Crazy Life

Been going through some crazy busy times lately.

So, work kinda blew up recently (2 weeks ago? I don't know it's getting hard to keep up), going from a manageable, reasonable, daily activity to a "what the heck happened here" type experience. Earliest I left all week was 1 hour overtime. YIKES. Here's a little recap. Got my first Level 1 student, and I think we had a pretty good week. Tried to arrange for some interesting stuff everyday (hard to do when we started the week with 5/5 pts having severe dementia). Most amusing moment may have been the kitchen assessment with the man who required step by step instructions and multiple interventions for safety. He wanted to make oatmeal by pouring milk into the oats canister, then tried to fill the pot with water while the pot still had a lid on it, then had to burn it a bit... fun stuff. A good time to demonstrate how hard it is to remember all the details of your treatment.

It was also my first week with the pediatric outpatients, which went pretty well. But it was a little awkward getting to know them both, do a reassessment on the first day. I had prepared for the time that outpatients would take, but I hadn't counted in the other pediatric crew- the NICU. I've been moonlighting up there a bit, and the OT that normally covers left for vacation with a very large caseload left behind. Had to weasel out a few hours each day for babies, and also antepartums on Friday.

Now I'm looking at my outpatient peds caseload growing EXPONENTIALLY in the coming days. I'm turning into a morning inpatient / afternoon outpatient person again. I even got swept over to take a hand patient last week (definitely not my thing) which at least wasn't hard, but did prove that OP is starting to climb into my schedule a lot. It's odd, like reliving my old job... deja vu all over again. We're also switching floor teams again soon and I will be moved to surgery, which is ok for a switch but I worry about seeing all their priority patients (especially when they don't even end rounds until after 9, 930) and then making all my OP appts. There is also a limit to how much I can write in a day, as evidenced by me STILL working on an eval from Friday. I'm out of practice, and the templates for kids are very un-helpful. I will basically have to make my own peds template before Wednesday. I had just wanted to help out a little... I just forgot that with school ending the outpatient caseload would grow grow grow... oy.

In other OT news, I have been actively observing the continued RA-related debates on OTC, and hope that others are too. I'm disappointed to see that many people are choosing to abandon the discussion for one reason or another. I did start a group for Millennial-aged students/practitioners in support of the Participation Committee's suggestions, primarily as a way for newer members to voice their opinions on the matter. I've also been working on arranging an interview and podcast for the blog, I suspect it will be harder to schedule a time than to do the editing and whatnot. Kinda fun to branch out in that way.

Other demands on my time lately have been: trips to play with friends' babies (so big compared to my guys in the NICU); the NCAA basketball tournament; Healthcare reform; seeking out concerts for the summer; and planning a fun weekend getaway. I believe we're coming into a time where I will be traveling or at an event almost every weekend, which does make it hard to get other stuff done. Got to have that occupational balance though ;)


Pre-CI Jitters

I'm getting my first Level 1 student and trying to beat a case of the pre-CI jitters.

I'm growing out of the "new practitioner" label. I'm on my second job, practiced in multiple settings (sometimes daily) and I'm pretty sure that I pay "big girl" OT prices for AOTA membership now. But of course there are still "firsts," and I am now, finally, getting my first real OT student. I've played hostess to several job-shadow candidates before, but those were usually just for a couple hours. Most of those also came from the local high school and had to rotate through multiple healthcare jobs and were not particularly interested in OT. I missed out on students at my last job because state law required that you have 1 year experience before being a supervisor (or Clinical Instructor... same dif) and the offers for students after that first year didn't coincide with my availability. My current job requires that employees have 1 year experience at the hospital before taking a Level 2 student, and I definitely feel that it is a complex enough environment to learn in the year allotted without additional pressures. But now I feel pretty confident in my navigation of the hospital, finding the right people, getting the right supplies. Onto the next challenge!

I was to get 2 students, one for 1 week straight and another just once a week for several weeks. But we had some shuffling of schedules going around to best allow for shared responsibility and best experiences for students, so now I will just have the one. It does make me a little nervous... the feeling of having to bring the A GAME all day (especially early morning, ugh), be on my best behavior, be smart, and most importantly facilitate learning for the student. I don't usually have a problem with imposter syndrome, but the thought of having a person watching my every move and asking me to then JUSTIFY each one is a bit frightening. There are many things that I understand that I don't know well enough to teach.

So I borrowed a book- a handbook for acute care PT (I know, I KNOW, but there aren't any OT ones available to my knowledge) to brush up on things and try to feel more mastery on the material. It did make me feel better... as my supervisor says "you know more than you know" but there were some frustrating points. I brushed up on causes of common ailments and meanings of lab values since those sorts of imbalances (plus weakness and dementia) make up most of my medicine-floor caseload. I know that I came across a lot of that information in biology classes and physiology class but I didn't retain ALL the implications of certain things. Was I not paying attention the first time or did I just need something practical to relate the knowledge to? Is this comparable to suffering through higher level math with no explanation offered except "you'll use it in calculus/physics," which -while true- is not really a motivating factor? It was a relief to know that I did know the concepts in the book... I'm not just faking it everyday :)

I think that being a CI will be a good time for me to question my skills in a constructive way. Am I educating patients and staff on the role of OT? Am I conducting a thorough evaluation? Are my goals client centered, SMART, and varied? Are my patients getting what they need to facilitate the best possible discharge? It will be a good exercise, but undoubtedly a stressful one.

High levels of critique and reflection would be enough, BUT I'm also changing my schedule again for a short time. I will be covering 2 outpatient pediatric clients while another OT is on leave. It will be good to revive those skills, but it's hard acting as a fill-in. These clients are also older than my former clients (who I still miss *sniff*) so it will be tapping into different occupations- chores, computer use, hair care instead of blocks, buttons, and 1 step commands.

Wish me luck! I hope that I am smarter and more capable than I sometimes think I am. If not, I'm sure my student will let me know :-/ haha