This past week I was able to complete my level one fieldwork. I was placed in acute rehab in a step-down ICU working with adults who have experiences seizures, strokes, spinal cord injuries/surgeries, and traumatic brain injuries.
I went into my level two fieldwork meeting with my fieldwork coordinator talking about the various setting that I would want to work versus the settings that I definitely would not want to work. Acute care was one of the settings that I absolutely did not want to work. We laughed about how much I wasn’t looking forward to the adult acute care setting and said that it’s only one week to get through.
Fast forward a few weeks…
Because of HIPPA and all, I can’t get super specific. But I CAN say that I ended up absolutely loving it! Halfway through the week I ended up emailing my fieldwork coordinator saying that I wanted to switch one of my level two fieldwork sites to inpatient acute care.
I got to experience several really interesting things and I was able to do actual hands-on occupational therapy! Here’s a few stories…
For privacy reason, I am going to use the pronoun “he” for each of the stories. This does not mean that each patient was male.
Hallucinations. I got to see one patient who was having major hallucinations. This patient was laying in bed and asked why everyone else was laying on the ground because he thought that he was standing up. When the physical therapist went to sit the patient up, he thought that the physical therpist was pushing him over. When asked where he was, the patient said that even though everyone kept telling him he was in the hospital, he was actually in his living room. Later on when we needed to get some clean linens, the patient described where his linens were: “they’re past the second bedroom and in the closest across from the bathroom.” We were constantly having to remind him that he was in the hospital. Luckily, the patient was able to identify when he was having hallucinations. Another example of this was when we moved him over to the bedside commode and as he was sitting down he goes “wow, that’s one loud speaker!” We asked what he was hearing on the speaker and he said that they were voices, like a talk show. We would validate that what he was hearing was real to him and encouraged sharing what he was hearing and seeing so that it could be tracked medically. These are two examples of many that we encountered with him.
Seizures. One of the other things that I got to see was patients who have had/have seizures. A few of the patients I saw had portable EEGs attached to their heads and cameras set on them. People who have seizures are more likely to have strokes, which is usually what got them in the hospital in the first place. It was cool to see how to read an EEG!
Neglect. The most common diagnosis I saw was a stroke. Almost all of the stroke patients that I saw had some sort of neglect. This means that their brain isn’t picking up things on the right or the left of their visual field. For example, we had one patient try sorting out his medications to see if he would be able to go home and safely manage his own medications. He did Wednesday – Saturday, but completely neglected Sunday – Tuesday because he had left side neglect. In addition, he wouldn’t notice any people standing to his left unless given verbal cues to scan to his left.
Craniotomy. I also got to see a patient who had a craniotomy. He was the cutest little thing and I wasn’t even freaked out by the huge, bloddy scar and 20-some staples. Definitely an interesting experience.
My Favorite Memories. My favorite memories include the people that I got to work with throughout the week. Contrary to popular belief of acute care, I got to create a relationship with several of the patients and their family members over the few days that they were there. I got tearful several times, all of happiness. One time was because of the cutest old man who described how he’d be with his wife every second that she needs him. Another was because one of the patients was getting ready to leave and she cried as she explained how much we meant to her during her stay. She even asked us for our names to put on a survey – unfortunately we won’t be on there! Another one of my favorite memories was hearing someone talk for the first time in a month – even if it was just to say he pooped. Another was the first time a woman smiled in 3 weeks when she saw us walk in the room … and when I complimented her beautiful (and clean!) hair. In addition, I enjoyed peaking my head into patient rooms and saying hello to them and their family members that I had come to love. Lastly, I had the best CI I could’ve asked for 🙂
I definitely hope that I get to experience another rotation in inpatient acute care! Back to class now… but it was a good taste of the real world.