Left Arm Touch My Chin

This week I got to shadow an OT do a session on a patient who suffered from a right hemiplegia stroke several months ago. I noticed as I was observing how much patience it takes for the therapist during the session. I caught myself moving my body in the direction the patient needed to move in because the process was so slow and tedious. I realize you really have to keep a professional persona during everything because at times I'm sure it can feel like you're (the therapist) are not being heard when you tell the patient to do something and they don't do it right away.

 

Due to the fact that I was shadowing rather than actually doing the therapy session. I did not get to demonstrate any professional or clinical skills. One thing that I did do was try to ask questions and get clarification when the time was appropriate to make sure I was on track with the lingo of the session. I did observe the OT and another student who was shadowing try to scoot the patient back into her wheelchair. They were trying to grab underneath her legs and pick her up and scoot her back which was unsuccessful. The whole time I was thinking about how we do our transfers and how we learned how to scoot someone back in the chair. I asked if they have ever tried it the way we learned it and it seemed like she was unaware of what I was referring to, but they then approached her from the front and that worked. I am still curious if our method would have been successful or not or if the patient was too unstable to even try. There were a lot of things that the therapist did that I really liked; she had the patient say out loud what she wanted her to do to help reinforce movement from her arm that was spastic. For example, the patient had to touch her chin so the patient would say "left arm touch my chin."

One thing I need to work on is apply what I see to what I need to document in a SOAP note. I'm still having trouble processing the important parts of the information. I really tried during the session to keep a mental note about what I would record for my SOAP note by remembering that she did 2/5 trials of ROM flexion and extension. I'm not sure if I'm thinking accurately when it comes to trying to documenting what I see. I did learn that a lot of the things the OT observed I observed as well so I feel like I am doing better at analyzing therapy sessions like an OT.

My favorite part of the day was seeing the OT use different tactics to facilitate and decrease spasticity. She did a contract and relax method, each time she did that the patient was able to move her arm a little more in extension. Also having the patient use commands to move her arm was cool to learn too and seemed to work well.