New Grad Occupational Therapy and Why You Should Be Following

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^^^featuring some fab OT friends at my recent bridal shower ūüôā #represent

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With internet access at the touch of a tablet screen to allied health social media accounts to online journals, there is a plethora of ways to retrieve valuable information on all things   o c c u p a t i o n a l   therapy.  The most valuable site is undoubtedly our national American Occupational Therapy Association aota.org website. This is the resource I always recommend to high school or undergraduate students curious about seeing the world through an occupational therapy lens.

AOTA MISSION STATEMENT

The American Occupational Therapy Association advances the quality, availability, use, and support of occupational therapy through standard-setting, advocacy, education, and research on behalf of its members and the public.

Even Al Roker agrees that occupational therapy is legitimate and provides its patients from all backgrounds and abilities with limitless future opportunities.

Furthermore, AOTA provides us with invaluable insight and is easy to navigate around the website. Broken into 6 general categories,¬†the American Occupational Therapy Association website is a phenomenal resource for all things OT. Click the 6 categories listed below for detailed information and further subset categories.¬† ***For my international (non-American) blog followers, how helpful is your national website! I’m curious to know :)***

1)Practice

2)Advocacy & Policy

3)Education & Careers

4)Conference & Events

5)Publications & News

6)About Occupational Therapy

Of course I say all of this with the realization that if you have any inclination towards the occupational therapy profession, 9 times out of 10 all of y’all have perused through our national website (or through your country’s national website) prior to reading my short highlight blurb.

But……. DID YOU KNOW —-> there’s another OT online source that eagerly¬†awaits you??? Especially if you are a baby OT like me #newgrad

>>>>> New Grad Occupational Therapy<<<<

NewGradOccupationalTherapy (NGOT) exists for its readers.

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Each published article is created to help new grads become their #BESTself while providing a site that showcases passion for the profession through writing.¬†NGOT¬†can help you transition from being a fresh-faced first semester¬†OT student to a confident Level 2 fieldwork student to a brand new grad OT practitioner ready to take on the week ahead.¬† Regardless of your area of practice -pediatrics- -geriatrics/productive aging- -rehabilitation- -ergonomics/work/industry- mental health- -private practice- and loads more… there are resources and people willing and excited to connect with you on your journey.

NGOT is a source of encouragement for all whether you are a high school student nervously anticipating your first OT shadowing experience to a new grad OT to an occupational therapist who is preparing to totally switch practice settings to avoid burnout. *click here* to our dearly loved mentors and senior therapists. NGOT also invites family members of an individual who is receiving OT services or other allied health and medical professionals to come see what the profession of occupational therapy can do to enhance a multitude of lives.

For me being a Staff Writer for NewGradOccupationalTherapy keeps me mOTivated to learn more, reflect more, and be more present in the field. It¬†increases my likelihood of continuing to be proactive therapist rather than a reactive worker who just does what is asked and nothing more.¬†Now if only writing my daily documentation notes would come as quickly as writing up this post haha:) ūüôā After passing the NBCOT¬†in February while working fulltime under a temporary OT license, I was excited to accept this new position as part of the NewGradOccupationalTherapy Community after being approached in October of last year. So far, I have two published posts 6 Awesome Tips for your First OT Job and 50 Occupational Therapy Instagrams for New Grads.

 

To sum up, I invite any and all of my readers to sign up for daily content from NGOT! We can’t wait to hear from you!¬†Subscribe and¬†join the New GradOT community!

stay mOTivated,

SHANNEN M.

 

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Maevn Scrub mOTivation Review

 

When you look good, you feel good and when you can wear clothing that is basically the daytime equivalent to pajamas –well, you feel great!!

After three months in the real world as an occupational therapist (#promOTe) in the hospital setting, I am in scrubs five to six days a week; I’m so much more inclined to invest in another scrub set rather than a trendy dress that would sit in my closet!

Recently¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†Maevn Scrubs¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† ¬†had an awesome giveaway challenge through their Instagram page to promote their fantabulous scrubs. Thanks¬†Maevn Scrubs for gifting me these pretties that are being put to great use! Below is my personal review on¬†a set of¬†EON Active Brand scrubs! ūüôā

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Scrubs that can be described in one word –>comfy

In all seriousness, I am really happy with the fit, style, and quality of these scrubs. In regards to the fit, they run true to size. I am 5’7″ and wear a Small in the top and bottom. These scrubs have an athletic feel to them with the shorter sleeves, tailored fit, and yoga style waistband. There is a variety of colors to choose from. I am wearing the scrub set in Pewter!

Scrub TOP: ACTIVE BY EON WOMEN’S COOLMAX MESH PANEL V-NECK SOLID SCRUB TOP

The material includes CoolMax technology that magically¬†works to¬†wick moisture away even when you walk back and forth across the hospital a million times a day. The neckline is V cut and it is not too low. I love the mesh panels located on the sides and down the center of the back for enhanced breathability. If you are looking for a top with a lot of pockets, you won’t be disappointed either. The top has two major front pockets with an inner utility loop in addition to a side zipper pocket. Click¬†here to view details in regards to other colors and pricing.

Scrub PANTS: EON WOMEN’S COOLMAX KNIT WAISTBAND PURE YOGA SCRUB PANT

The best part of these scrubs is the Yoga style knit waistband that is seriously awesome because 1) everyone loves yoga pants and 2) there is a hidden mesh pocket in the waistband which is perfect to store your phone. There are mesh panels on the sides for circulation. There are no shortage of pockets in these pants! Two slip pockets are located on the front in addition to two back patch pockets and a cargo patch pocket. To view details click here.

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Go online and browse  Maevn Scrubs to find his look and many other scrub designs to fit your unique style!

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It’s always a great time to serve others!! Cheers to all the physicians, NPs, PAs, nurses,¬†therapists, and students out there working in a variety of settings and populations. Thanks again Maevn!

stay mOTivated,

SHANNEN M

Reflecting on 2016 and Recharging for 2017

 

2016 was a whirlwind for me.

Rang in the 2016 New Year with my family in Epcot along with everyone else in the world, the park was filled to max capacity!

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Wrote my first blog post out of frustration, necessity, and determination to advocate for DO and OT after one too many individuals questioned whether osteopathic physicians are ‚Äúreal doctors‚ÄĚ and since half of my friends were convinced that I was just going to occupational therapy graduate school in order to help people find jobs. Here is my first blog post ever inspired by my fiance and his classmates on their way to becoming osteopathic physcians.¬†¬†¬† If you are interested in OT or have no idea what it is, click here.

 

Finished an exhausting but exciting last semester of OT school in the classroom. Praise to be to God- no more research although I loved my group.

Watched my little brother graduate from high school across the same stage I walked across years prior,

Completed a long, mentally taxing, but rewarding 12 weeks at an outpatient pediatric clinic for my first Level 2 OT fieldwork. Learned a lot about myself, found a new appreciation for parents of special needs kids, and increased my tolerance on caffeine. Curious to what OP peds is like through an OT lens, click here.

Became engaged to my college sweetheart who thoughtfully proposed to me in¬†the most meaningful way¬†-also he picked the loveliest antique ring out himself- we only went ring shopping once and that was a year and a half prior to the date we got engaged!- Who knew that the then 18-year-old boy in my freshman bio class would not only be my biology tutor, but also my husband! Click here to read “Our Story”.

asked six beautiful friends to be my bridesmaids,

mini vacation to Orlando with my parents and my uncle and aunt from Northern Ireland and their two princesses -saw Disney world through the lens of a captivated 3-year-old, priceless-

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spent three months in Auburn and was convinced to move there because of my person, the people of Auburn, my experience at my 12 week second Level 2 fieldwork in an inpatient rehab/SNF setting, and the city itself, went out of my comfort zone to give a 45 min presentation¬†to Auburn University’s Pre-OT/PT club eek, joined a weekly bible study with 20+ kindhearted girls, Click to read about my experience in an inpatient rehab setting.

adopted a grumpy 3-year-old cat whom at the time James and I didn’t know he was a Scottish Fold Hemingway cat (folded ears, and has six toes!!)

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Coley/Seidel Thanksgiving

survived and thrived at my first Seidel/Coley Thanksgiving -James has a really large, but really loving family,

accepted my first real OT job offer in an acute inpatient rehab hospital  where I get the pleasure to work in a unit that is newly renovated, provides me with mentorship, and is staffed by a number of awesome physicians, physical therapists and assistants, occupational therapists and assistants, speech therapists, social workers, nurses, and care assistants,

 

presented my final case poster and graduated with my Master’s of Science in Occupational Therapy with¬†my Class of 2016¬†-2 and a 1/2 years of continuous grad school, check,

hosted James for his first Weyer/Cyr Christmas,

a¬†month of relaxing, hanging out with my family, somewhat studying for my national ¬†OT boards exam (please help me God), ¬†reconnecting with high school friends that I hadn’t seen in quite awhile, wedding planning, and running down the beaches of the MS Gulf¬†Coast.

2016 was awesome, but I am ready for 2017 and to begin my career as an occupational therapist and marry my fiancé!! I am not one to make crazy resolutions but I do have a few things I anticipate doing this new year.

