Introducing OT >
September 16, 2020
Between our summer session ending and the start of fall, we had a one week break. And I tried to make the most of the time. I engaged in some of my favorite activities that had been pushed off during finals week, including different musical occupations. One of the most entertaining is making parodies of songs and rewriting lyrics.
I found myself reflecting on my school experiences as an OT. Ever since freshman year, I’ve had to have a definition of my major at hand. That basic introduction question of “What are you studying?” probably brought more explanation than that poor engineering student was expecting. But I thought it would be fun to put it all in song form. I hope you find this parody of Nick Jonas’ “Introducing Me” both informative and amusing. So whether you’re here for the laughs or you’ve stumbled onto this page by accident and want to learn more about OT, here it is, for your perusing:
An Interview with Hand Therapist Lisa Adams ‘81 >
September 2, 2020
I was recently able to contact one of the practitioners that introduced me to occupational therapy. I shadowed Lisa Adams, a Certified Hand Therapist, for a summer as she worked. Lisa is also a USC Chan ‘81 Alumnus. Through her understanding how a person’s use of their upper extremities affects their daily activities, I fell in love with OT. I was able to email her a few questions about her profession, and she shared a little bit about her experience:
Lisa Adams (LA): Hi, my name is Lisa Adams, and I have been an OT for a very long time: forty years.
Bethany Yew (BY): We have to start with the question: Why OT?
LA: I loved the psycho-social aspect and treating the patient or client as a whole. Even though hand therapy has a lot of medical based components it also addresses all the occupational roles of the client. As an OT I have a vested interest in computer ergonomics, and thus I can advise and evaluate patient’s workstations to alleviate their hand problems…OT’s lucked out in having splinting skills as well as being able to respect the tiny anatomical structures of the hand in the rehab process. This is why, the surgeons I worked for originally, chose an OT over a PT to work in their clinic. I am a Certified Hand Therapist (CHT). This certification can be earned by either an OT or PT after working 3 years as a general therapist with hand experience and passing the CHT exam. 80% of CHT’s are OT’s.
BY: How did you decide to do hand therapy?
LA: I started out as a COTA working for two hand surgeons, in their hand clinic run by an OTR. I was kind of thrown into hand therapy in the late 70’s not knowing what it was. I was sent on the interview while doing my COTA internship at Rancho Los Amigos Hospital. After working in the neuro unit at Rancho with head trauma and Guillain-Bare patients I couldn’t fathom why a hand injury would need specialized therapy. Well, I learned differently. Originally, I thought I’d work there for 6 months, but I ended up working at the LA Metropolitan Hand Center for 22 years. The surgeons had me go to surgery with them and watch procedures which enable me to learn more than I could have ever hoped for. The surgeons urged me to go back to school (I went to USC.) and become an OTR, which I did after working 5 years as a COTA. I returned to work for them for the next 17 years.
The clinic was the first hand center in Los Angeles, opening in 1975. Hand therapy was in its infancy as were the surgical techniques. We treated a lot of trauma (stab wounds, finger and hand amputations, tendon lacerations and fractures). We had the luxury of treating our patients for two and three hours in group settings. Each patient got individualized hands-on care, had a therapeutic activity (leather work, macramé or simple wood project) in addition to an exercise program. Those were the good ole days when insurance companies didn’t regulate the reimbursement rates, number of visits and time spent in therapy. It is a different story today, but as an OT I have adapted to provide quality care within the confines of the payers, although not always easy or profitable.
BY: What is the hardest part of your job?
LA: The hardest part of my job is the time it takes to do documentation. We now have EMR systems but they are not all conducive to OT, and I have a difficult time navigating them and making sure I do so correctly… We have many documentation requirements per Medicare, so making sure everything is clear and concise is difficult for me. This is very time consuming and non-revenue producing, so more often than not I am doing my documentation on my time.
BY: What is the best part of your job?
LA: The best part of my work day is hearing a patient say, “Look, I can now bend my finger!” or “I don’t have pain anymore after doing my therapy program.” Witnessing a patient’s recovery is the best part of every day. I also love when I can help a patient through the emotional roller coaster of having pain and having limited functional use of their hand. When I hear a patient say, “Thank you for listening or putting up with my crying” it’s the best part of my day.
