OCCUPATIONAL THERAPY
THERAPEUTIC RECREATION
AFFILIATE/INTERN
MANUAL
Western State
Hospital
STAUNTON , VIRGINIA
2006 EDITION
STUDENT MANUAL
INDEX
I. Statement of Philosophy
II.
III. Introduction to Staff and
Clinics
IV. Departmental Policies and
Procedures Overview
V. Assignments and Behavioral
Objectives
VI. Directions to
VII. Housing Rules
VIII. Expectations/Job Essentials
MAILING
ADDRESS
REHABILITATIVE SERVICES DEPARTMENT
PHONE
(540) 332-8334
FAX
(540) 332-8014
Michael.Poole@WSH.DMHMRSAS.VIRGINIA.GOV.
Revised –December, 2005
REHABILITATIVE SERVICES
DEPARTMENT
Statement
of Philosophy
It is the purpose of the
Rehabilitative Services Department to assist each patient to reach his/her
optimal level of functioning. The department is concerned that all aspects of
the patient be treated, be they mental, physical, emotional, spiritual or
social.
A psychosocial rehabilitation
treatment model (PSR) is utilized to provide the bulk of the patients’ active
treatment. Interventions are presented in a curriculum-based program that runs
20 hours per week. Each patient, in concert with his or her treatment team,
develops an individualized schedule based on the person’s discharge goal.
Facilitators for the interventions are from all clinical disciplines, so ample
opportunities to work as a team exist.
In broad
terms, occupational therapy can be equated with: "The action or activity
and the objects used in the action process function as catalytic agents or
stimuli eliciting intra-psychic and interpersonal responses which in turn are
used in whatever way is appropriate to patient needs and treatment
orientation." (from Fidler and Fidler)
Recreation therapy embraces a
definition of “health” which included not only the “absence of illness”, but
extends to enhancement of physical, cognitive, social and affective development
so that a person may participate fully and independently as possible, in chosen
life pursuits. Therapeutic recreation treatment utilizes a person’s existing
skills and interests as well as facilitates the establishment of new skills for
daily living and community functioning.
Continuing education is viewed as
important and necessary to adequate patient treatment. The importance of
keeping one's skills current is vital, and staff members are encouraged to
attend and give in-service education as well as participate in continuing
education opportunities outside the facility.
Professional staff members are
encouraged to belong to the appropriate professional organizations and to
attend such meetings as appropriate.
The department is committed to
provide a solid learning experience in psychiatry for professional level
occupational therapy, therapeutic recreation, and certified occupational
therapy assistants. A well-developed performance improvement process shall be
used to search for ways to identify opportunities for change and track
strategies implemented to improve care.
MEET
THE STAFF
DIRECTOR OF
REHABILITATIVE SERVICES – Michael L. Poole, OTR/L has the responsibility
to supervise and coordinate the delivery of rehabilitative services at WSH.
Besides occupational therapy, these services are: therapeutic recreation,
pre-vocational training, and adult education. He is the fieldwork coordinator
for the facility and has experience as a psychosocial therapist, and
administrator. His office is in the
SECRETARY FOR
REHAB SERVICES - Linda Mader handles the mechanics of all supply
ordering, correspondence, filing, and typing. She will be the one to see when
you have questions about the above. She is also located in Stribling, or you
may call her at 28334.
OCCUPATIONAL
THERAPISTS - Edna Stone, OTR/L, and Clay Huie, OTR/L are senior
therapists. Suzanne Roberts, OTR/L, Sara
Snider, OT, Brenda Early, OTR/L, Jim Stevens, OTR/L, Susan Bevins, OTR/L and
Susan Baizley, OT are our staff therapists. Mary Miller, COTA and Alice Webb,
COTA are our COTA’s.
THERAPEUTIC
RECREATION SPECIALISTS - Sue Smiley, CTRS; Laura Edwards, CTRS; and
Cathy Fulk, CTRS provide the professional leadership for therapeutic recreation
programs. Sue is also the Service Chief for the Leisure Skills Development PSR
service and coordinates the TR internship website. Sue, Laura and Cathy provide
the clinical supervision to interns.
MUSIC
THERAPIST – Melissa Graham, MT BC is our music therapist. She is
involved in the PSR program.
TEACHERS - Patt
Hollar and
VOCATIONAL
EVALUATOR – Sarah Snider, OTR/L and Jim Stevens, OTR/L, provide
vocational evaluation services for the pre-vocational programming using a
variety of standardized and non-standardized evaluations.
SOCIAL SKILLS
SERVICE CHIEF – Cindy Caldwell is a clinical social worker assigned to
Rehab Services. She is responsible to coordinate the social skills service area
for the psychosocial rehab program.