2017 aspirations…

  • Be more confident in myself and say “no” more often.

  • Call my grandparents once a week and tell them about my day.

  • Learn to enjoy running again without feeling the pressure to run the times when I was running collegiately.

  • Sign up and complete a half marathon.

  • Pass my National OT boards exam. This one is a have to.. so not really an aspiration.

  • Seek mentorship and be my personal best entry level therapist without forgetting that it is okay to ask for help.

  • Be a mentor to undergraduate students who are interested in OT.

  • Be more patient with myself and others.

  • Be¬†present, instead of worrying about the next step on my to do list.

  • Eat more whole foods. Including choosing specialty coffee drinks without syrups. sigh.

  • Write and submit¬†an article for the OT practice magazine.

Cheers to 2017!!

I’d love to hear your goals for 2017! Comment below!

stay mOTivated,

SHANNEN M.

Guest Post – Shoshanah Shear, Occupational Therapist and Author of “Healing Your Life Through Activity”

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Occupational therapy is a worldwide, dynamic, and enabling profession that facilitates meaning and independence into the lives of others.img_3011 therapists from all around the world have the opportunity to connect with other OTs through national conferences and also world conferences through World Federation of Occupational Therapists. Learn more about WFOT here. In addition, as in the case for Shoshanah and I, social media (Facebook, Instagram, blogs, etc) gives us another avenue to share our experiences as a new grad OT (me) and an advanced OT practitioner (her).

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2016 World OT Day – October 27

 

Shoshanah reached out to me through an international FB group called OT4OT.¬†¬†She is a super cool occupational therapist with a diverse background and 25 years of experience (lololol 25 more years than me #babyOT – I’m not even 25 years old yet) in the field. She received her education in South Africa and currently practices in Israel. Shoshanah has also written the book Healing Your Life Through Activity: An Occupational Therapist’s Story¬†which is available on Amazon and Barnes & Nobles. Click here to view more information about her book, pricing, and comments from her readers.¬†I am pretty excited to read my copy soon ūüôā ūüôā (guest I’ll wait til after I take the NBCOT meh…)!!

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The most enticing aspect this book has to offer is the fact it is written for the layperson as well as to the most seasoned OT. If you are considering a career in this profession or if you are unsure of what the profession entails, this is the book for you.

In brief, if we don’t promote the profession and actively advocate for our practice, OT will continue to be underutilized and under-appreciated.¬†

I introduce my readers to Shoshanah¬†Shear occupational therapist, healing facilitator, certified infant massage instructor, freelance writer and co-author of Tuvia Finds His Freedom and author of Healing Your Life Through Activity – An Occupational Therapist’s Story.

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Thank you Shannen for the opportunity to share a little of who I am as a person and as an occupational therapist for your OT blog. I appreciate the opportunity. The following provides answers to the 3 questions that Shannen asked me to include in addition to mentioning my book in order to display my perception of OT.

1) Where I am from:

The mini answer is: Israel.

The slightly longer though short answer is: I obtained my basic degree in Occupational Therapy from the University of Cape Town in South Africa and currently live and work in Israel.

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University of Cape Town in South Africa

The long answer is: I was born in Bulawayo, Rhodesia (now Zimbabwe) and moved to Cape Town, South Africa as a child. I lived most of my life in South Africa and obtained my degree as a B.Sc (Occ Ther) Honours degree and was capped at my graduation from my late grandfather who was the first full time Dean of Engineering at the University of Cape Town. I worked for 4 and half years at a teaching hospital in Cape Town before traveling to the UK to work for 4 plus months, followed by a year in a school and vacation cover in a hospital in the US. I then worked in private and the community for 6 years in South Africa before moving to Israel.

Out of interest, where I am from confuses people. When I worked in the UK, no-one could place me. My accent is almost South African but not quite, it is sometimes leaning towards somewhere in the UK but not quite that either. They joys of being born in what was a British Colony. So when I was in the UK they thought I was either from Ireland or some thought North England and some disagreed and though South England. It took someone in a post office to pick up my accent. She stood a few people behind me in the queue (line) and suddenly got very excited to say exactly which city and country I was from. Though our skin colour differed she recognized me as she was born there too.

In the US I had another problem. In the school where I worked, I was denied attending the assembly to celebrate Africa Week, I also found several African American teachers would not permit me to enter their classrooms to work with students. I asked why I could not attend the assembly and was told it was not relevant to me and not to make fun of this important celebration. My response was to offer to sing Xhosi Sikaleli Africa for them. I even sing it with the correct clicks. This confused them terribly. I asked again what the problem was telling them I was born in Central Africa and grew up in South Africa. I told them I was even learning to speak Xhosa. To this they were most confused and one teacher said “It can’t possibly be!” while another said “but you are white!” almost in unison. This was a great eye opener for me as to the lack of education for many in the US of those who live in Africa. Not everyone born in Africa has a dark skin, yes there are all kinds of cultures living there and yes, someone who is Caucasian can be born in Africa.

 2) How Did I Become Interested in Occupational Therapy?

 The short answer: I heard about it from a career guidance counselor who could not tell me anything about the profession other than in her opinion it combined all my high school subjects.

The longer answer: I was actually exposed to OT from a young age but had no idea that I was until I began to study the profession. Even then some information only came to light as my studies progressed and even after graduating.

So, after I enrolled to study OT I discovered that my mother had explored studying OT but the screening process in those days included observing a surgical procedure which she struggled to do and was therefore denied applying. My aunt considered OT before beginning to study for her career.

A relative of mine had received OT when I was a child. I would go with my mother to drop the relative off but had no idea where she was going or what took place there. All I knew was that she went to this building and we would sit in a hot park and wait for ages until it was time to collect her and take her home. I was fascinated to learn years later that what transpired in the building that we went to weekly for a while was occupational therapy. This made an impression on me and today, in my practice I include family members in therapy as far as possible, wherever relevant to do so.

My greatest introduction to OT, however, came from my late grandfather. Once again I did not realize how various experiences I had throughout my childhood actually fitted into OT, until I began studying the profession. My grandfather was a very humble person. As I grew older, I learned that my grandfather had sustained a war injury during WW2 when he was stationed in Italy. His back was severely injured and it was a miracle that he ever walked again. He did all that he could to hide his pain and difficulties from us and never complained. Due to his gratitude at being able to walk, after returning to South Africa and resuming working as a Civil Engineer, he turned his attention to how to assist those less fortunate than he. He became chairman and later honorary life president of St Giles Organization for the Handicapped in Cape Town, South Africa. Through this role combined with his position of Deputy City Engineer he designed a rehabilitation centre for the organization, which he made a model of and used this to obtain a plot of land and necessary funding. He wrote a number of papers on accessibility for the disabled and his home was adapted so that his wheelchair dependent friends could both visit him and enjoy his beautiful garden too. He built the ramps himself that ran from the drive way into his garden and from the garden onto his veranda with access via the side door. His guest bathroom was wheelchair accessible. As a child I had asked about this and was only told these are for our friends to be able to visit.

My grandfather was instrumental in certain laws coming into place for accessibility of buildings in South Africa. Some of my grandfather’s wonderful work and the influence he had on my career as an OT is written up in my book: “Healing Your Life Through Activity – An Occupational Therapist’s Story“. The book is also dedicated to him.

 3) My Personal Definition of Occupational Therapy:

So many have no idea what OT is and sadly many offer the suggestion to change the name of my profession. I do not understand why there are so many definitions of OT, this surely is confusing to everyone.

To me, the title “occupational therapy” describes everything we are about. We use occupations as a medium of treatment in order to assist our clients to be optimally independent in all areas of their life, throughout the life cycle.

Occupational therapy is concerned about what our clients need to or want to achieve in their lives both as long term goals and on a day to day basis. We evaluate their unique situation in much detail in order to establish how the person functions as an individual, in their family, school / work, environment and their community and how each of these impacts on his / her daily functioning. This information guides us in formulating a treatment plan that is case specific and evidence based to enable our clients to live a functional and active life of meaning and purpose.

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Reviews include:

“This book is a remarkable description of the development and the journey of Occupational Therapy. It is described in a unique manner through the eyes of a professional, drawing on experiences gained in various countries and clinical settings… The book will be read with interest by patient’s families, all health care students, and medical practitioners, who will be enlightened further, and gain significant understanding of patient care.

Emeritus Professor Tuviah Zabow, Retired Head of Psychiatry, Cape Town, South Africa.

“I was most impressed with the very extensive coverage of occupational therapy as an important modality to help so many people of all ages and different disabilities and backgrounds to regain function, and return to productive life.”

Norman Samuels, M.D., Part-time Medical Director and Retired Obesity Surgeon, Florida, USA.

The book, “Healing Your Life Through Activity – An Occupational Therapist’s Story” by Shoshanah Shear can be found on:

CreateSpace eStore: https://www.createspace.com/6406489

Amazon: https://www.amazon.com/Healing-Your-Life-Through-Activity/dp/1535161604

Amazon UK: https://www.amazon.co.uk/Healing-Your-Life-Through-Activity/dp/1535161604

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I for one hope to receive a signed copy of this very interesting, personal, and impeccable analysis of occupational therapy.

