Kbenso2's Blog

12-6-10 Summary

kbenso2 — Fri, 10 Dec 2010 03:02:29 +0000

Today’s blog is a summary of my strengths, weaknesses, challenges, and accomplishments this semester in clinic. Do I have a self-directed plan for career development and lifelong learning as a PTA?
Strengths & accomplishments, well I have become much more confident in myself and ability to deliver a safe and effective treatment. I am finding I do not doubt myself as much. I have noticed there are times when I do but when I stop and think my gut usually tells me what needs to be done. I have also become more personable with my clients and trying to build that rapport with them. I have been interviewing them to find out more about them, and try to relate to them on a personal level. I have found it has made the difference making that connection more on a personal level. I think it is a good aspect to continue to work on as I will be able to build trust faster in my clients long with having them feel comfortable enough to talk to me about any issues which arise. I feel I have become a more critical thinker in problem solving issues which arise during clinic, as I tried to do different things with my clients to not only change things for them but also to work the muscle in a different way so accommodation doesn’t happen. I have become more confident in my soap note writing and been able to write them in the chart with out writing them out and then transferring them. It is a good feeling knowing I have the ability to do and wish I would have stated earlier. I however still feel I need some tweaking to do yet on my note writing abilities. I am sure that will come with time and with experience. I feel I have become and made good gain and am ready for my off campus clinical.
Weaknesses, I have still to beat the test taking and nervousness of new patients I think this is because I am not totally trusting myself is doing a good job along with being creature of habit. I am not always open to change, but then again I am sure that will change as I the profession I have chose changes constantly. I enjoy having the same patients for a while as it gives me time to get to know them; however I need to transfer those skills to a new patient.
Do I have a self-directed plan for career development and lifelong learning as a PTA? Yes, I have interest in aspects of physical therapy which I would like explore more once I get my license. I hope to expand on my license by having certifications in other aspects of therapy which I find interesting and am able to do so in. I think this will only make me a better person and clinician.
Over all this semester has had its ups and downs which I have had to jump hurdles to accomplish things but I feel it has only made me stronger as a person.

11-29-10

kbenso2 — Mon, 06 Dec 2010 20:00:14 +0000

Today’s blog is about wellness and health promotion and patient education. Do I work with the PT students or PTs in addressing primary and secondary prevention needs of the patents I am working with? Do I educate patients, family, caregivers, staff, students, and other health care providers, using relevant and effective teaching methods?
Well I have not utilized the SPT’s this semester as I have in the past. I know I made a goal in an earlier blog about making more of an effort to utilize them. I have not completed that goal to the best of my ability. I think I could have done a better job at making more of an effort to ask them for opinions and help. I know I did end up using one SPT to help me review the exercises I picked out for a patient, to ensure they were suitable for the patients and somewhat challenging. It was nice to have the SPT there to explain how and why the exercises I picked out would work well. I enjoyed having that conversation as it allowed me insight to what will come in the future. It was also nice to know I was able to choose appropriate exercises based on the patients needs. I have recently utilized our PTA who was covering for a staff member. I wasn’t sure about the ultrasound treatment which was suggested by the PT for this patient, so I decided to talk through my thoughts with the PTA that day to endure a safe effective treatment. The conversation was a nice relaxing setting as I was able to review my ultrasound skills and be able to talk myself through which settings would be best for the patient and refresh my memory. After the conversation it dawned on me that I was able to make the correct decision I just needed someone to listen to me “think out loud”. It truly is amazing at how much I am able to remember and recall. It makes me feel more confident about my abilities knowing I have the knowledge and skill to deliver an effective treatment, and that I am able to apply the knowledge I have learned. I think now I need to take time and review my past learned skills along with trusting myself. I am not sure why there are times when I doubt myself? I am hope it will dissipate after I am on my off campus clinicals. So in answering the question of do I work with the PT students or PT’s in addressing primary and secondary prevention needs of the patients I am working with, the answer is yes, but not as often as I should.
Do I educate patients, family, caregivers, staff, student and other health care providers using relevant and effective teaching methods? I guess I have not done a lot of teaching to patients, family, caregivers, staff or other health care workers. I have done some teaching to fellow students on transferring and positioning but that is really about it. It was more teaching from what worked best for me, when I had that particular patient.

11-22-10

kbenso2 — Thu, 25 Nov 2010 03:58:17 +0000

Today’s blog is about safety and support. Do I perform in a safe manner that minimizes risks to patients, self, and others? Do I utilize the volunteers properly as PT aids following legal and ethical standards?

