member (and of course you should be!) then there's no reason not to use this tool. OT Practice has nice color ads organized by region and job type and Advance always has hundreds of ads in the print magazine, you can search their listings as well. 2 other sites come up in a google search, but I haven't used either- OTJobs.com and JobsOT.com. I don't have time to give them a full trial, but I suspect that they are likely to have more national staffing companies than location specific jobs.
If you have a location in mind, it's easy to find links to the Chamber of Commerce for the different areas, you can search for hospitals or nursing homes in the area to see if they list on their website that they're hiring. Also finding local newspapers online will often let you search the help wanted ads. I get a lot of emails and mailers w/ job opportunities (that's actually how I found out about my current job), the other way to find a job is to ask your friends and acquaintences what's open in their area(Hello Facebook!). I still get emails to my school email address from classmates who have job openings at their facilities. Going to conferences big or small will also provide you with a time to network and find out about openings.
Even if you don't see an opening on a company's website, don't assume their not hiring. (Unless it's for the feds, they're pretty clear about when there's an opening) You can always call the rehab department or submit a resume without a specific opening, you will probably have more luck with this if you're willing to do prn work.
Not much to say about choosing a setting, except to keep your options open. It is very possible that you could try something different and find out that you really like it. Going into my last job, I thought that I would prefer the SNF floor over the acute care since it would be more like rehab, and I had no expectations of even participating in pediatrics at all. I didn't know the way I would appreciate those different areas. If you can find a site to give you experience in several different populations and diagnosis types, I'd say that is very valuable. It is much easier to learn to be a specialist after getting a firm grasp on being a generalist, I think.
Once you've found a few places that look promising, go ahead and set up interviews. If you can do all your interviews within the same general time frame, that will be helpful, since each place will probably want to pressure you a bit to commit or decline the opportunity quickly. Just make sure you keep good records of the benefits, daily details, and pros/cons of the different jobs so you don't get confused about what facility had what. More details on acing the interview in another post.
Anyone else have tips for finding a job? Feel free to share. One of my professors used to say that you'd be innundated w/ employment offers once you had a job, so even if prospects look bleak, remember that Job 1 could allow you to find Job 2.
4.28.2009
Learning to read without getting sick
I have canceled my parking pass and purchased a monthly metro pass, resulting in saving money on gas, reducing my carbon footprint, and increasing my free time in the day. A few days ago I posted about how my leisure time has been all off balance and that I would like to restore some activities, particularly reading books and my OT mags. But to do this, I would have to overcome carsickness...
OK, it's embarrassing, but true, I used to get carsick all the time. Honestly, it's probably all related to my sensory processing differences that were not identified as a child, but that's another story. I did progress in my teens to not needing Dramamine-induced sleep to make it through any trip with a curve in the road, and even was able to watch movies on the TV in our van (not a handheld) with great success. In the past few years though, I would say that I have taken a few steps backward. Fewer journeys out to rural locations for school and girl scouting events have put me out of touch with the country roads, but now at least I am able to drive when feeling ill and thus avert crisis. Never at any time was I able to overcome my vestibular problem and be able to read or operate a handheld device in a moving vehicle, and I can't even remember the last time I tried.
It never made sense to try- the risk was not worth the reward, and I could always talk to my companions. But now I have 30+ minutes of unoccupied silent time on the metro. It is a smooth ride in comparison to other transportation options. I thought that in order to make use of this time for my chosen pursuits that it would be worth it. I am not an expert on inner-ear issues or vestibular function, but it just seems that this system should be trainable. So I am trying-
Day 1- I read straight through my trip, with minimal nausea. On my return trip home, I got a nasty headache in addition to the nausea which persisted through the evening.
Day 2- I tried my husband's idea of reading in brief spurts and then looking up in the train. No discomfort during the trip, but afterwards developed low grade nausea and headache that lasted til bedtime and seemed to get worse through the day.
Neither day a success, obviously, and I am reluctant to try again in the morning as it was a very unpleasant day at work.
I have tried most every product and strategy to alleviate motion sickness in the past. I cannot find my Sea Bands. I cannot take Dramamine in the morning as I will fall asleep, can't take Bonine because it doesn't work for me. Club soda and gingerale are also ineffective. I am thoroughly disappointed by the LACK of information on the internet about anyone trying to overcome this problem and learn to read in the car, most information is on preventing motion sickness in general. The most relevant posting I could find was this monstrosity, and there wasn't even anything on metafilter. This reminds me of the internet of 1996, where it was not uncommon to not find anything on the topic you searched... you could just forget about finding obscure lyrics.
