Week 1- Information Overload

Well, I’ve successfully completed my first week at my internship and, guess what…. I’M STILL ALIVE! I made it and no one got seriously injured in the process!

I began the week on orange team which made for an interesting week because I had this week to get to know my orange patients before moving on to green team next week. Orange team was exciting and was PACKED with great experiences. To give you a quick run down: I participated in core team conferences, went on a home evaluation, evaluated a new patient, got to lead some aquatic therapy in the therapy pool and even learned what a rapid response was.

Now to expand on these:
Core team meets twice each week in the morning. The case manager, physician, head nurse and rehab team huddle together for 15 minutes in the morning to give a brief overview of each patient on the caseload and voice any concerns that may have come up to ensure that each member of the patient’s care team is on the same page. I thought this was so cool because if everyone is on the same page, it cuts out confusion and mistakes.
The home evaluation and my aquatic therapy experience were with the same patient; a wonderful woman in her 40’s that suffered a subarachnoid hemorrhage (brain bleed) spontaneously. She loved to swim and be active prior to her accident so aquatic therapy was a great way to get her motivated and enjoy therapy. My CI, Amber, suggested I bring a suit and then told me that I should try to prepare a few exercises that might help this patient. So, I went home and started researching and thinking of exercises that I could do based on the deficits present in the patient. She has poor balance and coordination and leans to her left all the time- she kind of neglects the left side of her body actually… knows it’s there and can see it and all that but kind of forgets about it (common in certain types of stroke). So, I came up with some strengthening and coordination exercises to perform in the pool and they were a hit. My patient loved them!
The day before that we set aside a couple hours to go visit this patient’s home to make sure that the set up was going to benefit her when she returned home. Our main goals at this facility are to make our patients as independent and safe as possible before returning home or discharging to another setting such as an assisted living facility or a skilled nursing facility. Her husband was quite nervous about having her home without the 24 hour support so a lot of the home evaluation was to put his mind at ease as well. We followed our patient and her husband to her house and spent some time getting around from room to room and going through a daily routine to ensure she was going to be safe to get into and out of the bathroom and shower and up and down the stairs. This also helps us to make recommendations on what level of assistance is appropriate for our patients. For example, although our patient can go up and down the stairs, it is not safe for her to do so on her own. We were able to show her husband the safest way to guard her going up and down the stairs and brainstormed ideas to remind her that it’s not safe for her to be trying the stairs on her own yet. At the end of the session I think he husband felt more at ease about bringing his wife home and maybe even a little excited too!

I was able to perform part of an evaluation on my own during the first week too which is huge. My last internship it took me three weeks before I was attempting to evaluate a patient. The patient that I was lucky enough to evaluate was a woman that slipped and fell outside and broke her ankle in three places. To make the evaluation even more interesting, she had suffered a traumatic brain injury (TBI) in the past making communication with her slightly more difficult. She required much more time than usual to both comprehend and answer questions. At one point she told me she used to be a gymnast training for the olympics- now this may be true, but I tend to think it was something her brain made up for her. It was a tricky evaluation for sure but I think it was a good one to start with. We’ll see how the next couple go that I get to do.

And finally, the rapid response: this is something that is called when there is an emergency somewhere within the facility. This happened during the aquatic therapy session I was in. Someone in the gym had begun having a seizure so they called a rapid response overhead. The doctors and all other personnel that are equipped to handle these situations come running and take care of the patient. It turns out that the patient was not actually having an actual seizure… more of a pseudo-seizure instead. We believe that this has become more of a behavioral thing for this patient as she has had multiple episodes of these “seizures” but the way her body acts/responds during these episodes is not consistent with a seizure. And guess what…. this is a green team patient. Guess what team I’m switching to next week….. GREEN!

If my first week has been this entertaining and exciting, I cant wait to see what the next handful of weeks have in store for me!

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