Archive for March, 2008

Getting my First Student

In a few weeks, I’ll be getting my first student, guiding her through her Level I fieldwork.  I like to help others (isn’t that why I became an OT?), and I think that assisting other students going through school is a great way of helping them.  I’m looking forward to the experience and was also looking for guidance.

If you have had students or you are a student yourself, what kind of things are you looking for in your Level I experience?  What worked for you and what didn’t work for you?  What kind of supervision did you enjoy?  Let me know!

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March 16, 2008 at 8:36 pm 7 comments

Spinal Precautions

I have previously blogged specifically about sternal and hip precautions but only briefly mentioned spinal precautions.  Every day, I get visitors to this blog looking for information regarding spinal precautions, so here they are:

  • No Bending
  • No Lifting
  • No Twisting

The precautions, also known as BLT’s (for Bending, Lifting, Twisting) are usually in effect from anywhere between two and three months.

The bending will depend on where in the spine the surgery took place.  If it was in the cervical spine, don’t bend your neck.  If it was in your back, don’t bend your back.

One should not lift anything more than 5-10 lbs. after a spinal surgery.  A gallon of milk is about 8 pounds (or 8.35 according to a patient of mine who was a firefighter), and is usually a good reference point as to the maximum you can lift.

Twisting is pretty straightforward.  Don’t twist your back (or neck).  The two areas people have trouble with this is when sitting down, one tends to twist and look to see where they are about to sit; and when wiping themselves after a bowel movement.  Be careful!

These precautions apply to most spinal procedures, whether it is just a spinal cord stimulator placement, a laminectomy, ACDF, ALIF, etc.

March 5, 2008 at 12:16 pm 14 comments

Ethical Dilemma with Treating Unethical Patients

I have been struggling with an ethical dilemma ever since my Level I fieldwork assignment, where I was doing my clinical at an outpatient facility within a hospital located near one of the local jails.

Since this hospital was affiliated with the city, we often got the prisoners that needed occupational therapy at this facility.  If a prisoner is scheduled to come in for an appointment, they are accompanied by two police officers and their hands and feet are both shackled.

As part of our assessments, we typically ask our patients what their own goals are for therapy.   Unfortunately, I had one patient (who had had an ulnar nerve and tendon injury from a knife fight) tell me that his goal for therapy was “to be able to close my hand into a fist so that I can fight again.”

When I hear something like that, I think to myself, “Why do I want to treat this person?  Why do I want to help this person meet his goals?”

This question bothered my enough that I knew right away that I would never want to work with forensic patients.  As an occupational therapist, I know that we have to work with patients to meet their goals and increase their occupational well-being.  But if that involves beating up other people and doing illegal things, how can I, in good faith, treat this type of patient?

March 3, 2008 at 11:51 pm 10 comments


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