My most interesting and mildly challenging evaluation I have ever done was on a middle school basketball player’s wrist. He had tripped and fallen on an out-stretched hand. He came in really calm and his complaint was that his wrist would click every time he bent it and that it hurt to move. Immediately I knew I had to rule out a fracture. I did palpations and felt crepitus around his lunate. I then did Range of motion and a mobility for all of his carpals. His range of motion was normal, but as he stated, there was a pop every time he flexed and extended his wrist. At this point I was a bit confused. I thought there may have been a dislocation because of how mobile his carpals were, but then I checked them bilaterally; while there was a bit more mobility on the injured side, it seemed relatively normal for him. Then I went into some special tests. I did a couple of percussion tests, but it was hard to isolate the carpals. I also did a squeeze test on his forearm which was positive. I was stuck between a radial ulnar sprain, a lunate fracture, and a lunate dislocation. At this point is when my preceptor helped me think through the process. He reminded me of his age and how we need to be worried about growth plate injuries and greenstick fractures. He also stated how when we are young our joints are very loose which explains the amount of mobility I saw in his wrist. What I learned from this evaluation is that sometimes there are parts of the history you don’t ask, but you need to take into account. In this instance, obviously I see a young boy and an injury around the joint, but I didn’t think of it as a factor that would play into the evaluation. Maybe because I’m more used to an older population, this just slipped my mind. Now I know for the future I will need to be more cognizant of age and other factors that are implied but not asked.
This week I had 12 attempts and 0 masteries in my clinical packet.
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As a student, I have always felt like I have good time management skills and a good gauge of what is truly important. I feel like in most instances I balance my responsibilities well. A challenge I typically face is staying 100% motivated to do everything to the fullest and not getting behind. When I feel like I am behind I feel it is important to do a personal check on myself. Am I dedicating enough time to accomplish this task? Am I prioritizing something less important? When I feel like I am behind the first thing I do is talk to my class mates and see where they are standing. If I find someone just as behind as I am, I will usually try to work with them and we will pound some work out together until we are caught up. If this option isn’t available, I always find it helpful to talk to a professor to get a real sense of where I am and what I can improve on. Another good option is to talk to the preceptors and see if they have any advice or tips. We are lucky to have an Emory & Henry Graduate as one of our preceptors. She is well aware of how to make it in the program and is a good source to talk to when I feel like I am struggling or behind. My final resource if I feel seriously behind or lacking motivation is to give a call home to Dad. This is mostly what I do and need when I feel like I’m losing motivation. My dad gives me new perspective and is a sounding board for what I experience. He helps me find solutions I may not have thought of yet. If I’m lucky when I call he will tell me a silly story about something my cat did which always makes me happy and motivated to start working hard again.
This week I had 6 attempts in my clinical packet What I learned from last semester is that I need to be more proactive about my education especially when it came to my clinical packet. I felt like I had everything under control and that I was on pace but until the last few weeks when I realized I was very far behind. The way I will combat this is by actually committing to my goal of attempting 8 tasks and completing 6 to mastery a week. The most important part of this is to be simulating attempts. A large portion of this semester is general medical conditions. While I may have experiences with some conditions in the clinic, there are very many tasks that are not so likely to come into the clinic for an examination. Another way I plan to be proactive is by reading new research more often. I feel like this will expose me to a lot of new and interesting things in the athletic training profession. This brings me to my next goal, “I will develop my knowledge of therapeutic exercises by conducting research every 2 weeks on the best 2 exercises for each injury per body region throughout the semester.” I decided to make this a goal because I feel very comfortable in examining injuries, but now I believe it will be important for me to know how to effectively treat them. I feel like my classes this semester are fairly subdue in the level of difficulty, therefore, I will have time to be able to do research and progress my knowledge as a student. My final goal is to be able to present my research. This goal is not yet formed into a SMART goal, but I plan on accomplishing this goal by working with our ampersand center and attending sessions in order to prepare to present my clinical question. I really want to present my research because I enjoy talking about interesting things in the medical field. It will also be a good opportunity to push myself and meet some new professionals who may be pertinent to being successful after I graduate
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This is where I do my weekly clinical blog assignment. There is either a prompt I am responding to, or I just talk about something exciting I saw during the week.
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April 2019
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