BY: Thank you so much for sharing.
I am so thankful that I got to get back in touch with Lisa. When I had finished volunteering, she gave me a cute candle as a reminder of my experience.
I will always be thankful for her impact on my introduction to OT and how it can change people’s lives.
Be Prepared for Grad School >
August 12, 2020
As part of the Bachelor’s-to-Master’s program, my entrance into the Master’s program was unique in that it was also my senior year of undergrad. It was a strange transition, as I was trying to get used to being a Master’s student while holding on to my friends and senior year activities. I struggled with being simultaneously at the top of the school “hierarchy” and the new kid. However, I learned a lot during this past year, and am hoping that if anyone starting this Master’s student life transition resonates with my experience, you can find a new tidbit of information to make the transition easier.
Make New Friends
I struggled with figuring out how to spend my time with people. I wanted to spend every last minute that I could with friends from undergrad, as I knew it was not likely we would live this close to each other again. We had to make the most of our proximity. And yet, it was hard to feel connected to people that I was in new classes with when I was not as open to conversations. It took me a while to realize that these students were going to be with me in the field, and they were people I could learn from and rely on. All this to say: (1) Take the time to have conversations. Whether it be in class (during designated discussion time such as breakout rooms, of course) or not, you can learn about a person even through the course material. One entire class discussed the Therapeutic Use of Self, so we discovered a lot about our own and each other’s personalities. (2) Take the time out of class to hang out. I did not do this one very well, but maybe once a month, whatever you can swing out of your free time, log on to an event. Go meet new people. Start up conversations with people outside of your cohort and classes. Many people would open conversation by asking about the Bachelor’s-to-Master’s program, so I had to learn to use it as a conversation starter, to ask about their own undergraduate experience. We’re all OTs, so we’re all here because we love talking to and helping people.
Another strange factor is our new professors. We meet different OT faculty during these next two years, all with different experiences and expertise. Each student is also paired with a faculty mentor according to their interests. Take advantage of their knowledge base; reach out to them with questions. (3) Use office hours. If you may be unsure of what area of OT you want to go into in the future, as I am, use each practice immersion to further understand your fit for each area. Have conversations with the professors, who are experienced members of their field. It is only during this time that you will have the excuse of class material to start conversations. Even if you can’t use that excuse, faculty are always happy to talk about what they are passionate about. They are also very understanding and can help with any difficulties into the transition to grad school and classes.
Bring a Snack
Three-hour classes feel longer than I care to admit. And although we do get stretch breaks, (4) have food ready! It’s helpful for staying engaged. Be sure that the snack is something you can eat relatively neatly, as you may want to type a quick note on your computer without having to wipe your fingers of Cheeto dust. (Or like some of my creative friends, you can eat Cheetos with chopsticks.) We also have a nice lunch break in between classes. If you’re on HSC, you can go pick up a burrito from the surrounding food trucks, or eat your own homemade lunch. Lunch time is still a great chance for a stretch break, and one good quesadilla, whether off the stove or from the cafeteria across the way, can be a turning point after a tiring class.
Any Time is Usable Time
This is a lesson that I learned riding the shuttle to and from campus, but it’s applicable in more ways than one. It can feel like a long commute to the Health Science Campus from the University Park Campus or from wherever you call home. However, you can make the most of the ride. I was able to journal on the shuttle if I was awake enough, or catch up on another thirty minutes of sleep (which was a more common occurrence). Start on school readings, review slides for the upcoming quiz, or re-read the Harry Potter series. Download a movie on your phone. If you’re driving, take the time to listen to new music on the radio, or get pumped up for the day with some of your favorites. Listen to a new podcast. (5) Make the most of seemingly unusable minutes, even if it is just to relax and take a break. Some of my favorite shuttle rides would be when I ran into a friend on the shuttle, often a friend from UPC that I had not seen in a while, and we would use the shuttle ride to catch up on life. Unusable minutes may take a different form while we’re taking online classes, but that goes into my next point…
All of life is about balance, between work and school and friends and commitments. Adjusting to Master’s classes requires an adjustment of that balance. After completing a Blackboard quiz, make time to go grab dinner with a friend. My first semester, I personally decided to make time to stay in the Trojan Marching Band, blasting summer hits on Cromwell Field. Music was part of my life, and going to practice and playing piccolo was a bright spot in my day. (6) Make time for the things that keep you going. I had never used the calendar app on my phone so much as when I transitioned to grad school. My friend helped me color-code my schedule into different categories, a system I thought I would never use but ended up loving. Seeing the red of a band event or the green of an Intervarsity Christian Fellowship event was a bright spot in my day, and my calendar ensured that I did not miss things that were important to me. For me, this adjustment to online classes changes the balancing act. Now, it means calling a friend during my lunch break or taking time after class to play an instrument.
