Playing games

One of the fun aspects of being an occupational therapist is getting to play games. There are several legitimate reasons for doing this. Part of my role is to find ways for my patients to do everything they consider important. Obviously most people wouldn't consider games to be very important in the big scheme of things but it ranked up there with one of my patients who gets together with friends once a week to play cards. She was in the rehab unit to regain her strength following surgery. One days she has been working hard on the physical aspect of her recover so I suggested we play a game of cards. Her daughter was there so we got a three person game going. There wasn't anything particularly challenging about the physical aspects of playing. She could shuffle, deal and hold the cards. She also didn't seem to have any problem understanding the rules of a game she hadn't played in a long time. But it did lift her spirits and remind her that she would soon be back home getting together with friends for a lively game of bridge.

Connect Four is another game I've played several times this past week with a patient who is recovering from a stroke. Physically she is making big strides as she regains strength and coordination on her left side. She is now walking around the unit with the help of a walker. Last week her left hand began to cooperate enough to be able to consistently tie her shoes without any help. One of the big barriers to her functioning independently is paying attention to what is on her left. She has a visual field cut which is common after strokes. As a result she thinks she is seeing everything, but in reality she isn't. Imagine your left peripheral vision shrinking to just a few degrees left of center and you'll have a good idea of what she can see. This can result in running into the left side of doorways or not seeing the piece of pie on the left side of your tray. Connect 4 is a great game to play to remind her to look all the way to the left. As we play, my goal is not to beat her but to give her enough cues that she realizes what she is missing and can figure out how to block me if I'm about to win. I also have told her that she can win with one more move and waited until she found it.

Drifts

During the three months in Fergus Falls I'm living a mile out of town with some friends of the family. Their home is on the top of a hill with a great view. We can sit at the dining room window and watch the ice fishing across the lake. If you've spent any time on the prairie you know that most homes have trees on at least the north and west side to block the wind. This home has only a few trees so the wind blows the snow around the house and dumps it right on the driveway. I received a call on Tues evening that I should park at the neighbors (completely surrounded by trees so no drifting occurs). As I walked up the driveway, the drifts weren't bad but the next morning I was very glad I had parked at the neighbors. There was no way I could have gotten my car out. By Friday when the winds stopped blowing the drifts were as high as the snow fence.

The highlight of the week was on Wednesday. I arrived at work to learn that two of the 10 OTs had called in sick and another was off. I was sent up to help one of the rehab patients with their shower and dressing while schedules were reshuffled. When I was finished, I was handed an almost full  schedule of patients to treat. "Are you comfortable with this? Here's a beeper if you have any questions or need help." OK, here we go. If I got my feet wet last week, this was jumping in the deep end. A few times an OT popped in on a treatment session to help out a bit but somehow I survived and so did the patients. I left work that day thinking that was the most fun I'd had since starting this program. We were short three OTs on Thursday as well but that was for weather related reasons and the scheduling had been done accordingly so it wasn't as crazy, at least not for me.

Getting my feet wet

During Christmas break an uncle said he would be interested to know if I was more tired after a day of "working" than I had been after a day of studying. During this first week of fieldwork, I'd definitely say I'm more tired now than I was after a day sitting at my desk. Most evenings I felt like I could have go to bed at 6. That is a bit early so I've managed to stay awake until about 8:30. It's not that the work is hard and I haven't been tired during the day. Rather, everything is new and I'm learning to think in new ways. It all requires plenty of mental energy.

Over the first few days I would observe an OT work with a patient and think I knew what was going on -- until the OT asked a question about what I'd seen. Oops, I hadn't been paying attention to that. I was a bit overwhelmed by all I was to be observing while also figuring out what to do with patients that would actually help them improve. As the week went on, I became more comfortable in my role. I think there are two main reasons for that. One is the encouragement of the OTs I'm working with and their gentle corrections. The other is the significant improvement a couple of the patients made over the course of the week. There is still a long way to go before I'm ready to be on my own, but I'm headed in the right direction.

Ready or not...

I arrived in Fergus Falls yesterday and am enjoying a beautiful sunny day while remaining inside during the sub-zero temperatures. It took me several days to find things when I arrived at my parents a couple of weeks ago so I knew I needed some time to unpack and find a home for everything in my new location. I am staying with some friends of our family who have given me the run of their basement. I spent yesterday evening getting settled in. Hopefully I can remember where I put everything.

Tomorrow morning I start in on 12 weeks of fieldwork. I'm looking forward to it but not exactly sure what to expect. This first week will be mainly orientation beginning in the Human Resources office. We have some assignments to do: a weekly journal posting, the presentation of a literature search done to answer a clinical question, and the ever-present final reflection paper and evaluations. But the main idea is to gain the experience to carry a full case load by the end. It seems like a rather tall order but with some guidance from my supervisor it will happen.