[OTlist] OTlist] Really Should be Studying But....

[Michael Holmes]

I can say that I have been there too. I work in a very rural town with the
hospital, nursing home, ALF, and outpatients seen basically in the same
clinic area. Needless to say the level of awareness of OT is limited at
best. I can't tell you how many people have introduced me to, or explained
to another that I am an "OT" that works down in "PT". The concept of
anything other than initials is non-existent to most here.

 

I have been promoting our profession. I scheduled and presented an
in-service to many CNA's, attempting to educate them as to the real role
delineation. Much to my surprise, it was accepted well. I feel a strong
component to enlisting the nursing staff to buy into OT is to sell it as
help to CNA's. I put it this way.We help people become more independent in
their own self care. This way you can let them do these things for
themselves and it will give you more time get someone else ready that needs
more help.

 

This logic seems to work. Most CNA's seem to be in favor of "lightening
their load". Then, we appear as allies to the "boots on the ground", and
that is not a bad place to start. CNA's have approached me afterwards and
asked what else they could do to help make people more independent.
Sneaky...but it worked.

 

Anyway, hang in there OT's and continue to plunge your sword of
determination into the heart of ignorance!  

 

Michael A. Holmes MSOTR/L

North Valley Health and Rehabilitation

203 S. Western Ave.

Tonasket,WA 98855

  o...@nvhospital.org

(509) 486-2151 x500

 

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[OTlist] Vision ~vs~ Reality

[Michael Holmes]

Wonderful dialogue. Sometimes, with the overwhelming treatment regimen they
press upon us it is necessary to take that one smile, or the "thank you", or
the look of accomplishment upon a patient's face after an OT tx to tell
yourself you have "won one" for quality of life. Perhaps that is why we
enter the profession to begin with. Despite the corporate bull,
productivity, etc., we must take those little battles that we "win",
evidenced by our patients gratification, and use it to heal our souls. just
a bit. This will allow us to continue to deliver the service to patients we
believe to be valid and meaningful to out clients, patients, residents or
whatever we call it these days. Finding meaning in occupation with a client
doesn't necessarily require the COPM. The client and therapist have a
relationship and the more meaningful the relationship the easier it is to
find out the persons desired occupational pursuits. Let's not forget the
client centered interview or the occupational profile. These are free, last
time I checked the COPM was for sale. I am not knocking that assessment I do
indeed see its' value. Sometimes just taking the time to "discover" your
patients' goals through meaningful exchange of conversation is the best way
to tap into a patient's desired end game for therapy.  

 

Michael A. Holmes MSOTR/L

North Valley Health and Rehabilitation

203 S. Western Ave.

Tonasket,WA 98855

  o...@nvhospital.org

(509) 486-2151 x500

 

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[OTlist] Intro To OT: Assignments?

[Michael Holmes]

We did a "Trust Walk". Two person team, one blindfolded and walked around
the campus "guided" by the other person, over, around, and through obstacles
such as stairs, doorways, parking lot curbs, cafeteria line, bathroom ,etc.
It really helped understand low vision and blindness from one perspective,
and it is good for learning to provide tactile and verbal cues to someone by
future OTA's.  

 

Michael A. Holmes MSOTR/L

 

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Re: [OTlist] Massive new CVA patient

[Michael Holmes]

Great input everyone. I must concur that there are lots of things that you
can do. The ebrsr is a terrific resource for evidence based intervention for
stroke. I really don't have much to add other than using a watch with an
alarm and or hourly chime to be placed on the left UE. This will encourage
him to attend to the left arm even if it is to locate an annoying watch
alarm that he keeps on hearing. He also has to engage in a bit of bilateral
movement to turn the alarm off (if he will initiate this). This movement
would be more "automatic" as far as his initiation to attempt to move the
left arm to meet the right arm to silence the watch alarm. Hope this helps
too.

 

Michael A. Holmes MSOTR/L

 

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Re: [OTlist] Renew AOTA or NOT??????

[Michael Holmes]

The AOTA also advocated for OT's to utilize PAMS. In California for instance
an OT cannot apply ice, heat, etc. without advanced certification. How is it
that any dolt off the street can apply ice to a person, but an educated
professional cannot? I will tell you why because OT's did not get together
with AOTA to fight PT in the state legislature to include PAMS as part of
their education. The AOTA is for the advancement of this profession, and
perhaps Ron, if you wanted to change OT's perception from UE therapist, you
might find them an ally. I am sure the AOTA would welcome the opportunity to
promote OT as more than an "arm pumper". 