Lean on Your Support System
Every day, I’d come home to my apartment-mates, and I’d get to hear about how aerospace or linguistics classes were going and share about my own day. They and my other friends made time to let me ramble about adjusting to life and gave me time to just be myself. When I felt stressed, they would drive me out to get mandatory ice cream. When I needed a day out, we’d go to drive-in movie nights and have picnics. When I needed advice, they’d sit me down and tell me what I needed to hear, even when it was hard. You can find support in many forms, whether it’s finding tips on Calvin’s Survival Guide and reaching out to the student ambassadors, or having good, long conversations with friends. (7) Lean on your support system. These days, I go downstairs to do a workout with my mom and rant if I need to. But whether with friends or family, you are not alone in this.
Lastly, (8) be kind to yourself. It is a transition, and everyone will adjust differently. Don’t be harsh on yourself if the transition takes time. Make the most of these opportunities that we have: learn a lot, have fun, and Fight On!
Childhood Occupations In Summer >
July 20, 2020
For part of the summer, my brother and I went to stay with our cousins. It was the perfect time to go. Our parents wanted to remodel the kitchen, which would frustrate my brother and I, as we are stuck taking online classes from home, and my aunt and uncle needed to entertain their three kids who were also stuck at home. So we moved to Hawaii for six weeks, continuing online classes, which now started at 6am instead of 9am for me, and spending our afternoons with the cousins.
Having not been out of the house for a while, I loved observing the occupations that people chose during an encouraged stay-at-home time. I was in a unique position to be able to see others’ occupations, not just my family’s. I especially loved the fact that I had an excuse to engage once again in childhood occupations. It’s harder to find reasons to have random water balloon fights when all of your friends are over twenty and everyone is being encouraged to stay away from one another. But now under the same roof with three younger cousins, I had the chance to observe, relearn, and engage in some of the most exciting childhood occupations.
One of my cousins fell in love with baking. He had already loved the culinary arts before the safer at home order, and then as his free time expanded, so did his passion for baking. My brother and I were a new audience to wow with the recipes he had perfected for his own family, and we helped him concoct new ways to get creative, too. The second we arrived, he showed us his first creation: a red velvet cake decorated with green lemon-flavored icing. The red was for my love for USC, and the green for my brother’s school. The cake was gone all too soon, but my cousin was quick to create an entire baking schedule with things we had to try while we were here, including a double-layer carrot cake. My brother and I helped him come up with ways to make use of extra pie crust, like making cinnamon-roll-like creations topped with blueberry compote.
The youngest cousins showed me the garden. Many different potted plants stood out in the front of their house. She took care to water the garden daily and to check to see if things were growing. In contrast, the oldest cousin’s most common occupations were playing video games with my brother and self-learning riffs on guitar or piano to famous songs like “Piano Man.” And although the cousins engaged in occupations I was used to, such as going to walk the dog and watching TV shows, my favorite occupations to witness and join in on were self-made entertainment.
The cousins could entertain themselves, and me, by turning anything into a game. For example, my brother started showing them a magic trick, having them pick a card from the deck and finding it again. Once he got tired of that, somehow, the game instead turned into “randomly guess the card.” The entire 5-cousin group would randomly shout cards (“Ace of spades!”), someone would turn the next one in the deck over, and you would either hear shouts of disbelief and excitement, groans of frustration if the number was only one off, or more commonly small sighs and next guesses. The game took up at least ten minutes. Ten minutes of random card guessing, and I had fun with it. I guess the anticipation in the occupation and the people with whom I was participating made the occupation increasingly engaging.
