Photo Phriday- early a.m. style!

It's early and I can't sleep, which is becoming the new normal. So I thought maybe I'd swing by my neglected blog and put up some new entertainment. Blogger has so kindly moved into this new editing format... hopefully someday I will adjust to it. On with the photos that are truly random because it is just that early!

One of the things I do when I'm not sleeping is jigsaw puzzles. This one is hard anyway because it does not have my preferred style (lots of words and defined objects) but instead is a fall vista in WV. Clearly there was a small perceptual problem in assembly... glad to say it's been fixed now.

Went to a football game and saw this bus in the parking lot- seems like I should jump aboard!

Normally my spiral staircase looks awesome. Normally, it doesn't look like it will send you to your doom on a tile floor 15 feet below. We are not living in normalcy right now.

This was a sensory challenging snack to make and eat.  I sliced bananas (gross) and spread on peanut butter, yogurt, and nutella. Then I froze them. They are certainly tasty treats but your hands get disgusting when making or eating them.

That's all I have for you today and sorry, some of them are twitter repeats. Posts always decrease during football season and the holidays but I will have some more updates soon including info about how I've been doing in EI. Verdict after first post in new blogger format: picture editing much improved, everything else more difficult, toolbar getting cut off on my tiny screen. Not loving it.

Photo Phriday: Accessibility IRL

This week's photo pheme is about accessibility. The whole point of universal design is that one object can serve multiple people with varied abilities. So here are some examples of increased accessibility that I have lately seen in real life which I think are noteworthy.

I saw these toothbrushes at a friend's house. These are made by Radius and claim to be more ergonomic for reaching back teeth. The brushes come in right or left handed versions with a soft, large head. My friends are convinced that you only need to try them once to be hooked for life... there were 6 of these at the house.

My grandmother had an "accessible" hotel room when she came to visit recently. This included a doorbell, low step tub, and these nifty alternative to drapery pull cords. I liked it and was able to move with only gross arm movements.

This pill dispenser is named for Ease of use by the arthritis foundation. My grandmother found one like this in Walgreens and really likes using the push-button.

I follow the "One Man's Access" blog and he has a feature I featuring annoying/interesting/aggravating pictures of access. We saw this double doorway with stairs while on vacation, and while we were hoping it was just a terrible grammatical error, I had my husband take a picture just in case.

Acute Care Tricks

There are so many OTs in the Acute Care/Hospital setting, and yet sometimes it's as if we're the black sheep of the OT family. There's not a lot of OT research done in the field, we must work within the medical model, and turnover of patients and therapists is high. I remember when I was getting started, I borrowed books on PT in acute care to try to bridge some knowledge gaps and vowed that there should be more on the role of OT. (click through to continue)

After spending four years in the hospital system, I had made up a list of topics that were relevant to OT in acute care that weren't covered well in my textbooks and had decided to do a series of serious blog entries covering these topics. Of course, this was in my +50 hour work week and long commute days and just never got it started. That is about the time that I saw this book coming out, and while I was excited, I was also really depressed about not doing my series ahead of time, and I stopped writing on the topic for awhile. (I haven't been able to see the book yet, but based on the contents I think that it would be really good for people new to the acute care setting)

Anyway, that's a really long intro, but I wanted to share some of the off-book tips for acute care therapists (many of these would be relevant to physical therapists as well) that I've developed (or stolen from smarter people) over the past few years.

- learn to get good at manipulating equipment. If you don't know what it is, what it does, or what happens if it gets disconnected- ask and figure it out. A good nurse friend will come and disconnect IVs, foleys, and PEG tubes if they're able to per order. Ask people to show you how to pop the ICU monitors off the wall. Stack your O2 tank on the IV pole, hook a chest tube on a walker, pin loose drains to the patient's gown... possibilities are endless. Pay attention to what the good nurses and techs do and take a page from them.

- double up on everything. Think you need 2 washcloths for your ADL? Better bring 4. Because one will drop on the floor or get really dirty and you'll need another.

- Be creative with what you have. You can't carry a lot of items with you in acute care, so nothing can be a unitasker. A mitten (used to keep people from pulling wires) can be a ball, which is a good early purposeful activity in the ICU. Objects like a safety pin and comb can be good for fine motor and stereognosis testing.

- speaking of the ICU, if you are working with someone (particularly male) who isn't able to stay covered with a gown and is kicking the covers off, the sleeves of a gown can become leg holes to help keep some modesty.

- Try to make it easy for the next person who comes along. This is a list of things you should return to place before you leave the room. If your patient is anything less than 100% ambulatory, make sure the bed is right beside the chair. Don't leave all the cords tangled up in a corner. And if you can make the bed fresh (or even get the tech to help you during the tx) then it will very much be appreciated. When you're working with someone on their first day after an orthopedic surgery, or any time that you don't feel very confident that the person will actually make it to a chair, you need a different bed changing strategy. As a person is sitting EOB, (maybe as you're taking vitals or the PT is checking something) pull the four corners of the sheets off the bed. Then your helper can put the new fitted sheet and a folded draw sheet on as close to the patient. When your patient stands up, the helper pulls off the old and moves over the new stuff LICKETY SPLIT. Voila! new bed, ready for your person to collapse back onto if needed.

- In a pinch, the back of a sturdy chair can serve as a walker for standing. This usually ends up happening in the ICU when you weren't expecting a person to do any standing, but they surprise you in a good way. Not such a good way that they start cartwheeling across the room, but good enough to get a short stand in.

- lastly, there's one accessory you should never be without. Jumbo safety pins. Stick 10 of them on your lanyard or off your badge tag- they are so often useful.



What's the trick that makes your life in acute care easier?