PT Clinic Reflection Journal

10/24/07

P: Today I worked with a patient who has MS, who is working on lower extremity strengthening. I practiced a Thomas stretch, SLR, TKE with manual resistance, dorsi flexion strengthening, toe raises, walking on heels, lunges, side stepping with mini squats, and donkey kicks.

The patient was really hyper during the treatment, so the main challenge I faced today was trying to keep the patient on task. I think I did pretty well with this listening to what he had to say then starting another exercise.

O: I watched and instructed the first year student I was working with do a hamstring stretch to the patient.

My first patient cancelled, so I observed and helped out two first years who were working on their first patient alone. They were working on sitting balance, weight shifting, and trunk control. I also showed them how to do upper extremity PNF.

L: Today I learned that it can be difficult to keep a patient on task when they are having a hard time focusing.   

K: I have worked with the patient I had today a couple of times previously, so I was comfortable working with this patient and doing the exercises with him. I was also able to help the first years with their patient today, because I have worked with that patient last year.

A: Overall, today went pretty well. I am becoming more and more comfortable with my documentation by not only trying to write the note during a treatment, but it has helped by reviewing the first year’s documentation. I feel like I didn’t involve the first year enough in today’s treatment because I was really focused on the treatment. I plan to make sure the first year is more involved next week.

10/17/07

P: Today I only had on patient, which is the same patient I have had since the beginning of clinic. I practice ROM, taking heart rate, using the tilt table, and helped with the transfer. I also worked on getting the patient into the proper posture on the edge of the tilt table and head control by using verbal and visual with a small basket ball.

I also work with the first year student on transfers, doing ROM on someone with spasticity and contractures, getting the patient in alignment, using the tilt table, asking subjective information to the family, and writing the note.

O: Today I observed another second year student working with her patient while helping out. I watched the patient do heel slides with the powder board and work on the rocking board in the parallel bars.

I also watched the first year students transfer the patient I was working with and do ROM on one side of the body.

L: Today I learned that I can not use heart rate as a measurement to monitor the patient on the tilt table. I also found that it is sometimes easier to look at someone else’s treatment and decide what I would do differently then when my own treatment.

K: Since I have worked with the same patient for awhile, I feel comfortable and knew how to do the skills that I used today.

A: I plan on practicing taking blood pressure this week, so I am prepared for my patient next week to monitor my patient on the tilt table. Also, I will continue to review and practice past learned skills to continue to develop my skills. I feel pretty good about clinic in general. There are still obvious things that I am still learning, but I feel comfortable about what I am doing now. It is a little different having a different first year following me. I need to adjust how I teach and what this person is able to do.

10/10/07

P: Today I worked with a new patient who has MS. I did a hip flexor, hamstring contract relax, scalene, and pec stretch. I also work on trunk control with alternative isometrics and rhythmic stabilization. I also did soft tissue mobilization to the upper traps.

The second patient is the same patient I have been seeing since the beginning of clinic. Today, I practiced PROM, tilt table, and balance exercises with this patient. While on the edge of the tilt table I had the patient in proper posture and we work on head control with verbal stimulation. I also did a total assist transfer.

O: Today I observed the first year student I am working with asking my first patient questions for subjective information, and perform a hamstring stretch. I also watched the first year student perform PROM on one side of my second patient.

L: Today I learned that I need to review massage because that is one skill I don’t feel complete comfortable with. I never feel like I am being effective while doing it. I also need to be more comfortable being more assertive and in getting the patient to talk and do his treatment. That was a main difficulty with my first patient. I didn’t get a lot of the things done that I wanted to because the patient really has a lot to say, but is not necessarily relevant to the treatment. While I am interested in what the patient wants to talk about, I feel we needed to get more done in the treatment.

K: I already knew how to perform the skills I used today. I just need to practice some of the skills to become

A: The action I am going to take is to practice massage on classmates and ask for feedback, so I am improve and become comfortable giving a massage. I am also going to practice being more assertive, so I can be more effective in my treatment.

10/3/07

P: Today I worked with the same patients as last week. With my first patient I practiced strengthening exercises for the quads, hamstrings, and tibialis anterior. I also did a Thomas stretch to stretch the hip flexors.

With my second patient I practiced ROM, a total assist transfer, head control, and trunk stability.

I really focused on getting my first year more involved in everything today. I had him help me plan the treatments, come up with questions to ask the patients, and write a whole note for one of my patients with my help.

O: Today I observed the first year student I am working with take goni measurements on the lower extremities. I though this would give a good chance to practice on a real patient with someone their to help. I also observed another second year work on head control with my second patient with verbal and visual clues. This worked really well.

L: I learned how messy people can be. After we were done seeing patients the clinic was trashed. It is really annoying when people just leave their treatment area with out cleaning it up. I plan to be more conscious about cleaning up after myself.

K: I already knew how to perform all the skills I practiced today. This week I felt more comfortable about the exercises I had my first patient do. Last week with this patient is was more about exploring the didn’t exercises to find what was going to work best, where today I could really focus on strengthening. With my second patient I practiced the same things I have been for the past couple of weeks.

A: I had a good attitude today in clinic and worked well with the patients. I did get a little annoyed at the end with mess the clinic was left in. The things I still need to continually work on are documentation and body mechanics. I feel like I am getting back into the swing of things, but want to improve the amount of time it takes me to write a note. I started off today really conscious of my body mechanics, but by the end of the day I was back to my horrible habits. I am going to keep trying to be aware.