Observations Part 3

My next observation was in a skilled nursing facility.  I was currently working there as a Certified Nursing Assistant and met the OT there.  She allowed me to observe her after my shift was over.  All in all I observed and assisted in therapy sessions with older adults, both on the rehab floor and other floors.

I observed the OT working with patients who had knee replacements, hip replacements, and other diagnoses.  Most of the sessions focused on balance and motor planning.  I observed patients walking around obstacle courses, picking up different colored cones from various hiding places.  I watched patients gain endurance on stationary bikes, and by walking the halls of the facility.

Most of the therapy sessions were based on gaining endurance and evaluating the patients strategies for moving around their environments.  On the surface the sessions seemed boring and simple.  Make a obstacle course, walk a patient around the halls, talk with them while they ride a bike.  After thinking more about and asking what each exercise was doing for the patient, I discovered that most of the work on the therapist part was done before the session.  She was making decisions on how to improve the patients function and how to engage him or her in such a way to further the patient's endurance, strength, and motor planning.  So much of what a therapists does can seem easy and basic but like an iceberg the real "mass" is below the surface and goes unseen during therapy sessions and observations.

Some good questions to ask in this setting are how to manage behaviors, how long therapists spend on notes and paperwork, and what strategies they employ in working with other therapy professionals and nursing staff.  In the last post I mentioned why managing behaviors is important.  Paperwork and notes are a constant thing in OT.  No matter in what setting you work, you will need to write up what you did, your goals, and what to do in the future.  I have found that using SOAP notes is a easy way to write good notes.  SOAP stands for subjective, objective, assessment, and plan.  You can google SOAP notes and read much more about them.  The strategies employed with other professionals will give you an insight into what team meetings are like, any in-services that therapists may be responsible for and the kinds of things that an OT needs to communicate to others in the setting.

Observation Part 2

My first OT observation was in a client's home.  The session was very interesting.  The first thing we did was roll around on the floor and bear walk through an obstacle course.  After that we tried some foods with "weird" textures, according to the client.  I was surprised at the amount of fun I had and the client had.

I later learned that this "play" was what sensory integration for a young child can look like.  The therapist created a safe environment for the child to try new foods.  The strategy was to work the body and the different senses in a fun and adventurous way.  Foods were a real issue for this child and so for each new food she had to touch it, feel it, smell it, describe it, and finally taste it.  She did not have to swallow anything just try out each new item.  We tried yogurt, tortillas, and carrot sticks.  I enjoyed every minute of it.

This session opened my eyes to just how interesting pediatric therapy is.  It awakened a desire to learn more about Sensory Processing Disorder and a passion for all things OT.  I have observed in other settings and enjoyed it all but I will always look back on that first observation with fondness.

After the session the therapist and I discussed what we had just done and talked about why I wanted to be an OT.  We discussed my background and set up another session a few weeks in the future.  All in all this observation sparked an interest in all things OT and a passion for treating the whole person.

Reflecting on this observation, there are a few questions that someone could ask.  The first question that comes to mind is what a typical day is like.  It is important to get a feel for what the day entails for, in this case, a pediatric occupational therapist working in clients homes.  You could also ask how the OT deals with challenging behaviors.  Challenging behaviors are a part of any therapist's life, children throw fits, teens are moody, and make excuses.  How to deal with the challenges is an important skill that you will need to acquire.  There are many more but these should get you started.

P.S. since April is OT month I will also be posting a blog on what it means to me to increase awareness for OT in 2015.  Next month I will feature a guest blogger to tell her thoughts on her own personal brand of therapy.  Stay tuned.