Week 6
We have arrived (almost, I see one kid on Fridays) at the end of week six. I think I can compare the first six weeks of a level 2 fieldwork to one of those tough mudder races. It was not pretty, but I made it. The new has worn off, and the responsibility, stress, and learning has kicked in. Being in pediatrics for this rotation is kind of it's own circus - many of my friends working with adults in various settings are reporting that things are 'clicking' for them - they remember learning certain protocols, theories, or treatment ideas, and they're finally seeing them in action. Pediatrics is a lot different - theories still apply, treatment ideas and protocols still apply, but sometimes the exact same diagnoses shows up in two kids in polar opposite ways. Even the opposite is true - sometimes two very different diagnoses can show up in kids and look the same.
One of the trickiest parts of my fieldwork so far has just been the kids. Most of the time, adults understand the concept of therapy. They know that they have an accident or an illness that has caused them problems. They know that it isn't going to be fun, but they generally just want to get back to doing whatever they need to do to enjoy their day to day routine. Kids, on the other hand. Kids are something else.
My challenges can basically be grouped into four categories, as of week 6.
1. My own background.
I was raised in a family that was pretty structured. My parents are great about always following through with promises they make or even discipline as a child. My life maintained a pretty steady predictability. I also had a solid understanding that when mom or dad asks you to do something "Just a minute" "I don't want to" or anything similar to that is NEVER okay to say. You get up, and you do it now. To add to that, I used to teach preschool. I usually had 5-10 kids in my class at a time, and structure is the strategy I HAD to use with them because otherwise, 10 two year olds for ten hours a day will pretty much steamroll you. I had to maintain structure in order to stay sane. However... it doesn't work here. Not all of these kids are raised the same way I was (expected), and although I try to teach them that when I ask them to do something, they need to do it, it just doesn't always work. Some kids downright DON'T CARE about that, they just flat out aren't doing it. I've found that motivation is a big factor (you only have to try it one more time. Last time you did it almost perfect! Let's give it a shot.) or (I know you don't want to. It's really hard. But we have to practice to get better at it.) I even have a few kiddos, specifically those that have feeding therapy, that do well with negotiation. Licking the cracker or biting it and spitting it out earns one minute of trampoline time per time you try it.
2. Dancing around therapy
Although I still like to live my life by the 'I'm the adult, I make the rules motto', some battles really aren't worth fighting. Even though I think that's how things should operate doesn't mean they will (can you tell this a big learning curve for me right now?). I'm learning to dance around the fact that it is therapy and turn it into a game. Truthfully, I think that most people that are OT's have this skill naturally. We can turn BASICALLY anything into therapy. This morning I had a session with a little boy and I had him standing on a yoga ball (inside a tire so it wouldn't move, don't worry, and I was right there) and I sprayed shaving cream on the wall and let him stick the letters of his name in the shaving cream. (I can feel my mom cringing as she reads this) Boom. We just worked on balance, motor planning, spelling, problem solving, visual motor integration, and fine motor control in about fifteen minutes. Plus, he thought I was the greatest human ever for letting him play with shaving cream ON THE WALL. I sometimes will have a hard time with this when I'm seeing more than one child at one time, because I don't believe in idle time while they're there. They should be busy. But having kids one on one helps me be a more creative and attentive therapist to the things they like. Pairing something they hate with something they love is a great strategy.
3. The vast majority of my kids have no idea why they come.
This is a tough one. It's a big difference than when working with adults. A lot of our kids know that certain things are hard for them, and they come to therapy to work on them. I think everyone has a different perspective on how you handle this, but I'm a no-wasting time kind of girl. It isn't going to get easier by avoiding it, but maybe by working hard I allow some free time at the end of a session or a specific game that they love once they've done it. However, you can't really explain to kids that they struggle with something or are bad at it - so you have to come up with other ways to do it. "So we can move our body and stay healthy and try new things" are three of my current favorites.
(Side note: I know I've mentioned free time a few times now. One minute doesn't sound like a long time. But if you've never been in a pediatric therapy gym, it's basically all the things you dreamed about as a child. Slides, trampolines, ball pits, games, giant fluffy pillows, and shaving cream on the walls. It would be like, if after your hardest week of work ever, someone offered you a quiet room and a massage chair while feeding you your favorite dessert and watching your favorite guilty pleasure TV show. while getting a foot massage. and they paid off all your student loans for you.)
