Hillside is a different clinic than anything I can imagine. We treat outpatient, home health, schools, and we go to different villages to treat there. My CI (who is from Sweden) lets me take the lead on everything and then we discuss all the decisions and findings I have made. I love that aspect because I am totally hands on at all times. I also am getting a HUGE variety of patient populations as well as injuries.
Today I had outpatient clinic from 8-12 and then home health visits from 1-4. The outpatient clinic is always interesting because often time patients are referred down directly from the medical clinic. I had two initial evaluations and a treatment in the morning. My first treatment was a pediatric patient. She was super energetic and the treatment was really fun. We competed in different races and games that worked on heel walking and toe walking to help strengthen her ankles. We also worked on fine motor skills by playing with play doh and using a foam puzzle.
On a completely different side of things, I had another patient today that was an initial evaluation who did not speak any English and instead could only speak Mopan. We found someone in the clinic who was able to translate for us however it went nothing like I was expecting it to go when working with a translator. We were taught in school that when working with a non- English speaking patient you should always talk to them and have the translator repeat word for word what each person is saying. In this situation, the translator and the patient just went on and on having conversations and I was almost the intruder in the conversation. It was very awkward. Then mid-session my translator stood up and explained that she had to catch a bus so she left. Even more awkward. In the end the evaluation took way longer than expected and my CI had to step in to help confirm the diagnosis because I was struggling with the case in general.
Home health has definitely culturally different. For starters the “addresses” on the form stating where we should be going is written like this: “white house on end of the 3rd dirt road from the flower shop past the large brown building behind mango tree.” Every time we read them we laugh. The homes are all very different. It is so interesting to me because it is not like the people of PG are all poor. They simply just don’t have access to a lot of things that we (Americans) are used to; health care for one. When you walk up to a house in PG you are always a little surprised to what you are walking into. Some of the cases can be quite sad. Today I had a patient who lays in bed all day and doesn’t move. He had no TV, no radio, nothing. All he did was lay there and stair out a window. We got him moving a bit but it was still sad. At a different house however, we have this little lady with an amputation below the knee. She was very energetic and loved showing us the different activities she does to help build her strength.
Home health visits are both culturally and clinically different from the norm treatment. All the treatments need to be creative due to the lack of materials. It is super beneficial to see the patient in their natural home environment doing different tasks.
For my first full day of clinic I got to see a wide span of patients from age 9 to age 78 with amputations, shoulder issues, back pain, wrist pain, CVA, and more.