Tales from the Pokemon Center- My Adventures in Healthcare (Story #2- Taco Tuesday 3/2/21)

[Spectacles]

Hi folks!

As the title suggests, I've decided to start a casual blog detailing my experiences in various aspects of the healthcare field. As of this first post, it has been my job to provide care to others in some way, shape or form for nearly ten years now. I've been a veterinary assistant, a tutor, a TSS (therapeutic staff support), and most recently an occupational therapist!!

And from nearly a decade in so many areas of the medical field, I have accumulated some WILD stories in my time. Some are sad, some are triumphant, and some are just plain hilarious. I've always wanted to write them down for my own personal memory, so why not share it with you guys at the same time? Hell, maybe I'll even raise some awareness about what it's like to be on the other side of the scrubs!

To keep with the heart of the forums itself and to protect the identity of those involved with the stories I share, all names will be replaced by Pokemon species names!

Since this is a casual blog, there won't be much rhyme or reason to the order in which I post my stories and how often I post, or even how long each post will be. But, if anyone does read this and has any questions or wants to hear about something in particular, please feel free to ask away either on this thread or via DM, and I would be happy to answer/discuss either in private or in a new post!

Spoiler: Table of Contents

Each story will contain in parentheses what setting it takes place in and what my job title was when the story took place.

Bedbound (SNF OT)

Taco Tuesday (school TSS)

 

[Spectacles]

Bedbound

*Possible Trigger Warnings- dementia/Alzheimer's, aging, severe disability*

At this time of writing, I've been a real, working occupational therapist for 3 weeks. I am currently working at a skilled nursing facility (a nursing home), where I have been seeing a lot of patients with Alzheimer's disease and other forms of severe dementia.

We'll call one such patient Lotad. I had been treating Lotad for a few days, and her main problem was that she was not sitting well in her wheelchair, which was causing her difficulties with eating. She sat with what we call a strong "posterior lean", where she is basically so slumped backward that her bottom could slide right out of the chair and land her on the floor. And when you're that poorly positioned, food tends to go down the wrong pipe a lot when you're eating and can cause them to aspirate and possibly lead to pneumonia.

There's also very little Lotad could do about this herself, since she has very severe dementia and is unable to recognize if she is poorly positioned in her chair or bed and cannot communicate any discomfort she does feel. I had been trying to use different cushions and wheelchair adjustments during my sessions, but she never seemed to keep a good position for long and would still slide forward in the chair.

One day, I went to see Lotad at lunchtime for my session and found that she was still in bed. I went to the nursing staff on duty and said that I was ready to help her get in her chair for lunch. But the CNA told me that they were no longer getting her out of bed, not even for meals, because she was no longer safe to sit in a chair because of the risk that she would slide out.

This was a blow to me. Once a patient becomes bedbound, it's very likely that they will progressively decline from that point on. Their muscles weaken from disuse, they're even more prone to aspiration while eating, and their sleep/wake cycle becomes disrupted (which can cause increased confusion, especially for patients who already have dementia). It's just a huge decrease in quality of life, and it broke my heart that one of my first patients was never going to leave her bed again.

And, of course, please don't mistake this for me blaming or badmouthing the nursing staff in this scenario. Keeping a patient in bed is never an easy decision to make, and one that is not made lightly. Patient safety is the highest priority. And if a patient is at risk of falling out of their chair and getting hurt, that risk far outweighs the long term effects of the patient being bedbound. Sometimes, as much as it sucks, it is the safest solution in some instances.

So anyway, in a desperate last attempt, I scoured the place for a whole new wheelchair. I tried to find one particular wheelchair called a Broda, but the two we had at this facility were broken and it's hell to try to order a new one thanks to insurance (the quality of skilled nursing facilities and the difficulties caused by insurance could be one hell of a post in and of itself). But I did manage to find something different- some sort of frankenstein chair I'd never heard of with a higher back and a sturdier footplate. It was originally meant for another patient who left the facility.

Desperate, I decided to give the Frankenchair a try. I convinced a CNA to help me get her out of bed and into the chair for lunch...

