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Archive for the ‘occupationalTherapy’ Category

MRSA

We just admitted someone with Methicillin-Resistant Staphylococcus aureus, though we don’t know where the site is.  So I came home and read up on it:

Some settings have factors that make it easier for MRSA to be transmitted. These factors, referred to as the 5 C’s, are as follows: Crowding, frequent skin-to-skin Contact, Compromised skin (i.e., cuts or abrasions), Contaminated items and surfaces, and lack of Cleanliness.  Locations where the 5 C’s are common include schools, dormitories, military barracks, households, correctional facilities, and daycare centers.

You can protect yourself by: 

  • practicing good hygiene (e.g., keeping your hands clean by washing with soap and water or using an alcohol-based hand sanitizer and showering immediately after participating in exercise);
  • covering skin trauma such as abrasions or cuts with a clean dry bandage until healed;
  • avoiding sharing personal items (e.g., towels, razors) that come into contact with your bare skin; and using a barrier (e.g., clothing or a towel) between your skin and shared equipment such as weight-training benches;
  • maintaining a clean environment by establishing cleaning procedures for frequently touched surfaces and surfaces that come into direct contact with people’s skin.

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And Mary said:
   “My soul glorifies the Lord 
    and my spirit rejoices in God my Savior, 
 for he has been mindful
      of the humble state of his servant.
   From now on all generations will call me blessed, 
    for the Mighty One has done great things for me—
      holy is his name. 
 His mercy extends to those who fear him,
      from generation to generation. 
 He has performed mighty deeds with his arm;
      he has scattered those who are proud in their inmost thoughts. 
 He has brought down rulers from their thrones
      but has lifted up the humble. 
 He has filled the hungry with good things
      but has sent the rich away empty. 
 He has helped his servant Israel,
      remembering to be merciful 
 to Abraham and his descendants forever,
      even as he said to our fathers.”
(“Mary’s Song” from Luke 1:46-55)

I had a work field trip today (honor code).  You can find the history and background for Magnificat House in the links below.  They have a rule to be home by 9 pm.  They have enough staff to provide guidance but not enough for it to run without the consistent multiple input from members.  The house they are in is quite an old house–it even has servants steps from upstairs down to the kitchen for back in the day when they are to stay out of sight as much as possible and to be readily available to quickly bring refreshments.  They have a sand volleyball court in the back, but it doesn’t seem to really be used.  They gave me a video to watch (about how this clubhouse model started, playing “Against Me” by Godspeed in the background), and a guy who had slight tongue thrust came in, sat in a chair, and started rocking back and forth.  It really is a clubhouse because you just come in and do whatever you want, hang and chill or do work, etc.

I met the sisters present that afternoon and Ernie, an HCC professor of transportation law who comes Tuesdays to teach Bible study.  I was paired up for about an hour with an ex-prisoner for him to tell me about what they do out in the yard (horticulture’s quite a big factor here – I helped with flower arranging earlier).  I was told one of the Sisters is actually an OTR (pediatrics), but she’s not here today.

“Work is a regenerative force.”  They have a sense of together helping the house run well.  It gives them a sense of success and companionship.  In fact, they don’t only have the opportunity to contribute but the expectation to do so.  They are members for life, because it’s okay to not be strong 100% of the time.  They utilize horticulture duties as I mentioned earlier, hospitality and kitchen (I ate lunch with them, which was prepared and served by the members), chapel, household/newspaper (they have their own newsletter that they work on together and print), admissions, and education/employment (learning skills, helping each other out, etc.).  They work and reach out to help get student loans forgiven.  They make and edit videos to give to sponsors as to what their money is going towards.  I only asked a few questions, which was answered like they all have a Gold Card for health care, although a few have private insurance.

