Saint Francis Memorial Hospital is an accredited, not-for-profit community hospital that has been providing exceptional health care in San Francisco for more than 100 years. As San Francisco’s only downtown hospital, Saint Francis is uniquely situated to care for international and domestic visitors, as well as the residents that make up San Francisco’s diverse population.
Located in Nob Hill, Saint Francis is home to the largest burn center in Northern California, the Bothin Burn Center, the Saint Francis Orthopedic and Sports Medicine Institute, and the Center for Pain Management, to name a few.
To learn more about Dignity Health or SFMH click the link below:
Burns
Cerebrovascular Accidents (CVA) or Strokes
Toxic Epidermal Necrolysis (TEN)
Stevens–Johnson Syndrome (SJS)
Hip Replacement
Spinal Fusion
Hypothermia
Necrotizing Fasciitis
During the month of March, I had the pleasure of completing my Level I Fieldwork at San Francis Memorial Hospital (SFMH). During that week I shadowed an Occupational Therapist (OT)/ Clinical Instructor (CI) who was a five year veteran at SFMH and a Dominican University Alumni. My CI was wonderful and brought great value to my experience and education. During the week we worked with on five different floors of the hospital, with each of them having a unique diagnoses or setting. We worked with 1) Outpatient 2) Burns 3) Telemetry 4) Intensive Care Unit (ICU) and 5) Acute Rehabilitation. With this wide-range of observation I was able to learn and reinforce so much in just a short amount of time.
1) Our voice and documentation are very important. Documentation serves as a legal document, proof for insurance reimbursement, demonstrates our OT skilled services, and helps communicate between interdisciplinary teams. While sitting at a table during "rounds" I quickly realized that the entire medical team valued each others skills and clinical reasoning as to what action should be taken next with each patient. We worked closely to monitor for any sign of improvement and/or decline so the necessary steps could be taken. It gave me a clear picture why we must be mindful of our interventions and documentation as it could potentially change the course of the patients prognosis and road to recovery.
2) Another moment that stood out to me was the vast need for psychosocial needs for almost every patient that I came across. The main objective in an acute hospital setting is to make sure the patient is medically stable, prepare the client for safe discharge, and help determine the best setting for the client to be discharged to. Psychosocial issues rarely get acknowledged in this because it is not life threatening therefore it tends to slip between the cracks as patients progress. However, I observed that often times patients who were experiencing psychosocial needs were less motivated to participate in OT sessions. Therefore, I think that something should be implemented in order to help individuals get the services they need and OTs should be mindful on how they approach each client. This could simply mean building better rapport and working to create a better therapeutic use-of-self. This would help create a meaningful relationship between the therapist and the patient in order to produce meaningful participation and progress in occupations that matter to the patient. In addition, OTs should have proper documentation before the client gets discharged so the next professional could further address those needs.
We used Smart Glove Technology with several patients. The tool measured joint range of motion, coordination, and some executive function while allowing the patients to engage in a fun activity.
During one of our outpatient sessions we really got to see and engage in an occupation-based therapy session. (Not pictured) is a patient who had limited range of motion due to scar tissue formation and contractures secondary to 3rd degree burns in bilateral UEs. The patient who led us through the Yoga routine was preparing for discharge and reintegration to the work force as a Yoga instructor.
I am very thankful for this experience and will take this knowledge with me to my future practice.