Post-Interview Reflection

 I thought my interview went very well. I was able to answer the questions I was asked without going too in-depth or dragging on. I also was able to think quickly and not pull/make-up things for the questions. To prepare for my interview, I went over the resources that were provided by Dr. Lancaster. The resources that really helped me in my preparation were "Best Answers to the 11 Most Difficult Interview Questions" and "How to Answer the 31 Most Common Interview Questions". I went through these interview questions and reflected on what I would say if I were asked each question. I made a reference document to aide me in this. Having the interview was challenging because you always have to consider technical difficulties. During my interview, I had to ask for a question to be repeated twice because of this. I was also expecting to be asked more questions than I was. In a real-life interview situation, I would come with questions prepared after I had done my research on the company and position that I was interviewing for. I would like to make it known to the employer that I put effort into the interview and also that I really wanted the position. Something that I learned throughout this process was to just be yourself. Never try to make up anything that is not true and always come prepared.

Locus of Control

I scored a 16 on the Locus of Control worksheet. Based on the scale below, this means that I fall closer to an external locus of control. This means that I believe that I have little influence over what happens to me. 

    As a future occupational therapist, it is important to understand the locus of control of my future clients. The understanding of each client's locus of control will help me plan my treatment sessions in a way that my client's will be able to take on. As a provider, we want the best for our clients. We want to encourage an internal locus of control in our clients. As I was reading the article, Are your patients out of control?, I noticed an aspect of occupational therapy. It stated that one of the ways to help influence an internal locus of control is to let the client know that they are the decision maker. As an occupational therapy student, we have learned that our treatments revolve around what the client would like to work on and the things they need to participate in meaningful occupations. 

    As an individual who falls on the external locus of control side of the continuum, I did not agree with some of the things that I read for myself. One of the things that I read was that people with external locus of control tend to be more of a "please fix me" kind of person. This may be true for the majority of people with an external locus of control but not for myself. Based off of my answers on the worksheet, most of the things that I agreed with summed up to the fact that as humans, there are some things out of my control. I am curious to see if I can tell the difference between my clients with an internal locus of control versus an external locus of control on my fieldwork this fall. I think it was neat to learn about locus of control and will try my best to apply it as a student clinician. 

References: 

Meira, E. (2016, June 22). Are your patients out of control? Retrieved August 02, 2020, from https://thesciencept.com/are-your-patients-out-of-control/

A Glyph on Leadership

Instructions:

My Drawing:

I loved getting the chance to do this assignment again and the opportunity to compare my drawing from last year to my drawing this year. I saw many similarities in my two drawings: face shape, eyes, eyebrows, nose, mouth, ears, hair, and accessories. I also saw some differences in my two drawings: eyelashes, skin, and the finishing touch. Throughout my time in OT school, I have learned a lot about leadership in a variety of settings (class, group work, etc.) and have even gotten the opportunity to hold some leadership positions. 

Peds SIM Encounter

             Walking into the simulation, I was super nervous and did not know what to expect. I had an agenda on my mind and was set to follow it to make sure that I covered all of the bases. In the moment, I did not think that my encounter was going great by any means. I felt somewhat defeated and shut down. When I watched my video, I realized that I was just too hard on myself after. I know these things take practice and experience, so it's okay not to do perfect the first time around and like my professors said it's good to learn in the SIM lab before we actually go out into the field. If I could do things differently, I would sit next to the patient and gaze the situation more. In some situations, such as when a parent is upset, it is appropriate to sit next to them and look along the same paper. I also have a hard time with fluctuating my tone because I am very monotone. It is sometimes hard for me to relate to others when they are upset, especially if its something that I have not experienced before. I think by practicing more, realistic scenarios of empathetic listening would help me with this as well. An attitude of caring that could be communicated by an occupational therapy student would be asking what the client thinks or asking open ended questions. It shows that you care about what they have to say and that you are not just trying to get in and out quickly. Another attitude of caring would be to be attentive (verbal and non-verbal). Nothing feels worse than when you feel like someone isn't paying attention to you when you are speaking and it puts off a vibe that you do not care. Being attentive means being in the moment with that person and really focusing on what they are saying and how it is affecting them. I would incorporate what I learned from this SIM lab into future encounters by having less of plan and letting the conversation flow as needed. I think when you have a plan and you are thinking of all the things you have to cover, it can often times prevent you from actively listening to that client and building a therapeutic relationship with them. In future encounters I would like to learn more about the client and discuss there concerns even more than I did in this simulation lab. In clinical scenarios, I think it will be easier for me to talk to the parents about concerns and their child, especially if I have seen the child multiple times and have more insight about what is going on. I have learned not to be so hard on myself and will try to reflect on what I did well instead of what I didn't do in future simulation labs. 

