Today I was working with Michael and Jessica who are responsible for social services. This department is responsible for as I learned everything.
Social services work with every department. The main job of social service workers is communication. They communicate between the patient, family and staff members. Another aspect of this job is seeing what each insurance is able to cover. Their job is also to prepare discharge plans for residents and make sure that they are able to leave the clinic. For instance if a patient is close to being discharged the social services will communicate with the physicals therapy department to see if the residents required any additional items, if so order them and make sure that the patient will receive it. Then they have to make sure the residents will have proper medication by contacting the nurses. Next it is time to see if their current house situation is able to provide them a self environment, if not part of the residents rehabilitation plan might to for instance practice walking up the stairs. Next important part of the job is just planning, organizing and making sure everything runs smoothly. Michael and Jessica and often at different meeting where they meet with the family or just various department at the clinic. Today I learned how much of an impact social service department has on the whole clinic and how much other departments rely on it.
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Today I spent time working with Debbie who is a speech therapist. The day began with Debbie showing me what speech therapist do, and what are the main goals while undergoing speech therapy.
At the clinic, most of the residents see a speech therapist at least once per week. A lot of them have swallowing issues. Usually the patient who is unable to properly swallow starts of with eating foods that do not require biting, then small chunks but moist, soft solid foods and eventually all kinds of foods. Additionally, there is a lot of exercise that help with swallowing. Another part of speech therapist's work is to help patients whose speech needs improvement. For instance if someone had stroke and their speech got worse, they might require help in order to properly communicate again. Today I learn a what kind of job speech therapy is and what it does. The most interesting part was that I though that speech therapists only focus on treating speech disorders and communicational skills, however a big part of their job is also helping with swallowing issues. Today I was working with Jay who is an occupational therapist. He showed me what his job is all about, what kind of work does he do as well as how his documentation looks like.
We began with seeing residents and figuring out what are their needs or wants. Those could vary all the way from helping them how to dress, independently use a bathroom, get out of bed, but also they might ask for some more basic things that they might need in their room. It was interesting to see how some residents were trying to be independent, they were trying to do a certain tasks fully by the selves, event though sometimes it seemed very hard. It was great to see how big of an impact an occupational therapist makes. It is one of those crucial things that a residents require to live by themselves. The job itself seemed very interesting but definitely one that requires a lot of patience and communication skills. Today I was working with Physical Therapy department, where I was able to see a lot about everything related to physical therapy.
I stared the day by overviewing what goes into the job of physical therapist at the clinic. We have gone over the procedures of documenting information about the residents as well as what a regular work day looks like. We were talking about the emotional and physical struggles that come with that profession. Most of those things were just typical health-care related job struggles, however there was a few things that brought up my attention. For the rest of the time at the clinic I was able to shadow the physical therapist and see what kind of procedures are done to the residents, as well as how documentation of their progress looks like. I was able to see what kind of equipment is used for rehabilitation, how speech and way of giving instructions to the residents looks like. Today I was working with Kayla who is responsible for Physical(PT) and Occupational(OT) Therapy management. She introduced me to the process that the resident under goes as well as what are is the formal part of PT and OT. We were going over the computer system that is used in that department of the clinic. She showed me all the details related to each patient as well as their treatment plan as well as the equipment that she orders and manages.
The clinic is divided into two units: the intensive care unit and the long term unit. Accordingly, the first one requires more nurses, the patients are there temporally, the second unit consist of patients who are there permanently. Relating that to the therapy, the intensive care unit gets their therapies more often with a specific schedule, in order to get them physically ready to leave the clinic, while the long term unit gets it whenever the residents are requiring a therapy. The treatment plan is prepared by the physical therapists that coordinate it with the insurance company. Each insurance requires the resident to have PT or OT at least 5 times per week. Then, some residents might require both PT and OT in order to complete their therapy, because they have higher needs. The problem comes when the insurance company doesn't cover their PT and OT. The insurance gives a certain amount of time that the resident is supposed to spend doing their therapy, but sometimes that is not enough. It that case it is possible to apply for medical aid from the state of Oregon. This Monday was full of interesting discoveries. I was working with Marigold who works at the case management department. She is responsible for providing appropriate medical treatments, correct healthcare coverages as well as look over patients and the most importantly make money for the clinic .
