Level IIA Fieldwork: Week 1

Week 1 is DONE. Leading up to this week, and especially the first day, I was so so nervous. I’ve heard way too many stories of nightmare CIs, or unfortunate circumstances of last second site changes. But one of the first things my CI said to me (besides “don’t be nervous”) was “be gentle with yourself.” Throughout the first week, this phrase kept replaying in my head; every time I felt like I wasn’t doing enough, or I gave a child one too many verbal cues, I’ve been learning to give myself grace.

My CI is very laid back, she allows me to observe other therapists, including the speech therapist. She has allowed me to take the lead on two sessions, including performing the PDMS-2 on a two month old. She is constantly telling me about the children we see, what progress she has noted in them, and what she intends to work towards. Just a couple of days ago we had a patient who is nonverbal and in a power chair using their Tobi Dynavox AAC device; my CI is in the process of figuring out a better and more efficient set up for this patient and allowed me to ask tons of questions, set up the device, and invited me to a session she will be having with an assistive device dealer next month. There is just so much to learn, and my CI is all about being hands on, asking questions and soaking up all the experiences I can.

Setting

Private outpatient pediatric clinic in North Georgia

Work Schedule: Tuesday-Saturday 9-5 (unless there are cancellations)

Population: ages 0-21

Conditions I Have Seen So Far:

  • Autism
  • Down syndrome
  • Tetrasomy 18p
  • KBG syndrome
  • Attention Deficit Hyperactive Disorder
  • Oppositional Defiant Disorder
  • Anxiety/Depression
  • Cerebral Palsy
  • Traumatic Brain Injury
  • Sensory Processing Disorder
  • Torticollis
  • Developmental delay

Some Sessions I Have Seen:

  • Handwriting
  • Feeding
  • Sensory Integration
  • Social Skills
  • Hygiene
  • NDT
  • Assistive Technology (AAC device)
  • Vision
  • Strength/Conditioning
  • Emotional Regulation
  • Memory

Expectations from My CI

From the moment I stepped in the clinic, my CI exuded calm despite the chaos of running a pediatric outpatient clinic. She threw me for a loop when she saw my university’s fieldwork goals sheet they had emailed to her and said I don’t need to worry about any of that. I am definitely a person who needs structure, or someone to tell me exactly what to do. This placement has shown me how flexible I can be (or that I just know how to create structure for myself). And don’t get me wrong, I will definitely be reaching all of my school’s goals as they come, she’s just been doing this for over 25 years so she knows the drill.

In the first week, my CI just wanted me to explore the clinic and observe all the clients I could. Soon I will be assigned my own clients, which I’m super excited for, and I will be documenting their progress. Which leads me to my next topic:

Documentation

Since I wanted to provide some structure for myself, I asked my CI if I could write progress notes after each child I see so that I can get feedback. When I get my own clients I will have to write my own notes in their documentation system and I definitely wanted to get some practice in before that. My CI was pretty shocked that I actually wanted to write notes, but has been happily reading over them and giving me feedback.

Their electronic notes system is a little different from what I’ve seen, and it combines the O and A in SOAP, which threw me off at first, but I’m getting acclimated to the style for when I write real notes. The bad news is that they are switching systems soon… Just another test of my flexibility!

Research

I like to do some research during the lunch hour and during my down time in the clinic (between patients or when there are cancellations). I have access to the patient charts and assessments, as well as the online system that holds all of their session notes. To prepare for clients, I like to look first at their hard chart which contains their referral, evaluation and plan of care. Then I look at their soft chart which contains the formal assessment materials from the day they were evaluated. This gives me a good look at where they started out in the clinic. Then I go into the online documentation program and look at their progress notes. This gives me an idea of how far they have come, and what the therapists are working on with them.

Once I get a good grasp on the patient, I do some research on their primary condition (and secondary, if they have one) if I don’t know what it is. Then go to AOTA.org to see what their fact sheets have to say, or if there are any recent articles on it. If that doesn’t give me much then I go into my school’s library database to do more research on OT intervention with those conditions.

The clinic also uses some specific methods more often, such as sensory integration, and a computer program called “Interactive Metronome,” (definitely worth googling). So I’ve done some extra research on these areas to get a better understanding of what I’m seeing in the clinic and how this is impacting the kiddos functionally.

Self-Care

Well, it’s only been on week so I haven’t really formed a routine yet… BUT I did join a gym that I’ve gone to twice so far. I also do various things to help me relax and decompress after (and before) a day of running around with kiddos.

If the morning starts later in the clinic, I go to a coffee shop and read (I’m currently reading Letters to the Church by Francis Chan), sip on coffee and organize my planner or do homework. When I leave the clinic I am getting into the habit of going straight to the gym, where I’ll spend about an hour. When I get home I eat and FaceTime my boyfriend to talk about our days at work or anything else that happened, and then we watch our show over FaceTime (we’ve gotten really good at pressing play at the same time… lol).

Other things I do that are not necessarily built into a specific daily schedule are doing devotionals, calling friends and getting updates on their fieldwork experiences, calling family, relaxing on the dock in the backyard of the AirBnB I’m staying at, and adventuring around town.

It has been raining all week, so I’m hoping that the weather makes a change for the better and I’ll get to spend more time outdoors; hiking, hammocking, or just soaking up some vitamin D.

Overview of Week 1

In the past week I have seen such a wide variety of kiddos, diagnoses and ages. I have seen and learned about various treatment styles and methods. Just in this first week, I know that this site is going to be a huge blessing in my learning and it is going to impact my future career for the better. I cannot wait to see where I will be at at the end of these 12 weeks!

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