MSTH210: On Campus Internship 1

CLINIC LOG FOR PAUL HUSSEY

Date of Submission: October 2nd, 2014

Date
09/11/14

Time

1200-100

Patient
ID

Type/ Focus of
Treatment Plan
N/A- no patient this
slot

Clinic Instructor: Andrew Clapperton

Procedures Completed (Assessment/ Treatment/
Modalities/ Home Care)

Comments

I didn't have a patient during this time slot so I

Made sure my appearance
practiced looking over some various SOTs and
standards were internship
MMTs I could perform with my patient that was
prepared to allow for superior
coming in in the next time slot. Looked over what I professionalism in the clinic.
was about to assess and make sure I had all the
Learned how to interact and
tools I needed to be successful during my first
treat with guests based on
treatment.
watching other classmates treat
a patient. Gave me a brief
understanding before I went and
got my patient during the next
time slot.

MSTH210: On Campus Internship 1

09/11/14

130-230

Wellness TreatmentCompleted health history with patient, as well as

Upper Neck and Shoulders performed the vitals RR HR and BP. Performed a
postural assessment in all four angles to see for
imbalances in the body. Noticed slight head forward. As
for the treatment worked on upper back in the
Rhomboids, Upper fibres of Trapezius. Did techniques
such as broad contact, superficial stroking,
effleurage,petrissage. To finish off treatment I added a
hydroculator to the upper traps, to reduce inflammation
and reduce muscle tension. While that was working I
worked on the neck, working SCM, scaliness, as well as
Levator scapulae. Took the hydroculator off and
wrapped up the treatment, and took my patient to the
front.

This was my first treatment and I

was really nervous so I did the pre
treatment vitals and health history
but was too nervous to remember
to do any of the other assessments
and put the patient on the table
right away. Also forgot to add the
pillows in until halfway through
treatment. Learned how to properly
complete a SOAP note and what
details it entails in order to be
effective. Learned how to allocate
my time properly throughout
treatment to allow for all treatment
to be complete.

09/18/14

1200-100

N/A- no patient this

slot

Was able to get more

comfortable with the vitals and
made it more clear how the
procedures should be done.

During this time slot I practiced with classmates

with different assessments such as vitals as HR RR
and BP. I did this so we could be more comfortable
with doing vitals with our patients when they came
in. We also helped hold curtains for other
classmates who were needed of assistance and had
another task to complete.

MSTH210: On Campus Internship 1

09/18/14

130-230

Rehabilitation- Upper Neck

and Shoulders

Patient came in and I double checked to ensure nothing

has changed on the HH since the last time they came in.
Following that I completed PROM RROM and AROM of the
affected shoulder, neck area. After that , I completed
an MMT for the shoulder to test for any pain.I did the
Empty Can, Full Can test, to receive a negative response
meaning no pain. Patient then got on the table for
treatment. Worked on the upper neck and shoulders
more vigorously then last appointment going in more
deep. Areas such as UFT, Rhomboids, Levator Scapulae,
MFT, SCM were worked on. Techniques such as; broad
contact, superficial stroking,
effleurage,petrissage,specific compressions,muscle
stripping. Didn't have a chance to provide any modalities
to the treatment since time was cut short.

This was a follow up treatment with

the patient as they came in the
second time. Finished up all the
assessments I didn't have a chance
to complete the previous time.
Needed to work faster to be able to
apply the after steps of muscle
stripping by applying a modality so I
should of worked faster. Following
the appointment, patient said they
felt better and more relaxed, as
well as less tense in their upper
back. Learned how to build on a
therapeutic relationship by having
conversation within professional
boundaries with the patient, and
allowing for the trust level to
increase. This allows for the patient
to be more comfortable with the
therapist and good progress was
made. Good learning experience.

09/25/14

1200-100

Wellness- Rhomboids and

Middle Fibres of Trapezius

Patient came in looking for a treatment that would fix

his injury. Went over his health history and confirmed
consent to allow for all the assessments and treatment.
Did postural assessment and noted that he had slight
head carriage as well as higher muscle tension in his
right upper trapezius muscle. While looking at AROM in
the shoulders all ranges of motion seemed to be normal
and their wasn't any impairments associated with the
ROM. Went to the treatment after that and worked on
his Middle FT as well as Rhomboids, and Levator
Scapulae and UFT. Patient complained of tweaking back
so tried to reduce muscle tension and palpate TPs that
were in the area. Used techniques such as; superficial
stroking, effleurage, petrissage, connective tissue
techniques to help fascia movements in the scapula
area. Tried to reduce the pain that was initiated by the
initial problem. Modalities added was a hydroculator to
the Rhomboids and MFT. It was intended to keep the
muscle tension lower than it was, as well as make the
tissues more pliable. Re-assessed the area after
hydroculator was removed and tissue seemed more
pliable and didn't seem as tense as when the treatment
first commenced. After treatment patient said he felt