During the time of resident's stay Marigold is responsible for monitoring and documenting their progress. For instance, when a person comes in to the clinic they might require two people who will help the resident walk or dress or do any other activity. Over time the resident might require just one assistant. Another example is drug dosing, usually when a resident's drug dose decreases it might be a sign that their well-being increases. All those changes are carefully noted and reported to the insurance provider. On the other hand, if a person is misbehaving or keeps on skipping their physical therapies, case manager will report that too. It is important to keep record of all that because the insurance wants to make sure that the resident is getting the best treatment possible. The most interesting part from all of that is that each diagnosis has point which indicate how much funding the state can pay for a certain issue. For instance, if a person had a hip replacement it will be noted as a priority diagnosis and most likely will have more points that other diagnosis therefore the clinic will receive more funding for that person. When a new resident comes in it is important to check their insurance in order to cover their stay, usually the insurance covers each patient for 100 days. After the 100-day period the insurance stops paying for the resident's stay. Hopefully by that point the residents is able to function properly, but if not and additional stay is required social services take care of that. Overall, today I learned a lot about the insurance part of resident's stay as well as where the funding for all the residents come from. It was definitely a different side of what I was expecting to learn during my independent study, nonetheless it was very fascinating. It was my last day this week, during which I was working with Tina who is responsible for medical records at the clinic. She completes all the records and profiles for the residents at the clinic. Tina has been working at the clinic for 39 years, so she was able to tell me how the process of recording data about residents has changed but also some general history of the facility. It was very interesting to hear her stories as well as what her job looked like before.
I was able to work with her and learn the program that is used for recording and documenting everything that has ever happened to the patient, from which hospital they came from, what are their diagnosis and what medications they are on. Going through some of the profiles it was almost scary to see on how many different medication some residents are, it is crazy to think at there are events that will change you whole life and force you to take so many different medications just to survive another day. Today I spent time with Sara who is the person responsible for activities in the clinic. She does activities ranging from games like bingo to physical activities , stretches and walks. Moreover, she organizes special events like Christmas, Halloween and birthdays.
Currently because of the pandemic it has been really hard to work with the resident, since they are not allowed to spend time with each other. All the activities are "one on one" with Sara and the resident in their room. It has been really hard on the residents not to be able to get out of their rooms or just see their friend residents. Since the pandemic started most of them became more depressed and not as enthusiastic about their life . Social activities such as different trips or weekly going out to different places in the city had a huge impact on their general well being in the clinic. It is sad to know that right now they feel so down because they have to spend time in their rooms. I spent time walking around with Sara and helping out the residents as well as we were keeping them busy mentality and physically by playing various games with them and some simple physical activities. It was great to speak to the residents and get to know them a little bit more. Today I began my day with Jeffrey and Jim, who are two of the staff members responsible for guest services and the entrance desk, where they approve everyone who is allegeable to come in to the building. Their function is also to transport residents from the clinic to hospitals but also new patients from the hospitals. Currently, because of the pandemic every resident who comes in has be separated in a different wing of the clinic where they spend 14 days during which they are tested for Covid-19. During pre-covid times the clinic would let in family members and visitors , however now because of pandemic they are not allowed anymore. Overall, I learned about the process of people coming in and out of the clinic as well as what precautions that everyone needs to take.
Today was my first the of the intensive. My day began by going to the clinic and getting tested for Covid-19 rapid test. After that I was introduces to a few of the staff members and nurses at the Avamere clinic.
One of the first things before I even began my shadowing journey, it was required for me to get a background check. I was asked about my travels, where I was from as well as where have a lived for the past 5 years. After that I was given an ID that indicated who am I during the time I will be spending at the clinic. After I was ready to start my first day of shadowing I was introduced to Rob, who is the administrator of the clinic. He is responsible for the whole building as well as everything that happens at the building. Rob and I were going over "Abuse Prevention Policy and Procedure". It was a couple of documents that stated the policies and procedures as well as some definitions about neglection and abuse. As a worker at medical facilities it is important to acknowledge the difference between abuse and neglection, because it happens surprisingly often. Of course the difference between those two is that one is intentional where the other is not and as I was told both happen at the same frequency. The idea behind going over those policies was that when for example a resident doesn't follow the direction from the physician/ nurse there is a protocol what are we as the staff supposed to do. As Rob said, which I think was a brilliant point, the residents have every right to refuse to for example take a shower or go out on a walk, but also it is important to notice that we as the staff are the "guests" in resident's home. It was eye-opening to read and hear about all the procedures as well as know what steps do someone need to take when the residents are not willing to follow directions. I did no expect that to be the first thing before starting anything else at the clinic. After we have finished the Abuse Prevention Training Jeffrey who is one of the staff members who is responsible for guest services, the sanitation of hands and face shields and check up on the proper mask wear. Jeffrey showed me around the whole clinic, I was able to see most of the departments of the clinic as well as the staff. |
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