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This guest post is written by Shoshanah Shear.

Occupational Therapist, healing facilitator, certified infant massage instructor, freelance writer and co-author of “Tuvia Finds His Freedom” and author of “Healing Your Life Through Activity – An Occupational Therapist’s Story

***Have any topics for my next post? Comment below! :)***

stay mOTivated,

SHANNEN M.

mOTivation For the Long Term (care and inpatient rehab level 2 fieldwork)

 

12 weeks goes by even faster the second go around.

 

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My final occupational therapy Level 2¬†fieldwork was at an inpatient rehab/long term care facility just 15 minutes from Auburn University >>>war eagle, hey<<<. What are Level 1 and Level 2 fieldworks? Click here!¬†With¬†a patient caseload pretty much 3-4x older than me –they basically thought I was about 12–, this was a¬†complete contrast (or so I thought)¬†to my prior fulltime fieldwork in outpatient pediatrics where the majority of my caseload was younger than 8 years old.¬† The experiences of working separately with the two populations on opposite ends of the spectrum was truly¬†invaluable for my clinical competence and personal¬†growth.

>>>>>BASICALLY, LEVEL 2 FIELDWORK IS THE BEST (and in some ways the most challenging) PART OF OT SCHOOL.<<<<<

In this post, you will find my stream of consciousness thought process as a student in addition to a broad overview of the process of OT in this specific setting!!

In outpatient peds my full attention was given to an individual kiddo in¬†an isolated¬†treatment room (with my stellar supervisor) away from other therapists and distractions from outside those four walls. However,¬†an OT who works in an inpatient rehab/skilled nursing facility/long term care whichever way you refer to this site does not operate like this at all. A nursing home is in essence an extension of a hospital; thus, it provides 24 hour medical care in addition to rehabilitative or restorative services and so therapists must be much more cognizant of the patient’s medical needs.

runnMoreover, in¬†an outpatient setting-¬†yes you must¬†understand the medical history of the patient-¬†but these individuals are considered “medically stable” and are eligible to receive rehabilitative services without ¬†constant medical care.¬†When I was in the very fast-paced OP pediatric world I felt like I was rrrruuunnnnnnning 90 miles an hour every hour, but¬†I was able to attend to the occupational (primarily areas of occupation including ADL, education/school,¬†play) needs of the child without really worrying about how my intervention plan would affect¬†the medical status of the child.

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Fast forward three months later on my first day as an OTS in the inpatient rehab/LTC setting— and these five thoughts piddled through my brain.

  1. Cute old people!! I just love them. Second thought-eeeeeek at all of this medical equipment to navigate around during therapy hmmmmm foley catheters, IVs, nasal cannulas and oxygen tanks, wheelchairs, walkers, the works. Brain immediately and silently freaks out because although I can tell these patients are resilient-they are also fragile and need a med terms refresher.
  2. Wayyyyyy slower paced than peds. Between ensuring adequate rest breaks to checking O2 sats to asking a nurse for a snack for a patient with low blood sugar to stopping briefly for medication administration, there are multiple brief interruptions in this setting and that is okay!
  3. Less documentation. Whattttt???? I don’t have daily detailed (loooovved my kiddos but pediatrics or outpatient in general equals a lot of documentation) soap notes and reassessments to write. #score
  4. Holy crap there are a ton of people in multiple professional healthcare disciplines needed to work (with goal being collaborative care) together for the health and well-being of these patients. (Also on that first day I asked myself how in the world would I learn every individual name…)
    1. Physicians to nurse practitioners to physician assistants to rehab-occupational, physical, speech- to audiologists, to¬†RNs, LPNs, and CNAs, to restorative care to social services to janitorial services, to cafeteria staff and more–each job duty with its own unique contribution and need.
    2. I have an utmost appreciation for physical therapists and speech therapists after countless awesome cotreat sessions with them.
  5. Woot woot I get my own desk. feelin da love. Really though. My coffee cup enjoyed having a place for it everyday.

PSA***MDs and DOs worked as the attending physicians over the plan of care at this facility-what a concept that there are 2 and only 2 real types of physicians in America-please for the love if you know a DO (Doctor of Osteopathic Medicine) or a DO student give them a hug because for some reason the world hasn’t caught on to them yet-admittedly, I didn’t know how awesome osteopathic physicians were either¬†until about 3 years ago*** and click here to learn more.


Where to begin-

Nursing homes get a bad rap- let me just start out with that. But this misleading perception can change if we become the change (which is undeniably difficult to do when you have the pressures of Medicare billing and productivity). ~~~~Think person-centered. Be person-centered.~~~

Patients are people first.

It’s just as important¬†to remember this as a student therapist as it will be years (many years) down the road as an advanced occupational therapy practitioner-as well as in any healthcare fields.

Their occupational identity (how the individual describes himself/herself): Teachers, Engineers, Nurses, Salesmen, Carpenters, Administrators, Counselors, Realtors, Secretaries, Welders, Church leaders, Janitors, Retail workers, Police officers, Volunteers, Grandfathers, Grandmothers, Fathers, Mothers, Sons, Daughters, you name it.

Their occupational identity (how the chart describes him/her): COPD, Parkinson’s disease, Alzheimer’s disease, Peripheral neuropathy, Diabetes, Hip replacement, Knee replacement, Cognitive decline, Low vision, OA, RA, history of cancer, Myocardial infarction, Cervical spine survey, Rotator cuff repair, Amputations, Cardiac disease, Anxiety, Depression, Schizophrenia… to name a few.

***note- I am not saying that the medical chart/patient history isn’t important!! It is¬†extremely important!! I am just emphasizing that it is also imperative to retrieve enough info on a patient’s occupational/work/life history in addition to their medical history. This extra effort is demanded¬†from OTs in order to develop an¬†occupational profile that¬†will promote client centeredness¬†from the beginning (initial evaluation) through the end (discharge). Gathering an occupational profile in this setting will enable the occupational therapist and/or occupational therapy assistant to choose treatment interventions that not only address underlying problems or weakness areas, but also are of some meaning to the patient.***

The OT PROCESS

(at least this is how it was at my site):

  1. Initial Evaluation

  2. Evaluation Write Up and Goals

  3. Intervention Plan and Implementation

  4. Progress Reports with Updated Intervention Plan and Goals

  5. Family Meeting to discuss progress

  6. Discharge

#1. Initial Evaluation-

  1. READ and comprehend the patient’s medical chart. Physician notes, nurse notes, therapy history, precautions, etc. Reason for referral. Length of prior hospital stay. Find out treatment and diagnosis code.
  2. Patient/caregiver interview and general observation. What is the patient’s occupational identity? What is the patient’s prior level of function? Any falls in the last 6 months? Behavior changes?¬†Where does the family/patient hope to discharge to after rehab? Using your clinical competence–is this potential D/C location feasible and safe? EXPLAIN IN PATIENT FRIENDLY LANGUAGE WHAT OT IS IN REFERENCE TO THAT PATIENT’S NEEDS.
  3. Have patient rate his pain verbally or nonverbally depending on cognitive status.
  4. What can the patient do now? Includes bed mobility, assessment of ADLs-toileting, feeding, grooming, bathing-, use of an assistive device, range of motion/manual muscle testing, sensory testing, visual  processing, and more.

#2. Eval Write Up and Goals

  • Varies by facility and electronic documentation system
  • Along with the initial evaluation, the Evaluation write up and goals must be written by the registered therapist
  • Short term and long term goals
  • Probably should make it a habit to make a long term bathing goal for most patients because it addresses a jillion things (functional mobility, safety, activity tolerance, dynamic sitting or standing ability, visual perceptual skills, sequencing…)

#3. Intervention Plan and Implementation

  • Be creative, client-centered, and occupation-based
  • Improve strength, endurance, and coordination in effort to reach PLOF
  • Treat underlying impairments that are hindering occupational participation
  • Think >>>>occupation as means, occupation as ends<<< (I need a new post to explain this)
  • ADL training, ADL training, ADL training!!!! In the patient’s room, in the ADL kitchen, in the rehab gym–so important
  • Co treat!!! PT and ST bring awesome cards to the table!
  • Teach modifications to activities -change the task, completely eliminate a portion of the task, provide adaptive equipment as needed
  • Compensatory strategies are always a win -joint protection, task segmentation, energy conservation…)
  • OT is all-encompassing which is probably why it is so hard to explain at times, hmmm.

I will explain each of the above pictures in a later post that dives deeper in the intervention process- ūüôā

#4/5. Progress Reports and Family meeting

  • Discuss the patient’s progress, activity tolerance, medical concerns, insurance/ Medicare days (mehhh), plans for D/C, and any needed AE fr home.