  • Four Guaranteed Rights of Membership:
    1.) A right to a place to come
    2.) A right to meaningful relationships
    3.) A right to meaningful work
    4.) A right to a place to return.
  • Magnificat Houses Inc, is a nonprofit charitable organization chartered by the State of Texas in 1968. The agency has been providing the poor and homeless of Houston not only with the basic needs of food and shelter, but with hope and the belief that every human being has dignity. The Magnificat House, Inc. was founded by Rose Mary Badami with the intention to help those in Houston who are most in need. Magnificat Houses, Inc. now includes nine residential houses for the homeless, the recovering mentally ill, ex-offenders, women and children, and anyone who might need a place to stay. In addition to the nine residential houses, Magnificat also runs multiple programs including a house for those with HIV/AIDS, St. Joseph ClubHouse, a psychosocial program for residents recovering from mental illness, a soup kitchen located on Houston’s “skid row”, an overnight emergency shelter for street women, and a thrift store that offers discounted furniture, clothing, etc. For more information on the organization, see: http://home.surfree.com/~magnificat/houses/index.html (Aurora Seminara, GSBS).
  • Eli Lilly and Company announced today the winners of the 2004 Helping Move Lives Forward Reintegration Awards.  The annual awards honor individuals or groups who help and support people living with severe mental illness; the achievements of people living with severe mental illness who offer hope to others facing similar challenges; and local and national efforts to raise awareness for mental illness:  http://www.prnewswire.com/cgi-bin/micro_stories.pl?ACCT=916306&TICK=LLY&STORY=/www/story/11-11-2004/0002403814&EDATE=Nov+11,+2004
  • The Artistic Contribution Award honors accomplishments in self-expression, in areas such as painting, video, dance performance, music, design or fashion.  The Fountain House Audio Visual Department (New York, NY) won first place with “Opening the Door,” a thoughtful, well-crafted feature length documentary that tells the story of Fountain House, the first clubhouse program for individuals suffering from severe and persistent mental illness. The film was created by the Fountain House Audio-Visual Department, which is comprised of ten Fountain House members and a staff member.  Founded in 1948, Fountain House offers a rich array of social, residential, educational, vocational, and advocacy opportunities. Membership is lifetime, voluntary and fee-free. Upon visiting the clubhouse, located in a Georgian colonial-style building complex in mid-town Manhattan, one is immediately aware of the commitment and teamwork of members and staff who are working together to enhance the program, while maximizing the ability for each member to achieve his or her greatest potential.
  • “A model of the dissemination of self-help in public mental health systems” by Edward L. Knight, Ph.D. (DOI: 10.1002/yd.2330227406).  Self-help in public mental health systems has been disseminated with five different strategies; these strategies sometimes overlap and complement one another: The four forms of self-help discussed are mutual support, advocacy, consumer/survivor-run services, and coping.
  • Fountain House Sketch by Scott Martin (book)
  • Prince Michael

More links:

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Considering what happened last night, I went to work on crutches wondering what the day would hold.  Would I have to be sent home?  My heart was torn to whether to want to stay or not.  On one hand that would mean I get to postpone starting since I am still apprehensive, but that would mean I would have to make it up at the end (or on a Saturday) anyway.  On the other hand, I already took the effort to get up so I might as well stay since the first week is usually orientation anyway.  My clinical instructor met me in the lobby (since they have a metal detector) and exclaimed, “What happened?”  He decided the best thing to do would be to allow me to see outpatients downstairs (since inpatients are more dangerous – they could grab my crutches and injure someone) and read the student manual during down time.  That way I could experience seeing some of the symptoms in people and I wouldn’t have to make up any days.  I was satisfied with that plan.

These were a few things I read:

