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Marzan, Darren
N210 4/15/2015
Rehabilitation Observation and Reflection
On Thursday the 10th of April, myself and 5 fellow students visited the Rehabilitation
Hospital of the Pacific. Each of us were assigned an occupational therapist (OT) or
physical therapist (PT) to follow and observe throughout the morning shift and switch to
a different person in the afternoon shift. I observed Joyce (OT) in the morning, Nalani
(OT) in the afternoon, and various other PTs/OTs working with their patient throughout
the day in the therapy gym. From the experience that day, I had learned much more about
the rehabilitative side of health care and also got to see the nurses and nurse aides do their
line of work as well.
The collaboration between health care disciplines spans throughout the day for the
patient. There is a new schedule every day for the patients and they work with PTs, OTs,
speech pathologists (SP), and nurses. The goal is to get the patient improve since their
initial admission and possibly return them to baseline function within 2-4 weeks for
discharge, depending on their condition. Initially the PTs and OTs evaluate the patient and
give them a functional independence measure (FIM) score which measures the level of
patients disability and how much assistance is required to complete activities of daily
living. This information is shared with the other disciplines of nursing and SP to ensure
proper and adequate help is provided to the patient to aid in their recovery and daily life. I
had observed a patient having a BM while working with the OT during shower
evaluation, after which the OT had notified the nurse. Another observation was when a
foley catheter bag began leaking, the OT had called for assistance and an RN had come

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by to check on it and fix the problem. The floor acted as a cohesive unit and I observed a
high standard of communication among the different health care disciplines.
The OT had setup a family training session for a patient about bed to wheelchair and
vice-versa transfers. She demonstrated proper transfer technique and explained step by
step throughout the process. The OT was the sender; the receivers were the patients
family; the message was on transferring; the barriers to communication were external
noises (the other patient in the same room had the TV on, NAs were coming into the
room to check on the other patient). After demonstrating, the OT had asked 3/5 family
members to do transferring, and she gave them the necessary cues to do so. The message
was received clearly and with more practice transferring would come more easily. The
OT had setup a new family session for the following week so they could practice again.
A new safety skill that I observed was the use of grab bars for the patient when it
came to bathing. During a shower evaluation, the OT had instructed the use of grab bars
for a patient with stroke and aphasia. She reminded constantly that grab bars were
important for stabilization and balance and although the patient could not talk, she did
respond to the safety measure. The OT had evaluated the patient at moderate assistance
with the need of set up help and discussed with her and the family of ways to shower
safely.
One similarity I noticed was on instructing patients on how to go up and down stairs.
Cane-bad leg-good leg going down and good leg-bad leg-cane going up. Another
similarity was the use of active ROM and passive ROM to support muscle conditioning.
A difference I had observed was the amount of exercises and activities available for the
patient. The PTs and OTs gave specialized activities specific to the patients needs for

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rehabilitation. For example a patient with right sided weakness caught and threw bean
bags into a basketball hoop from a distance; a different patient with impaired gross motor
function passed a big beach ball around with cues and encouragement.
15 points
1. Note the nurses role with
communication with client
care between the disciplines.
2. Give an example of one
client interaction that you
observed.
Include topic, sender, receiver,
message, any barriers to
communication and how the
message was perceived/
received / acknowledged
3. Give an example of one new
safety skill that you observed
4. Give an example of the
differences and similarities
that you observed.
5. APA formatting, spelling,
sentence grammar, structure,
and punctuation. Rubric has
been added to the last page.
Labeling in drop box is
correct. Signature page in.

3 points
Communication strategies
were fully discussed
Example that was discussed
included: noting the receiver,
message, and barriers to
communication and how the
message was perceived/
received/ & acknowledged by
the patient. Discussion showed
insight into the education
process.
A new safety example was
discussed that was not
previously known and its
importance to care.
Both differences and
similarities were discussed
when referring to previous
learned care from KCC
APA formatting, spelling,
sentence structure, and
punctuation were correct.
Rubric added to the last page.
Labeling in drop box was
correct. Signature page

2 points

1 -0 points

Communication strategies
were slightly mentioned or
idea not developed
Example discussed was
missing some of the areas
required. Insight or example
chosen was weak

No mentioned or not discussed


in a professional way

Safety skill was not new to the


student but was discussed well,
importance was not discussed
well
Both differences and
similarities were discussed but
were not well defined

Skill was not discussed. Skill


was not new.

Small APA errors, one


spelling, sentence structure
one error in grammar, etc.
Rubric not evident. Labeling
not correct.
Signature page late

Many error in APA


Rubric not evident on last
page.
Labeling for drop box
incorrect.
No signature page

Missing more than one area


that was required. No example.
No insight into the
communication process

Some areas forgotten, or not


well defined.

15 points total. 11 points are needed to pass. Less than 11 points must be resubmitted.