#6. Discharge

  • PT, OT, ST and other disciplines collaborate with the patient’s D/C goal in mind to determine the safest environment that is the least restrictive

Death and Dying–For me the most difficult¬†part of working in this setting can be summed up in one experience I had at mass¬†one Sunday. “We pray for those who have died this week including…” And that’s when I broke down in tears because one of the names read was one of my patients whom I did not expect to pass so soon. It is this experience and a few others that will remain with me and remind me to be kind and compassionate to even the most irritable patients because when it comes down to it-they are someone’s mom, dad, sister, brother, friend¬†before they are patients.


Halloween ———————————Rehab Style

Since Halloween was on a Monday this year, we brought the holiday spirit to the residents. As an OT to be, it’s important for me to be able to adapt to multiple contexts… so I altered my Statue of Liberty costume in order to be in appropriate attire necessary to treat patients. Summer, the speech therapy student, brightened up many patients’ days as a strawberry. The rest of the rehabilitation team -speech, occupational, and physical therapists and assistants- dressed as deviled eggs, which was quite a sight. Also, creating a caramel apple pumpkin was pretty sweet as well.

 


 

I am without a doubt grateful for my 12 weeks spent collaboratively working with my clinical instructor, speech, occupational, physical therapists and assistants, nurses, CNAs, social workers, physicians, and other disciplines. I am most thankful for the patients who have deepened my passion for the profession, increased my insight, and allowed me to be a small part of their lives-they are the reason this field continues to grow and enables us to have fulfillment in our role of being advocates, listeners, encouragers, adapters, and lifelong learners through our professional identity of occupational therapists.

As much as I love kids, my heart belongs to the patients with the old souls, the wisest stories, and the most loving hugs. I am so excited to begin my career as an occupational therapist and am so stoked to graduate December 10th!!! Cheers to the class of 2016!!

Let all you do

Be done in L O V E.

1 Corinthians 16:14

 stay mOTivated,

SHANNEN M.

OT Month: ABCs of OT 2016

Occupational therapy is a powerful, science-driven, and evidence-based profession. Part of an OT’s role is to help meet society’s occupational needs. However, how¬†can¬†we¬†help meet these needs, if OT is not widely known much less widely understood? April 1-30 was designated “OT Month” to correspond with AOTA’s Annual Conference & Expo. I decided to participate in the #OTPhoto¬†challenge on IG by posting a picture and description of how valuable OT is using each letter of the alphabet in order to promote #OTMonth.

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the OT Alphabet…

A is for ADAPTIVE Equipment.

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To enable functional outcomes sometimes our clients need a creative way to do an activity differently. We want them to maintain as much independence as possible. Adaptive equipment can come in many different forms. Here are a few examples.

  • Sock aid: a client who recently had a hip replacement will have hip precautions that interfere with his dressing. We use the sock aid to help him put on his socks without bending down too far.
  • Colored overlays: useful for¬†little kiddos who have trouble attending to the reading task or has dyslexia
  • Adaptive door knob: picture a client who has a SCI and cannot grasp or pronate/supinate-wrap foam tubing around a door and zip ties so that client can use his wrist to push down to turn the knob.

B is for BALANCE.

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Balance can come in many forms. Here are a few examples.

  • To improve one’s dynamic sitting balance, the client may be guided through an isometric core routine as a warm up before performing ADL’s on the EOB which will require client to reach and work on balance simultaneously.
  • To improve one’s dynamic standing balance, the client will be asked to perform an activity such as a sorting task (laundry, meal prep, etc) while standing. OT will have a gait belt on the client for safety reasons.
  • Balance is not just for clients. The OT or in my case-the OT student-always will need to work on her own occupational balance. When I prioritize my time and balance my schedule in order to fulfill OT school demands with my leisure pursuits (writing, painting), social needs (spend quality time with family and friends), and self-care/health maintenance needs, then I consider myself in occupational balance.

C is for CONTEXT.

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Context can mean many different things and can be analyzed in every situation. Here are a few examples. 1) Personal Context: an individual’s internal environment that comes from his or her gender, age, values, morals, and beliefs 2) Social Context: this is the human environment that helps us define our roles and can hinder or facilitate one’s occupational function 3) Cultural Context: these are the norms or traditions that the community creates or establishes.

Context applied to my life when I went for a family boat ride… Personal Context: made the choice to wear a life vest during the part of the ride when we were in much deeper water d/t my personal beliefs to be safe rather than sorry. Social Context: my social role was “child” since I was with my parents which influenced my behavior- in contrast to if I was on a boat with a bunch of girl friends. Cultural Context: to comply with unwritten norms my dad chose to pull his boat up to the farthest spot rather than parking at the closer, more convenient spot. Each client brings their own personal, social, and cultural context which influences assessment and guides treatment planning. Before trying to understand our client’s context, we must first think about our own. Becoming familiar with the multiple context in our clients’ lives will help us to empower them.

D is for D R E A M T E A M .

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And no I’m not referring to me and my ‚ėÄÔłŹ, but to what this picture represents in the context of this moment. When you look at this picture you see two seemingly healthy people sharing a meal, but actually I’m pretending to be an OT helping to teach my “client” with visual impairments, dementia, and poor safety awareness how to cut and eat his meal again with the appropriate visual and tactile cues. This was for a project video that my classmate Kris and I did did on our well-mannered patient (my boyfriend) last spring.What you don’t see in this picture is my depression, anger, and anxiety from tearing my ACL literally two days beforehand in my senior recognition track meet which exemplifies how much we don’t immediately see in our patients. If you relook at the picture now you’ll see my long stabilizer brace. However, to make the video seem like a realistic OT/client simulation I tried my best to hide my emotions.

What does this picture have to do with OT month and dream team??
1) SLP: eating and feeding is an ADL but without our speech pathology friends, this fictional client would struggle even more with cognitive and swallowing tasks.
2) PT: without physical therapy this client’s ambulatory and balance ability will decline further; without my¬†PT I would not have a normally functional knee joint again
3) OT: this fictional client wouldn’t have a choice in strengthening his functional ability to perform previously meaningful occupations. Without my OT friends/classmates, I would have forgotten that I was still meant to be in the Class of 2016 and that I could be resilient and practice what we preach to our patients in overcoming an obstacle.
All three of these disciplines are needed! SLP + PT + OT = Rehabilitation DREAMTEAM

E is for ENCOURAGER.

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The art and science therapists encourage their clients on a daily basis. The art of occupational therapy requires the OT to examine different or creative strategies to create a rich intervention while displaying appropriate empathy and giving encouragement as needed to enhance the recovery or to empower a client. The science of occupational therapy requires the OT to plan Evidence-based, Science-driven interventions while adhering to AOTA’s Code of Ethics.

In this picture, my current Clinical Instructor of my fifth and final Level 1 fieldwork (in an orthopedic/hands OP setting) encouraged me last week by giving me a challenge to do by today. Because of her encouragement and guidance I am now able to (without cheating and looking at my anatomy book) draw the Brachial Plexus out, label all of the nerves, group and name the muscles, categorize common conditions and apply this knowledge. OTs encourage their clients, but OTs can also encourage their coworker or student OTs as well!!

{Brachial Plexus: C5-T1; draw it by remembering 3 Y’s, 2 E’s, 1 X and a long thoracic; helpful nemonic is Reach To Drink Cold Beer for Roots, Trunks, Divisions, Cords, Branches (I actually hate beer..) and for the nerves to remember lateral from medial Most Alcoholics Must Really Urinate for Musculotaneous, Axillary, Median, Radial, Ulnar! }

F is for FUNCTIONAL.

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Occupational therapists design client-centered interventions with functional outcomes in mind! It all starts with listening to what is meaningful for that individual client and moving forward from there.

Functional assessment: OTs observe a client’s behavior in a natural context (shout out to home health) or in an environment that closely simulates the natural context to understand how environmental factors affect performance. We observe our clients performing their normal occupations to determine their strengths and what needs to be strengthened, their needed level of supervision/assistance, and address any barriers that are inhibiting their occupational readiness.
Application: A client who works at a coffee shop as a barista was recently diagnosed with MS. She relates that feels depressed and very fatigued and is worried that she won’t be able to keep up with the motor demands (both fine and gross) that it takes to be a great barista.

G is for GROWING.

m7Did you know that the job outlook for occupational therapy is very high in demand!! Not only has it consistently ranked high on multiple lists of top and recession-proof jobs but it is grrrroooowwinnggg! Idk about you but job security is kind of an important trait when deciding your career path.

Don’t take my word for it! Look up the following sites for yourself! List from AOTA website.
‚ÄĘU.S. News & World Report, Jan. 2016, “Ranking of Best Health Care Jobs”
‚ÄĘTIME Magazine, Jan 2016, “These 12 Jobs Will Grow 30% by 2024”
‚ÄĘNPR/WNYC-TV NBC 5, Jan 2016, “Following Up; Occupational Therapist Shortage”
‚ÄĘCareer Alley, December 2015, “Hot Jobs for 2016”
‚ÄĘThe Examiner, December 2014, “Top 5 Health Care Jobs for 2015”

H is for HOME modifications.

