Daniela Pineda

3/20/19

PTA 262 Spring 2019 - Internship II Reflection Paper

Throughout my time at Bridgeport hospital I have learned many new and exciting things.Those 7 weeks have further proved to me how much compassion I have for the geriatric population. At first I was apprehensive and nervous about working in acute care, however as I kept working with my CI and practicing I realized that I could definitely see myself there after I graduate. It was great to see everything come full circle in acute care. From things that I learned in PTA 125 the first year, to it now being done with actual patients. Everything made sense and I am glad that I was well prepared to assist the patients. One of the great things that I learned was how well the communication is within the staff. Before entering a patient’s room, I would speak with the RN to make sure that the patient was okay to see. The staff is very helpful and would even give more information that was not on the chart to help guide me. Also co-treating with an OT was also a new learning experience for me, I was able to see how to work as a team member to help the patient.

One of the patients that I was working with is a paraplegic and every day I would work with him and every day he would make progress. From being able to sit unsupported edge of bed, to being able to get in and out of bed without assistance. It made me excited because I wanted to keep challenging him and help him to improve. There were days that I would consult my CI and an OT on ways to help him progress. Those are the moments that I really appreciated because it helped me to think outside the box. The last day I was able to teach him how to use a transfer board and it took me back to the first year when we learned about that. I was very grateful that I practiced that in class so that I could be able to utilize it with a patient.

Another learning experience was a patient who had a TIB and exhibited a lot of retropulsion when standing up. I learned to think outside the box to help with the retropulsion by putting a standing table in front of her and have her reach the other side. It would help her to lean forward and combat the retropulsion. Those are the things that made me excited because we were trying different things aside from just getting them out of bed and ambulating patients.

Bridgeport hospital also offers a lot of learning opportunities that I am very grateful for. One of them was being able to observe surgeries. I was able to observe 3 TKA and 1 THA. It was even more exciting afterwards when the patients were awake and I was able to ambulate with them. There was a patient who had a double TKA and I taught her how to negotiate stairs with crutches. It was a new learning experience because I know that in class I always practiced with a patient having one bad LE, however this patient had two TKA. So I was very thankful for my CI that he was able to teach me first and then I was then able to teach the patient.

I really appreciate how the 1st day my CI asked me what kind of learner I am. I am very visual and a hands on learner. I like to see it and then do it automatically. This conversation helped out a lot because I then was able to pick things up very fast by observing and then doing. The more I practiced with the patients the more confident I got. Through this learning I know that in my next clinical I can be able to speak to my CI and communicate what type of learner I am.

I also liked that Bridgeport hospital offered classes for students one Friday out of the month. I was able to attend two classes. One of the classes was on how to help patients with Parkinson disease get out of bed. It was really interesting, and I really liked how the OT spoke on how we should target the deficits that are affecting the patient and not just simply get everyone out of bed the same. Not every patient is the same, so they should not get the same treatments. The second class that I was able to attend was on patients that had a CVA. The OT taught us many ways and equipment to use to assist with the weak upper and lower extremity of the body. Those are the classes that I looked forward to because the OT taught us to not ignore the important qualities of the patient.

Another learning experience was that once a month the students would gather with the supervisor and they would teach us many different topics of the facility. The first class was on how to interview better. That one was extremely helpful because he taught us what to expect when applying for the job and what they are looking for. I made sure to pay attention to key information for my future interview. The second class was on financial healthcare in the hospital. It was also about insurance and although it is a very tough and dry topic, it was still great to be there to learn more about how the hospital functions.

It was definitely a blessing to be out in the field and to treat high to low level patients. I really feel that working there for those 7 weeks pushed me to want to do acute care when I get my license. As an entry level PTA, there is so much to learn in acute care, and there is also room to continue to take educational courses. I am excited to see how different outpatient will be like. It will be a different environment and a diverse population. Maybe I will change my mind about where I want to work next. However, for now, I really enjoyed my time in acute care. It will be a great stepping stone for my future.