One of my new coworkers is a PT who works with people who have BPPV. (I had been informally tested for this in the past by a PTA and it was negative) But, she has a greater understanding of the inner ear than I do and believes that through some adaptation I should be able to achieve my goal. We are planning a consult for when we are not busy (ha. ha. ha.). Until we can meet and determine a plan of action, I am issuing a call for help from the internet.
I know that reading exacerbates the problem, but it is a MAIN occupation of mine. Trust me, I have heard the suggestion to do audiobooks- it is not a viable solution for me. (for 1, I want to read magazines, 2- I don't process auditory information as thoroughly, 3- reading is a treat for me which is why I want to devote more time to it). So I am taking any sensible ideas for how I can read on the metro that don't have the word "audiobook" in them. If I ever do find something that works, I will post it here, so that at least on some little corner of the internet, there will be information. I can't be the only one who wants to overcome the issue.
OK, it's embarrassing, but true, I used to get carsick all the time. Honestly, it's probably all related to my sensory processing differences that were not identified as a child, but that's another story. I did progress in my teens to not needing Dramamine-induced sleep to make it through any trip with a curve in the road, and even was able to watch movies on the TV in our van (not a handheld) with great success. In the past few years though, I would say that I have taken a few steps backward. Fewer journeys out to rural locations for school and girl scouting events have put me out of touch with the country roads, but now at least I am able to drive when feeling ill and thus avert crisis. Never at any time was I able to overcome my vestibular problem and be able to read or operate a handheld device in a moving vehicle, and I can't even remember the last time I tried.
It never made sense to try- the risk was not worth the reward, and I could always talk to my companions. But now I have 30+ minutes of unoccupied silent time on the metro. It is a smooth ride in comparison to other transportation options. I thought that in order to make use of this time for my chosen pursuits that it would be worth it. I am not an expert on inner-ear issues or vestibular function, but it just seems that this system should be trainable. So I am trying-
Day 1- I read straight through my trip, with minimal nausea. On my return trip home, I got a nasty headache in addition to the nausea which persisted through the evening.
Day 2- I tried my husband's idea of reading in brief spurts and then looking up in the train. No discomfort during the trip, but afterwards developed low grade nausea and headache that lasted til bedtime and seemed to get worse through the day.
Neither day a success, obviously, and I am reluctant to try again in the morning as it was a very unpleasant day at work.
I have tried most every product and strategy to alleviate motion sickness in the past. I cannot find my Sea Bands. I cannot take Dramamine in the morning as I will fall asleep, can't take Bonine because it doesn't work for me. Club soda and gingerale are also ineffective. I am thoroughly disappointed by the LACK of information on the internet about anyone trying to overcome this problem and learn to read in the car, most information is on preventing motion sickness in general. The most relevant posting I could find was this monstrosity, and there wasn't even anything on metafilter. This reminds me of the internet of 1996, where it was not uncommon to not find anything on the topic you searched... you could just forget about finding obscure lyrics.
One of my new coworkers is a PT who works with people who have BPPV. (I had been informally tested for this in the past by a PTA and it was negative) But, she has a greater understanding of the inner ear than I do and believes that through some adaptation I should be able to achieve my goal. We are planning a consult for when we are not busy (ha. ha. ha.). Until we can meet and determine a plan of action, I am issuing a call for help from the internet.
I know that reading exacerbates the problem, but it is a MAIN occupation of mine. Trust me, I have heard the suggestion to do audiobooks- it is not a viable solution for me. (for 1, I want to read magazines, 2- I don't process auditory information as thoroughly, 3- reading is a treat for me which is why I want to devote more time to it). So I am taking any sensible ideas for how I can read on the metro that don't have the word "audiobook" in them. If I ever do find something that works, I will post it here, so that at least on some little corner of the internet, there will be information. I can't be the only one who wants to overcome the issue.
4.26.2009
Another week down
Ok, I'm sure there are people getting sick of hearing about how I'm adjusting to work, so those people should not click on the expander for the full story. Other details coming soon, I promise.
Made it through my second full week of work. It's been an interesting transition. At this point, I still have to ask occasional "how-to" questions of the other therapists or staff (often it's "what's the code to the supply room again?") but for the most part I am on my own. Reflecting back on when I started my first job and my fieldworks, I remember there being a longer period of easing in, getting comfortable, hand holding. I know that on my first licensed day at my first job that I did not pull my fair share in comparison to the COTA- I believe that I would look up 1 pt, formulate a treatment idea, go try to see them. If it didn't work out, I had to come all the way back to the office, and either look up the pt again to try to find something else, or look up someone new and start the process over. It's nice to actually feel that I have grown as a practitioner- I think I've been a lot more useful thus far to this job than I was in my first weeks at my first job.
