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Life is busy this spring and since it was, our class was alittle behind when it came to OT month, but better late than never. This past week, my classmates and I hosted an OTA open house. We did are best to represent as many aspects of OT as possible. We had mental health, pediatrics, geriatrics, and specialty areas tables providing a variety of information. We also had kitchen, bathroom and bedroom stations to showcase adaptive equipment, compensatory strategies and safety in those areas. We all worked very hard on our open house and it paid off. We had over 80 visitors which is huge for our small school. It was a wonderful experience getting show off what OTAs can do and just educating people about occupational therapy in general. It was great to have students from other programs including nursing come visit because they wanted to know what it is that OT practitioners do. I think we provided a great deal of exposure just within our small community. The greatest thing I took from this experience is confidence and awareness of my own knowledge. I will admit that at this point in the term and even the program, I still feel like I know nothing. However, when visitors asked questions and I was able to confidently answer them, I realized that I do know something! It was a great experience.
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It is week 8 of 12 and I am for the first time feeling that I can't wait for it to be over! I have learned so much and taken in so much information that I can't possibly fit anything more into my brain. I am struggling to convert myself from an experienced COTA into an entry level OTR. I am so used to taking in information and not analyzing it that I am struggling with the analyzing. I always had assumptions in the back of my head about what the information meant but I knew my place was never to figure it out just take it in and pass it along. Now I have to figure it out and it is...scary! I am learning, from my supervisor, that I just need to give myself a little credit, relax, and realize right now I am just a student, I don;t have to have all the right answers right now I just have to try. A concept that is difficult for me I have to realize that sometimes I will be wrong, I know enough that I would never put a patient in danger (and my supervisor would never put me in a position where that could happen) but I don't know everything and I am starting to become okay with that. It is a difficult process and I am still working on it but it is a new direction of learning I did not expect in this fieldwork process.
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Another set of midterms has come and gone. I’m thrilled that I only have to go through that one more time before graduation. Midterms are always a bitter sweet time for me. First of all, they're midterms, so that’s never fun, but they do signify that these courses are half way done! However, they also mean it is time for the end of term push to begin. Everything starts becoming due. 2 or 3 major projects a week is terribly stressful. And it starts right away, with no time to recover from the draining effects of midterms. However fast the first 5 weeks of the term seem to be, the last 5 weeks always seems to go by faster. I can’t complain about that as I am anxious to close the door on this chapter of my life, but I could do with out all the stress and stress side effects. Speaking of stress, I should probably get started on my mountain of homework . . . only 14 more weeks of classes!
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As graduation approaches this weekend I have become nostalgic looking back at the time I spent in school. While this ceremony is somewhat arbitrary because I still have 6 weeks in this clinical and a second 12 week clinical to complete before I am officially done it is a step in the direction of completing my Master's degree. Looking back I realize how crazy I was! After I confirmed my acceptance two and a half years ago I found out I was pregnant, I decided I could handle it I would work full time, go to school full time and raise a child...crazy! While I have survived and would not change a thing I have to say I may have delayed my admission if i knew then what I know now. That being said I don't know what I am going to do with myself once school is completely over. Of course that is after I take my cert exam! I love what I do, I can't wait to officially be an OTR and find my niche. What about you, did you get nostalgic when it came time for graduation?
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How many of you OTRs and COTAs have pursued specialty certifications after you graduated? Do you feel those extra certifications have helped you in your careers?
In my Specialties class we have had several guest speakers come to talk to us about a wide range of specialty areas available for OT. Almost all of the speakers have had some sort of specialty certification. They have all been so passionate about their work, even when they’ve bounced from one area to another. This week we had a presentation from an OTR who started out working with people with brain injuries and so she got a specialty certification for that field, she then later started working for construction companies to consult on home modification and got another certification for that field. She stated that she loved both fields so much. All this talk of specializing has me considering all the options out there and just what extra letters I might want to follow my name. So I’m curious, is it common to get specialty certifications? And are they benefical?
