Reflection: Weeks 5, 6, & 7

It's crazy how much you can learn and adapt in a few weeks. Like in anything. A new semester. A new job. New roommate.. (ok it depends on the roommate).  BUT, for this internship, it's been a whirlwind in some ways and very routine day in and day out.. all at the same time. Current thoughts on it all:

• Documentation is an art. And also, don't over think it. In some ways, you're just writing what happened. But it's not a novel, and it takes some thought to put into words what skills the child worked on and what was important. Also anything important the caregiver said and any bruises/scratches on caregiver or child and where they were said to come from - just so it's all in the record.. Things we often write:

• tolerated tummy time (better than last week, or while reaching for toys, or lifting head up taller, or while pushing up with arms)
• played in sidelying, on tummy, and on back
• worked on using both hands
• practiced reaching overhead, and to the left and right during X activity
• was able to sit or maintain hands and knees with support
• needed verbal and physical prompts to do X
• imitated words (list the words they said)
• participated in active stretching (of left or right side) through reaching overhead and across his/her body
• was shy/ talkative/ playful/ fussy/ just woke up from nap, etc
• still showing a preference for (left/right) hand/foot/side; continue doing X
• mom reports... x, y, z happened or is coming up this week..

• I'm no longer exhausted at the start or end of a workday. Yay for adjusting!

• We play with children and follow their lead of what interests them, in order to work on our goals. Not all things a child is interested in doing is considered play. Sometimes they are "stuck." So I'm learning to stay flexible and decipher when to follow their lead and when to intervene, take something away, or push for a child to complete an activity. Lining toys up in a row is not play. Eating your hands past a certain age instead of exploring your surroundings is not play. You need those hands to push up and get moving. Selecting only toys with strings so you can play with the string is not play. It's getting stuck on strings. And yet for some kids, lining a few things up, playing with strings sometimes, and eating your hands sometimes would all be completely fine. 

• Creating your schedule is an art! Some families are picky. I mean I get it, they have things to do but sometimes the conversation goes something like: Suzie wakes up at this time, takes an hour to eat, then is sleepy again, then it's time to pick up the older one, then we do errands, then she takes another nap until dinner..." So... can we see your kid? Other families are super flexible and want you to come as often as possible. Some kids are at daycare all day long, so you can see them whenever. You also have to keep locations in mind. We see kids in various towns who live 35+ mins from each other. You have to keep a certain productivity rate up (billable hours in a week/ hours worked). Travel time, weekly team meetings, phone calls with parents or doctors, time in the office doing paperwork, reviewing charts, researching a new kiddo's diagnosis - not billable. Also kids are coming and going, so having things make sense geographically often doesn't line up with the random opening you may now have due to a kid leaving your caseload. The times you have 2 or 3 appointments near each other are golden! Ahhh... 

• I'd like to give a round of applause to my bladder. It's a champ! We go half a day without peeing, which I never could have done before, and no Depends or accidents yet! ;)

• Remembering pet names gets you HUGE buy-in with the parents. Like they trust you more because you respect their animal enough to remember it's name. Mind you I don't remember some of the parent names but... you just refer to them as "mom" or "dad" the whole visit anyways so it's ok, right?

• I really love this. It's so rewarding to be a small part of these families' lives during this time in their life. The kids won't remember me but I'll remember them. They're impacting my life. One child started crawling last week! They've been working on that goal for a while. Someone is making more eye contact! Others are speaking more, or finally gaining weight and will be coming off their NG-tube soon, or are sleeping better or having less tantrums. All rewarding! Some parents are taking big steps as well. Some therapy teams are becoming more unified in how to approach certain family situations. It's all very neat, ever changing, and ever staying the same. It's cool to go home each day feeling great about it.