Roger C. Peace Rehabilitation InternshipHANNAH JOHNSON

Roger C. Peace Rehabilitation Hospital

Mission: Heal compassionately. Teach innovatively. Improve constantly.Vision: Transform health care for the benefit of the people and communities we serve.Values: Together we serve with integrity, respect, trust and openness.

Roger C. Peace Rehabilitation Hospital

Roger C. Peace has over 30 years of experience with inpatient and outpatient therapy and is a leader in brain injuries.The center serves on the South Carolina Brain Injury Leadership Council.

The center has 53 inpatient beds and an outpatient center that provides physical, occupational, recreational, orthopedic, and speech therapy to patients. Roger C. Peace works with patients to provide work, school, and community re-entry. Goals:

1. Provide the latest rehabilitative and technological services with compassion and encouragement

2. To help motivate patients

3. To assist patients in re-entering the community as smoothly and as quickly as possible

Special Features of RCPSponsor of a Para cycling team that has competed in world-wide para-cycling events.

Therapists aid individuals with various disabilities to allow them to participate in water skiing, golf, sled hockey, and sailing.

Roger C. Peace Team at the National Championships in Chattanooga, TN

Roger C. Peace 2015 Annual Ski Bash

Outpatient Rehabilitation The majority of my internship was spent in the outpatient rehabilitation facility.This facility sees a variety of patients but specializes in brain injuries. Many of the patients that come to this facility have suffered from major traumas including spinal cord injuries, strokes, and spinal fractures. Through my observations I was able to see the various methods of evaluating, treating, and recording progress for these different injuries and conditions.

Occupational therapist assistant working with the BTE in the therapy room

Acute CareDuring my time at RCP, I was able to observe an acute occupational therapist. Acute occupational therapists work in the ICU and on the floor to see patients that are recovering from strokes, heart attacks, surgeries, and other illnesses and traumas. The goal of these therapists is to determine if an inpatient stay is warranted and to aid the patient in regaining their independence with self care activities while still in the hospital. This was an eye-opening and very educational experience as I got to learn more about clinical diagnoses and how those diagnoses affect the patient’s mobility, speech, and comprehension skills.

Inpatient Therapy I was able to spend a day working with the inpatient occupational therapy team.Inpatient therapists work with patients who have been discharged from the main hospital but are not strong or healthy enough to return home. Therapists work with these patients to help them regain the strength and coordination needed to complete basic tasks of self care and daily living. I saw patients learn proper wheelchair mobility, complete strengthening exercises uses weights and body resistance, and work on tasks that involved using fine motor skills and advanced cognition.

Clinic for UnderservedThe Greenville Hospital System sponsors a clinic near the hospital that serves individuals who are underinsured or would otherwise not be able to receive the care that is needed for optimal recovery. I visited this clinic multiple times and observed occupational and physical therapists work with patients recovering from surgeries, injuries, and strokes. Splinting is a key component of providing care to these individuals because it allows the therapist to control the position of the hand or extremity when the patient is not at the clinic. I was able to observe multiple splint makings, which helped me to get a better understanding of knowing which splint to make, determining how to make the splint, and adjusting the splint so that it does the most good and discomfort is minimalized.

Demonstration of splint making

Clinic for UnderservedVisiting the clinic also showed me the importance of improving the Affordable Care Act so that individuals can truly live healthy lives. If unable to receive therapy after a major surgery or stroke, the individual is unable to fully recover and permanent disabilities can form. These disabilities have the power to cause chronic pain and keep an individual from working and providing for themselves and their dependents. Visiting the clinic also highlighted the many unseen obstacles that this underserved population must overcome. Getting to therapy can often be too difficult due to lack of knowledge of public transportation or lack of access to it. To ensure that these individuals receive the best care, there needs to be more institutions in place that aid these individuals in coordinating transportation, child care, and time off work.

Driver Rehabilitation Roger C. Peace hosts a driver rehabilitation program for individuals looking to return to driving after a debilitating illness or injury.This program is run by three certified occupational therapists from the outpatient clinic. The program includes an initial evaluation of strength, coordination, cognition, and visual acuity. Drivers are then placed in a simulator to learn how to operate any new equipment that may be needed for their car. In the last step, the therapist takes the driver on the road to see how well he or she operates in a real driving environment.

Driver simulator at Roger C. Peace

KidneticsKidnetics is a part of the Greenville Health system and is specialized to work with children from birth through 21 years of age. At Kidnetics, children receive services from occupational, physical, and speech therapists. During my time at Kidnetics, I observed an occupational therapist work with a young child on feeding. From this experience, I learned some of the techniques that are used to develop a psychological acceptance of food as well as how to build the muscles and coordination needed to be able to chew and swallow foods. Occupational therapist working with young

boy at Kidnetics

ALS ClinicGreenville Hospital System is one of a few hospital systems in the nation that hosts an ALS clinic The clinic is for patients with Amyotrophic Lateral Sclerosis, a fatal disease that slowly destroys the communication between the brain and the muscles. This deterioration makes mobility, speech, and breathing increasingly difficult and eventually impossible.