I do my best to perform in a safe and effective manner which minimizes risks to patients, me and others. I try hard to ensure my treatments are safe. I do utilize the volunteer; I did several times before we switched patients, as there were moments when I needed something, and I could not leave my patient. It was nice to have the aid there as he was able to get the items which I needed, allowing me to stay with the patient. I can’t express how nice it is having an aid there especially when I needed something like gloves or a clean towel and not able to leave the patient due to safety concerns. The volunteer turns into the “gopher” allowing me and my fellow students to have that extra set of hands to run and get missing items or just to aid in the treatment such as holding the patients limb to allow an accurate goni measurement. I feel I did my best to ensure I followed the legal and ethical standards.

11-15-10

kbenso2 — Wed, 17 Nov 2010 02:19:37 +0000

Today’s blog is about several tops since we need to play catch up. Documentation, Communication, Quality of service delivery, and clinical problem solving and judgment are the topics of this blog. Do I document to support the delivery of the skilled physical therapy services? Is it reproducible and am I communicating in ways that are congruent with situational needs regarding patients care and clinic operation? Am I delivering good quality care in clinic? Do I follow the guidelines for the delivery of PT service? Do I know how we could run the clinic better to meet the needs of our patients? Do you participate in patient status judgments in the clinical based on the plan of care established by the PT? Am I aware of the ethical and legal standards and adhere to them?

I do my best to document to support the delivery of the skilled physical therapy service I proved. I will admit I have now started documenting in the chart rather then writing it twice. I am finding it is easier however it is taking me longer as I am trying to error as little as possible and make it an accurate note. I think it is getting better, but still needs some work. I hope what I document is reproducible, I try to paint that picture for me fellow students but it is hard as every one is different and will view things differently. I try to used common terms and ensure it is clear what I am doing with the patients.
Communication has not been as good this semester with the SPT’s as I have not gotten the chance to do so. I have not had the need to or if I do I find I am asking the instructor as they are available at the time. I would like to try and communicate with the SPT’s in these last weeks of clinic, as this is my last opportunity to improve my skills before my off campus experiences. I feel most of my communication is congruent with the situational needs of the patient and the clinic. If I have a question or need I address it according to the urgency of the situation.
As far as delivering good quality care in clinic I find I do my best to. I notice once we came back to clinic and switched patients I had to review past learned ultrasound skills to ensure I would deliver a confident and efficient treatment. I did well and found it came back to me pretty easily once I stared setting the machine up. I feel I have followed the guidelines for the deliver of physical therapy services to the best of my ability. I feel I have become more confident in myself which has made things easier during the transition of patients. I am finding I am trusting myself more and not doubting my instinct.
The way our clinic is run I think has been effective and I am confident it will be even better once we get our new equipment and new space. I feel the needs of the patient will be met better as we will have more options for treatment. I am aware of the ethical and legal standards which we as students are to follow.

Blog 11-8-10

kbenso2 — Wed, 10 Nov 2010 03:08:21 +0000

Today’s blog is a sad one as we are still not in our clinic/class room area due to mold and water damage control. . . But we did get a chance to re-enforce past learned skill through a mock acute hospital setting. It was nice to re-enforce those skills and hearing how great I did from my first year. Makes me feel great knowing I remember things which I felt were rusty and or forgot about. Hopefully next week we will be up and running. . . till then.

11-1-10

kbenso2 — Thu, 04 Nov 2010 03:58:42 +0000

Today there was no clinic due to the flooding which occurred on Tuesday October 26th 2010. Today was a bit unorganized and somewhat productive. I did get two skill checks completed and was able to attempt to get the outreach project done. However ran into some snags. So will have to blog about the missing criteria when clinic opens which should be the 8th of November, depending on how fast the MaterClean people can get things put back into order. I know there was some mold issued along with dry wall and carpet needing to be replaced.

Blog 10-25-10

kbenso2 — Sun, 31 Oct 2010 00:53:29 +0000

Today’s blog is about patient services. Do I think out of the PT box and address patient needs for services other than PT?
The only time I can recall thinking outside the PT box is when a patient I was treating had issues with secretions. We had someone from respiratory therapy come down to see if there was anything we as physical therapists and physical therapists assistants were missing or over looking. This is really the only time I have experienced thinking outside of the box, as I wasn’t the one who thought of it. I am glad someone from respiratory therapy came down as it they made some suggestions which we could recommend to the patients care givers to help address the issue before coming to therapy.
It was nice to get that incite from someone else who specializes in that field as we did over look some simple things which could benefit the patients. It is always nice to have that second pair of eyes and thoughts about certain topics/issues as there are times when we get too focused on things and forget to look at the big picture. I defiantly think it helped me have a better understanding how to utilize the resources around me better.