Patient came in complaining about

soreness between both scapula from
a tweak in a muscle that had
occurred when he was working out.
Wanted to get back to optimal
health as soon as possible. I
assessed the area and realized
there was some muscle tension that
needed to be reduced and that
there were TP present associated
with pain and tension in the taut
band. Didn't have time to do the
PROM RROM OR MMT/SOT since I
had a late start with this patient.
Learned about people that have
different body types. Having one
patient twice and then a different
patient the third week allows me to
see what different body tissues feel
like under my hands, so I get a
sense of what I'm dealing with.
Allows my hands to get good
experience.

MSTH210: On Campus Internship 1

better.

09/25/14

130-230

N/A- no patient this slot

During this time slot that I didn't have a patient I

reviewed and practiced various SOTs and MMTs with
my classmates. I wanted to get familiar with different
tests for various issues on the body. I still need to
review the tests so that I have multiple options to
choose from once a patient comes to me with a
complaint. I also helped classmates fold the sheets once
they were done the treatment to speed up the process
so they had sufficient time to finish their soap notes.

Was able to get more seasoned

within knowing various SOTs
and MMTs for different parts of
the body. Got me more
knowledgeable and gave me
more understanding, in which I
can apply more tests to my
patents who come in with
various impairments.

MSTH210: On Campus Internship 1

LEARNING LOG FOR PAUL HUSSEY

Date of Submission: Thurs. October 2nd,2014

Date
09/11/14

Clinic Instructor: Andrew Clapperton

Description of Experience
This was the very first patient I was going to treat that was not
a classmate. It was very nerve-racking and I was very worried
about all the potential disasters that could arise. I got my
patient and brought them into the clinic. I walked them to my
cubicle and went over their health history. I went over it all
and ensured them that everything was confidential and that
nothing would leave this conversation unless by permission or
by law. I told the patient at any time if questions were to arise
that feel free to ask them and I will gladly answer them.
Questions that arose throughout the treatment were answered
in a professional manner and the boundaries for the
therapeutic relationship were kept inline.
I also ensured that everything was set up the way it needed to
be as well as having everything that the patient asked for. I
asked whether lotion or oil was acceptable and she said doesn't
matter so I chose. Also my patient asked if the curtain to be
closed just for more comfortable manner and I accepted her
decision with the approval from my internship teacher Andrew.
I ensured I had all my towels and necessary supplies before the
patient came in the room. I also ensured that the table being
used worked properly and had a proper head cradle that
worked. During my techniques I always asked the patient about
comfort and pressure, and ensured everything I was doing was
what the patient wanted. Allowed for feedback on everything
that I did during massage.

Performance Indicator Achieved

1.3.b Maintain professional boundaries in

relationship with patient.
1. Manage personal responses to patient
reactions.
2. Demonstrated respect for the personal
boundaries of patients.

3.1.b Maintain a safe and comfortable

treatment environment.
2. Establish and maintain a safe and
comfortable environment.
3. Ensure setting and equipment meet
patient needs.
4. Maintain equipment in proper working
order.

1.3.d Comply with confidentiality and

information privacy requirements.
2. Maintain the confidentiality of patient
information.

MSTH210: On Campus Internship 1

09/18/14

During this treatment it was a return appointment of the

patient in the previous week. When she came in, I advised her
that there would be more in depth techniques being done
today to target the underlying issue some more. After an SOT
and some ROMs, I told her to take off as much clothing as
possible. I told the patient it would be in her best interest to
remove or unclip her bra due to the fact it will allow me to
access the areas that need to be treated easier, thus allowing
a better and more effective treatment. I told her it was fully
her choice though and didn't give her any indication that she
had to. As I left her to get changed and onto the table, I
clipped the curtains together so that she had optimal privacy
to get onto the table. I went to go wash my hands and up my
arms as per protocol in the lab. When I came back to the
cubicle, I asked for permission to come back in, and to her
consent I went into the cubicle. I started with techniques and
started superficial and worked deep. Throughout the
treatment I informed my patient of the techniques I was doing,
and ensured she knew what they meant by speaking in laymen's
terms. The treatment seemed to be more effective and have a
more positive result as due to the fact that I was able to use
deeper techniques such as Muscle Stripping and Specific
Compressions.I was also able to use my elbow to work on UFT
and Levator Scapulae, near superior angle of the scapula. At
the end of the treatment she told me she felt really good and
really relaxed which was a positive outcome for me. As I
brought my patient to the door I came back and wrote my
SOAP note. In my SOAP note, I ensured to use professional
language and write down and document everything effectively
and accurately according to what I did during treatment. If I
had a question about something I was going to write down in
my SOAP note, I was sure to ask my instructor for proper
clarification and guarantee the best possible answer, so that
the SOAP note could be accurate.