I know I had talked before about trying to leave on time so that I wasn't working for free... obviously I don't have that down to a science yet. I found that if I left the house early (to try to avoid traffic, etc) and started work early, I still would not be able to drag myself away early at the end of the day. There's always more to be done at the end of the day, I just try to prioritize it. Sometimes a person only has to be cleared by therapy before they can discharge home- nobody wants the hassle and fees of another night in the hospital just because their therapist had worked their 8 hours already. Just trying to balance all that- it is the life of a salaried employee, which I knew coming in.
Learning the computer system has been pretty easy, since I used one of the programs at my previous job. Now I get to tote around a laptop so that I can slide in urgent notes immediately. I am a longtime laptop user (since 2002 my primary computer has been a laptop, and they have been used A LOT) but the added usage of the touchpad is trying to aggravate my RUE into RSI symptoms. Not happy about that, and of course don't want to cut back on personal computer usage, so it is a growing issue. My work computer is a notebook w/ stylus, however, the program we use for documentation does not communicate with the stylus program that lets you write with the pen and guesses your words. This is a major design flaw and I may need to bug my techno-savvy boss into finding something that will work with that documentation program. I will also need to bug her for a mouse, and just use that while at my desk.
I need to create a checklist for work because there's so many different things to do for each pt. in the computer system. Some of it is a little redundant, but it is important to the dept for their QI projects so I need to remember to remember.
I have access to the scrubs machine now, which presents a dilemma. Obviously, it's great to have access to free scrubs whenever, and I think that the experiences I have had with getting nasty stuff on my scrubs and having to sit in a locked OT office in my underwear while I ran them through the washing machine really make me appreciate that I could just get a new clean pair at any time. Hygenically, it seems that it would be best for my pt's and everyone I come into contact with outside the hospital if I wore only hospital scrubs in the hospital and changed into something else for the commute. Economically and time wise, it makes sense not to have to wash scrubs in my incredibly small apartment washing machine. BUT- the work scrubs are ugly icky green, worn by 60% or more of the staff in all departments. So I haven't decided how to balance my need for cool cute tops with everything else, and while this is an incredibly frivolous dilemma, it does affect me.
Hard to believe, but finals week is coming up for many schools, which should bring thousands of new OTs into the burgeoning profession looking for jobs. I will try to get some interviewing/job search tips up here soon, and will really try hard to do that since I forgot about the AOTA conference (again). :( I won't forget next year though- Orlando here I come!
Made it through my second full week of work. It's been an interesting transition. At this point, I still have to ask occasional "how-to" questions of the other therapists or staff (often it's "what's the code to the supply room again?") but for the most part I am on my own. Reflecting back on when I started my first job and my fieldworks, I remember there being a longer period of easing in, getting comfortable, hand holding. I know that on my first licensed day at my first job that I did not pull my fair share in comparison to the COTA- I believe that I would look up 1 pt, formulate a treatment idea, go try to see them. If it didn't work out, I had to come all the way back to the office, and either look up the pt again to try to find something else, or look up someone new and start the process over. It's nice to actually feel that I have grown as a practitioner- I think I've been a lot more useful thus far to this job than I was in my first weeks at my first job.
I know I had talked before about trying to leave on time so that I wasn't working for free... obviously I don't have that down to a science yet. I found that if I left the house early (to try to avoid traffic, etc) and started work early, I still would not be able to drag myself away early at the end of the day. There's always more to be done at the end of the day, I just try to prioritize it. Sometimes a person only has to be cleared by therapy before they can discharge home- nobody wants the hassle and fees of another night in the hospital just because their therapist had worked their 8 hours already. Just trying to balance all that- it is the life of a salaried employee, which I knew coming in.
Learning the computer system has been pretty easy, since I used one of the programs at my previous job. Now I get to tote around a laptop so that I can slide in urgent notes immediately. I am a longtime laptop user (since 2002 my primary computer has been a laptop, and they have been used A LOT) but the added usage of the touchpad is trying to aggravate my RUE into RSI symptoms. Not happy about that, and of course don't want to cut back on personal computer usage, so it is a growing issue. My work computer is a notebook w/ stylus, however, the program we use for documentation does not communicate with the stylus program that lets you write with the pen and guesses your words. This is a major design flaw and I may need to bug my techno-savvy boss into finding something that will work with that documentation program. I will also need to bug her for a mouse, and just use that while at my desk.
I need to create a checklist for work because there's so many different things to do for each pt. in the computer system. Some of it is a little redundant, but it is important to the dept for their QI projects so I need to remember to remember.