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As I continue on the fieldwork process I have started to struggle to find my role. After eight plus years as a COTA with someone to fall back on to make decisions, evaluate when something changes and write goals I have to do it! I have fallen into a pattern of treating the patient, following the OTR's plan instead of thinking about it from an OTR point of view. My supervisor has caught me a few times, and I have caught myself even more. I find it much easier to fall into my old role than challenge myself to think like an OTR. I also realize my classmates and I are among a few who have traveled this path. It is not common for OTR's to have started as COTA's and few know how to navigate this process. Did you or someone you know start as a COTA and then go back to become an OTR? How did you, or they, navigate the transition?
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This past Friday, my cohort joined 6 other colleges for the annual OT/OTA Role Delineation Conference. We represented 1 of 3 OTA programs and were joined by 4 OT programs. The conference started with a presentation and lecture about OT/OTA roles as stated in the AOTA’s Standards of Practice, the ACOTE Standards and Michigan’s licensure laws. Afterwards, a panel of OTRLs and COTALs spoke about their experiences in clinical practice regarding the relationships between OTs and OTAs. It was a very interesting discussion, and honestly, a bit ego boosting to hear all these practitioners speak about how vital OTAs are in practice. It was also encouraging to hear how most of the practitioners had positive relationships that were more akin to equal team members as opposed to supervisor and supervisee. The last portion of the conference had us breaking into groups to answer questions regarding OT and OTA roles in specific scenarios. I was placed in a group with three OT students. I was surprised to hear that the other students knew nothing about the role delineations and that, in some cases, this was the first they had ever heard about it. They had no idea how much an OTA could do. The lack of education the OT students had received on this subject was surprising as these are my future “supervisors” but they don’t know what I can and cannot legally do. It was obvious that this was a similar trend in all the groups, the OTA students knew about the roles but the OT students did not. In my school, we have been taught the roles from day one and continue to learn and discuss them throughout the terms. I am curious as to why this is not the same for the OT students. It is just as important for them to know the roles as it is for us. Did anyone else have similar experiences in school? As newly graduated OTs, were you expected to supervise OTAs without knowledge of their role in the practice? And vice versa for the OTAs, did you have to educate your supervising OTs about your roles?
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This week our assignment was a blog to reflect on what is going well and what we are finding difficulty with during fieldwork. What I am finding my ease with is talking to patients a definate strength, I find I am able to quickly gain a rapport because I am very comfortable talking to patients I have been treating patients for over 12 years. I am finding my weakness to be of poor recall of anatomy. I have started studying again and some of it is coming back but there is so much to remember and rote memory is a weakness of mine. As I watch the other therapists I can see how important the recall is because it really helps put patients at ease when you can clearly explain their condition complete with what movements and pointing to what muscles are going to bother them until they are healed. My goal for the end of these 12 weeks is to be able to readily recall all the muscles in the upper extremity. What are some of your weaknesses you had to work through in fieldwork?
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This semester started off with such a rush that I completely forgot to post last week! I have a full and diverse term this time around. I am taking a Geriatric Patient Care class, a Principles and Applications in Pediatrics class, an OT in Specialty Areas class and a Professional Career Strategies class. I am very excited about the pediatrics class. I have worked with kids off and on since I was in 6th grade (and a kid still myself). I would love to pursue a career in a pediatric setting. Up till this point, we have not covered anything with regards to pediatrics so I have been anxious awaiting this term. Our instructor is a school-based OTR and has arranged for us to visit 3 outpatient pediatric facilities throughout the term. I cannot wait! The Specialty Areas class will also be interesting. We have a different guest lecturer every week who will present information on a wide variety of treatment settings and interventions. Everything from hippotherapy to amputations will be covered. I am really looking forward to getting a glimpse into all of these different fields and getting to talk to such a wide range of experts. This class will highlight what a diverse field OT is and how many options are out there for as we look ahead to our future careers. It has me thinking about specialization and certification options already! It also has me curious about what the specialization and certifications are for COTAs. Do COTAs have the same options as OTRs when it comes to specializing?
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This week I am delving into tendon injuries in fieldwork and find them facinating and challenging at the same time. The patient I am seeing is over 3 months out so the precautions have all been lifted and the focus is now on returning sensation, increasing AROM and increasing functional use. In order to prepare my supervisor has me researching sensory tests to allow for proper diagnosis of her sensation and to determine where to go from here. I have to say this is not something I was prepared for and found there is so much information out there about sensory. I am studying the return and found that sensation returns from deep pressure to moving touch to static light touch and finally descriminative touch now I just need to find a test that determines which level the patient is at. Have you ever come across a problem like this? What resources did you use to find an appropriate test?
