Comfortable With The Patient
11/20/06
Today I worked with the same patient as last week. This time however, I worked by myself without the help of the other first year student. I still needed help with the transfer from an instructor. I worked with the patient on balance, PNF, AROM finger extension, and AROM in the upper extremities for strength. I felt comfortable with treating the patient this time around. I was also able to communicate well with the patient today. I felt comfortable with most of the treatment. The things I want to work on are transfers, repositioning the patient from sitting to supine, body mechanics while treating the patient, and chatting with the patient while continuing the treatment.
I am not totally comfortable transferring the patient by myself yet. I feel like I need that extra person there just in case I have trouble. It is also nice to have that extra person there to help me move the wheel chair out of the way and make sure the patient maintains balance while I position her feet on a block. It is also hard sometime for me to move the patient into different positions by myself because I have to help her maintain balance and try to position her trunk, so that it is straight. My goal is to become more comfortable with transfers and to organize my treatment area better, so I do not need an additional person for the transfer.
I need to start paying more attention to my body mechanics while I am treating the patients. I have noticed a couple of times like when I was stretching the patient and apply resistance during PNF and AROM, where I was not maintaining a straight back. I need to make sure I have correct posture for the whole treatment session, so I do not end up hurting myself. I could also try to use a mat that I can raise up, so I don’t have to bend so much to reach the patient.
I also want to work on communicating with the patient. I felt like I was communicated well with her today. We talked and joked around throughout most of the treatment. I just felt like at times I lost my focus. This happened especially with PNF and AROM when I lost count of the rep the patient was on and didn’t add enough resistance when I needed to at times.
Overall this was a good day in clinic. I felt like I have the patient an effective treatment. I was comfortable and confident throughout most of today’s treatment. Now that I am familiar with the patient I feel comfortable to try new things with her. My goal is to become more confident and comfortable quicker with my next new patient. I also need to practice documenting faster.
Almost All By Myself
11/13/06
Today I got to work on a patient by myself. At first I was really nervous and scared, but it turned out okay. The one thing I need to work on in planning for the patient is looking at the goals and deciding what I am going to do from there instead of just repeating the last person’s treatment. I felt like I used the treatment time effectively. The only part I would have like to have spent less time on was transferring and positioning the patient. But that part did go better than the last time I worked with this patient. I also need to work on keeping a more organized treatment area. This patient was one that I couldn’t just walk away from, so I definitely depended on the floating first year for help at times because I didn’t have everything I need in at hands reach. I think I have improved in working with patients in last month or so. I was working with the patient on doing AROM in short sitting. This did not work out with keeping her balance. Before I probably would have gotten flustered and not known what to do, but this time I did a little more problem solving. One thing I think I did really well this time was talking to the patient. I asked her opinion on she felt as far as her body being straight, or if the exercise was challenging her. I also feel that the documentation went well. I feel more confident with documentation each time I do it. Overall, it was a good treatment.
For the second hour, I followed the second year. She was working on gait with a patient. Now that we have gotten through the lower extremity unit in kinesiology I feel like I understand a little better and can pick up when patients have an improper gait. So overall this was a good day in clinic.
Changes
11/6/06
Today in clinic I got to switch and follow a different 2nd year around. It is interesting to see how different people treat patients. The 2nd year I followed today explained everything she was doing to me and it helped me understand a lot more of what was going on in a treatment session. I really liked this because it felt I was actually something rather than just standing around and observing. I also got to do MMT, goniometry of the lower extremities, and hamstring stretches. I did well on the MMT and stretching, but I feel like I still need to practice on the goni. I liked having a second year watching me as I was working on the patient. It made me feel more comfortable to know if I was doing the treatment right or not. She also gave good feed back as to what I need to work on and what I am doing well. I also got to learn how to do computer document, which I don’t think I am going to like because it is confusing and time consuming.