Neuro Note #4

       For this Neuro Note, I chose to watch a YouTube video called Andrew’s Story: Guillain-Barré Syndrome. Throughout the YouTube video, we see pictures and videos of Andrew’s journey with GBS, from the moment he started showing symptoms all the way to his recovery. The film starts off by saying that Andrew was feeling sick and developed a high fever, experienced severe weakness, and he had a rash occur. Andrew went to the doctor and they diagnosed him with strep. They prescribed him medication and his rash went away but not the weakness. A couple of days after, he had numbness in his feet. Andrew was very active, so he assumed that his muscles were fatigued and went to the chiropractor. Only two days after the numbness in his feet occurred, he could no longer walk due to severe weakness and tightness of his muscles. Once again, Andrew went to the doctor but this time they did a spinal tap. The spinal tap revealed that Andrew had GBS. They immediately started IVIG and plasmapheresis. They also ran a central line to his heart and placed him into the ICU. He started experiencing even more symptoms, such as facial paralysis and blurred vision. They sent him home only 2 weeks of being in the hospital. Andrew was paralyzed from the waist down and only had shown signs of slight improvement. He was terrified, exhausted, and unable to sleep. When they knew that his condition was no longer improving, they checked him back into the hospital. He received a femoral catheter and plasmapheresis. Around this time, Andrew also started Physical Therapy. More symptoms developed, such as an inability to swallow. He received a NG tube and started a liquid only diet. Doctors were afraid that Andrew’s digestive system had shut down, so they gave him another medication that caused severe abdominal pain and burning. Andrew had accepted and agreed to be intubated and placed on life support. During the intubation, he went through cardiac arrest for a total of 7 minutes. It took three shocks to regain his normal heart rhythm. Andrew was paralyzed for three weeks from the neck down, he was getting frustrated. He was fully aware of everything but felt that he was trapped in his own body since he could not speak or move. He received a trach, peg tube, and was placed on a ventilator. Soon later, he was transferred to Atlanta to the Shepherd Center. Here he went through more therapy, which included yoga, horseback riding, and outdoor therapy. Andrew was determined to recover, and he did!

             I chose this video because I had never seen a case of GBS before and really had not even heard of it up until I started my neuro courses. GBS needs more awareness. I gathered this resource from the list of references. I wanted to see Andrew’s journey, specifically because he was very active, and it must have been very challenging for him to go through his body attacking itself. 

           To further my learning, I watched for symptoms that I took notes on in class and found in my diagnostic snapshot. I noticed right away that the numbness in his feet could possibly be an indicator of GBS, since it starts in the LE. Andrew’s GBS also followed some sort of illness, which was his high fever (that they thought was strep). His symptoms continuously worsened, and I would not say he was in the plateau phase until he transferred hospitals the first time. He did experience trouble with respiration, talking, and swallowing due to his paralysis. However, I thought it was neat that his family was still exploring options to communicate with him (dry erase board). Andrew received a spinal tap for them to get the diagnosis of GBS. He immediately started plasmapheresis, which we learned about in class. Throughout the film, I loved that we got to see Andrew go through all the phases: Acute, Plateau, and Recovery. At one point, we almost lost Andrew but we saw him push through. As we know, Andrew made nearly a full recovery. He is now able to do the things he loves with his family. I saw how important family was throughout his journey and he always had someone to watch him. I enhanced my learning by also thinking about what activities and things I would do with Andrew as his therapist. For example, Andrew was very exhausted due to the rebuilding of his muscles. I immediately thought of the 4 P’s for energy conservation and how perfect it would be to teach Andrew about them. I enjoyed watching this video and applying my knowledge to Andrew’s journey.  

The video can be found at https://www.youtube.com/watch?v=VWvrHhs2jps

Media Project

When I was assigned an egg carton, I thought to myself, “There is no way I can create something out of that”. This project encouraged me to think outside of the box in order to create something that would be useful to my client as an intervention. The most useful things I learned from this assignment were to be creative, have an open mindset, give myself time to think and not be afraid to get crafty. For my project, I had to break out my craft box and use paint and my hot glue gun. I needed an open mindset to be able to think of something unique. I needed to give myself time to think, great ideas are not rushed! My idea took me about a week to come up with. This project really changed my mindset and my way of thinking about normal household items. I have learned so much that I did not know before. By doing this project, I was able to look at a patient’s diagnosis and their profile and design an intervention that was individualized to them. I learned just how important it is to come up with new and exciting interventions, instead of just the same things all the time. As a result of this project, I will be able to pinpoint certain aspects of a client’s profile and use it in unique ways to form a just right challenge. As a future OT, I will need to be able to modify other interventions to use on various clients. I will also need to be able to use what is available for me! I can reuse items and make them into something new, fun, and affordable. This project prepared me in so many ways and I am very thankful for the opportunity. 