  • “Persons with mild conditions may have a more dificult time adjusting because they are almost normal.  They may try to hide or deny the deficit because it is marginal.”  <–this struck a cord with me since I am diagnosed with MDD but I wasn’t pushed to take any antidepressants, which I am still wrestling with.  If I was taking medication, then I would rationalize it that it was my body chemistry’s primary fault.  Since I’m not, I’m wondering if it wasn’t really my own fault, that somehow I did this to myself amidst all the good I am surrounded with in family, friends, academics, shelter, health, spirit, the works.  I mean, people always tell others that the diagnosis doesn’t reflect on “who the person is” (e.g. if you’re manic and you strip in public).  But then again, you still have to face the consequences of your actions.  Just as if you’re diabetic by genes or diabetic by bad dietary decisions, you’re going to have to deal with the finger pricks for the rest of your life.  Might as well move on and take this opportunity to learn the better lifestyle (such as in changing the way I think), whether they contributed to my depression or not.
  • The main difference between anxiety and fear is that anxiety is a response to no specific object while fear is a response to a specific object.  For example, I have to evaluate a patient and I start getting nervous but I’m not sure what I’m anxious about.  Whereas as soon as I see an lion I’ll be scared that it would attack and thus harm me.  Interesting, eh?  I think that’s why I don’t like to watch horror movies but I can enjoy some thrillers.  Thrillers cause me anxiety but horrors cause me fear.  (There are also different levels of anxiety but I forgot them.)
  • A person falls into an impaired-role behavior occurs when an acute episode of illness turns to a chronic course, and the person has to adjust to a more permanent condition.  I think of this phase as moving from denial to acceptance.  I mean, as an assignment I had to pretend I could only use a wheelchair to get around.  My roommate said that she was impressed with my determination because I had elevated my bed (in order to put my dresser underneath for more space in my bedroom at Miner Village – the dorms in UTEP) and yet in the middle of the night she heard me us the wheelchair to get into the bathroom.  Well, I said that I just wanted to get as full an experience as possible.  Plus, I knew the next day I could walk immediately.  I can’t imagine having the realization that, gosh, you know what, maybe I won’t ever be able to use my legs after all.  *shudder*
  • When people have lifelong disabilities, especially from childhood, the family will most likely suffer some sort of chronic sorrow.  Meaning, they will not only mourn at that moment the loss of their child not having a “normal” mental ability, but also mourn the loss of hope, of their expectations, of their dreams for their child.  As each developmental milestone and “normal” accomplishment approaches and then passes, the grief is rekindled as they see that their child cannot graduate like the rest of the children, cannot marry, cannot contribute to society through a career.
  • Some tips they offered were:  “Maintain a detached perspective through which the stress could be interpreted”, don’t ignore your problems but also don’t excessively worry about them, and “Regularize the environment.  The same stressors are less harmful if they occur predictably or if the schedule can be arranged to fit in the stressful events.”  <–It lets the person know that they can still have a sense of control over the illness instead of having the illness direct their lives.
  • “Giving clients information that describes what they will see, hear, taste, smell, and experience during health care events such as ECT and cast removal reduces stress more than the traditionally prescribed procedural information that tells what is going to be done.”  <–This stuck out to me due to my future role.  I guess I can explain both.
  • “A specific phobia is excessive fear upon exposure to a specific object or situation (but not of a panic attack or being embarrassed in a social situation). When confronted by such objects or events as elevators, funerals, lightning storms, insects, or animals, phobic individuals become extremely fearful. Specific phobias may also involve fear of losing control, panicking, and fainting when confronted with feared object. Adolescents or adults recognize the fear as unreasonable, but can do little to stop it. Often the individual can lead a relatively normal life by simple avoidance, and the diagnosis not made.”  <–sounds like me!  When the psychiatrist I saw told me that I had social phobia, I was like….um…are you sure???  But thinking back, it makes sense (see items 7bcfg).  Actually, the first and last examples really reflect the sentence I italicized.  While under the table, and behind the door, I was thinking to myself, “This is absolutely ridiculous.  Not like they can’t see you from here.”  But that instance of terror sure drives into many illogical behaviors.
  • “As stress increases, ‘learned behavior’ tends to give way to the natural style, so the ISTP will behave more according to type when under greater stress, such as withdrawing from people, sorting out detailed points that could perhaps wait, and ignoring their feelings.  Under extreme stress, the ISTP’s shadow may appear, a negative form of ENFJ.  Example characteristics include displaying intense feelings towards others, insisting on things being done without any logical basis, being very sensitive to criticism, having a gloomy view of the future, and attributing unrealistic negative meaning to others’ actions or statements.” 

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