4. A continually growing body.
A lot of times in pediatric therapy we help meet milestones. Sometimes kids are delayed for no particular reason at all, or they follow an unusual sequence when meeting milestones. Sometimes, things like crawling up and down stairs, eating, dressing themselves, carrying toys while walking, moving from laying to sitting, or climbing onto furniture is something kids naturally pick up and learn how to do. Other times, the kids really need to be 'taught' how to do it. It required breaking the task down into steps and working one step at a time. That being said, sometimes developing a new skill can show other difficulties. We might work and work and work on walking, but once they start walking, we notice uneven weight shifting, unusual gait, or something else that opens up a whole new world of challenges. Additionally, kids grow crazy fast, so sometimes they just haven't gotten used to the size of their body yet and that's why they aren't sure where or how to move it. Kids have tons of expectations placed on them through school, home life, and extracurricular activities. Their goals are constantly changing. It's like they are running a race and we are running beside them trying to give them as many tools as we can to help them keep up and succeed.
Besides the nature of the work itself, the last six weeks have been a huge growth opportunity. I definitely thought that Level 2's wouldn't be too much different than Level 1's, just longer, and that is a HUGE LIE. I've learned a lot about business logistics, working with parents, co-treatments, things I will and won't look for in a first job, the way that different sites do their documentation, and a thousand other things. It's also interesting to think through feedback that is given to you and try to sift through it to decide what is clinic specific and would need to change if I were to work somewhere else, or what is key to being a good all-around therapist. The view that I had of myself six weeks ago being a great learner, loved by my kids, and feeling much more natural at what I do. Instead, I kind of feel like a one year old trying to chew peanut butter for the first time. In the words of my dear friend Christin, "I need to be complimented by my CI at least once a week or I turn into an anxious mess". It sounds like she's kidding, but she isn't. I'm searching for any and all signs that I don't TOTALLY suck at this, because it kind of feels like I do.
One new thing that I've never really experienced before is having my 'fill' with kids. I have ALWAYS loved working with kids. When I worked at a daycare throughout high school and college, I hated going home in the evenings because I missed them. Now, I've learned that as much as I love kids, I am happy to have adult conversation (via facetime of course, more to come on that) with anyone and everyone who will talk to me, as long as it's any subject besides Fortnite (what even is that. like really.), any current children's movie, or poop. I actually had a child what to explain his most recent bowel movement to me yesterday. You can't make this stuff up. Please, these kids are exhausting, please talk to me about something adultlike. If you can talk to me about interesting topics and not sneeze directly in my cornea, I want to talk to you.
Another new thing to me right now is being homesick. I was thinking maybe I would enjoy exploring a new city and being so far away all on my own, but I think that this has taught me that my home is wherever my people are. I have definitely enjoyed learning about a new place and exploring on my own, but exploring is just a lot less fun on your own. Two of my best friends from college are living near Topeka in the fall and I am so excited to get home just to be with them. I haven't seen Emma in seven weeks and I'm about to go crazy. The other night my mom and I were on the phone and I asked if we could hang up and FaceTime so I could see my dad and talk to him too and she was like well, he isn't here. So then I had to admit that I just REALLY WANTED TO SEE MY MOM. (*Quick shoutout to my parents, who have handled my VERY stressed, anxious, and tearful phone calls for the last two weeks about being overwhelmed and wanting to come home. You are both champions.)
Living 14 hours away from home has brought it's own challenges. Each week, I'm trying to be diligent about keeping a running list of all the things I love about Louisiana and will miss in six weeks to align with the ever growing mental list of things I miss about Kansas. We'll start with the more sad list.
Things I miss about home
1. My friends and family
2. Beef. I cannot stress this enough
3. Living with Leah (this is a life adjustment. It's fine. We're all fine.)
4. Being able to drive a mile in under 15 minutes.
4a. Drivers that actually follow driving laws here and there.