I have access to the scrubs machine now, which presents a dilemma. Obviously, it's great to have access to free scrubs whenever, and I think that the experiences I have had with getting nasty stuff on my scrubs and having to sit in a locked OT office in my underwear while I ran them through the washing machine really make me appreciate that I could just get a new clean pair at any time. Hygenically, it seems that it would be best for my pt's and everyone I come into contact with outside the hospital if I wore only hospital scrubs in the hospital and changed into something else for the commute. Economically and time wise, it makes sense not to have to wash scrubs in my incredibly small apartment washing machine. BUT- the work scrubs are ugly icky green, worn by 60% or more of the staff in all departments. So I haven't decided how to balance my need for cool cute tops with everything else, and while this is an incredibly frivolous dilemma, it does affect me.
Hard to believe, but finals week is coming up for many schools, which should bring thousands of new OTs into the burgeoning profession looking for jobs. I will try to get some interviewing/job search tips up here soon, and will really try hard to do that since I forgot about the AOTA conference (again). :( I won't forget next year though- Orlando here I come!
4.21.2009
Still adjusting, and occupational balance is out of whack
I am continuing to adjust to my new job, and it seems to be going ok. So far I have been able to get a fair amount accomplished without working free hours (oh the bane of being salaried...) so hopefully that will continue to go well. Having some other difficulties though.
Remember those "balance your life" worksheets, with the clock face that you colored in depicting how you spent your day- leisure, work, and uh... whatever the 2 other things are? Drudgery? Self care? I don't know, I haven't had a copy since school. Anyway, I have been feeling quite out of balance lately. I think that I have a decent amount of work and leisure time, but I could probably use more sleep at night. And the added commute is eating up time that could be spent in other ways, and adding a lot of stress as well. The biggest problem though, is that I don't think my various leisure activities are balanced. For example...
My leisure activities:
- reading internet sites, newspapers, blogs
- email, facebook
- video games (animal crossing has edged out all other competitors for several months, which is itself out of balance)
- exercise
- spending time with husband
- talking to family
- making blog posts
- reading OT magazines
- reading novels
- watching TV (House, Big Bang Theory, CSI are the only current shows. Cartoons when I remember)
- travels (day trips, weddings, parties)
- puzzles (crosswords, sudoku, jigsaw)
- outdoorsy stuff (camping, canoeing... it's been so long)
This is list different than last year and the year before. I have removed activities- no more fantasy baseball as it was eating my time; no softball or girl scouts since the move since I am trying to adjust to the new city. But I am finding that some of these things are not getting done at all (exercising! OT mags! what happened?!) and that I am wishing I spent more time doing other things, but am limited in the overall time that I have. I have tried doubling up and doing 2 things at once, or being really devoted to one item for awhile, but neither have been really successful. I am afraid I will have to cut again and feel like I'm missing out.
My current plan:
I. Eliminate driving by using public transportation
(this should reduce some stress, save some money, and that cannot be bad.)
1. Figure out bus, metro, and shuttle routes (mostly done)
2. take trial runs to figure out timing
3. cancel parking pass at office
4. Benefit from extra time
A. learn to read on public transit without getting carsick
II. Make better use of time at home
(limited to ~4.5 hours between work and bed)
1. Start exercising again
2. Cut down on worthless internet time
3. Decrease days playing Animal Crossing (it's just so darn addictive!)
It's hard because I have diverse interests and I hate telling myself 'no' when I want to do something relaxing or fun. Also I am near the point of elimination on some hobbies and internet things... I feel like I just need to get rid of a lot and start from scratch. It is so easy to spot the lack of balance in another person's life, but it is hard to fix it in your own. And now it's bedtime again (sigh) so I will have to call this to a close and just try to work in these directions tomorrow so that each day gets a little better.
Remember those "balance your life" worksheets, with the clock face that you colored in depicting how you spent your day- leisure, work, and uh... whatever the 2 other things are? Drudgery? Self care? I don't know, I haven't had a copy since school. Anyway, I have been feeling quite out of balance lately. I think that I have a decent amount of work and leisure time, but I could probably use more sleep at night. And the added commute is eating up time that could be spent in other ways, and adding a lot of stress as well. The biggest problem though, is that I don't think my various leisure activities are balanced. For example...
My leisure activities:
- reading internet sites, newspapers, blogs
- email, facebook
- video games (animal crossing has edged out all other competitors for several months, which is itself out of balance)
- exercise
- spending time with husband
- talking to family
- making blog posts
- reading OT magazines
- reading novels
- watching TV (House, Big Bang Theory, CSI are the only current shows. Cartoons when I remember)
- travels (day trips, weddings, parties)
- puzzles (crosswords, sudoku, jigsaw)
- outdoorsy stuff (camping, canoeing... it's been so long)
This is list different than last year and the year before. I have removed activities- no more fantasy baseball as it was eating my time; no softball or girl scouts since the move since I am trying to adjust to the new city. But I am finding that some of these things are not getting done at all (exercising! OT mags! what happened?!) and that I am wishing I spent more time doing other things, but am limited in the overall time that I have. I have tried doubling up and doing 2 things at once, or being really devoted to one item for awhile, but neither have been really successful. I am afraid I will have to cut again and feel like I'm missing out.