 

Michael A. Holmes MSOTR/L

  o...@nvhospital.org

(509) 486-2151 x500

 

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Re: [OTlist] A New One

[Michael Holmes]

Just wanted to say how much I liked the "elephant" analogy. I think is
really is clever and indicative of the profession as whole. We do function
in so many different realms that it is difficult to be united on our
explanation to "lay persons" what it really is that we do. Great way to put
it Mary.   

 

Michael A. Holmes MSOTR/L

  o...@nvhospital.org

 

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[OTlist] Ultimate Insult

[Michael Holmes]

P.T is ever increasingly working on our domain. I reviewed an outpatient
chart today and read a long term goal written by a PT that floored me. It
read, "Pt will complete ADL tasks such as washing hair without pain". This
was a LTG established by a DPT for a pt w/ an elbow injury. I have also
heard rumors about PT pushing for a "universal" therapist where PT, OT, and
ST are basically considered "one" and with various "specialties." 

I am NOT in favor of such a thing. I truly believe that O.T is a beneficial
therapy and does address things that people do hold most dear to them.ADL's.
People are more public about PT because walking is the "in" thing, people
can "see" them walking, they equate it to "independence" People do not want
to seek help for peri-care, much less perform it with someone they barely
know.

The bottom line is that people taking care of themselves, doing whatever it
is that they need to do to accomplish, "a day in the life" is what I feel OT
is all about, it is "occupation". Be it due to limitation from cog deficit,
ROM deficit, neurological impairment etc, people deserve every little bit of
dignity they can get from completing "private, personal" things privately
because it is their "occupation" and only O.T. 's have the training,
creativity, and organizational skills to assist people to complete these
things properly, effectively, and independently.

I feel with P.T. trying to include "function" and "ADL's" that it is THEY
who truly want to be like US.

 

BAM!  How about, "OT, we are so much more than arm pumpers" for our campaign
to battle the P.T. takeover. LOL   

 

Michael A. Holmes MSOTR/L

  o...@nvhospital.org

(509) 486-2151 x500

 

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[OTlist] Speaker

[Michael Holmes]

Just came from the Washington OT conference and our keynote speaker was
Patch Adams. What a great speaker he was. If anyone ever gets a chance to
hear him speak it is certainly worth it.

 

Michael A. Holmes MSOTR/L

 

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[OTlist] Flu shot

[Michael Holmes]

I decline. I have had several patients w/ Guillan Barre swear that they came
down with it because of the flu shot. The severity was ventilator dependency
for quite a while in two cases. I understand that the flu is serious, but I
will take my chances w/ good old fashioned hand washing, vitamin C, and
common sense. 

 

Michael A. Holmes MSOTR/L

 

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[OTlist] Time management

[Michael Holmes]

Good idea. I was trying to guide him along the "flow" concept by Chicksa
mahya ( I know I spelled that wrong). I thought he might be able to get into
a "treatment" flow first, and then a "documentation" flow later in the day.
It seems to transition from treatment to immediately writing a note can take
extra time to "change gears" from treatment, ideas, "flow" action movement,
to sit down, think a bit,  analyze, etc, Then back to another treatment and
so on.

 

Thanks for the help.

 

Michael A. Holmes MSOTR/L

 

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[OTlist] Time Management

[Michael Holmes]

Thanks Ron. I will pass it on.

 

Michael A. Holmes MSOTR/L

 

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[OTlist] Evidence

[Michael Holmes]

 

Just to interject about the handwriting requests. I remember a saying
that, "Proximal stability allows distal control." Perhaps a fancy way of
saying that scapular/shoulder weakness prevents a solid foundation for
stability to allow greater fine motor control with the writing utensil.
The joint laxity, poor endurance, poor posture, etc., are all things
that contribute to poor penmanship. Sorry if this is redundant, but
hopeful it helps.

 

Michael Holmes OTR/L

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[OTlist] GROUP PROTOCOL

[Michael Holmes]

Willard and Spackman's 10 edition by, Crepeau, Cohn, and Schell,  has a
great chapter, (Chapter 15) that explains in depth all you could want
about groups.

 

Michael A. Holmes MSOTR/L

 

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