Reflection

Excerpts from Selected Journal Entries

Taylor Cocuzza
GLD-Portfolio


“I love working at the Sigurd Center. I really enjoy the fact that they treat every patient like family.
For example, when a patient “graduates,” we play the graduation music on the stereo, have them
put on a graduation robe and hat, and take pictures of them walking through a banner of toilet
paper. They have a huge tree that they have the patients put their painted fingerprint on once they
have been discharged. A lot of our patients enjoy getting to know the interns and I’ve been learning
so much from them and the therapists simply by watching their interactions. Every patient is
handled differently and its important to understand that some patients may not have had the best
of days when they are here. The owner is the busiest person I know and I really appreciated the
feedback she has given me. She really likes that I am very good at multi-tasking, talking to patients,
and bouncing back and forth helping the therapists when they need help. She mentioned I needed
to work on writing progress notes and becoming more familiar with the abbreviations that are used
as well as some of the exercises. She would also like to see me be more proactive by grabbing
patients from the lobby when they arrive and having them start on something while the therapist
finishes up on the patient in the last hour. She told me she would like to see me guide the new
interns for the practicum and help them learn their way around the clinic. These are all things I
intend on working toward in the next few weeks. Sometimes I can get so caught up in doing the
busy-work that I forget to pick my head up.”
-Journal 1 Entry


“I find it fascinating how far technology has come with rehabilitation. I didn’t realize they had
orthotics such as these that induced electrical stimulus to the body in result to brain signals. This
could make a huge difference in rehabilitation of some of the toughest patient prognoses. I enjoy
how creative this job is and can see myself doing well with this profession. This week made me
realize a lot of it involves trial and error. It’s interesting seeing the therapists encourage
incorporating cognitive skills alongside therapeutic exercise such as with DG acknowledging colors
and letters or the Parkinson’s patient who recreated different pictures while working on his
balance and steadying his hands. I appreciate my exercise science classes because a lot of
terminology that we use and apply was taught in my classes. The knowledge I gained in my Aspects
of Motor Learning class helped me understand why certain exercises benefit the patient more than
a different approach. Such as not telling the patient that there is another beanbag to grab, but
waiting for them to instinctively reach and grab it. In addition, I really respect the OT for what she
had to say about the patient with a severe traumatic brain injury in regards to taking care of him
and treating him. I plan on working with patients such as these and I find it important to
communicate to them regardless of whether they can respond right away. I wouldn’t want someone
just moving my body around with out me at least knowing why or what he or she were doing with
it. For this patient to experience that on a daily level must be unsettling. You have no control over
your body or what that person is doing with it. Simply be patient and let him fire those signals in his
own time. I plan on applying this lesson later on in my career while dealing with patients of this
degree.”
Journal 3 Entry



“I really enjoyed this week. I’ve started to become very close with some of the patients that come to
the clinic. One of the patients brought me a present for my birthday that had passed this weekend
while others were very interested to hear how I spent it and how it went. I also had one patient sing
me happy birthday. It just goes to show how much of an impact you can have on an individual. I
personally want to use my career to help my patients not only recover, but to motivate them to
work at it every day in various aspects of life. Whether it’s within the gym or outside, I want to
improve the life of that patient. Some patients live in community homes and coming to treatment is
a chance for them to get out and about and socialize a little. It’s important to not only be
professional, but to be friendly and have conversations with your patients. Building relationships
with your patients can be beneficial because it builds trust and respect. If a patient is comfortable
with you, they will communicate better and enjoy their treatments more often. I see that a lot with
this clinic. It’s essentially a family-like atmosphere with majority of the therapists and patients that
comes in. I really enjoy coming in every day. The owner also asked me if I would be willing to come
in a couple Fridays a month and that she would pay me to help out around the clinic on those days. I
am very grateful to have built relationships amongst the therapists and to feel comfortable with
asking them questions and having them demonstrate certain things on me. The patient that worked
with the amputee showed me how she was pulling prior to having him start so that I could
understand what the patient would experience. I am very fortunate to be working here and I really
believe it is facilitating and shaping my path into this field.”
-Journal 7 Entry



“This week included a lot of really great conversations with both the physical therapists and the
occupational therapist. I’ve learned a good bit about some technical terms and how that applies to
the patients. With the OT, we discussed the brachial plexus injuries and how you could have a crush
injury, total pull, stretch, swollen, etc. As she was describing some of these injuries, I was able to ask
if some of them were associated with other patients we have. A stroke patient I shadowed the OT
working with had an anterior displacement of 1 finger. Another patient we work with from a car
accident had a stretch injury to the brachial plexus. All of these imply different things and different
mechanisms of recovery. Some injuries won’t show complete recovery. I thought it was interesting
to learn that you make neural gains about 2cm every month. This applies to adults and children. We
also got to talk about Erb’s Palsy and how it relates to these injuries. Discussing the different end
feels of joints and movement with one of the PTs was also very interesting. I did not realize that
those terms existed until she mentioned them. She even let me put the patients leg into position to
feel what a hard or boney end feel is like (with permission from the patient of course). The different
end feels that a therapist will have with that patient and that specific joint can indicate the amount
of ROM that should be expected from that patient. I definitely feel like the conversations I have with
these professionals and the additional research I complete outside of the office in regards to the
topics we discuss can help me in the future as I progress through school and my career. “
-Journal 8 Entry








“The Occupational therapist was discussing a topic that sparked my interest this week with one of
the Physical Therapists that specializes in vestibular and gait. They were talking about a man who
developed a very creative and innovative therapy technique that has become relatively well known
over the last decade. The owner, the Physical therapist (discussing this topic), and the Occupational
therapist have all attended some of the classes that he offers. They mentioned however, that his
program is very rigid and does not allow for deviation from his intended training. He is a very harsh
teacher and extremely intimidating. Another downfall of this therapy is that it is only truly useful in
specific conditions. Ideally it would work great if you could see a patient four days a week and only
you would be working with them. In addition, if the patient transfers to another clinic or has a week
to two-week break from therapy, a lot of progress will be lost. You are not supposed to change
anything about his methods and practices if you apply them to a patient. In result to his work being
patent, if you use any of his methods, you must mention his theory in your notes. The Occupational
therapist mentioned that she finds some of his methods very useful, but likes to adapt his ideas into
new methods (even though you aren’t supposed to) that work for that specific patient. Every
patient is different and it’s important to become knowledgeable in various theories (gait control for
example). You can pull new ideas and methods from that vast pool of knowledge that can be better
applied to your patient. We apply this man’s work by paddling our patients who have muscular
tone in the hand. However, we practice it in a different manner depending on the patient’s needs. I
enjoy learning about the workshops and classes that the therapists take to stay on top of their work.
I think it’s important as a professional to stay active in continuing your education within this field.
New studies are coming out every year that could better enhance your ability as a therapist. So I
find that it’s okay to modify that technique to that patient and a little mix between multiple
theories.”

-Journal 14 Entry