While at the facility, I came across a client with schizophrenia who expressed he had feelings for me. This particular client had returned to the unit a few times in the matter of a couple weeks. During his last admission, the patient told an interviewer that he had gotten an OT student pregnant and he was going to marry her. As I was reading the patient's chart and came across this section, I was startled at the delusions this man was experiencing and very anxious about how to handle this situation. Our professors in the past have given us many options on how to handle a situation like this, however, all situations are different and the types of clients who express these feelings will be different. In this case, the patient has a mental health diagnosis with serious delusions and I needed to make sure I was very clear with our therapist-client relationship boundaries. During his stay, the patient asked to sit down with me and continued on to tell me how he felt about me. I immediately responded by explaining that I was part of his medical team and that any sort of relationship between the two of us outside of the hospital would be inappropriate as my job was to ensure he was receiving the best health care possible while he was at the facility. After this conversation, the first thing I did was notify my supervisor. She expressed that she was glad that I came to her with this and if the patient continued to escalate she would help me figure out the next step."

I encountered clients with varying mental health difficulties

c

ire

are

My feelings towards this fieldwork experience felt very different from my last. At the start of my last rotation, I felt very nervous and unprepared for what was to come in those 12 weeks. However, at the start of this rotation, I felt eager and excited to learn all that there was to offer at this site. I had improved my confidence in my skill set from my first rotation and just couldn't wait to see where it led while at this pediatric hospital/unit. With this excitement, I wanted to set very high, yet achievable, goals for myself to ensure my preparedness to transition to entry-level practitioner at the end of the rotation. I met my short term goals while I was on the burn unit of the hospital where I fabricated 2 different types of splints independently, completed independent research over several articles for an evidence-based practice project, and was able to complete treatment plans with assistance from my supervisor. For the remainder of my rotation, I was located on the CVICU, where the clients were in more critical condition. For my long-term goals, I wanted to focus on completing each day as if I was an independent practitioner. This goal would come to be very difficult to reach as I was only able to spend two weeks on the unit, due to the way students rotate between units as well as the scare of the coronavirus. This unit also requires very specialized clinical practices, such as feeding with very critical infants. While I did not feel independent on the CVICU, I did feel independent while on other units of the hospital. For example, while on the inpatient rehab unit of the hospital, I was able to independently complete thorough chart review, plan treatment sessions, write appropriate goals, write evaluation and reassessment documentation, interact with families and staff on the unit, as well as determine if treatment sessions were appropriate based on lab values or prior procedures completed. I felt very confident in my skills on this unit that I could participate as an independent occupational therapy practitioner." 

client's

students are expected to know only be knowledgable i

these

have

is

have

have

have

and weakness

bring my

while in the field that majority of settings uti

my need to find common ground in conflict, finding potential and opportunity in all situations, and my drive to solve problems for everyday situations in the field not only promoted me to become a better student practitioner, but also a better team player.

I learned to utilized

we

have seen

the

have been

ione

is form

really

If there was a case, that I had been working with the client more often than physical therapy, I would be able to provide insight on activities the client enjoys while also including any ideas or activities they needed to work on during the session

ursing

PTs, SLP

is a something

ing link

the population

they were receiving at the hospital.

over

continuing educational learning to promote evidence-based and up-to-date learning.

have been

link:

over

within this specific presentation

ecognizing that the process as well as appropriate evaluations and interventions will adapt to the needs of the patient is important for successful treatment and care of the client

identify the following

These characteristics

To carry these ideals throughout the entire process is pertinent to the client's overall therapy plan

or follow-up

best practice measures

as to be able to relate it to my specific setting

I truly enjoyed this experience and felt as if the articles provided a higher level of value to my learning as well as promoted evidence-based practice.

as if

Confere

this provided us with how vital this would be to practicing clinicians on a daily basis

over

wo

ield

​In practice, we are often able to utilize our own personal experiences along with our therapeutic use of self and clinical reasoning to make decisions and demonstrate integrity

atter.

far more than I understood

This was very upsetting for me and difficult to imagine not finishing out my rotation for many reasons.

skills

LTAC, IP psych, and IP

include

on

have

experience

while also upholding a variety in skills

ce

FWE

provided

utilized

I am able to determine areas that I n

ork.

trive to provide independence

ssions.

hat the profession can really work on with it's clients

rotatio

During my time at UTHSC, I fulfilled commitments to the community through the following activities: coordinating Kindergarten Readiness workshops for schools/parents and arranged developmental screenings with an underserved population

diverse backgrounds and holistic care perspective. 

