Fall down seven times, Get up eight.

I have always struggled with midterms, as I take more time to adapt to a new year’s requirements than other students do. I also feel as though strikes really affected my preparation for my demo treatment session. I was originally going to do my demo on my Case study client, however strikes cancelled our prac day and my client was discharged the following day. Hence, I had to change my demo and prepare one for my tetraplegic client. 

This client had poor UL JROM as a result of very weak MS. I therefore found it very challenging to perform a successful ADL. I would have preferred to use ‘activity as a means’ for the client, but Demo’s are meant to incorporate a functional ADL task and I therefore had to do feeding with the client, with the use of a suspension sling. 

I needed to perform the activity with a ‘where is my client at’ mindset as the client had an extremely weak right UL which was in a splint. He also had limited active Left elbow extension and passive wrist flexion JROM as a result of extreme muscle stiffness of the left UL. I therefore positioned the bowl on the client’s right side, as this was a technique I knew my client could cope with and I could physically assist appropriately with, considering his client factors. I also did not want him to be so challenged that he spills the yoghurt a lot and does not enjoy the activity, as a result. My aim was not to encourage feeding, but rather improve left active elbow flexion. I therefore shouldn’t have positioned the bowl on the right side but rather in his midline, as this would have required greater elbow flexion, despite the increased difficulty he and I may have faced. I would have then achieved my aim more effectively. I also learnt that an aim to improve active JROM should incorporate a Muscle strengthening activity as a warm up, including resistance of that muscle and possibly including weighted cuffs in the activity.

In terms of my midterm presentation I discovered the need to research my diagnoses in depth and incorporate these facts into the presentation. This allows for an informative, more objective approach, rather than an uncertain opinionated view on the client. I also discovered the need to  allow time to practise the speech for a more fluent, less shaky delivery.

These are aspects I will work on before performing my next presentation:

·         Reading from a word document and not the slides. 

·         My posture whilst presenting must be upright and confident. I should therefore not be fidgeting whilst presenting, as this distracted my listeners.

·         Practising my speech and timing it so that I am not so nervous with regards to this and the pitch of my voice will not change so drastically.

This week Monday I performed a bed mobility and dynamic sitting balance treatment sessions with my two clients. My client performed well in the bed mobility, coping with grasping the new technique for rolling and getting into short sitting. My dynamic sitting balance activity with my second client needed to be adapted to incorporate a greater trunk rotation and I therefore positioned the puzzle pictures behind the client on her affected side. My weaknesses during this session were my height of the table, which did not allow for effective bilateral hand functioning. I also need to ensure my tone does not change despite a low cognitive level with this patient. 

After a great break down from the head of OT, regarding midterms feedback and finally making a start to NDT practical lectures I am feeling more confident for my next few weeks.

Today was a productive day in terms of my development and progression as a therapist. I taught my patient how to use her strong foot to propel herself in her wheelchair and she even managed to turn independently into her ward. I then performed multiple NDT techniques as a warm up and proceeded to use the Bobath bed mobility technique to get into short sitting and perform UL dressing. We laughed and connected well throughout the session. My therapeutic relationship with the client definitely improved through today’s session. She spoke of her stressors including her poor speech (which is a result of anomic aphasia) and laughed loudly at silly errors she made e.g. gathering the sleeve and then trying to place it on her head and not her arm.

I became quite emotional after receiving my midterms results today. Failing can be stressful considering the hours of effort I put in and being overwhelmed about how to improve.

As blogger Beth Werrell says, “Let’s face it. Criticism can be hard to take. Depending on context, our critic’s delivery, or the mood of the moment, even well-intentioned criticism can make us feel embarrassed, devalued, or just plain angry. Yet criticism is an unavoidable fact of life. Learning from criticism is an essential life skill”. 

These are the strategies I am going to use with regards to receiving criticism:

·       Pause and reflect on what is being said. It is very important to understand the criticism in  order to improve.

·       Accept the points and ask questions on how these attributes can be developed.

·       Formulate an action plan for the changes to be made.

My action plan includes: Research, Being more organised and planning effectively, practising my assessment techniques, treatment sessions and presentation skills and organising a buddy in order to improve my skills for our Client Presentation and Case study.

 

1. Werrell, B. (2017). How students can accept criticism and Grow From Feedback. https://blog.connectionsacademy.com/how-students-can-accept-criticism-and-grow-from-feedback/