Narrative Assignment, Essay Example

I was assigned to a nursing home occupational therapy in the field of psychosocial mental health.  Overall, the length of stay of the patients varied: For example some on the individuals dealt with issues related to dialysis, while others had issues related to Alzheimer’s.   For Alzheimer’s patients, the main care was long-term custodial care; there were also individuals that needed restorative hip replacement, sub acute care for strokes.  The type of setting was predominantly inpatient and day treatment.  There were also a few patients who were assigned to the home over the short-term, that being roughly 1-3 months to rehabilitate.   The method of reimbursement in the home was either through Medicare of Medicaid; there were a few individuals who were dual eligible- that is, used both Medicare and Medicaid.  In the home, there was psychological intervention, supportive reinforcement intervention, and a care plan staff intervention over seen by a medical doctor.

From my initial impression of the nursing home, the home’s population was primarily senior citizens (older than 65 up to roughly 90), predominantly female, Caucasian with a roughly middle-class background.  There were, however, individuals that varied from the norm.  That is, there were also minority individuals (although less); in addition, there were also individuals from a likely lower middle class background

The diagnoses and problems in the nursing home had a wide range: Some individuals did not have long-term chronic illnesses, but needed help due to a fall, or incapacity due to age.  On the other hand, there were individuals with chronic disease (mostly diabetes and heart disease) that required greater clinical care in addition to the care needed to go through daily life. The were two main reasons for referral to this facility: 1) Individuals who were referred to the facility as a result of intensive surgery that needed time to recover; 2) Individuals who could no longer take care of themselves at home and were referred by the individual him/her self or a family member.  Discharge was not common in the facility except for the individuals who were there for the short term- that is, those individuals who were using the facility for rehabilitation.  As far as team members at the facility, there was a nursery official, dietery rehab, occupational therapy, physical therapy, and a social worker- the team worked together. The supervisor’s typical day had 4-5 individual sessions, followed by meetings, and administrative paper work.  The primary treatment modality of the facility is individual.  The safety precautions used in the population included constant observation due to confusion, wandering agitation.

During my first day at the facility, I experienced a number of different feeling including happiness and eagerness.  I felt happiness  because  although U had not spent much time with older residents, I wanted to help them achieve a better quality of life.   I also felt eagerness because I wanted to dealt with a challenging population- that challenge is certainly met at a nursing home.  My orientation was divided into two different parts: 1) A one-on-one meeting with the supervisor getting instructions on what she does from day-to-day; 2) A general orientation with an administrator regarding how the nursing home operated.  The supervisor said for the first couple of sessions that I would watch her and the assistant dealing with particular patients.  After that, I would gradually be given greater freedom to work with patients, although that would be under the management of the supervisor.  In addition, I would also be given general duties around the nursing home to become more familiar with the environment including interaction with residents.  My learning style, in general, is through watching.  I felt comfortable with watching the supervisor conducting tasks, and after watching them, I was able to do them with adequate proficiency.