Physicians on the unit believed he should be discharged home immediatelt, however, this was not going to work due to his unfortunate circumstances, so the OTs on site had to advocate for them to understand we couldn't discharge him to the streets of the city

though, was left homeless after a lapse in medication

patient

admissions

MOHO

Applying theory throughout the occupational process can often be a difficult thing to do as you enter real world settings and practitioners have often forgot this component.

rd

this goal for him

this requires a lot of lower body strength and endurance, but writing his name is only something he can do

thing

item in particular he wanted to accomplish was his handwriting skills.

GBS

u have to do the hard work. 

s different motivator

your therapy as well as their personal outcomes

TBSA

ensure their buy in

is

el c

he group members were able to process and create ideas ways to establish appropriate patterns and habits that they each would like to incorporate into their routines.

ffect

s

ice

PT/ST,

PMH, CLOF

is

OT

SES

ers were

opics were sensitive topics to clients that I saw, however, these topics

only member

e!

I am a third year occupational therapy student at The University of Tennessee Health Science Center in Memphis, TN.

re!

remain independent

I am currently a third year Master of Occupational Therapy student at The University of Tennessee Health Science Center.

Welcome

caregiver like me more

making the activities not therapeutic

also experienced how families can sometimes try to cross the boundary of the therapeutic relationship to where it becomes more personal and friendly than what is considered professional.

they

These are great qualities to have and things to do

Especially when they sit in during all the sessions and are very involved with their care

It is extremely important to be active in these organizations to support the initiatives and causes established, remaining informed with the profession, along with taking advantage of the resources associated with these organizations. 

Through this role, I was responsible for overseeing the day to day operations of the clinic along with working alongside the other officers and members to serve the local Memphis community through outreach events, marketing, and treating and observing on clinic day

I had the opportunity of holding

theirs for example

This way, the other treating therapists were able to feel much more confident going to treat them for the first time, and they were able to be efficient with their time.

them

here were multiple times that another therapist would see that I was seeing a client that was new to them

skills.

has

ills

of the standard paper

riting

The client and caregivers had experimented with several strategies related to handwriting because the client struggled with not getting distracted with all the lines on notebook paper.

I also had the privileged

the zip-line

to have

explaining safety.

We had a zip-line that starts on a stage and ends at a crash pit below the zip line

a difficult time in

we had

myself and my fieldwork educator

manner we were treating him with

breaking his precautions

myself

Had I not utilized humor, the client may have refused the shower session because he felt too uncomfortable and then I would not have obtained the vital ADL performance scores that were required to be documented weekly to track progress throughout stays in inpatient rehabilitation. 

along with other ADLs to his doctor and other interdisciplinary team members the next day

for me

we

us

with his shower.

I also grew in my confidence to teach clients how to use adaptive equipment including dressing sticks, sock aids, shoe horns, and reachers along with problem solving situations when clients demonstrated difficulty with using the adaptive equipment.

I felt much more confident during family training when I was responsible for  effectively educating caregivers on proper transfer techniques including applying a gait belt, setting up the environment and client for success and safety, using proper body mechanics and encouraging communication between the caregiver and client during the transfer.

hemi techniques

score above

patients

ur lives. 

is

connectio

I l

administered

administered

to apply their feedback

I felt at the start of the rotation that I was not confident administering and scoring various pediatric assessments, and felt that this was a weakness of mine

utilizing a firm voice and not being afraid to utilize that strategy

firm

ometimes the clients are not receiving ABA therapy, so you become the primary therapist having to address behaviors.

s-2 (PDMS-2)

tions

take over evaluations.

discuss what our plan would be for that session

share the sessions with him

with

After observing one session with him

ADD/ADHD and autism spectrum disorder characteristics.

les

NBCOT,

AOTA

In addition, I learned about the importance of location of a client's advanced care directive as it should be easily obtainable by a caregiver should the client be unable to obtain it themselves due to medical status or decreased cognition. 

in

research and share research

assessments we researched and found supportive evidence for

research

We then decided more individuals should know about our research, and the results we found, so we were accepted to present our research at the Tennessee Occupational Therapy Association conference to occupational therapy practitioners, students, and faculty members.

We were able to present our research at an inpatient rehabilitation facility along with presenting to our peers

research

research team

I would also implement IADL activities including medication management as clients often demonstrated poor insight into the impact of their stroke on the motor and cognitive skills required to  locate their medications from a bin, read the label, open the bottle, remember the correct dosage, open the medication organizer lids and sort the medications correctly based on their dosage. 

IADL

hemi techniques

I was able to assess meaningful occupations and then grade activities related to their meaningful occupations

In addition, I grew in my skills to use clinical judgment and reasoning when determining appropriate goals for the client following the evaluation. 

nts

vision testing results

saccades

ers.

therapeutic exercise to address psychosocial factors of recovery.

(GAS

regarding

g

W

ksThe articles included in the review are of moderate to high methodological quality