REHAB STAFF - a group of
paraprofessional folks complete our staff. These individuals are invaluable
sources of information regarding how to deal with patients and what types of
activities work best. You will be assigned times to observe and work with many
of them.
Cindy Rudin Brenda Fisher Donna Nulty
Bruce
Thompson Ned Sparks Ray Lambert
Carol
Williams Nancy Coiner
Stan Fann Margaret Adcock Linda
Mason
Bobby Smith Doug Clemmer Betty Weeks
PSR
(Psychosocial Rehabilitation) TREATMENT AREAS
WEBB MALL – is in the
HARVEST MALL – is the PSR
program serving admissions wards A-1, A-2 and B-2. It occupies space in the
FIRST STEP
MALL – is located in C Unit. It serves patients who are more cognitively
impaired. Its design utilizes shorter, more frequent interventions that those
found in Stribling.
Deaf Program – is located
in the B1 unit. This space is utilized for the hearing
impaired PSR program.
GENERAL POLICIES AND PROCEDURES
1. Working
Hours
You will be expected to be present
from
2. Meetings
Meetings will be assigned to you
once on site.
3. Appropriate
Attire
Casual, professional attire is
suggested. Footwear must be closed toe and secured at the heel. Jeans are
acceptable but should not be badly faded, drag on thefloor, or torn. Items made
of see-through material are not allowed, nor are items that would allow your
underwear to be exposed. Shorts must be of a reasonable length.
4. Absences
a. You must obtain
approval to accrue compensatory time. This is time worked over your normal
expected duties and can be used to extend weekends, or take time off for
personal reasons. Comp time may not be used to shorten the affiliation.
b. Leave time is granted
for emergencies and illness. Any extended leave will require an adjustment of
the original termination date or will require extra hours worked at night or on
weekends. Again, supervisor must approve.
c. If an absence should
occur for reasons other than illness, arrangements must be made with your
supervisor.
5. Reporting
Incidents Occurring During Activities
In the event that a patient or staff
is injured in any way, the staff person involved in or observing the incident
must complete the appropriate form(s). Blank forms may be obtained in the rehab
services office or on the wards. Specific directions and assistance in filling
out the forms is available from your supervisor. Under no circumstances should incident forms be mentioned in the
patient's medical record.
6. Professional
Courtesy
a. Please inform therapists,
assistants or other treatment team members when you will be unable to attend a
scheduled group. It is preferable to select a competent/qualified substitute to
assume your duties in your absence as opposed to canceling the group.
b. Check with ward staff, rehab
services staff and any other person involved in appointments or activities
before scheduling patients for treatment. Avoid double scheduling of patients
in order to promote favorable interdisciplinary relations.
7. Clinic
Maintenance
a. All materials must be returned to
the appropriate place once a group has been completed.
b. Any equipment that is lost or
damaged should be reported to your supervisor for replacement or repair. NOTE: areas will have specific
guidelines for sharps. Familiarize yourself with them.
c. Before leaving the clinic or area
at the end of the day, all windows must be closed, coffee pots unplugged,
lights and air conditioners turned off, and doors locked.
8. Use of
Telephone
a. Calls within the hospital - dial
5 digit number. Example: 28334 for the office.
b. To make a local call - dial 9 to
get an outside line. Once a dial tone is heard, dial the number. Example: 9-886-XXXX.
Toll free numbers use 9-1-800-XXXX.
c. If you need to make a business
related long distance call, you may use the phone in the Conference Room. To
access the long distance lines (which include numbers outside of the local
calling area but within area code 540), you need to dial an 9 followed by a 1,
the area code and the number. Example: 9-1-XXX-XXX-XXXX. Please log all calls you make that use long
distance.
d. DO NOT ACCEPT COLLECT CALLS
e. Credit card calls or calls
charged to another number may be made by contacting the hospital switchboard at
28000 or through 1-800-CALL-ATT.
f. The emergency number in the
hospital is 29111.
9. Patient
Records
a. Patient records should not be
removed from the ward without permission from the appropriate ward staff. They
should NEVER be taken from hospital
grounds.
b. All evaluations and notes must be
countersigned by your supervisor.
c. Black ink must be used when
writing in the record.
d. Errors must be corrected by
placing one line through the error and placing the first initial and last name
plus OTS, TRS or OTAS by the error. Never use white out or an eraser.
e. Assessment related data will be
located in Data Base A, Assessment Section. Any item to be filed in the record
should have an accompanying ID note entry. Most wards have clerks to file items
in the record, so check before placing
anything in the chart.
REMEMBER THAT HIPAA REGULATIONS FORBID SHARING PATIENT
INFORMATION WITH UNAUTHORIZED SOURCES.
10. Holidays
The following holidays will be
observed. You may wish to work one for compensatory time. If so, consult your
supervisor to obtain permission and work schedule.