On a socially-distanced beach trip, I stayed in the shallow water with the younger cousins, jumping waves. Then the youngest dived down and grabbed a rock. We spent the next twenty minutes using the rock as if it were a pool dive toy, where I’d throw it and she’d get it, over and over again. That day, we also dug a giant hole. And then right after, we filled it in before leaving to make sure no one would fall into it. But I was struck by the short-lived nature of these occupations, how it seemed so necessary and important to frantically dig water out of the hole as the waves rolled in so that the hole would not fill up, but then we filled it up ourselves an hour later. And yet, these became some of the most fun moments.
It’s the small daily activities of entertainment like making toys act out a play, trying to mimic how Han Solo runs, or trying to bounce a ping pong ball into a cup that become memorable, silly moments. It’s not just the activity, but the context, the place, the people, and the purpose, that make them meaningful occupations. In one of the books I was able to pick up this summer, Liturgy of the Ordinary by Tish Warren (2016), I read that “Children never tire of beauty and pleasure. They embrace enjoyment with abandon. They don’t feel guilty about taking time to search for feathers, invent a game, or enjoy a treat” (p. 132). And getting to participate in these activities with my cousins has helped me begin to rediscover my own wonder with the world.
Warren, T.H. (2016). Liturgy of the ordinary: Sacred practices in everyday life. InterVarsity Press.
Try Everything: Selecting Electives >
July 8, 2020
Due to the pandemic and recommendations for social distancing, our summer classes have put us ahead of schedule in terms of coursework. So when I went to go check my email the other day, I found a message about picking electives for the Fall semester. I was both overwhelmed and nervous, but thankfully, the email also mentioned a Zoom information meeting to help us learn more about our options and what Fall is going to look like.
The electives have been something I have been looking forward to in this program for a long time. A lot of the Master’s coursework follows different practice immersions and thread courses throughout a specific course sequence designed to let us get a taste of OT in all of its forms. After those first semesters, we get to choose from a variety of electives for us to consider, either to specialize or to broaden our scope of knowledge further.
I had come into this program very interested in hand therapy, since it was one of my first experiences with OT. I also had the chance to volunteer under the same hand therapist later during my undergraduate career. For next semester, there were two courses related to hand therapy, OT 573: Hand Rehabilitation and OT 562: Advance Practice in Hand Therapy and Physical Agent Modalities. Hand therapy had always been a consideration, but now, after going through two of the Division’s immersions, I am considering other possibilities as well.
I was excited to be in Adult Physical Rehabilitation as my first immersion. I wanted to see more hand therapy, but then even just starting the immersion, I was able to experience the ways in which Rehab applies to so much more: transfers after hip replacements, creating memory devices, or even relearning the use of a limb after a stroke. At my fieldwork site, I was lucky to be able to experience interdisciplinary work, looking at how occupational therapists work with experts in other fields. In observing an interdisciplinary group for a wheelchair consultation, I began to understand the unique perspective that OT has to offer to complement the views of a physician, a physical therapist, and nurse.
I had been wary of the Mental Health immersion. Being a type A person, I had expected to be most drawn to the Adult Physical Rehab process of having certain activities tied to certain physical outcomes. I was at first almost scared by the seeming vastness and uncertainty of Mental Health. Instead, I found myself intrigued by the power of conversation and by the power of activity. I ran groups at my fieldwork site, engaging people not just through words but also in actions, through activities like a music group, origami, and activities engaging the senses. I fell in love with occupational therapy all over again, amazed by the power of doing, how activity does not just impact the physical, but mental aspects as well. I had expected the immersions to help me narrow down which field I wanted to be in; however, I feel like my choices are only expanding.
And now, I am very much looking forward to the Pediatrics immersion. I expect myself to come into the immersion with a more open mind. Though, I am worried that I will come away from the immersion with my mind open to even more possibilities than I am already considering.
The electives open to us for the Fall were numerous and varied, covering topics from Lifestyle Redesign to ergonomics to dysphagia and swallowing. I realized that I do not have to take courses only focusing on hand therapy if I do not want to. I’ve decided this Fall that instead of taking two hand courses, I will instead take a few others to diversify my course load. In addition to OT 573, I have requested clearance for OT 563: Occupational Therapy in Primary Healthcare Environments and OT 566: Healthcare Communication with Spanish-Speaking Clients. I’m excited to see how these different courses will prepare me to be a better clinician in the future!