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I found this past week that I may just need to give myself more credit than I do. I completed my first evaluation, my first (set) of wrist cock-up splints without the pre-fab cut outs and a slew of treatments all with good praise. While I still have so much more to learn I am calming down a bit and starting to do well. Outside of this I have come across a technique I have not seen very often is kinesio taping. The first time I came across this technique was when working with a physical therapist who was taping a low back for pain relief. So far this week I have seen taping for edema, fractured fingers, carpal tunnel and pain relief. It seems that it really depends on the patient whether or not any relief is seen but it doesn't matter the diagnosis. I look forward to learning more about this technique and hopefully taping a few patients myself soon. How about you, have you used kinesiotaping in your treatments?
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I only have 7 days left of break before I start the next term. Why do breaks go by so fast? I don’t feel like I’ve been very productive this break. The abnormally warm weather has been partly to blame. It’s hard to sit in the house and do chores and projects when it’s 70 degrees outside. So I’ve been spending time with friends and out at parks instead which has been good for my mental health. Last Friday was spent back at school participating in the Health Living Project which is an event that provides health screenings to people with low incomes or no insurance. It was an interesting event but sadly under-attended by the community.
Today I decided to buckle down and get some of my “to do” list done while I still have time. First thing on that list was to find my desk again under the piles of books, binders and papers. It has taken me all morning, but my workspace is mostly organized again, all of last term has been filed away and I have prepped my binders and notebooks for this upcoming term. Now it’s on to the rest of the house.
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Today I started my first level two fieldwork and it is already nerve-wracking. While I have worked in outpatient as a COTA for 2 years I am finding myself nervous about evaluations. Today I only shadowed the OTR but come Wednesday I will do my first evaluation, that is scary! It has only been one day and I have already learned new treatment ideas, and the best new technique, or at least new to me, serial casting. I can't believe I have never come across this method of increasing PIP extension. It was so interesting to watch the OTR use paraffin as a base then wrap the clients finger with plaster so the cast is not only able to provide a slow stretch on his PIP but can also be easily removed. I can't wait to go in tomorrow and see what else is in store. I can already tell this is going to be a great experience.
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Yesterday the final grades for the term where finally posted (a day late) and it was not pretty. Thankfully, I did well with my lowest grade being a B+ but others in my class were not so lucky. Many students just barely passed this term and they are understandably rattled. Unfortunately, three of my classmates did not make it. That’s 15% of us who will not be there in April. That's just amazing to me. I’ve been thinking about those three a lot. How devastating it must be to come this far, to work so hard and miss moving on to the next term by a few dozen points. I believe that the one's we've lost would have been great OTAs. They were all dedicated to the field. We have all worked hard and made many sacrifices to be here, I just cannot imagine being dropped from the program halfway through. I also cannot imagine what my classmates who just made it by a dozen points are feeling/thinking. Is it common to lose such significant portions of your class throughout the program? We did not lose anyone after our first term, so that may be why this is such a shock to me. I’m hoping it will not be repeated in the next few terms. For now, I’m just trying to move on, enjoy my break while I can and prepare myself for the next round.
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So the academic portion of my course work is finally complete and I am on to fieldwork. I am proud of myself for managing two A's this quarter to finish with a 3.6 gpa. After our final presentations our professor did one of her own reflecting on the two years we have been together and everything we accomplished, and survived. To recap for those of you who don't live in Rhode Island, we survived the flood of 2010 just after starting school our state was underwater for a week. Later that year we missed a class because of a fluke October snow storm and got buried for the rest of the winter in snow. Outside of crazy weather we had five babies born to our class (my baby included) two weddings two divorces and lots of fun times. Reflecting back I can't believe how quick it came and how slow it seemed to go by. I can't wait to start fieldwork next week as I know I am ready. As my professor said to us in our reflections,
Dr. Seuss says it best, “You have brains in your head. You have feet in your shoes. You can steer yourself in any direction you choose. You're on your own. And you know what you know. And YOU are the one who'll decide where you'll go." And on to fieldwork I will go.