My current plan:
I. Eliminate driving by using public transportation
(this should reduce some stress, save some money, and that cannot be bad.)
1. Figure out bus, metro, and shuttle routes (mostly done)
2. take trial runs to figure out timing
3. cancel parking pass at office
4. Benefit from extra time
A. learn to read on public transit without getting carsick
II. Make better use of time at home
(limited to ~4.5 hours between work and bed)
1. Start exercising again
2. Cut down on worthless internet time
3. Decrease days playing Animal Crossing (it's just so darn addictive!)
It's hard because I have diverse interests and I hate telling myself 'no' when I want to do something relaxing or fun. Also I am near the point of elimination on some hobbies and internet things... I feel like I just need to get rid of a lot and start from scratch. It is so easy to spot the lack of balance in another person's life, but it is hard to fix it in your own. And now it's bedtime again (sigh) so I will have to call this to a close and just try to work in these directions tomorrow so that each day gets a little better.
4.14.2009
Long Term Goals
This is a cross post from OT Connections, but I thought I might get quicker and more diverse responses here.
For goal writing, I was taught that your STGs should be directly related to your LTGs, and that they should all be able to be achieved in the timeframe for the facility. In acute care, therefore, a LTG could be set for only 1-2 weeks. However, my new employer says that their policy is that the LTGs are the overarching goals for the pt when they are completely rehabilitated. This would include driving independently, resuming work, being completely independent. They claim that this is how Medicare wants to see the goals, but it doesn't make sense to me. A goal of driving independently in the acute care setting is not achievable, realistic, or fitting the timetable of therapy. I don't understand why my goals for a pt. in a short term setting would have to encompass the potential months of additional therapy that the pt. should receive, especially when there is no firm discharge plan. Has anyone else heard that this is the "preferred" way of writing goals? Is anyone using these as their only LTG? Thoughts please...
For goal writing, I was taught that your STGs should be directly related to your LTGs, and that they should all be able to be achieved in the timeframe for the facility. In acute care, therefore, a LTG could be set for only 1-2 weeks. However, my new employer says that their policy is that the LTGs are the overarching goals for the pt when they are completely rehabilitated. This would include driving independently, resuming work, being completely independent. They claim that this is how Medicare wants to see the goals, but it doesn't make sense to me. A goal of driving independently in the acute care setting is not achievable, realistic, or fitting the timetable of therapy. I don't understand why my goals for a pt. in a short term setting would have to encompass the potential months of additional therapy that the pt. should receive, especially when there is no firm discharge plan. Has anyone else heard that this is the "preferred" way of writing goals? Is anyone using these as their only LTG? Thoughts please...
4.12.2009
First week done, second week coming
Made it through the first week!
It's strange going back to work after an absence, especially when you're starting all over in a new place. Spent 2 days in orientation classes, learning about 'service excellence' and the ins and outs of all the benefits and whatnot. Sat next to another Cheryl, who has the same middle initial and a very similar last name as I do, which was amusing. Part of the difference between this job's orientation and my last, besides the extra day, was at my last job, we took a 30 minute tour around the hospital. For this job, I got multiple maps of the campus and a driving tour, and my boss has been orienting me to the things inside the hospital. I hope to one day know where I am going! :)
Navigating to the job has also been a challenge, tomtom has done a good job keeping me from being hopelessly lost in the big city. I kinda got pressured into buying a month's parking pass during the first 10 minutes of orientation and didn't have enough time to research all my options. Now that I have some time to look into it, I think that I will be able to commute for the same time or less using some combination of metro/bus/hospital shuttle. That would make my environmentalist side happy, and also my "I hate driving" side. I knew from my fieldwork in Arlington that cities with good public transit programs often have kickbacks through the employer and/or the local taxes if you use the mass transit. So I hope to get that figured out and the kinks ironed out before I would have to pay for another month. (and yes, I think paying to park at your place of employment is the pits.)
I was also really cheesed off about my flexible spending account from my last employer- I knew that you had to spend that money before the end of the year... I learned that if you terminate employment, you have to spend that money within 30 days. I learned this after that time had expired. I had attributed it just to that employer, but the new employer's HR people have the same policy, so it must be some federal rule or some such. Obviously, those things can be helpful, but I've been burned 2x over on them and probably won't get another one unless I'm planning LASIK, baby birth, or some sort of elective large procedure.