....And lo and behold, it worked! Lotad looked better than ever, and didn't choke or cough at all for her whole meal! For the whole rest of the day I kept walking by her hallway to see if how she was doing, and every time she was still looking great and was in no danger of sliding! She stayed in her chair for the whole rest of my shift.

Hopefully I'm not bragging by saying this, but it just feels really damn good to, in my first three weeks as an OT, be the one to pretty much single-handedly save a person from being bedbound. THIS is exactly why I busted ass all these years in school to become an OT. It just makes me so excited for the future and so ready to help as many people as I possibly can.

 

[Spectacles]

Taco Tuesday

*possible trigger warnings- severe intellectual/developmental disability, toilet humor

Before I became an occupational therapist, I was a TSS (therapeutic staff support). Apparently TSS are called different things depending on the agency and location, so not a lot of people know what they are and what they do. Basically, TSS are responsible for behavioral therapy for kids with special needs. However, we were often seen as babysitters or a meat shield for school staff if our kids started to flip out.

Whenever I told people which facility I worked for, they cringed. Most of my clients belonged to a private school specifically for youth with severe developmental disabilities or behavioral disturbances. The school had a reputation for being a very difficult place to work, since it took kids no one else would take. Honestly, as difficult as it was sometimes, I loved my job and I loved working with the kids and young adults. If it had paid better, I might have made it my lifelong career.

Anyway, one of the kids I worked with-who we'll refer to as Pancham- was a teenager with a very severe developmental disability. He could not talk or communicate with a device and was unable to recognize colors or shapes or anything like that. But he loved Disney, so we got along great.

Pancham was also about a foot and a half taller than me and about double or triple my weight. And sometimes, at seemingly the drop of a hat, he would throw fits. One time, when I was trying to block him from throwing a chair, he literally picked me up off the ground and threw me out of his way. The kid was like a linebacker. He also, especially when he was mad, would like to sit on the floor in very inconvienent places and refuse to move for hours on end- which is a total mood if I'm being honest. Not even the crisis workers (a group of very large men whose job it was to physically intervene if some of the stronger kids became too much of a danger to themselves and/or others) could move him when he decided to "drop".

Often times, his fits happened when he was in the bathroom. Pancham was incontinent in both bladder and bowel, so this often resulted in unpleasantly messy confrontations. Side note- incontinence is a sensitive topic that I have a lot of thoughts on, and I might make a little PSA posting about it after this.

One afternoon, I was coming into this school to work with Pancham after seeing a client from another school. When I got there, Pancham was in one of his "drops" in the middle of the hallway. It was also Taco Tuesday, so the staff members who were working with Pancham at the time told me to run and get one before they clean everything up.

I did and came back, placing my burrito (I have a beef with tacos in that they are simply unfinished burritos and therefore shouldn't exist) on a high cubby shelf so that I could talk to Pancham and try to get him to go back to class.

Suddenly, Pancham stood up. I was happy because I thought his drop had ended and he was going to cooperate. Nope.

He reached up, grabbed my burrito in his fist, and whaled me in the head. It was like a reverse pinata. Kablooey.

This was not the first time Pancham had used food to attack me. One time he was eating a cupcake during a class party when a fit took him and he crushed the cupcake with his hands. I tried to turn around to protect my face, but he reached around and slammed his hands over my spectacles, covering them with icing and effectively blinded me while he beat the everloving snot out of me until help arrived.

Anyway, after a brief struggle and some help from the crisis staff, we were able to calm Pancham down and get him back to his room. I went to get myself a new burrito since my old one was now mashed into the carpet and wall. But for some reason everyone was looking at me with extreme horror on their faces and saying "oh my God!". I decided I better stop at the bathroom on my way back to the burrito stand to clean myself up.

When I saw my reflection, I realized I was covered in refried beans. My coworkers, knowing the history of the kid I worked with, thought it was something quite different.

So yeah. I had to go around telling everyone I was not walking around with feces all over my face and hair and that I had simply been bludgeoned with my own burrito's intensines.

Fin.