New Years Day
Lee/Jackson/King Day (3rd Monday in
January)
Lincoln/Washington Birthday (3rd
Monday in February)
Memorial Day
Fourth of July
Labor Day
Columbus Day
Veterans Day
Thanksgiving Day
The day after Thanksgiving
Christmas Day
11. Insurance
Students must provide their own
health and liability insurance. The hospital will provide for minor medical
emergencies on grounds.
12. Student
Supervision
Supervision will be provided on-site
during some treatment sessions and weekly face-to-face meetings. Feedback will
be provided on observed strengths and weaknesses and will follow the accepted
TR or OT format. At mid-point and at the end of the affiliation, the supervisor
and the student will go through the proper form and assign formal grades.
Communication with your supervisor is the key to a productive relationship.
Follow through with the advice you receive and take responsibility for your
learning.
13. Keys
Keys will be issued upon arrival.
They are the property of the hospital and must be returned at the end of the
affiliation. If lost, a charge for each key will be made.
14. Safety
It is your responsibility to
familiarize yourself with hospital safety regulations located in the
departmental procedure manual, the hospital safety manual and the hospital
instruction manual. Also, ask questions when you have them. BE SURE TO FIND OUT ABOUT THE SPECIFIC
SHARPS CONTROL PROCEDURE FOR EACH AREA!
15. Orientation
Will begin on your first day with an
overview of the hospital and the department. A photo ID badge will be provided
and must be displayed while you are on duty. It will be returned to the
hospital at the end of your affiliation. Specific orientation to your duties
will be provided beginning the afternoon of day one. If you bring your personal
vehicle, it must be registered with security. This will be done when you pick
up your keys.
16. Cell
Phones
As there are no in-room phones, cell
phones are permitted in the dorm areas. They should not be used during patient
activities. If you are expecting a phone call, have it routed into the main
office during business hours.
17. NO
PETS
BEHAVIORAL OBJECTIVES
NOTE: Specific
behavioral objectives for each clinical discipline are available on site. In
general, we like to offer the following:
ENTRY LEVEL The
following are behaviors/abilities expected of students upon arrival at
1. Can demonstrate the ability to be
flexible in terms of daily schedule; to be comfortable if things are not
tightly structured.
2. Is aware of and can utilize a
variety of resources for information gathering. These would include such things
as ward charts, treatment team members, other personnel, etc.
3. Can demonstrate basic knowledge
of psychiatric terminology along with psychotropic medications and side
effects.
4. For OT: aware of different
theoretical frames such as Mosey, Occupational Behavior, SI, Allen, etc. For
TR: aware of five domains, Peterson & Gunn model, TR theory and practice.
5. Is open to supervision and
recognizes the importance of interpersonal communications.
6. Demonstrates a willingness to be
responsible for their own learning. It takes active involvement in the program;
and recognition of the fact that students must effect change in themselves.
EXIT LEVEL The
following are behaviors/abilities expected of students by the end of their
affiliation:
1. Be able to take initiative in
data gathering, evaluation, treatment planning, interdisciplinary
communications, and scheduling with a minimum of supervision.
2. Demonstrates the ability to
problem solve.
3. Consistently selects appropriate
treatment modality.
4. Demonstrates competence in
written and verbal communication, accurately.
5. Will develop and project a
professional image that would include such things as self-confidence,
competence, etc.
6. Continue to be flexible.
DIRECTIONS
TO
BY CAR:
BY PLANE: The closest
airport is in
.
IF YOU GET LOST OR NEED ASSISTANCE, CALL THE
OFFICE AT (540) 332-8334 OR CALL THE HOSPITAL SWITCHBOARD AT (540)
332-8000.
HOUSING RULES
1. No alcoholic beverages or illegal
drugs or firearms are allowed on campus or in your rooms.
2. No overnight visitors are allowed.
Several local motels are available close to the WSH campus. Ask for special
hospital business rates.
3. Please do your own minor
housekeeping chores. Try to maintain a tidy, organized room. This will allow
for easy cleaning by housekeeping staff.
4. Maintain the kitchen in a clean
and healthful way. Always dispose of food wastes in the proper receptacle; do
not allow food to rot in the refrigerator (or your room, for that matter); and
be sure to clean up after yourself as others use the area.
5. Follow all hospital rules
provided to you during an in-service on the first day of your affiliation.
6. Keys to your dorm and room will
be issued to you. Keep track of them.
7. Hospital security makes routine
rounds in the building, so expect to see and/or hear them from time to time.
8. If you have problems with
patients snooping around the building, call security at 28000 (on evenings and
weekends). For emergencies, dial 29111.
9. Other problems should be taken to
the Rehabilitative Services Office, and we will try to get them fixed.
10. Pay particular attention to the
15 MPH speed limit on campus. Also always pull in to park; do not back into
spaces. Observe all stop signs, yield signs, no parking areas and one way
signs.