1.3.c Respect the patients physical

privacy.
1. Direct patient in degree of disrobing.
2. Create an environment of privacy and
safety.
3. Respond to patients individual privacy
needs.

3.1.c Apply standard hygiene and

infection control precautions.
3. Demonstrate standard hygiene
practices.
4. Apply standard precautions for
infection control.
________________________________
1.1.a Utilize effective written
communication.
1. Document complete and accurate
information
3. Employ clear, concise and professionspecific language.
4. Write in a manner that corresponds to
the needs of the reader.
5. Employ appropriate formatting,
grammar and spelling

MSTH210: On Campus Internship 1

09/25/14

During this treatment, I had a patient who came in but with a

different look at his injury. He came in complaining about the
injury he did to his area between the scapula, when he was
working out and warming up, he tweaked a muscle and its
been aggravating him ever since. I took him through the health
history and I informed him all the reasons why obtaining his
health history was important. I went through it with him and
asked him more about the injury that was noted down on the
form. Based on what he told me from his answers, I then
formed a treatment out of that. I told him that I would do a
postural assessment to check for misalignments in the body or
things that aren't symmetrical on both halves of his body. After
doing the assessment I found that he had more muscle tension
in his right UFT, as well as having slight forward head carriage.
Based on the findings of this assessment i was able to conduct
a more appropriate treatment because I visually could see
areas that need palpation and potential work to fix underlying
issues. I worked on his back the whole treatment with primary
focus on his Rhomboids and MFT, because it had the most
response from the patient as well as I could feel a lot of
tension in the muscles being palpated and worked on. After
sufficiently working on the areas that needed work, I went and
got a hydroculator to apply to his upper back to give the
muscles a chance to get rid of muscle wastes. Before i applied
the heat pack, I informed my patient of what it was, how it
was going to be applied, as well as the contraindications and
benefits of its purpose. After all that had been discussed I
applied the pack for about 5 minutes or so and took it off to
find the muscles were more relaxed and less tense. At the end
of the treatment he said he felt better than he did when he
first came in and hoped that it stays that way. I told him to not
do an extensive workouts or any vigorous activities that could
aggravate the muscle and just rest for the next couple of days.

2.1.a Obtain comprehensive case history

from patient.
1. Describe the importance of obtaining
case history.
2. Interview patient to obtain case history
and their desired treatment outcomes.
___________________________________
3.2.e.8 Perform heat pack treatment
1. Explain the purpose, effect and
outcomes of heat pack treatment.
2. Demonstrate the different types of heat
packs treatment.
3. Incorporate heat pack treatment into a
compressive treatment process.
___________________________________

2.1.g Perform postural assessment.

1. Identify the indications,
contraindications and precautions for
performing postural assessment.
2. Communicate the assessment
procedure to patient.
3. Describe the process for performing
postural assessment
4. Demonstrate postural assessment base
upon patient history and presentation.
5. Differentiate between normal and
abnormal findings

MSTH210: On Campus Internship 1

Three (3) Performance Indicators I have not achieved are

1.2.j Utilize professional judgement

1.3.f Obtain special consent prior to assessment and treatment of sensitive body areas.
1.1.d Communicate in a manner that respects diversity

My plan for achieving these three performance indicators is

The way in which I will achieve these performance indicators is just allowing myself to have more time working with patients and
getting exposed to a more diverse community within my clinic. Also I have to be more aware of my authority as a therapist and the
autonomy i have over the patients. It is crucial that I ask for consent on everything I do during treatment to ensure that my
patients are okay with it. Especially upper pectorals for female patients just confirm with them that its okay to treat there
because areas could be sensitive to them and I need to allow for consent before i proceed. I just need more experience and I will
be able to interact with a larger community of people and experience different treatment boundaries from patient to patient.

I am SATISFIED with my progress in this Internship so far

Thus far in internship I can say that I have learned a lot in this 3 weeks so far. It really sets me in a position of work where it feels
like I'm doing what Ill be doing for my career. It is pretty nerve-racking cause everything has to be done at once and all in specific
order. It gets overwhelming because the nerves get to you and you panic and forget to do specific assessments or special tests you
need to perform wont come to your head instantly. Ive learned over these past few weeks to just relax and take one thing at a
time and go at a rate i can work with. Allow for one assessment to flow into another and allow for the patient to dictate what
tests follow and based on the evidence you get from those tests and assessments I will then be able to create a treatment. I just
need to give myself a couple more weeks to get the hang of it and Im sure ill find my own and be comfortable with everything,
taking new knowledge with me every single lab.

MSTH210: On Campus Internship 1