Kaiser Permanente -Vacaville, CA

LEVEL 1 FIELDWORK: Acute Care Setting

Adults & Seniors

Biomechanical Frame of Reference

During my fieldwork placement, I observe a biomechanical frame of reference(FOR) being utilized in this setting. Biomechanical FOR is focusing on using remedial strategies for a disability or disorders which affect their occupational performance in their daily occupations (McMillan, 2011). For example, the Occupational therapist performed passive range of motion exercises, utilize a pain scale, and focus on developing interventions to increase independence in ADLs which are associated with FOR (McMillan, 2011).

3 ah-ha moments in Fieldwork:

During a session with a young-aged adult who suffered a TBI in rancho level 4 confused and agitated. The therapist did an excellent job of keeping the patient comfortable and using a calm voice to not agitate the patient. I observed that when a patient is in this state you have to be cautionuswith your tone and not ask too many questions. Additionally, talking with the family, friends, or caregivers when present in the room and understanding they are a part of the recovery process as well.
Second, “ah-ha” moment was definitely observing a patient with R CVA with LUE weakness. The therapist assesses ROM and sensation in UE. Also, observing the therapist quickly assess MMT for wrist, shoulder, elbow, and grip. I enjoyed learning rehabilitation techniques of bilateral UE instead of compensatory strategies. I related it back to CVA lectures I have learned in class and its important to prevent shoulder subluxation and observing the OT place pillows under the L arm was nice to see.
Third, “ah-ha” moment was learning about a patient who had a diffuse axonal injury and who got into a car accident. The patient's primary was not English and had to have a translater nearby. I really enjoyed seeing the OT building rapport with the patient by asking the patient what they like to do or favorite hobbies the patient engages in prior to the accident. Lastly, as a student seeing the OT comforted the patient and communicating it's going to take time to recover, but they will get better.

Reflection:

Overall, this fieldwork experience has taught me so much in a short amount of time. I have noticed my clinical reasoning skills are getting better. This taught me to follow necessary precautions, communicate well with co-workers, do thorough chart reviews before seeing the patient, and being clear and concise in evaluations. I hope to take what I have learned and remember to be professional at all times. Lastly, providing excellent care to future clients or patients when providing therapy.

References

McMillan, I. R. (2011). The biomechanical frame of reference in occupational therapy. In E. A. S. Duncan (Ed.), Foundations for practice in occupational therapy (5th ed., pp. 179-194). Edinburgh: Churchill Livingstone.

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