STUDENT EXPECTATIONS/ASSIGNMENTS
1) An evening
per week (
2) A case
study, typed and/or written will be required as scheduled by your supervisor.
3) A
presentation to rehab staff will be required. This presentation can be either a
modality, theory, or area of special interest; not necessarily a modality used
here already; or a an OT/TR theory. You choose. Also, students may work in
pairs on this (when possible).
4)
Evaluations, using approved WSH forms or other approved evals, will be assigned
by the supervisor according to the areas of major responsibility. There will be
opportunities to assess acute admissions, as well as chronic patients. and to
use specific living skill evals. The total number of evals will vary for each
affiliate, depending on availability of patients and student's needs.
5) There will
be specific groups assigned in which the student will assist regular staff in
the planning and conducting of the groups; by week seven, the roles should be
able to be reversed. There will also be a need for the student to develop a new
group(s) based on patient needs. This can conceivably continue after the
student leaves.
6) Documentation tasks
will be assigned once you are on-site. These may consist of narrative notes,
evaluation scales or other forms of written work.
7)
Communication between affiliates and supervisors is a must. If you have a
problem/concern, the proper way to handle it is to take it to your supervisor.
Discussion of individual problems should not be shared with others. You will
have formal times to talk with your supervisor as well as the availability of
the supervisor or department head as needed.
DON'T LET A PROBLEM BE OVER A DAY
OLD.
8) Special
projects may be assigned as needed. These could include such things as
assisting in designing new policies/procedures, or something else equally
exciting.
9) Students
are expected to participate, in a meaningful, professional manner, in scheduled
team or staff meetings. Behaviors will be assessed by observation and
self-report.
10) Nothing
is written in stone; we are here to not only teach and see that required work
is done, but we want to learn from you and get to know you. The key will be an
open mind and a willingness to be flexible.
POLICY REGARDING WORK TIME AND
ABSENCES
BACKGROUND:
Development as a professional includes demonstrating responsible work time
management. As
PURPOSE: To
establish uniform procedures regarding the work hours and time away from the
work site while on affiliation. The policies are consistent with personnel
policies for regular employees and will help the affiliate formulate a
professional approach to time management.
POLICY:
PROCEDURE:
A. Time cards are provided for each
affiliate and are kept at the sign-in station next to the secretary's office in
the
B. Affiliates must sign in each
workday morning at the beginning of shift, and sign out at the end of shift.
C. The work site does not include
the affiliate's home or room. Therefore, regular work hours may not be spent
there. Homework may be required, but this is not considered compensatory time.
D. If time is worked other than
normal hours, entries on the time card will reflect the actual time worked,
with those entries made at the beginning and end of the time worked.
E. Time cards must be signed by the
affiliate to verify that the information on the cards is correct. These are
legal documents which become a part of the affiliate's permanent record. This
information may be needed by the school, the AOTA, NCTRC or insurance companies
(in case of accident).
POLICY:
Compensatory time will be awarded for hours worked beyond the normal schedule.
PROCEDURE:
A. All approved time worked beyond
the hours of 8 to 4:30, Monday through Friday, will be compensated at the rate
of one hour off for each hour worked.
1. Affiliates are
expected to engage in patient-related activities when working additional hours.
It is not permissible to do written work during these hours unless it is
required as part of the specific assignment.
B. Time may be assigned by the
supervisor or the affiliated may request to work additional time.
C. Compensatory time will be kept by
the timekeeper on the time card, and can be accumulated at a maximum rate of
sixteen hours per month.
POLICY: Time
away from the work site is allowed during the affiliation.
PROCEDURE:
A. A maximum of three work days is
allowed in case of personal illness of family emergency. The supervisor must be
notified in a timely manner if this time is needed. If more than three days is
used, the time will need to be made up by working additional hours, or
extending the termination date of the affiliation.
B. Compensatory time may be used by
submitting WSH Form 600 to the supervisor for approval. The date(s) and time(s)
of the requested absence must be stated on the form.
C. Any time spent visiting other
facilities is considered to be work time. Time still must be accounted for by
signing in and out on the time card.
D. Supervisors have the right to
disapprove requests to work additional hours or to take time off, if it is
deemed in the best interest of the affiliate. Each affiliate's time will be
handled on an individual basis and is confidential information.
JOB
ESSENTIALS:
Performing
the essential functions of this affiliation requires: repetitious walking,
sitting and/or standing as part of the routine. Visual acuity to observe and
report changes in patients’ behaviors on a continuous basis; bending, lifting
and reaching overhead to position, restrain, transfer, transport or escort
patients and to assist patients to perform activities. Manual dexterity
sufficient to write assessments, notes and summaries – or sufficient to operate
a personal computer.