Caton Manor Week 2

As promised here is last week's stories :-) I started the week with two more evals and quickly realizing that my CI is not very time efficient. She is a very nice lady and gets excited about simply things which I will further explain; but, every day I stayed late from 30 minutes to 1.5 hours overtime. The reason for the extra time in clinic was simply because my CI has regular meetings during which I cannot treat any patients since the other PT has her own full caseload. So, I sit twiddling my thumbs waiting for my CI to come back, just sitting with my patients in the rehab gym explaining to those who would understand why we are not doing anything. The nice part is that I get to observe how the other therapists operate which has helped guide me with managing my patient caseload which I was quickly bumped up to 6-7 patients whom I regularly treat mostly on my own with my CI within earshot.
One thing that I learned this week is that I am going to be doing an in-service for which I am to provide food on either sarcoidosis or normal pressure hydrocephaly (NPH)...any thoughts? Apparently, there has been an increase in the patient population with both of these diagnoses. Also, I have been put in-charge of July's Theme Day which is supposed to be my CI but as the other therapists put it..."she takes the best route to do the least amount of work". Just to clarify, I do like her, she is very supportive which I appreciate for my first internship...however, I am nervous because she doesn't truly challenge me and she is disorganized. We will see what happens. Anyways, I am noticed that they like to celebrate/have special days for a lot of things at Caton Manor. So, a theme day is a day once a month in rehab where one of the therapists decorates and has special activities for treatments. For instance, on Wednesday, it was Luau Day where everyone had flower necklaces, some grass skirts, there was a beach ball for passing activities like hot-potato group activity, a magnetic fishing game for standing balance and coordination, a giant blow-up starfish ring toss (which I still use for one of my patients), stick-the-hand on the palm tree and arts & craft fish decorating. There was also popcorn, sugar free candy and italian ice for prizes for the patients participating. It was fun! So, for July...I'm thinking "Summer Drive-In" theme. When I suggested that, my CI got sooooo excited and went on and on talking about Bengie's Drive-In in Baltimore for about 20 minutes during our staff meeting, haha. And then, Friday was Fun Day which is when the staff of the facility have a cook-out and bring their children to hang out with the patients.
Now for my caseload...I have some fun patients:
(1) 99 y.o. female s/p R subdural hematoma, chronic on acute, who I eval'd during the first week. She is still cute when she giggles to herself. She is an intense pusher...its impressive...but her upright sitting tolerance has finally improved, she gets drowsy easily and has difficulty with coordination. L side more affected.
(2) 93 y.o. female with lung mass (now believed to have progress to cancerous since she has been sick everyday since and d/c to the hospital), O2 via NC, hx of breast CA, edema in B hands & LEs
(3) 59 y.o. female s/p L TKA secondary to OA, gout, obese, lives alone, insurance does not want to pay for SNF, severe generalized arthritis casuing spasms in B forearms/hands
(4) 56 y.o. male with neurosarcoidosis with paraplegia, s/p UTI, difficulty speaking, UE & chest tremors, anal fistula, lymphedema, multiple sacral & B LE wounds, thin skin secondary to steroid tx
(5) 72 y.o. female s/p multi-infarct CVA to parietal lobe/basal ganglia/insular region, chuckles to herself all the time saying "I'm just laughing at me", poor coordination, safety concern...all around my favorite patient right now :-) I'll talk more about her later
(6) 39 y.o. female s/p ARDS, severe jaundice, asthma, Hep C, alcoholic hepatitis, long hx of alcohol abuse, bipolar disorder, her eyes are as golden as her dyed hair
(7) 60 y.o. male s/p 45 min. seizure on the street, had been reported missing for 3 days, bipolar disorder, schizophrenia, difficulty with balance and gait pattern including trunk sway and Trendelenberg like whoa...haha
All of them are very interesting and I enjoy working with them! As you can see, most of the patients at this facility have intense histories. My CI asked me to come in for the 5 AM wound rounds on Wednesday but I asked if I could come in during week 3 so that I could arrange with a certain someone if I could stay with them the night before :-) I'll let you know how that went.