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CLINICAL OBSERVATION VISIT METROPOLITAN REHABILITATION CENTER

SUBMITTED TO: Ms. Sally Jane Uy, OTRP

SUBMITTED BY: Masmela, Anna Beatrice N. 2OTB

SEPTEMBER 27, 2011

I. II. III.

Metropolitan Medical Center Physical Rehabilitation September 20, 2011 11:00am-12:00nn The Metropolitan Medical Centre is specifically situated in Sta. Cruz, Manila. This region is regarded as Manilas Chinatown. This medical institution has been in operation for more than 35 years. For many years, the hospital has been enjoying patronage from Filipino and Chinese locals in the area.

The hospital has over 300 doctors with various medical specialities. It is a referral centre for complicated and tough cases in Internal Medicine, Surgery, as well as Endoscopy. Furthermore, its Department of Obstetrics and Gynecology,

Dermatology, and Physical Rehabilitation are regarded as Centres of Excellence. Its facilities include a fully automated diagnostic laboratory.

It has constructed a 27-storey medical tower to accommodate patients who are coming in from around the world as medical tourists. It has several packages for international patients including kidney transplants, gall bladder surgery, bariatric surgery, and endoscopic and laparoscopic procedures. More options are also available. The Metropolitan Medical Center Physical Rehabilitation is located at 4th floor of the hospital. The physical therapy area has the biggest space allotted for their treatment while there is an adequate space given for the occupational therapy. When we entered the room, there are a lot of clients undergoing their treatmen and there are a lot of occupational therapist present too. They are Ms. Katherine, Ms. Claudette, Ms. Hazel, Ms. Dolly and Ms. Angela. The last two were interns from UST. They are present to support the needs of their clients. They help them with the given activities

they have to do for their session. They also assist the clients into transferring and into finishing their treatment. Just like the other centers, they need to evaluate first the client into what they need and what goals they want to achieved. This is important for the therapist to be able to plan out a treatment that will greatly achieve the goals of the client or the clients family. After having the intervention plan, the intervention implementation must be done. This is now where the activities made by the therapist are laid out designed for the needs of the client. There are a lot of activities that they are able to give the patient and also a lot of modalities to be used to increase their capacity to get their goals done. From time to time, they speak with their clients and ask them how they are doing or if they are able to follow the given instructions. The therapists present are very friendly and approachable. I have observed that they really take time to talk to their patients about their personal lives. They even know what their clients likes and dislikes. They easily build a rapport with them. I can easily know that those people around are therapists because they wear a simple polo shirt and jeans that can be easily seen. They look neat and very reliable upon wearing those suits. The facility, in fact, is a very nice place to have a treatment. Although, it would be much better I think if there are more space allotted for the occupational therapy section. It has a clean and peaceful ambiance. It feels like when you get there you feel really in a different place. In fact, I first thought that the rehabilitation center would look small but I was really schocked when I saw different equipments used in therapy, the place with all the different types of clients. I felt like I am in one of those

hospitals abroad I have seen before. It is noticeable that they really take good care of the center. IV. The general population that the facility caters to are mostly those who have physical dysfunction, neurological cases, brain injury, spinal cord injury and orthopaedic cases like fractures and dislocation. They mostly cater to the adults rather than kids on pediatric setting. Mostly, these people are those who had stroke and brain and spinal cord injuries. Those people who usually undergo treatment are those in the working class of the society. Especially those who works as a seaman, marine officer, engineer and the like. Some of them met accident while working and now being under treatment for them to be able to get back to work. When we first get there, I really noticed first that this people are very eager to get their treatment. These are the people with a lot of willingness and are those persevere to be able to achieve their goals and be back at their working status. I felt eager to know what the story behind their condition is all about. I was not afraid to ask questions because they practically give me direct answers. Some of them were looking at us and asking what are we doing there. They seem not distracted but more of tense because we look closely to what they are doing. We were a group of three so we stick together and interviewed the clients. We were able to easily build a rapport with the clients. More so, we are able to ask questions about their condition. Huili, a lady around her late 50s maybe and as she said, she was a senior. She burned herself last February with a cause she does not know but she said that they were sleeping when it happened. She has burned almost 60% or more of her body surface. It seemed like that not only her body surface was damaged but also the

deep parts of her dermis. I am not sure but it also seemed that it was a thirddegree burn. Her nerve-ending must have been damaged as well. Because of this unfortunate accident, Ms. Huili has been under the treatment of an occupational therapist because she had difficulties in carrying out her daily activities such as self-care, walking, eating and etc. She had been in therapy since June. She is an in-patient in the hospital and gets 1 1/2 hours to 2 hrs of treatment under an occupational therapist and a physical therapist. Some of the activities that she does are the use of fine-pegs for in-hand manipulation and fingers, use of clay to increase her hand strength, pinch strengthening, sliding, grasping and transferring activities with weights included. These are for translation, stabilization and bilateral strengthening of hand, digits and wrists. Since then, Miss Huili is able to eat independently and groom herself with the extent of having her tooth brushed and wiping her face. The occupational therapist is working on the activities of daily living such as eating, grooming, basically all that requires the client to be able to help herself independently. The occupational therapist uses herself to motivate the client because when we asked what keeps her on doing these treatment everyday is that she really wanted to get out of the hospital. Also, the OT is working on how the client will get back in her own life without any trauma of the unfortunate event that happened to her. In Metropolitan Rehab Center, there are a lot of modalities that are used especially for promoting hand activities for hand manipulation and hand dexterity. There are also what they call the turning pipes, clothes-pin tower with application

of different grips, Oconner Pins for different grasping methods like tip to top, pad to pad and lateral pinch. These are mainly for the hands. Some of which are used also for the shoulders like the shoulder ladder, weights with different pounds. Aside from those modalities used, they engage their clients to leisure activities. V. First, I am very happy I was able to complete my clinical observation. Second, I feel very accomplished now that I have learned a lot from this activity. Somehow, I have an overview into what occupational therapy is all about. It was really true when someone I met before told me that doctors may have save lives but occupational therapist brings you back to life. I have every inch of respect towards the occupational therapists. What they do is not easy and needs a lot of patience and willingness to help their clients. As a professional, they always think of what is best for their clients. I want to be a professional occupational therapist. And soon, I will be able to do what other therapists do. It is more than saving peoples lives but bringing them back to life.

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