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Home modifications are keeping our baby boomers in their homes as long as possible!
‚ÄĘCurrently, only 1 in 6 of these baby boomers have made home modifications that will ensure that they will live safely in the comfort of their own home! ‚ÄĘOTs can specialize in home modifications with further education in order to achieve the SCEM or CAPS credentials ~~Specialty Certification in Environmental Modification | Certified Aging in Place Specialist~~‚ÄĘOTs can provide an evaluation in your home to assess your family member’s safety, skills, and abilities and make recommendations and offer solutions to increase accessibility or enhance function within the home environment.

We want your home to work for your individual needs!‚ÄĘInterested in having an OT help you stay in your home, >>>>ask your primary care doc DO/MD<<<< for a referral! Recent medical changes may qualify you for home health services!! Your local home health agency can provide you with a creative OT who is skilled in addressing your needs for home modification. Never heard of a DO???? click here—> MD vs. DO: DO your research

I is for INDEPENDENCE & IADLs

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Occupational therapists do everything they can can to make you as independent as possible again!! If making delicious pizzas for your family is a skill {meal prep/cleanup–> Instrumental Activity of Daily Living (IADL)} that is meaningful to you, well we can improve your ROM and endurance and remove any contextual barriers and even give you adaptive utensils if necessary to give you your independence back! IADLs are the activities you do within your home and community!! IADLs include: care of others,care of pets, child rearing, communication management, driving and community mobility, financial management, health management and maintenance, home establishment and management, meal prep and cleanup, religious activities, safety and emergency med, and shopping. OT is so necessary and I think it’s pretty cool how broad this art and science therapy truly is!! Cheers to holistic health-healthy mind and body & this pizza.

J is for JUSTIFICATION.

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How I feel trying to justify my rationale for a group class assignment case study. Mr. Skellie says life would be easier if we didn’t have to back up our intervention ideas with evidence-based practice, but that’d make things too easy (and not skilled)!

Documentation is just one of those things you have to get used to doing a lot of as a healthcare professional to justify your services to insurance!

Justification gets easier with practice and a little creativity! OTs document their evaluations, interventions, daily notes, and more–all to justify why you need our services–and to document your progress.

K is for KINESTHETIC.

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April 11, 2015 was not how I anticipated my USA Senior Recognition Track Meet competing in the steeplechase to have went!! Tearing your ACL can really throw off your plans! I had my reconstructive surgery during my two week “summer” break between second and third semester of OT school on May 12, 2015. This picture (my mom was cheering/taking action shots) was taken seconds before I landed and unfortunately hyperextended my left knee and tore my left ACL.I was a mixture of feelings that day, but I am rejoicing a year later.

In my physical therapy rehab to restore my mobility, I participated in a lot of kinesthetic activities. OT can also use kinesthetic approaches such as in teaching handwriting to kiddos through Handwriting Without Tears and even with an orthopedic client through kinesthetic biofeedback. Hurray for OT month and for overcoming trials!!

L is for LOW Vision.

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Low vision can occur throughout the lifespan! Low vision truly hinders individual’s ability to perform meaningful occupations and/or negatively affect their occupational roles. This is where OT comes in!! OTs believe it or not can work with ophthalmologists (MD/DO) ¬†and optometrists¬† (OD) on a vision team! Did you know that it wasn’t until 1990 that physicians could refer clients for occupational therapy with a sole diagnosis of low vision!!? Two certifications OTs can receive for low vision include becoming a Certified Low Vision Therapist or receiving a Specialty Certification in Low Vision (SCLV)-formal recognition for OTs for specialized knowledge and expertise with clients in this population. The SCLV is a 5 semester program that practicing OTs can go back to school for aka me after I get a few years into my practice!

M is for MANUAL Dexterity.

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M is for Manual dexterity (and for my advocacy blog mOTivatedtoDO ) Manual dexterity is for typing on our computers for our 250350 group projects we have in our last semester of OT school in the classroom. It’s also for Management, Modifications, Motivation, Motor Skills, Metacognition, MultiSensory and MawMaw at the SNF.

 N is for NBCOT.

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NBCOT – the National Board for Certification in Occupational Therapy// in addition to seven semesters of graduate education to get the beautiful “OTR” behind my name, I will take my boards shortly after graduating at the end of the year!! Can’t thank these two lovelies enough for all of their support through it all!

“NBCOT provides a world-class standard for certification of occupational therapy practitioners. They develop, administer, and continually review our certification process based on current and valid standards that provide reliable indicators of competence of the practice for occupational therapy.”

Mission Statement: “Setting the standard for lifelong professional growth, advancement, and practice excellence in occupational therapy.”

O is for OCCUPATIONAL beings.

m16My current apartment complex encourages my occupational role of graduate student by providing me with obscene amounts of coffee for freeeeee.

>>>>To be human is to be occupational!!<<

This is a founding principle of OT! We believe it is through the therapeutic modality of occupations that clients’ functions can not only be restored, but allows them to flourish!! As occupational beings, we each have our own individual needs that must be met to fulfill life’s daily demands! Occupational therapists recognize that the simple activities we do everyday are “occupations” (ADLs, IADLs, Education, Rest and Sleep, Work, Social Participation, Leisure) and our priority is to promote access, enable participation, restore functioning and more!! If you’d like to really dive into how OTs incorporate and perceive occupations a therapeutic tool then view my blog post at OT: the art and science therapy

P is for PERFORMANCE SKILLS.

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Performance skills are observable elements of action that have an implicit functional purpose for life’s daily activities! OTs look at a client’s performance skills in order to understand the client’s ability to use one’s body functions and structures to engage in desired occupations. The 3 main types of Performance Skills related to occupational therapy intervention are…¬†Motor Skills, Process Skills, Social Interaction Skills

  • Motor Skills: “Occupational performance skills observed as the person interacts with and moves task objects and self around task environment” (e.g. ADL motor skills, school motor skills)
  • Process Skills: ” Occupational performance skills observed as. Person (1) selects, interacts with, and uses task tools and materials; (2) carries out individual actions and steps; and (3) modifies performance when problems are encountered”
  • Social Interaction Skills: “Occupational performance skills observed during the ongoing stream of a social exchange”. Source: AOTA- OT Framework 3rd ed.

Q is for QUALITY of life.

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OTs care about you and hope to use our therapeutic use of self along with our client-centered interventions to help create, promote, establish, restore or maintain your quality of life! We do what we can to help you achieve your goals and participate in what’s meaningful to you!

 

 

 

R is for REGULATION strategies.

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Regulating your emotions is a strategy doesn’t come natural for everyone. OTs help our kiddos (and sometimes adults) with poor frustration tolerance, ineffective coping mechanisms, poor social interaction skills etc. learn how to >>>self-Regulate<<< their emotions to encourage age-appropriate behavior.

3 emotional >Regulation< strategies: (may or may not have used one of these strategies during our sand volleyball game)

  • Take Five“: Place your left hand flat on a table. Place your right index finger on the base of your left thumb (anatomical snuff box) and trace your thumb up and breathe in. Trace your thumb down, breathe out. Repeat for the other four digits.
  • Social Story: Create a visual aid through PPT that is catered to the problem areas that the child needs to work on. Make it fun and include lots of pictures and short captions that models appropriate behavior.
  • Calm Down Corner: create a dim lit space with soothing music, several pillows and blankets, soft colored lava lamp, and stuffed animals for your child to go to when he/she needs a moment to calm down

S is for SPLINTING.

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For my last Level 1 I was in an orthopedic/hands setting! All of these clients were affected by some type of orthopedic injury to the shoulder, elbow, wrist, or hand (rotator cuff injury, lacerated tendons, nerve damage, carpal tunnel syndrome, mallet finger etc..)They each had their own story -patient centered- and hopes to improve their functional outcomes in order to do daily activities that we often take for granted!

One of the coolest parts of this fieldwork experience was helping create >>>splints<<<< for different clients to prevent contractures, promote a functional wrist, improve position of MCP joints and more!! I also was blessed with a great CI for this rotation. The  bottom right picture is a cheapo version of a resting hand splint I made perhaps for a client who does not have insurance coverage. The idea is to decrease pain and prevent muscle contracture with the simple adaptation of a pool noodle and a strapped band.

T is for TEAM-BASED approach.

m21If you want to become an OT you better get used to being on teams. You need to invest in your team’s dynamics. OTs who work in schools will be on an IEP >>team<< comprised of other rebab/medical professionals and teachers. But what if you are like me and don’t want to be an OT in the schools…?? I envision my first OT job to be in a SNF or in a hospital-based setting.¬†I will not only have to frequently co-treat with PTs or SLPs and communicate with social workers and nurses, but also with –> referring physicians. All healthcare practitioners¬†are important to the team and all deserve to be acknowledged for their roles!

And contrary to popular belief, as an OT you should probably learn that physicians come from two backgrounds: allopathic (MD) or osteopathic (DO).

Most physicians will probably be too nice to correct you if you assume they are MDs, but DOs are a thing people and they are our referral source! In fact, DOs are taught from a much more holistic approach which is truly more in line with OT principles, whereas MDs are taught from a more symptoms based approach–but they are both awesome and are the ONLY types of doctors that can treat, prescribe medicine, and perform surgery on OUR clients.