I spent the other 3 days of the week getting oriented to the rehab department, getting followed around while doing evals, learning the computer system, hoping that I was calling people by the right names. I am on a team of 7 therapists for the general medicine floor, and I know a couple of the nurses and case managers now too. A PA had concerns about sending one of her pt's home, said to me, "She doesn't really need PT, but she really needs OT. I need to know whether she can be safe at home. Page me as soon as you're done." So that was nice, since we usually hear the opposite of that, and it's nice to be able to just text page all the important people if you need anything.
So tomorrow I start being a real worker, which will probably mean at least 5 evals a day and trying to follow up with other pt's as well. I've been trying to balance my evenings with my leisure activities and exercise before my husband makes it home, I'm still working that all out. One of my goals in this switch from being an hourly employee to a salaried employee is to not wind up working a million extra free hours and lose all my free time. Also, if this week is any indication, I might actually be getting better at handling mornings. Whether this is the 30 minute shift of the work schedule, or the increased commute time, or the increased time that I am awake before being expected to work, I don't know.
It's strange going back to work after an absence, especially when you're starting all over in a new place. Spent 2 days in orientation classes, learning about 'service excellence' and the ins and outs of all the benefits and whatnot. Sat next to another Cheryl, who has the same middle initial and a very similar last name as I do, which was amusing. Part of the difference between this job's orientation and my last, besides the extra day, was at my last job, we took a 30 minute tour around the hospital. For this job, I got multiple maps of the campus and a driving tour, and my boss has been orienting me to the things inside the hospital. I hope to one day know where I am going! :)
Navigating to the job has also been a challenge, tomtom has done a good job keeping me from being hopelessly lost in the big city. I kinda got pressured into buying a month's parking pass during the first 10 minutes of orientation and didn't have enough time to research all my options. Now that I have some time to look into it, I think that I will be able to commute for the same time or less using some combination of metro/bus/hospital shuttle. That would make my environmentalist side happy, and also my "I hate driving" side. I knew from my fieldwork in Arlington that cities with good public transit programs often have kickbacks through the employer and/or the local taxes if you use the mass transit. So I hope to get that figured out and the kinks ironed out before I would have to pay for another month. (and yes, I think paying to park at your place of employment is the pits.)
I was also really cheesed off about my flexible spending account from my last employer- I knew that you had to spend that money before the end of the year... I learned that if you terminate employment, you have to spend that money within 30 days. I learned this after that time had expired. I had attributed it just to that employer, but the new employer's HR people have the same policy, so it must be some federal rule or some such. Obviously, those things can be helpful, but I've been burned 2x over on them and probably won't get another one unless I'm planning LASIK, baby birth, or some sort of elective large procedure.
I spent the other 3 days of the week getting oriented to the rehab department, getting followed around while doing evals, learning the computer system, hoping that I was calling people by the right names. I am on a team of 7 therapists for the general medicine floor, and I know a couple of the nurses and case managers now too. A PA had concerns about sending one of her pt's home, said to me, "She doesn't really need PT, but she really needs OT. I need to know whether she can be safe at home. Page me as soon as you're done." So that was nice, since we usually hear the opposite of that, and it's nice to be able to just text page all the important people if you need anything.
So tomorrow I start being a real worker, which will probably mean at least 5 evals a day and trying to follow up with other pt's as well. I've been trying to balance my evenings with my leisure activities and exercise before my husband makes it home, I'm still working that all out. One of my goals in this switch from being an hourly employee to a salaried employee is to not wind up working a million extra free hours and lose all my free time. Also, if this week is any indication, I might actually be getting better at handling mornings. Whether this is the 30 minute shift of the work schedule, or the increased commute time, or the increased time that I am awake before being expected to work, I don't know.
4.05.2009
Eve of New Things
New job starts tomorrow...
2 days of orientation and then it's back to work for me. I had some goals during this transition time... packing, moving, unpacking, exercise, make lots of updates. Ended up spending more time decompressing than anything else, and the past week I pretty much ground to a dead stop on the unpacking business. But all the boxes are gone, now it's just the more mundane decisions of where the t-shirts go and whether to unpack all the books. So that just couldn't achieve a high priority for me. With the busy week up ahead, don't know if I'll find a lot of blogging time, but here are some future updates that are officially "in the works" and should be out soon.
-Video on making a fidget bag
- Beginning the Energy Conservation series
- Preparing for a job interview
- Making the most of the AOTA conference
- What to do if you don't get into OT school
Though my original plan was to spend the last week getting up at "work time" with my husband, my love of sleep won out. I was good in that I didn't sleep in to the extremes (no 1130 wake up calls) but it will still be an adjustment. OT is hard on my nocturnal temperament.
2 days of orientation and then it's back to work for me. I had some goals during this transition time... packing, moving, unpacking, exercise, make lots of updates. Ended up spending more time decompressing than anything else, and the past week I pretty much ground to a dead stop on the unpacking business. But all the boxes are gone, now it's just the more mundane decisions of where the t-shirts go and whether to unpack all the books. So that just couldn't achieve a high priority for me. With the busy week up ahead, don't know if I'll find a lot of blogging time, but here are some future updates that are officially "in the works" and should be out soon.