10-18-10

kbenso2 — Tue, 19 Oct 2010 04:12:03 +0000

Today’s blog is about patient intervention and fiscal management. Do I perform physical therapy intervention in a technically competent manner and am I billing appropriately on the mock billing sheet regarding the services I deliver?

I feel I am competent with my physical therapy interventions. I do have moments when I need to ask if I am on the right track, or if there are any other ways of delivering a treatment, as sometime I feel I am missing something vital which could benefit my patient. I am trying to explore more options of treatment delivery, and not to do the same thing over and over with a patient. I feel it’s not as beneficial when the treatment sessions stay the same. The human body is designed to move in all plains and there for therapy treatments should move in all plains. I enjoy trying new things with patients to see how they respond to the different treatment techniques. I know if I were a patient I would like all options to explore to ensure I am getting the best treatment possible.
I want to see improvement in my patients not only for their benefit but for mine too; I get excited for them when I see them improve. When I see they are only making minimal progress or the reason for physical therapy is only to maintain the patient level of function I feel almost helpless. I think it’s because I want them to get better, and to be able to live a relatively normal life. But reality is there are some cases when someone with a diagnosis will never fully recover to what they used to be, which it is sad. It is this reality when I feel helpless; even though I know I am helping them maintain what abilities they have which gives them some quality of life. It is not the same as when you have a patient who does recover fully or close to fully from an impairment, and you have that excitement for them. I am sure over time I will see how big of an impact I am having on someone’s life even if it is only to maintain the functional abilities they already have.
Yes, I do bill appropriately on the mock billing sheet regarding the services which I deliver. I can’t recall having a “nasty gram” as one of our professors calls it. I am proud of the fact I have been so diligent with my billing, this habit is a good one to have as once I graduate and find a job this is how I will be getting paid.

10-11-10

kbenso2 — Tue, 19 Oct 2010 04:11:01 +0000

I do feel I obtain accurate information by performing selected data collection which is consistent with the plan of care. I have had the opportunity to goni my patient twice since the start of clinic and have notice the patient making gains in their range of motion. It was nice as my first year student was able to practice their goni skills and a good refresher for me as I have not had to measure a “real” patient in a while. It was nice to see how well I remembered the normal ranges and how to line up the goni. There was a few degree difference between what my first year and I measured from what was in the chart but that could be accuracy of the person measuring and we were only off by two degrees which isn’t really bad at all.
I have discussed the need for modification to the plan of care with the PT, I have given the PT some accurate information allowing the PT to make modifications to the short term goals, which have benefited the patient nicely, allowing the patient to work towards a long term goal. It is nice to see how the communication with the PT is so important as PTA’s are truly the eyes and ears of the PT. Another benefit to having great means of communication with the PT is being able to address the needs of the patient and get the goals modified to better serve the patients needs.
Overall I can see myself making gains in confidence as the semester continues, I can also see my tendency to fall back on old habits too of relying on my PT too much at times for input. I catch myself asking silly questions which I know the answer too, which is something I need to work on changing. But it is a work in progress and I am improving every day.

10-4-10

kbenso2 — Sat, 09 Oct 2010 17:10:03 +0000

Today’s blog is about data collection and plan of care. Do I obtain accurate information by performing selected data collection consistent with the plan of care established by the PT and discuss the need for modification to the plan of care with the PT?
I feel I do a good job obtaining accurate information which is consistent with the plan of care established by the PT. I know I have observed my patient making gains in rang of motion, but since I didn’t have time to collect the goni data to see how much I wrote it in the plan of care to have them assess it on the patient’s next treatment session. I find it interesting to see how I have gain the ablilty to judge increases and decreases in range of motion. It is nice, as it’s a confidence booster, makes me feel more confident in my abilities of remembering range of motion for the human body. I have not had to discuss any needs for modification to the plan of care with the PT as the goals which have been set are still a work in progress for the patient. I am sure it would be a good idea to have the PT do a 6th visit so they are able to reassess the patient and see if there are modifications which need to be made to the plan of care.
Today was good, I ended up having my partner do the SOAP note as they are learning how to do it in their documentation class. I thought the note which my partner wrote was good for doing it all on his own but also felt it was a learning assessment for him. I know when I had to write my first soap note I was amazed and how difficult it was as I was used to writing closer to a nurses note, but with practice and persistence I feel I have come a long way in my documentation. I still feel there is room for improvement with time. When I offered my help or input in the SOAP note my partner was writing, he insistent that my help wasn’t necessary unless asked for. It was nice to see the determination, as the best way to learn is by doing.