MDs and DOs receive similar medical education and must pass several board certifications and residencies. DOs receive additional training on osteopathic manipulative treatment which is a more hands on approach to diagnosing, treating, and preventing illness.Be inspired to be team player for the sake of your clients and take some time to learn about the backgrounds of your teammates.

U is for UNDERSTANDING & UNIVERSAL Design.

m22Sometimes, we need to lend an extra hand to help out others.¬†OTs understand that if a client has a certain physical disability that causes him to be W/C bound he deserves the dignity of accessibility that doesn’t require him to feel further isolated by wheeling to the back of the store to go through the wheelchair entrance.

Universal design is the correct design choice. Design environments and products usable to all people! When OT makes adaptive equipment recommendations or caregiver education, we place an emphasis on this in order to simplify life for everyone.

V is for VERSATILE.

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This is one of my favorite OT professors and today was my MS2 class’s “going away” party for our Level 2 fieldworks hosted by the MS1’s.

<< OT is versatile because OT is needed and can be found everywhere.>>>

We can work in the “normal” places people assume such as in a hospital or at a nursing home but we can also work in prisons, medical homes, churches¬†or hold in political positions.

 

 

W is for WHOLE-person care.

m24OTs are taught from a holistic approach. We believe that our clients are >>not defined<< by their disease/diagnosis/injury. We recognize that every client brings their own story, upbringing, valued, beliefs, and more to therapy. While we envision always performing evidence-based and occupation-focused interventions, quite frankly it is more than that. OTs must provide client-centered treatment that truly takes the Whole person (mind and body) into consideration. While it’s imperative to strive for and to achieve good outcomes, emphasis must be on the person’s goals and needs from therapy.

 

X is for XENIAL.

m25.jpgI definitely had to look up an “X” word…. anyways OTs are xenial, another word for hospitable, since we serve a highly varied client population and provide a multitude of services. Cheers to my Class of 2016 because we are almost out of the classroom!! Praiseeeee.

Y is for YOUTH.

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this is actually my brain

As OTs one of the populations we serve is children and Youth. AOTA notes that children and Youth is actually one of OT’s emerging practice areas. (This picture is obviously for the adult parents, caregivers, and guardians who care for the kiddos for the 95% of time they aren’t in therapy. Also, it’s for higher caffeine consumption for approaching finals and end of the semester projects, yay.)

 

OT is really cool because we have the opportunity to mentor and serve our communities in places like prisons or in this case-juvenile detention centers-for >>>>Youths who have been incarcerated<<<due to a variety of different crimes. Shout out to my grant group because we are almost done with finalizing our grant that is advocating for (and asking for some moneyyyyūü§Ďūü§Ď) OT services to be provided free of charge to the Youths! We plan to provide Life Skills lessons (care of others, money management, health maintenance)to these Youths since they are experiencing a disruption from their developmental transition to teenage years or young adulthood! Cheers to the future and current pediatric OTs who serve the Youth of our communities! May your ‚ėēÔłŹ coffee pot always be hot.

Z is for ZEALOUS

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zigzagging around old, beautiful trees

 


Zealous is a positive adjective that describes a person and is marked by active interest and enjoyment! OTs are the zealous healthcare providers that are known for their creativity in the methods they use when planning client-centered interventions!

Personally, I am a zealous fan of health, fitness, and occupational balance. In the future, I strive to always model healthy, positive behavior for the clients I will be blessed to serve!

 

 

 

Happy OT Month. Until next year.

Stay mOTivated,

SHANNEN M.

mOTivated: the school-based OT

“School-based occupational therapy practitioners support academic achievement and social participation by promoting occupation within all school routines, including recess, classroom, and cafeteria time.¬†They help children fulfill their role as students and prepare them for college, career, and community integration. They utilize prevention, promotion, and intervention strategies for mental and physical health and well-being.¬†“

-AOTA

In my previous post OT: the art and science therapy,

we learned that   o c c u p a t i o n s   are used by occupational therapists as a therapeutic means to enhance quality of life, improve occupational participation, and promote physical and mental well-being. Well this same concept is utilized by school-based OTs with a primary focus on academics, social participation, leisure and play, as well as transitioning to work skills. In this setting, an occupational therapist may use her (or his) expertise to reduce barriers to participation within the classroom through environmental analysis and modifications among many other things.

  • Related service professionals—> occupational therapists are apart of a team of specialized instructional support personnel that are under Individuals with Disabilities Education Act (IDEA) as well as Section 504 of the Rehabilitation Act of 1973
  • It takes a village—> OT doesn’t work unless the parents, teachers, and other school staff are on board. It takes a team to promote occupational participation in these kiddo in order to support the child’s academic and behavioral needs as well as their functional performance

When it comes down to it, occupational therapy is anywhere and everywhere. Regardless of setting, OT helps

shanclients of all abilities and backgrounds to participate in their most meaningful occupations that are necessary or apart of their daily life routine.

 

Picture this.

In an ideal world, school-based OT would always occur inside the classroom with peer supports.

Imagine having¬†two groups of six children at a¬†table-a teacher at one table;¬†the OT at the other table. Four of the children at the table with the OT have some type of developmental delay, high tone, and maybe just take a little more time to grasp academic concepts; these children qualify for OT services. Instead of removing the four children from the classroom, the eight other children participate in the intervention (with their four classmates) and become peer models. The OT may teach the teacher certain strategies to inhibit tone and increase the children’s attention span. To most people, the games or objectives of the intervention session may look like playtime… but in actuality the¬†skilled¬†occupational therapy practitioner¬†¬†will use these “games”¬†or activities to address a student’s physical, cognitive, social, emotional and sensory aspects of performance.¬†

***note: Don’t be a rude OT and pretend like you know the students better than the teacher who is with them all week. Teachers are invaluable to the success of the¬†child; without them there would not be OT services provided in this setting. Thus, collaboration is key to benefit the student’s needs.***

However, sometimes it is necessary for the OT to pull the child out of the classroom environment to a smaller room. For instance, if the child has poor body awareness or is easily distracted by his classmates or by the classroom itself (yes, teachers are very creative and spend their money and time on classroom d√©cor…. but for some kiddos, it is overstimulating!!) then the OT may arrange with the teacher a time for that student to receive therapy in a different environment…in addition to perhaps¬†respectfully educating the teacher¬†on¬†why for some kids a crazy, beautiful, sparkly, multitextured room may spark some behavioral issues…

____________________________________________________________________

Now before we dive deeper into school-based OT, I want to share a fine motor craft that another classmate and I created for our fieldwork Level 1 site (just think of this like a clinical rotation) at an all special needs school.

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The finished product

 

 

For this group session, six children of various cognitive and physical abilities and diagnoses sat at a rectangular table. As our warm up activity, we went around in a circle and introduced ourselves and said our favorite color. While this may seem very simple to you, for some of these children it is difficult due to oral motor impairments or recall limitations to recite their name and a color of their choice.

After the introductions, we showed an example of the final product. Each child received one paper rainbow and if cognitively capable chose the first color (red) out of the crayon box. For some children, it was necessary to limit the color choice down to two or three colors in order to help eliminate some of the wrong colors. This process was repeated until the rainbow was fully colored to the best of each individual student’s ability.

If strength and the ability to apply just enough force was not an issue than the kiddos were asked to break their fruit loops into halves. Each fruit loop half was matched to the colored rainbow stripe and glued piece by piece.

This activity was very challenging for some of the students due to their difficulty to attend to the task, low tone or high tone, grasp requirements, and more…

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Palmar Supinate Grasp-appropriate for 1-2 year olds

 

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Dynamic Tripod Pencil Grasp-mature prehension grasp pattern

 

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Pincer Grasp
  • Supplies needed for this craft include: rainbow stencils, crayons, fruit loops, and¬†glue

  • Rationale: work on dynamic tripod grasp, pincer grip, color recognition, improve manual dexterity, in-hand manipulation, pressure modulation, visual perception, visual discrimination, and ability to follow directions

  • Grade down: to make this process easier set out only one item at a time until each step is completed, give verbal and tactile cues as needed

 

 

rb6.     rb8

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Back to why OT in schools is fundamental and needed…

Occupational therapists in the school-based setting are pretty awesome and unique in the therapy world. According to the American Occupational Therapy Association (AOTA), some of the things an OT who works in schools may do in hopes to support participation includes the following:

  • Adapting activities and environments
    • Ex: modify playground equipment so that it is accessible for kiddos of all abilities; recommend that elementary students sit in weekly lunch groups to facilitate social¬†interaction and communication
  • Collaborating with school staff
    • Ex: advocate for recess-kids need recess for their physical and mental health; teach Handwriting Without Tears
  • Increasing independence in daily living skills
    • Ex: promote organizational skills; address self care needs such as toileting or dressing-changing into gym attire
  • Supporting transition
    • Ex: kids aren’t kids forever-OTs help them transition to employment or assist them in community integration
  • Recommending assistive technology
    • Ex: recommending specific pencil grips to improve a child’s handwriting; recommending computer software specific to meet the child’s participation skills
  • Promoting positive behavior
    • Ex: this one is pretty simple-your child is more inclined to do well in school if he or she feels confident in his or her abilities; facilitate a positive learning environment to increase positive interactions
  • Supporting school mental health
    • Ex: initiate anti-bullying seminars; provide education to school staff on coping and calming strategies
  • Increasing attention
    • Ex: educate teacher on alerting activities for low tone children; recommend motor breaks
  • Addressing sensory, cognitive, motor needs
    • Ex: I don’t even know how to begin attempting to explain this one

 

Wait, I can’t afford occupational therapy services for my child.