-Video on making a fidget bag
- Beginning the Energy Conservation series
- Preparing for a job interview
- Making the most of the AOTA conference
- What to do if you don't get into OT school
Though my original plan was to spend the last week getting up at "work time" with my husband, my love of sleep won out. I was good in that I didn't sleep in to the extremes (no 1130 wake up calls) but it will still be an adjustment. OT is hard on my nocturnal temperament.
4.02.2009
Jobsite Analysis
So I did complete my jobsite analysis long ago, and it was actually simpler than I expected. I was evaluating a worker in the microbiology lab with a diagnosis of writer's cramp. I am finally getting this written up for the blog carnival on clinical reasoning, so make sure that you check that out. If you're new to this blog, perhaps forwarded from the carnival, please be patient since I tend to write long entries :)
OK, background information, since this happened so long ago. As a hospital OT, I was asked as a courtesy to perform a worksite evaluation of a woman ("Wilma") who was having difficulty at work due to a diagnosis of writer's cramp. Before I was asked to do this, I had no experience in work hardening outside of school classes, virtually no experience in hand therapy, or any idea what life was like in the microbiology lab. I was a little bored and willing to take on a challenge, so that's how the eval fell to me. Please note- there is a significant difference between the clinical reasoning used by novice, intermediate, and experienced practitioners; that was all fleshed out in a recent OT Practice CE article. I am not claiming to have an experienced level of reasoning, I just did my best.
My first thought was shock that "writer's cramp" was an actual neurological diagnosis. I mean, I have played Operation, and have had significant pain after essay tests in college filling up Blue Books, but I had no idea that this was real. So I looked online for information on the diagnosis from reliable sites, which included eMedicine, Merck Manual Medical Library, and Medpedia. I learned that this was a focal dystonia and a repetitive strain injury (RSI) that would likely cause increased pain and decreased grip force on small objects.
Next, I went back to my OT bookshelf. I still have many of my texts, but especially those for topics that I found interesting or complex. (I have found it unfortunate how much I have already forgotten from school in topics that have been outside my realm of practice) From my book, I was able to review environmental factors that exacerbate RSIs and go through case studies involving worksite evaluations for desk workers. My book was nice in that it also came with some ready-made forms to record measurements of various workstation pieces (example- depth of chair pan, height of chair from floor). I also asked my coworker if I could review a writeup that he had done for a different person, so I could get an idea of what was expected.
I was feeling more prepared, but still didn't know what to expect in Wilma's office. What does a person in a microbiology lab do? Where to find out? My favorite source for torturing my Girl Scouts when they're doing a career badge- The O*Net. If you haven't used the O*Net before, it's a great resource that has cataloged thousands of jobs, the skills required for each, the expected salary and job outlook for each. So I was able to pull up "Biological Technician," which gave me a few brief ideas aobut what to expect.
After gathering all this information, I spent some time trying to brainstorm possible problems that Wilma might be having. Writing, obviously, but I also thought that she might have some difficulty with manipulating other small-diameter tools, keyboarding, opening or stirring containers.
The morning of the evaluation, I got my tools together- a notebook, copies of the measurement forms from my book, digital camera, tape measure, and a goniometer.
I met with Wilma at the beginning of the day since that is when the bulk of her work was done. I asked her to describe the problem, describe the pain she was having, what made it better or worse and what she had already tried to do to fix the problem. I also asked about what she had done medically- neurologist visit, MRI, EMG, etc. Then I let Wilma go ahead and start her workday, trying to see as many of her essential job functions as possible, and asking her to report anything that caused discomfort or decreased grip. I observed the tools that she interacted with, and any time I saw something that was on my list of possible pain causers or looked like it would aggravate the RSI, I asked specifically aobut that. That included vibration, twisting, squeezing, of various tools including pipettes and cotton swabs. I also took some measurements (not a full spectrum of them) related to the position of Wilma's UE to the work surfaces.
My client was quite reticent throughout the eval, and had relatively few issues. She really only complained of difficulty writing, not with any of the other tools. I knew from my education on RSIs, phyical disabilities and assistive technology that to decrease problems from a tight grip on a small object, that the person would need to change the shape of the grip or the amount of force taken to maintain the grip. I tried to include a variety of high and low tech solutions in my suggestions, and also address other issues that I felt could potentially be a problem to Wilma.
