Acute Care Cheat Sheet

My CI has photographic memory and was able to remember every patient I saw so she knew which note to check at the end of the day. Some days I would have 8-11 patients.

My classmate was able to see 11 patients, write his notes and be done with work at 2PM.

Every therapist, including my CI never had a notepad but can give me a full account of what we heard during the pt interview, can correct my notes and point out the details that I missed.

I had to write down everything the patient said so that I can write a detailed note when I got back to my desk.

Here is my cheat sheet.
*It was a derivative of a cheat sheet that another student shared with me. Thank you Ayesha!
- I like that I can write 4 evals on 1 sheet.
- It has all the key questions to get a full hx.
- I would write the admission date on the top right hand corner to see if the pt is oriented to time.
- Top 2 lines, I fill out from chart review so I remember who I am dealing with, his/her room #,
  baseline BP and general dx/ precautions.
- And lastly, it folds in 4 so it fits perfectly in my white coat pocket and the palm of my hand so I
  don't need to carry a clipboard.

 

Picture from I am Science Geek Blog.

Done! Now for Graduation!

I am DONE with my clinicals. Yes!

Graduation is in a week. My school has 2 graduations - 1 ceremony for the whole graduating class (undergrad & grad) at a big concert venue and 1 intimate ceremony where I will walk up on stage, take my fake diploma and shake some hands. My dad, mom and bro will come to the intimate ceremony and take lots of pictures. I know my bro will hoot for me when I'm on stage. I'll attend the larger ceremony even though my family will not be able to because... why-not.

Lots of my second career friends chose not to attend their graduation. I will go because "It's kind of a big deal." I left a paying salary to go back to school for 4 years of my life (3 for DPT, 1 for the pre-req's) in a field that I had no background in. I will obtain my Doctorate of Physical Therapy. My school chose me from 800+ candidates. Five of my classmates didn't finish. I made it. I'm going to celebrate it. I always think that I will never regret going but I might regret skipping.

Picture from Cheezburger.

Peds Tip #3: My-Oh-My-Pizza-Pie wins them all.

Have you met a kid who didn't like pizza? I haven't. This is one of the most amazing plastic inventions ever. You can get kids (ages 3 to 5) to jump, run, hop, balance and walk up stairs with this pizza pie. Kids get excited when you pretend "eat" with them. I like to make the "nom nom" sound when I'm eating and they absolutely crack up!

A few ideas for using the pizza pie:
- Obstacle course: get the pizza and bring it to the table so we can eat it.
- Place a slice over the course of a several flights of stairs. They have to find all the slices of pizza and bring it to the bottom flight of stairs. A work out for both the kids and the therapist.
- Sharing: perform the obstacle course and then ask the kid to share with other therapists in the room.
- Reaching activities: reaching for the slice of pizza and squating down to put in the tray.

Here is a cute pizza with toppings. Extends the game/activity longer if they have to add the toppings to the pizza.

Picture from Amazon.

Better questions to get real answers

Yes, I only read one blog but its a really good one. Cup of Jo referenced a link to an article about "The questions that will save your relationship."

I thought about the questions that I ask people, my best friends, my family, my love and my kids at clinic. I ask "how is your day?" and I get generic or half-hearted answers. Sometimes, I even feel like the person wants to say something but I asked the wrong question. The kids at the clinic have trouble telling me about their day at school but get really excited when I ask them about pizza or dinosaurs.

I really enjoyed this article because it reminds me that I can ask better questions to get real answers.

Picture from BC Early Years Blog.

Peds Tip # 2: Kids Songs

I was working with a nonverbal, 3-year old kid who has autism. His parents report that he has trouble transitioning into new environments and for the first 2 sessions, he cried for 30 minutes straight, non-stop (and it was the all-out balling type of crying). At the end of the 3rd session, he seemed like he was humming something. It sounded a lot like Jingle Bells, which the mom confirmed! The family has a christmas tree  that plays the song from an ornament. So naturally, I started to sing Jingle Bells to soothe the child and it worked. Now, I sing every children's song I know when I treat him because he is so much more productive and attentive.

After that, I started listening to Toddler Radio on Pandora (don't judge me!) to learn the lyrics to the major kids songs. I found that being able to sing these songs have helped with many of the children - distract them from the pain of stretching or doing sit-ups, wanting to run to their mom, help them forget that they are on a MEDEK balance board on top of a tall table or get them excited about moving/dancing/jumping. Singing works WONDERS!

These are my favorite songs to sing:

Wheels on the Bus

Monkeys Jumping on the Bed

Old MacDonald Had a Farm

If You're Happy

BINGO song

Part of your World (I'm partial to this because I grew up watching this Disney cartoon)

Jump in the Line (And I grew up on Beetlejuice. I only sing the chorus line to get the kids to jump repeatedly and dance to challenge their dynamic balance.)

Feist sings 1,2,3,4 (I haven't memorized these lyrics but I think its an adorable rendition of a pop artist's song)

And an interesting article/video about a nonverbal child with autism singing.

Picture from What to Expect.

Peds Tip #1: Transitioning

I started my Peds affiliation about 8 weeks ago. I have never worked with kids previous to this experience. I don't even have kids in my immediate family. So this affiliation is minding blowing to me. Working with kids is completely different than working with adults! I learned a few key lessons early on.

Transitioning. My peds professor imparted this very important concept to me when I visited her. She said kids have trouble transitioning…going from mom in the waiting room to OT then to Speech therapy then to PT, then back to mom. So its important that when you are 10 minutes from ending your session, that you count down. "In 10 minutes, we will be finishing up and going to mommy. In 5 minutes…1 minute…." It eases the transition and manages the child's expectations. I used this advice immediately (and continue to do so) and I can definitely see the difference on how the kids exit the clinic.

Picture from My Aspergers Child. Interesting post on how to handle/prevent tantrums in public.

What do you want to do when you graduate?

What a dreadful question? To clarify, people want to know what setting (acute, subacute rehab, outpatient) or population (peds, geriatrics, ortho) I want to work with. 

I've been getting this question a lot lately since I'm 4 months away from graduating. Ugh! The thought of it leaves a knot in my throat. In previous years, I would say that I have 3 more affiliations to go… 2 more affiliations to go ...I'll probably figure out what I want to do, closer to graduation. Nope. 

I am 2.5 weeks away from completing my 3rd affiliation of 4. And I still don't know where I want to go. I came into the PT school with the desire to work in geriatrics or pediatrics. That still stands. My mentor reminded me about my path after undergrad. I had a dead-set plan to work for a certain company after college and I never got the offer. She said its better to find out from my professors which setting the majority of the graduates from my program move on to. Sadly, I got a lot of round-about answers which means they don't have any statistics either. So I looked online for about 20 minutes and found stats on Bureau of Labor Statistics. I interpret that 33% of PTs work in outpatient/private practice (they are much more vague and say offices of physical, occupational, speech therapists and audiologist). 

From my previous affiliations, I know that like pediatrics and geriatrics. My school faculty advises that students should work in a hospital to get exposure to treating a myriad of diagnoses. But one person that I met at a PT networking event said that acute rehab is the way to go because you get a full hour/5 days a week to really "do PT" and make a difference in someone's rehabilitation. Statistically,  I will most likely work in an outpatient clinic.  

So when people ask me what I want to do/where I will work. My answer is… "I guess I will go where there are jobs available. I'll let you know when I graduate and get a job." 

Picture from CrazyTownBlog. 

Note: The link connects to a nice post about a different view on graduation. Read it if you have a minute.