Good news, occupational therapy is provided for freeeeeeeee in the school setting when determined educationally necessary. In public schools, federal, state, and local funding are used to cover the cost of skilled therapy intervention. There is this document called an individualized education program (IEP) for each student; the IEP team is the group that decides if a child qualifies for OT services.

As required by the Individuals with Disabilities Education Act (IDEA), parents can¬†view¬†their child’s performances and progress rate of their IEP goals which includes the occupational therapist’s goals for the child.

There is so much to learn about OT and I hope this post broadens your horizons on just one of the many settings you can find the art and science therapists!!

stay mOTivated,

SHANNEN M.

OT: the art and science therapy

“The profession of occupational therapy will flourish because occupation, its core, is so basic to human health yet so flexible, depending on the needs of the individual human being.”

-DAVID NELSON

otco2016 (3)
USA Occupational Therapy Class of 2016

 

TO BE HUMAN IS TO BE OCCUPATIONAL.

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occupational balance

You may think you have never before been exposed to the wonderful, dynamic, and always present OT world, but in actuality you experience it everyday through the meaningful activities (occupations)that consume your time.

Everyone no matter their background, beliefs, culture, ethnicity,¬†gender, age, disorder, disability, diagnoses, political opinion, it doesn’t matter–everyone-deserves to experience occupations.

Therefore, it is also important that the general public and even other healthcare professionals widen their horizon and come to terms with the benefits of occupational therapy. Be mOTivated to expand your knowledge on how this profession may impact you or your loved ones.

As a profession that has been around for 100 years (next year), it is my hope to advocate and educate others on the field I fell in love with and felt God’s hands pushing me toward many years ago-aka since 9th grade of high school (in addition to advocating for sunshine’s profession as a future doctor of osteopathic medicine, I hope to always be an advocate of occupational therapy!)

In this first OT Post I will share some of the questions some of my friends and family members have asked me about in regards to the profession that is both an art and a science!!

So is occupational therapy (OT) like physical therapy (PT)…

No, not quite. Yes, physical therapists and occupational therapists often co-treat and attend to the same clients. Yes, they often will collaborate to design and implement the most appropriate client-centered intervention plan and goals. And yes, they both integrate their therapeutic use of self during the treatment session to build rapport and develop trust with each individual client. To be honest, there is a lot of overlap; however, there are definite and notable differences that I will expand on later. Nevertheless, both professions are blessed to inspire and improve the functional outcomes of an individual at oftentimes a very personal level.

“occupation”- activity in which an individual client is engaged// “physical”- of or pertaining to the body

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PT perspective: great knee extension a few days post my second ACL reconstruction surgery

 

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OT perspective: look at that community mobility and resilience

Physical therapists are here to help restore your mobility. They are well-versed in the anatomy and physiology of the body and are predominantly utilized in the physical rehabilitation of individuals recovering from injuries or diseases. These professional healthcare workers also work in a variety of settings. PTs help you manage your pain and also may teach preventative methods as well. PTs are well-equipped to prepare and implement individualized patient plans. They are concerned with muscle strength and overall motor development. They are very important and after four clinical rotations (level 1 fieldwork) where I collaborated with them in addition to -from my own personal experience as a stubborn but very diligent patient- three knee surgeries later, I love my PT friends.

Occupational therapists also take into consideration the physical rehabilitation standpoint, but with a twist. We like to see y’all get back to performing those activities of daily living–the meaningful occupations of your day-to-day life–in the way that is most functional and easiest for you! Through the therapeutic use of occupations, we are healthcare professionals that are dedicated to helping our clients meet their occupational¬†needs. In addition to using occupations as one of our modes of therapy intervention, we take into consideration the client’s context and think of nifty environmental modifications. We are very crafty with our modifications and utilize assistive technology as needed. An understanding of mental health is very important to OTs, because we design intervention plans that can be graded down or up depending on the client’s abilities and skill sets.¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† ¬†OT is awesome, just saying.

My¬†PT friends will help you walk, but¬†OTs will TEACH YOU TO DANCE ūüôā and dance with you!

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occupational therapy & osteopathic medicine = dynamic dancing duo

 

But occupational therapists help you find jobs right?

Well yes, but no because that is literally like a teeny tiny fraction of what an occupational therapy practitioner can do for you. For instance, perhaps you have worked as an auto-mechanic for the past 20 years but now you are having difficulty¬†performing your work tasks¬†due to decreased function of your hands and shortness of breath. Well an OT working as an ergonomic consultant (which is probably the last setting/area of practice I see myself working in)¬†can do a plethora of things for you such as…..¬†¬†¬†

  1. advocate for your supervisor to give you increased time to complete your duties
  2. perform a Work Capacity Evaluation-a universal full body test that addresses how one performs the tasks necessary to succeed in a specific job and also entails a detailed interview that determines the consistencies of work performance and more
  3. recommend you have a schedule that includes increased rest breaks and/or determine if any of the work duties can be executed in a seated position rather than standing
  4. create a home exercise program that is tailored to fit and improve your strengthening and endurance abilities.. the list goes on —-and that is only one of¬†many settings¬†where an OT can work
    1. ***in the future will expand on each of the environments an OT can work through individual posts about the different settings such as in a hospital setting, inpatient rehabilitation, outpatient rehab, hand clinics, schools, skilled nursing facilities, and many more***

 

Well then what does the term “occupation” mean if¬†OT is not really about finding people jobs?

The term “occupation” refers to meaningful activities. From an OT lens, it is through the therapeutic use of these everyday life occupations (not to mention evidence-based of course) that a client’s functional well-being can be restored to enable participation in multiple settings. Occupations may be simple, ordinary things such as reading your favorite magazine, babysitting your neighbor’s children, driving to the local grocery store… but also they may be special such as when you master cooking the family Christmas dinner or when you mindfully choose to volunteer your time at like a youth church group.¬† Perhaps the best way to describe/define occupations is to reference the Occupational Therapy Practice Framework-3rd Edition.

“Occupations are various kinds of life activities in which individuals, groups, or populations engage, including activities of daily living, instrumental activities of daily living, rest and sleep, education, work, play, leisure, and social participation.”

 

The following occupations exemplify occupation-based interventions in skilled therapy sessions used to facilitate growth or change in client factors (body functions, body structures, values, beliefs, and spirituality)…

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IADL/education-community outreach

 

  • ACTIVITIES OF DAILY LIVING (ADLs)–these are the basic activities you do everyday to take care of yourself and are the fundamentals people!!
    • Bathing, toileting, dressing, eating, feeding, functional mobility, personal device care, personal hygiene, sexual activity
  • INSTRUMENTAL ACTIVITIES OF LIVING (IADLs)–these are those activities you do to support your home and community; more difficult typically than ADLs
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    ADL-eating; IADL-thanks for the weekly meal after mass, South Alabama Catholic Student Association
    • Care of others, care of pets, child rearing, communication management, driving and community mobility, financial management, health management and maintenance, home establishment and management, meal preparation and cleanup, religious and spiritual activities, safety and emergency maintenance, shopping
  • REST AND SLEEP–restorative rest and sleep are vital to optimal functioning in your favorite activities
    • Rest, sleep preparation, sleep participation

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      work/education/leisure-studying poolside in the “winter”
  • EDUCATION–these refer to what you need to do learn and participate in educational environments
    • Formal educational participation, informal personal educational needs, interests exploration
  • WORK–because you can’t play all the time; this occupation includes the actual labor it takes to perform a task; how you organize, plan, or execute the task; constructing, manufacturing, or creating something with or without monetary reward
    • Employment interests and pursuits, employment seeking and acquisition, job performance, retirement preparation and adjustment, volunteer exploration, volunteer participation
  • PLAY–adults play too!! This refers to spontaneous
    ot-32
    education/social participation-3 semesters worth of research with my mindfulness fam

    or organized activity that provides you with entertainment, diversion, or enjoyment

    • Play exploration, play participation
  • LEISURE–include leisure in your everyday life or you my friend will have a terrible case of occupational imbalance… This occupation refers to participating in nonobligatory activities in your discretionary time. These are the intrinsically motivated activities you do when you aren’t boggled down with life demands such as work, self-care, or sleep
    • Leisure exploration, leisure participation
  • SOCIAL PARTICIPATION–All beings are occupational. All beings need to interact with each other!! This occupation refers to an interweaving of occupations to support community engagement. All about being social and creating interdependence
    • Community, family, peer, friend

 

While many occupations seem “ordinary”, it is¬†only through the individual¬†client’s perception that these activities transform into meaningful occupations.

Stay mOTivated,

SHANNEN M.