PTA 250 Reflection

My first clinical experience was at an SNF facility in Stratford. The intervention that I did the most was gait training. Many of the patient's have comorbodities and since it is an elderly population, the biggest thing is to get them to walk. The first thing is getting the patient to push off from the chair, because most of them want to push off from the walker. Once they are up, I had to educate the patient in making sure that they are inside the walker, because most of them would also push the walker too far ahead. I spoke to them about the gait cycle and the proper way to ambulate. I would also take a gait speed on them, which I first learned in the facility but then was also introduced in PTA 250. I thought it was fantastic that the facility uses a gait speed to indicate how the patient is doing, and if they are able to be discharged. The information that I learned in PTA 125 about proper gait, proper posture and AD measurements for the patient, were implemented in my clinical. Especially the most important safety measure, which is to lock the wheelchair. It is interesting to actually do an intervention like gait on a patient who may have spasticity, or COPD, TKA, osteoarthritis, or other comorbidities that does not allow them to ambulate properly, versus practicing gait training with our peers who are healthy. There is a lot more education, and contact guarding, and hands on that I really enjoyed working on with my patients. I believe I have been blessed with this program because of the teachers and the way the program is organized is amazing. I feel very prepared for the spring semester to be in my full time clinical. I am very grateful for all that this program has done to prepare me. There were many days were I wanted to give up, and life also brought on many unforeseen emergencies. These 2 years were one of the toughest years of my life. There were many nights where I felt like I was not enough or not prepared, since I had no previous experience in physical therapy and all my peers did. Then I would speak to them and I was not alone, they were also in the same boat as me. Sometimes there were days where I felt overwhelmed and things kept crashing down. However, I knew that what was meant for me will not pass me, that I was meant to help people. I now truly believe that I can do anything that I put my mind to, even when things do not seem to be going my way, I kept fighting. Now I am grateful for the opportunity, and I look forward to contributing back to the world through all the education that I learned from the PTA program at NCC.

The one thing that surprised me about preparing this presentation versus last semester was the information that I took for granted. The materials that I did not utilize last year that were at my disposal. What I mean specifically, is the evidence based practice modules. Those modules really helped me on how to appraise an article. What to look for in internal validity, reliability, how credible the report was. It becomes easier to pick out the important information of each article and how credible it is compared to others. I felt more comfortable in how delivered my speech this semester because I liked my topic. Last year, I felt fairly weak on the topic I chose and the information that I had to go off. This year the topic I chose was personal, so I really wanted to learn what interventions are being done to help ease low back pain. The difficult part was finding the articles. There were not a lot of articles on low back pain and some articles had results that still needed to be finished. Overall, I felt confident because I also had a sample from Dr.Bresnick that helped me to map out my presentation. To be more organized in my delivery, to make it make sense for the audience. Although my grade was not as great as last year, I still feel much better in how I delivered the speech this year. Grammar is not my best strengths, so one of the things I would have done to improve, was to ask someone to check my grammar. A weakness that I also had was that I should of compared interventions for all three presentations. I figured because in the sample it only chose the best one to pick out to use in a PT setting then I assumed I had to pick the one I would use. I should have asked more questions about that or spoke to my peers. Last year I was also very unprepared to know what exactly I was looking for in the research articles. There was a rubric to follow and questions to answer but I know that I spent a lot of time looking at statistics and trying to figure out those numbers. It took too much of my time, and I kept getting frustrated. This year I was more focused on the making sure I was using my time productively and taking out the information that was essential. Another mistake I made was when Dr.Bresnick had the extra help during spring break. I did not have my presentation finished therefore the questions that were crucial were not asked. The questions she did answer for me were really helpful, but it was not until I started to continue to finish my project that I realized I had more questions. Questions that could have got me more points. I feel comfortable speaking in front of people, I believe that is one of my biggest strengths. Everyone is in the same boat therefore I do not feel intimidated. I will feel more nervous when I have to do an in-service during my internships. However, I know that all of these mistakes that have cost me points towards my grade, are going to pay off in the future. I believe that when I am out in my internships and delivering a presentation, they will be very pleased with my work. I take criticism with open arms, because at the end of the day it only inspires me to be better.

This picture is me at the CT Physical Therapy Association conference September 29. It was my frist time attending a conference especially with classmates that I met a month ago. I have to say it was one of the funnest experiences thus far. The atmosphere was great, and there was a lot of information about new innovative ways to help push the physical therapy profession towards change for the better. My favorite part was the presentation about pelvic floor. Although it is not something us student PTA's will learn in this program, the presenter has such enthusiaum and passion about it that I was really intriguied by what she was saying. I really enjoyed how enthusiastic she was about it, and she made it very easy to learn. Another exciting part about the conference was watching the videos on THR. It was amazing seeing the body open and getting to see all the muscles, and bones. That was really exciting for me. I will have to say that one of the downfalls of the conference was how little it was geared towards PTAs. Most of the conversations were about PTs and better methods for them. I wish there was more time dedicated to the PTAs and what we can expect or how we can better our methods for better patient care. Overall, it was a fantastic experience and I have learned so much from it. I also learned many things about what companies are looking for from a person that they hire. I am very thankful for the experience.