5. Being able to have my windows open at night
Things I will miss about Lousiana
1. Amazing seafood whenever I want
2. Living so close to a beautiful lake
3. I do like living alone, minus the whole 'no friends' debacle.
4. Getting to work with kids all day every day
5. THE HEAT. :)
I write these in hopes that in six weeks, six months, or six years I can look back and be pleased with how much I've grown. Here's to hoping my future self plans better interventions, does speedier evaluations, and has the patience of a saint.
One of the trickiest parts of my fieldwork so far has just been the kids. Most of the time, adults understand the concept of therapy. They know that they have an accident or an illness that has caused them problems. They know that it isn't going to be fun, but they generally just want to get back to doing whatever they need to do to enjoy their day to day routine. Kids, on the other hand. Kids are something else.
My challenges can basically be grouped into four categories, as of week 6.
1. My own background.
I was raised in a family that was pretty structured. My parents are great about always following through with promises they make or even discipline as a child. My life maintained a pretty steady predictability. I also had a solid understanding that when mom or dad asks you to do something "Just a minute" "I don't want to" or anything similar to that is NEVER okay to say. You get up, and you do it now. To add to that, I used to teach preschool. I usually had 5-10 kids in my class at a time, and structure is the strategy I HAD to use with them because otherwise, 10 two year olds for ten hours a day will pretty much steamroll you. I had to maintain structure in order to stay sane. However... it doesn't work here. Not all of these kids are raised the same way I was (expected), and although I try to teach them that when I ask them to do something, they need to do it, it just doesn't always work. Some kids downright DON'T CARE about that, they just flat out aren't doing it. I've found that motivation is a big factor (you only have to try it one more time. Last time you did it almost perfect! Let's give it a shot.) or (I know you don't want to. It's really hard. But we have to practice to get better at it.) I even have a few kiddos, specifically those that have feeding therapy, that do well with negotiation. Licking the cracker or biting it and spitting it out earns one minute of trampoline time per time you try it.
2. Dancing around therapy
Although I still like to live my life by the 'I'm the adult, I make the rules motto', some battles really aren't worth fighting. Even though I think that's how things should operate doesn't mean they will (can you tell this a big learning curve for me right now?). I'm learning to dance around the fact that it is therapy and turn it into a game. Truthfully, I think that most people that are OT's have this skill naturally. We can turn BASICALLY anything into therapy. This morning I had a session with a little boy and I had him standing on a yoga ball (inside a tire so it wouldn't move, don't worry, and I was right there) and I sprayed shaving cream on the wall and let him stick the letters of his name in the shaving cream. (I can feel my mom cringing as she reads this) Boom. We just worked on balance, motor planning, spelling, problem solving, visual motor integration, and fine motor control in about fifteen minutes. Plus, he thought I was the greatest human ever for letting him play with shaving cream ON THE WALL. I sometimes will have a hard time with this when I'm seeing more than one child at one time, because I don't believe in idle time while they're there. They should be busy. But having kids one on one helps me be a more creative and attentive therapist to the things they like. Pairing something they hate with something they love is a great strategy.
3. The vast majority of my kids have no idea why they come.
This is a tough one. It's a big difference than when working with adults. A lot of our kids know that certain things are hard for them, and they come to therapy to work on them. I think everyone has a different perspective on how you handle this, but I'm a no-wasting time kind of girl. It isn't going to get easier by avoiding it, but maybe by working hard I allow some free time at the end of a session or a specific game that they love once they've done it. However, you can't really explain to kids that they struggle with something or are bad at it - so you have to come up with other ways to do it. "So we can move our body and stay healthy and try new things" are three of my current favorites.
(Side note: I know I've mentioned free time a few times now. One minute doesn't sound like a long time. But if you've never been in a pediatric therapy gym, it's basically all the things you dreamed about as a child. Slides, trampolines, ball pits, games, giant fluffy pillows, and shaving cream on the walls. It would be like, if after your hardest week of work ever, someone offered you a quiet room and a massage chair while feeding you your favorite dessert and watching your favorite guilty pleasure TV show. while getting a foot massage. and they paid off all your student loans for you.)