Neuro Note #3

   For this Neuro Note, I chose to watch the documentary Gleason. This documentary followed a retired NFL player, Steve Gleason, throughout his journey with ALS. In this documentary, we see everything from the diagnosis to where he is currently. The film starts off with an introduction to who Steve is, including many football clips. We are introduced to Steve’s wife, Michel, very early on. We learn more about them and what Steve’s interests are. Michel and Steve love to travel and are all about adventure. When first seeing Steve, the doctors suggest that it could be a variety of different things: molecular problems, mechanical problems, a ruptured/bulging disc (typical for a football player) or calcification in the vertebrae. However, they soon find out that is it ALS, a neurological disease. Steve quickly begins showing more and more symptoms, including an awkward gait. Steve and Michel soon learn that Michel is pregnant only 6 weeks after Steve’s diagnosis. Steve wants to make sure he is still the best father he can be and begins journals for his future baby. Four months after the diagnosis, we can start to see Steve have more symptoms. He can still run and swim but not as well as he used to, and he also needs to be lifted out of the water because he does not have as much strength as he used to. Even though the onset of symptoms is coming on quickly, Steve and Michel still make sure that Steve’s quality of life is maintained, they decide to go on a 2-month (15,000 mile) road trip to Alaska. Steve gets to do a lot on the trip like fishing and aircraft rides. However, we can see that Steve’s speech is not as clear as it used to be. We see more and more struggles as Steve’s ALS progresses, such as not being able to run. Throughout Steve’s journey, he has done his best to stay positive. In fact, Steve Gleason has started a foundation called “Team Gleason”. Through “Team Gleason”, Steve wants to help provide advanced technology, advanced equipment, and also provide people with a purpose. 

   I chose to watch Gleason after one of my classmate’s presented her case study to us. I learned that others in the class had also watched it and strongly recommended it. I remember doing the ALS ice bucket challenge in high school but did not really know anything about ALS. Since ALS is a progressive disease, I wanted to see it through another person’s experience and perspective. I believe that watching this documentary provided me with more knowledge and ideas about ALS and therapeutic interventions. 

    To further my learning, I took notes on various things that I saw while watching the documentary and compared it to my note-taking guide for ALS. ALS can cause atrophy, which is wasting away of the muscles. With Steve, I could see atrophy in both his UE and LE. Steve’s UE atrophy was easier to see physically because you could see his shoulders and arms get considerably small. In his LE, I could tell he experienced atrophy because he eventually had to use a powered wheelchair because his muscles could no longer support him. I also saw a lot of things associated with his upper motor neurons. Steve had trouble speaking, eating, and swallowing. Over time, he also had to use a ventilator while he was sleeping. The average life expectancy for ALS is 2-5 years but Steve is still living today, a total of 8 years later. He was diagnosed with ALS at 34 years old, so he is a bit under the average age of diagnosis (40 to 70). Steve has also had both surgical interventions to help with his ALS: the gastrostomy tube and the tracheotomy. Steve received his tracheotomy after having a hard time clearing mucus from his lungs. Without the tracheotomy, Steve only had a couple of weeks to live. Seeing this documentary also allowed me to see how important caregiver education is. Until they hired help, Michel cared for Steve and it was really hard on her, physically and mentally. It also made me realize in a more general scheme how important it is to maintain quality of life! Throughout the documentary, I saw Steve get agitated and depressed. His body does not allow him to do the things he wants but it does not mean that he should never get to do them. Steve’s family has made sure to try to enhance his quality of life in as many ways as possible, including making sure he still got to go to the lake, enjoy spending time with friends and family, and also still be able to work with his foundation! I really enjoyed this documentary and all the insight it gave about ALS. I have learned things that will help me with future patients who may have ALS. 

Tweel, C. (Director). (2016). Gleason [Video file]. USA: Amazon Studios. Retrieved from https://www.amazon.com/Gleason-Steve/dp/B01I2BH290