Lou Gehrig – a famous New York Yankees player plagued by the disease.

ALS ClinicOnce mobility declines, leaving the house becomes very taxing. The clinic makes it so that the patients can see clinicians, occupational and physical therapists, medical equipment providers, respiratory therapists, and hospice care workers all in one day at one location. Going to the ALS clinic was my most meaningful and affecting experience that I had throughout my internship because in an environment where death is an ever present fear and reality, there was constant smiles and laughter. Through attending the clinic, I saw the power of patient – provider relationships. The individuals suffering from ALS wanted to adhere to all recommendations from their providers because they trusted their providers and saw them as friends rather than authority figures.

Each provider has a label that is moved from one side of the door to the other to indicate who is in the room with the patient.

Major ProjectsALS Patient Education BindersAssistive Technology and Equipment Resources ChartCase StudyIADLs Home Lab

ALS Patient Education Binders My main project was to construct binders containing educational materials regarding the many components of ALS. Some of the components included in the binder were:

Symptoms and Treatment options

Respiratory Care

Nutrition and Feeding Tubes

Speech and Communication Devices

Physical and Occupational therapy equipment and exercises

Grants and Funding

Hospice Care and Advance Directives

Teamwork Lauren Wegnerd is the occupational therapist on the ALS team and was my supervisor in this project. I worked directly with each individual from the ALS clinic team to decide what materials should be included in the patient binders. Team members either submitted materials directly to me, or gave me ideas of the types of items that they wanted included. Together, Lauren and I gave the final say in what materials should and should not go in the binders.

The clipboard allows all the patient information to remain in one spot and allows providers to make notes for one another.

Creating ResourcesWhile the ALS association was able to provide me and the team with a large majority of the information for the binders, other materials had to be created.Some of the items that I created for the binders were lists of resources that the patients could refer to if they wanted additional information or services. Included were lists of resources for:Mental Health/CounselingClinical Trials and New ResearchSupport Groups and Forums

Presenting the BindersI presented the binders for the outpatient occupational and

physical therapists. By presenting the binders, the therapists gained

new information that they can use to help treat their patients with ALS

The binders inspired the other therapists to have similar binders made for other conditions such as spinal cord injuries, strokes, and Multiple Sclerosis.

Outpatient therapy team to which I presented the binders to.

Assistive Technology and Equipment Resource BankAn additional project that I completed during my time at Roger C. Peace was the construction of a document that included all the local associations and entities that loan or sell durable medical equipment to patients with disabilities. I completed this project by researching the various organizations that provide these services and contacting the organizations if more information was needed. This bank was distributed to many of the therapists in outpatient, inpatient, and acute care. The therapists were able to then distribute this resource to patients who were in need of medical equipment.

Case Study My interest in spinal cord injuries led me to choose to complete my case study on a 56 year old male who suffered from a cervical spinal cord injury after falling off a ladder.

The case study allowed me to learn more about spinal cord injuries because I was asked to compare the patient with the typical case. By studying the typical case, I saw how the patient was progressing in regards to others with similar injuries.

Observing the patient’s therapy sessions allowed me to see the progress that I had read in his chart. I was able to discuss with him his opinions on the accident and his hopes for recovery.

Me speaking with the patient I completed my case study for.

Instrumental Activities of Daily Living

Home LabRoger C. Peace was in the process of completing a project that would allow utilization of their home lab that includes a bed, pantry, washer and dryer, and a kitchen table. I aided in completing this project by helping to set-up the materials that would be needed for the activities created by the therapists. I helped to create the following:

A menu for an activity involving scanning for objects in the pantry and making a list of which objects are not present but are necessary for making the items on the menu.

Cutting out fake money to be used by the patient to practice money management at the store.

Setting up fake pill bottles to be used by the patient to practice medication management.

Creating a phone and address directory to be used by the patient to practice phone usage skills.

IADLs Home Lab Participating in this project allowed me to get ideas for therapies that can be used to help patients work on cognitive deficits and help therapists to assess a patient’s ability to perform daily activities safely and efficiently. I also learned the importance using activities that resemble the important skills needed for living independently. Other activities included in the lab were bill payment, table setting, and bed making.

Medication management activity that I set up.

Money that I printed and cut out for the bill pay activity.

References Images:

◦ http://kcts9.org/sites/default/files/imagecache/618x350/homepage-slides/connectsals_0.jpg◦ http://www.ghs.org/healthcareservices/rehabilitation/outpatient-inpatient-services/peacecenter#.VkD-

vE13G70◦ http://

www.clemson.edu/ces/departments/automotive-engineering/research/human-factors-hmi/i-can-still-drive.html

◦ http://www.cincinnatichildrens.org/service/o/ot-pt/upper-extremity-splinting-orthotics/◦ http://www.disabledsportsusa.org/chapters/roger-c-peace-rehabilitation-hospital-south-carolina/◦ https://www.facebook.com/RCPCTEAM/photos_stream?ref=page_internal◦ http://www.ghschildrens.org/myimages/p10305441.jpg