My first time working with the stroke population was near the end of my first fieldwork level II rotation at a hospital in San Diego. I was in acute care, and frequently in the intensive care unit, which was very daunting at first but quickly became my favorite unit to work in. One of my patients had recently experienced a stroke, was newly admitted to the ICU, and I was going to have my first treatment session with her. I remember thinking it was perfect timing because I had just finished creating a presentation on best practices in acute care for the stroke population, this was my chance to apply the evidence-based treatments that I had spent so much time researching!

My patient was very sweet and motivated to participate in therapy, which is always a real treat as a clinician. We worked on one-sided dressing techniques as she had left arm weakness and difficulty with movement of that side. I taught her to practice using self hand-over-hand assistance during tasks, using her unaffected arm to help incorporate use of her affected arm as much as possible to help rewire neuromotor pathways and increase functional return. She was also exhibiting pretty profound left sided neglect, inattentive to her left side, forgetting to protect her left arm and ignoring stimuli presented to her on that side. At this point, no one had mentioned unilateral neglect to her so I was able to provide patient education on this and ways to increase attention to her left side, especially during her daily activities and routines. For the first time throughout my rotation there I felt confident and knowledgeable about what I was doing, it was such a great feeling as a student OT! Even in our short 45 minute session, I really felt like I was making a positive impact on her life with this new challenge she was dealing with, and she was genuinely thankful for my help. As occupational therapists we get to help in so many different ways to improve people’s functional independence, maximizing quality of life, health, and happiness. This session further validated that I was in the perfect career and was pivotal in my decision to pursue an acute care position after graduating. I will always remember this particular experience and take it with me on the rest of my OT journey. 

Happy Occupational Therapy Month!

Ashley Shiner, OTR