4. A continually growing body.
A lot of times in pediatric therapy we help meet milestones. Sometimes kids are delayed for no particular reason at all, or they follow an unusual sequence when meeting milestones. Sometimes, things like crawling up and down stairs, eating, dressing themselves, carrying toys while walking, moving from laying to sitting, or climbing onto furniture is something kids naturally pick up and learn how to do. Other times, the kids really need to be 'taught' how to do it. It required breaking the task down into steps and working one step at a time. That being said, sometimes developing a new skill can show other difficulties. We might work and work and work on walking, but once they start walking, we notice uneven weight shifting, unusual gait, or something else that opens up a whole new world of challenges. Additionally, kids grow crazy fast, so sometimes they just haven't gotten used to the size of their body yet and that's why they aren't sure where or how to move it. Kids have tons of expectations placed on them through school, home life, and extracurricular activities. Their goals are constantly changing. It's like they are running a race and we are running beside them trying to give them as many tools as we can to help them keep up and succeed.
Besides the nature of the work itself, the last six weeks have been a huge growth opportunity. I definitely thought that Level 2's wouldn't be too much different than Level 1's, just longer, and that is a HUGE LIE. I've learned a lot about business logistics, working with parents, co-treatments, things I will and won't look for in a first job, the way that different sites do their documentation, and a thousand other things. It's also interesting to think through feedback that is given to you and try to sift through it to decide what is clinic specific and would need to change if I were to work somewhere else, or what is key to being a good all-around therapist. The view that I had of myself six weeks ago being a great learner, loved by my kids, and feeling much more natural at what I do. Instead, I kind of feel like a one year old trying to chew peanut butter for the first time. In the words of my dear friend Christin, "I need to be complimented by my CI at least once a week or I turn into an anxious mess". It sounds like she's kidding, but she isn't. I'm searching for any and all signs that I don't TOTALLY suck at this, because it kind of feels like I do.
One new thing that I've never really experienced before is having my 'fill' with kids. I have ALWAYS loved working with kids. When I worked at a daycare throughout high school and college, I hated going home in the evenings because I missed them. Now, I've learned that as much as I love kids, I am happy to have adult conversation (via facetime of course, more to come on that) with anyone and everyone who will talk to me, as long as it's any subject besides Fortnite (what even is that. like really.), any current children's movie, or poop. I actually had a child what to explain his most recent bowel movement to me yesterday. You can't make this stuff up. Please, these kids are exhausting, please talk to me about something adultlike. If you can talk to me about interesting topics and not sneeze directly in my cornea, I want to talk to you.
Another new thing to me right now is being homesick. I was thinking maybe I would enjoy exploring a new city and being so far away all on my own, but I think that this has taught me that my home is wherever my people are. I have definitely enjoyed learning about a new place and exploring on my own, but exploring is just a lot less fun on your own. Two of my best friends from college are living near Topeka in the fall and I am so excited to get home just to be with them. I haven't seen Emma in seven weeks and I'm about to go crazy. The other night my mom and I were on the phone and I asked if we could hang up and FaceTime so I could see my dad and talk to him too and she was like well, he isn't here. So then I had to admit that I just REALLY WANTED TO SEE MY MOM. (*Quick shoutout to my parents, who have handled my VERY stressed, anxious, and tearful phone calls for the last two weeks about being overwhelmed and wanting to come home. You are both champions.)
Living 14 hours away from home has brought it's own challenges. Each week, I'm trying to be diligent about keeping a running list of all the things I love about Louisiana and will miss in six weeks to align with the ever growing mental list of things I miss about Kansas. We'll start with the more sad list.
Things I miss about home
1. My friends and family
2. Beef. I cannot stress this enough
3. Living with Leah (this is a life adjustment. It's fine. We're all fine.)
4. Being able to drive a mile in under 15 minutes.
4a. Drivers that actually follow driving laws here and there.
5. Being able to have my windows open at night
Things I will miss about Lousiana
1. Amazing seafood whenever I want
2. Living so close to a beautiful lake
3. I do like living alone, minus the whole 'no friends' debacle.
4. Getting to work with kids all day every day
5. THE HEAT. :)
I write these in hopes that in six weeks, six months, or six years I can look back and be pleased with how much I've grown. Here's to hoping my future self plans better interventions, does speedier evaluations, and has the patience of a saint.
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