For more information on physical therapy check out APTA.org

For more information on occupational therapy check out AOTA.org

American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1-S48.

MD vs. DO: DO your research

“An osteopath¬†must know the shape and positions of every bone in the body, as well as that part¬†to which every ligament and muscle is attached. He must know the blood and the nerve supply. He must comprehend the human system as an anatomist, and also from a physiological standpoint. He must understand the form of the body and the workings of it. That is a short way to tell what an osteopath¬†must know.”¬†¬†

{ A. T. Still  MD, DO }

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Lifelong learning

First and foremost… let’s all remember one important thing… A¬†doctor (allopathic or osteopathic) can save your life… BUT AN¬†OT¬†CAN HELP YOU¬†LIVE IT and also advocate for your profession¬†if you’re lucky. >>>NEXT POST IS ON OCCUPATIONAL THERAPY’S DOMAIN AND PROCESS !!!<<<

 

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Neuro block vibes

 

Now I have to be honest; I did not know what¬†osteopathic medicine was until my¬†boyfriend started to consider applying to DO schools.¬†Even now when I describe¬†osteopathic medical school to my friends or peers, sometimes they hear the words “holistic” or “manipulative medicine” and instantly associate it with chiropractors or alternative medicine or Eastern medicine and ¬†even¬†say things like¬†–> “so¬†will he even be a¬†‘real’ doctor?” in which I bite my lip from saying something sarcastic like¬†¬†¬† “Are you in medical school?”¬†¬†¬† ***crickets (that individual pretty much immediately becomes quiet…)

  • When people say things like that I¬†used to get pretty feisty -I sort of still get annoyed¬† but that is why I am using this blog to¬†¬†¬†¬†¬†¬† actively advocate ¬†¬†¬† and educate others in hopes they will be¬†more receptive of both professions that are near to my heart and important to our growing society.

The fact of the matter is that¬†osteopathic medicine is not a¬†new¬†philosophy or approach to¬†medicine. My opinion as an occupational therapy student¬†is that it’s time we get behind the DOctors that truly DO… (***especially if you are a¬†PT, OT, or SLP student who will one day receive referrals from MDs and DOs and should therefore respect and probably learn about both types of physicians).

See my comparisons chart I created below of MDs and DOs to appreciate the similarities and differences of the only two types of licensed physicians in the U.S.

Screenshot (17)

Theodore Roosevelt once said…

“The more you know about the past, the better prepared you are for the future.” So let’s take a look back in history to see where it all began.

MDs – History

  • Practice of medicine dates back to colonial times–aka there have been medical doctors in existence for¬†a looooooooong time
  • 1766: New Jersey Medical Society-1st organization of medical professionals in the colonies
  • Early 1880s: Medical societies developed their own society based training programs called “proprietary” medical colleges
  • 1847: About 200 delegates from 40 societies, 28 colleges, and the District of Columbia met and formed the American Medical Association (AMA)
    • Elected president Nathaniel Chapman
    • AMA set higher education standards for MDS that were again revised in 1852
  • 18021876: 62¬† stable medical schools established
    • 1810: 650 students enrolled; 100 graduates
    • 1900: numbers rose to 25,000 students enrolled; 5,200 graduates- nearly all white males
  • Doctors began choosing to “specialize” in the mid 19th century
  • Check out more information about the history of MDs here!
  • Fast forward to 2016: More MDs choose to specialize¬†than DOs (key¬†word here is choose-there are a multitude of MD students who have passion for non-specialized practices and thank God they do because we need them!)

DOs-History

  • 1828: A baby boy by the name of A. T. Still who would grow up to follow in his father’s footsteps to become a doctor was born
  • Early 1860s: He became a doctor (MD) and went on to serve as a surgeon during the Civil War for the Union Army
  • 1864: His 3 children died from spinal meningitis. He concluded that the orthodox medical practices of his day were sometimes harmful and ineffective
    • Devoted the next 10 years of his life studying the musculoskeletal system and how it interacts with the other systems in hopes to find better ways to treat diseases and disorders
  • Prior to 1874: all allopathic based medical thinking
  • 1874: Dr. A. T. Still. believed¬†that there was more to medicine than treating patients symptom by symptom
    • His research and clinical observations led him to believe that by correcting structural problems¬†of the body, the body’s ability to heal could improve (Osteopathic Manipulative Medicine-OMM coming in clutch)
  • 1892: Dr. A. T. Still ( MD and a DO – can you believe it ) opened the first osteopathic med school in Kirksville, MO
  • Read more about the beginnings of osteopathic medicine¬†here.
    • Fast forward to 2016: single accreditation system for graduate medical education (more info on this below)

 

“Today DOs provide comprehensive medical care to patients in all 50 states and the District of Columbia, and have unlimited practice rights in more than 65 countries. Currently, there are more than 74,000 DOs practicing in the United States in a wide range of medical specialties including surgery, anesthesiology, sports medicine, geriatrics, and emergency medicine.” {aacom.org}

 

Now you are asking yourself…¬† “soooo why have I never¬†been to¬†a doctor with the D.O. credentials?” the short answer-> more than likely you already have came into contact with a doctor of osteopathic medicine

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    • 31 DO schools¬† <¬†¬†141¬†MD schools
      • Naturally, there is going to be more MD students, residents, and practicing physicians

 

    • DO students¬† =¬†¬†¬†about 20% of U.S. medical students
      • YOU have a 1 in 5 chance that you have already been treated by a Doctor of Osteopathic Medicine
      • “In the 2015-16 academic year, colleges are educating over 26,100 future physicians–more than 20 percent of U.S. medical students.” aacom.org

 

 

    • Graduate Medical Education (residency)
    • Single Accreditation System
      • “In early 2014, the Accreditation Council for Graduate Medical Education (ACGME), the American Osteopathic Association (AOA), and the American Association of Colleges of Osteopathic Medicine (AACOM) approved an agreement to transition to a single accreditation system for graduate medical education (GME) by July 2020.”
      • Update as of January 25, 2016: 117 programs have submitted applications for ACGME accreditation
      • 95 programs are “pre-accreditation status” and “continued pre-accreditation status”; 11 programs have achieved “initial accreditation”
      • Click here to stay up to date on the MD DO merger

Prior to the merger…there were 2 separate accrediting bodies for Graduate Medical Education.

  1. ACGME¬†–accrediting body for¬†MD students

    • USMLE licensure exam
  2. AOA –accrediting body for DO students

    • COMLEX-USA licensure exam

Medical students could take the USMLE board exam¬† and go to an (allopathic) ACGME residency or they could take the COMPLEX-USA board exam and go to an (osteopathic)¬†AOA residency. Because there were hundreds more ACGME residencies in different specialties that AOA didn’t have, many DO students also opted to take the USMLE in addition to their COMLEX exam so that they could apply to an ACGME residency.

Now that the merger is officially in progress (remember to click the link above for more info) between the ACGME and AOA, both licensing exams are accepted almost universally. However, this is a work in progress because there are still many ACGME residencies in highly specialized fields that still require the USMLE and haven’t yet accepted the COMLEX licensure scores. So although there has been some strides made in the path of recognizing the benefits of utilizing the merger, there is still some work to be done to fully implement it.¬†Nevertheless, this is the step in the right direction¬†in allowing our rising doctors of both backgrounds to have the opportunity to immerse themselves in a residency¬†offered by¬†either philosophy in order to become the best physicians of their potential.

Finally, most importantly, for those of us who have not been called by the Lord to be physicians the best thing we can do in our active participation and support of the profession that serves our families and friends is simply to¬†¬†—-> pray for them.¬†¬†¬†¬†¬†¬†¬†¬† Pray for every pre-med student, medical student, resident, practicing physician, and retired physician to look always¬†to Jesus, Our Savior, for guidance in serving others and¬†remaining humble in that service. JESUS is the only one in this world who perfectly serves. His whole life, the way he dealt with the poor and especially the sick, the actions and acts of his simple generosity and his integrity all are apart of his perfect self-giving; this is why we must pray so that our future physicians (allopathic and osteopathic) can fulfill what they have been chosen to do in a manner that pleases God.

 

I want to close with a quote from Pope Francis in his Message for the XXIX World Youth Day in 2014 where he went to evangelize and speak encouragement to young adults.

“Jesus challenges us, young friends, to take seriously his approach to life and to decide which path is right for us and leads to true joy. This is the great challenge of faith. Jesus was not afraid to ask his disciples if they truly wanted to follow him or if they preferred to take another path. Simon Peter had the courage to reply: ‘Lord, to whom shall we go? You have the words of eternal life.’ If you are able to say yes to Jesus, your lives will become both meaningful and fruitful.”

-Pope Francis

Stay tuned for my next blog post–switching gears from osteopathic medicine to my first love –occupational therapy

Stay mOTivated,

SHANNEN M.

Shannen Weyer, OTS

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***note: I am simply trying to raise awareness about this profession. I am very thankful for my two orthopedic surgeons (who were both fantastic M.D.s) that have previously operated successfully on both of my not so pretty knees. I look forward to working with M.D.s and D.O.s in the future in order to carry out their occupational therapy referral orders***