I have the summary writeup in a google document (as always, please be respectful and do not plagiarize my work). All the photos are from Sammons/Preston to give the reader a better idea of the different tools. If it had been me, I would have pushed for a label maker, because I think that would be best for efficiency sake (that and I love labelmakers anyway). I also found a $0.49 pen shaped similar to the PenAgain in a drugstore months later, so there are other options out there in the mainstream. I didn't get any follow up from this client, so I don't know what she chose to do, but I did leave the door open so that if she had any questions or problems later she could contact the department.
So that's the thought process that carried me, an inexperienced practitioner, through my first worksite eval. If anything, I think it was worth it just to get the experience and learn that I do have the foundation for a different type of practice.
OK, background information, since this happened so long ago. As a hospital OT, I was asked as a courtesy to perform a worksite evaluation of a woman ("Wilma") who was having difficulty at work due to a diagnosis of writer's cramp. Before I was asked to do this, I had no experience in work hardening outside of school classes, virtually no experience in hand therapy, or any idea what life was like in the microbiology lab. I was a little bored and willing to take on a challenge, so that's how the eval fell to me. Please note- there is a significant difference between the clinical reasoning used by novice, intermediate, and experienced practitioners; that was all fleshed out in a recent OT Practice CE article. I am not claiming to have an experienced level of reasoning, I just did my best.
My first thought was shock that "writer's cramp" was an actual neurological diagnosis. I mean, I have played Operation, and have had significant pain after essay tests in college filling up Blue Books, but I had no idea that this was real. So I looked online for information on the diagnosis from reliable sites, which included eMedicine, Merck Manual Medical Library, and Medpedia. I learned that this was a focal dystonia and a repetitive strain injury (RSI) that would likely cause increased pain and decreased grip force on small objects.
Next, I went back to my OT bookshelf. I still have many of my texts, but especially those for topics that I found interesting or complex. (I have found it unfortunate how much I have already forgotten from school in topics that have been outside my realm of practice) From my book, I was able to review environmental factors that exacerbate RSIs and go through case studies involving worksite evaluations for desk workers. My book was nice in that it also came with some ready-made forms to record measurements of various workstation pieces (example- depth of chair pan, height of chair from floor). I also asked my coworker if I could review a writeup that he had done for a different person, so I could get an idea of what was expected.
I was feeling more prepared, but still didn't know what to expect in Wilma's office. What does a person in a microbiology lab do? Where to find out? My favorite source for torturing my Girl Scouts when they're doing a career badge- The O*Net. If you haven't used the O*Net before, it's a great resource that has cataloged thousands of jobs, the skills required for each, the expected salary and job outlook for each. So I was able to pull up "Biological Technician," which gave me a few brief ideas aobut what to expect.
After gathering all this information, I spent some time trying to brainstorm possible problems that Wilma might be having. Writing, obviously, but I also thought that she might have some difficulty with manipulating other small-diameter tools, keyboarding, opening or stirring containers.
The morning of the evaluation, I got my tools together- a notebook, copies of the measurement forms from my book, digital camera, tape measure, and a goniometer.
I met with Wilma at the beginning of the day since that is when the bulk of her work was done. I asked her to describe the problem, describe the pain she was having, what made it better or worse and what she had already tried to do to fix the problem. I also asked about what she had done medically- neurologist visit, MRI, EMG, etc. Then I let Wilma go ahead and start her workday, trying to see as many of her essential job functions as possible, and asking her to report anything that caused discomfort or decreased grip. I observed the tools that she interacted with, and any time I saw something that was on my list of possible pain causers or looked like it would aggravate the RSI, I asked specifically aobut that. That included vibration, twisting, squeezing, of various tools including pipettes and cotton swabs. I also took some measurements (not a full spectrum of them) related to the position of Wilma's UE to the work surfaces.
My client was quite reticent throughout the eval, and had relatively few issues. She really only complained of difficulty writing, not with any of the other tools. I knew from my education on RSIs, phyical disabilities and assistive technology that to decrease problems from a tight grip on a small object, that the person would need to change the shape of the grip or the amount of force taken to maintain the grip. I tried to include a variety of high and low tech solutions in my suggestions, and also address other issues that I felt could potentially be a problem to Wilma.
I have the summary writeup in a google document (as always, please be respectful and do not plagiarize my work). All the photos are from Sammons/Preston to give the reader a better idea of the different tools. If it had been me, I would have pushed for a label maker, because I think that would be best for efficiency sake (that and I love labelmakers anyway). I also found a $0.49 pen shaped similar to the PenAgain in a drugstore months later, so there are other options out there in the mainstream. I didn't get any follow up from this client, so I don't know what she chose to do, but I did leave the door open so that if she had any questions or problems later she could contact the department.
So that's the thought process that carried me, an inexperienced practitioner, through my first worksite eval. If anything, I think it was worth it just to get the experience and learn that I do have the foundation for a different type of practice.
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