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Ashley Moore

9/9/14
Advanced Topics
Reflection with Strands
Factual Strand: Write a brief description of the incident, state WHY this is significant to
you.
During my forth week of level II fieldwork, I completed an evaluation for a client
who had been diagnosed with dementia. I was unsure if the information she provided was
accurate, therefore, my CI recommended that I call a family member listed on her admit
sheet. During my phone call, the clients son reported that his mother had been living in
an unclean and unsafe environment with his sister who relied on the clients social
security checks to support a drug addiction. He also reported calling Adult Protective
Services but reported that at present no action had been taken to remove his mother from
the situation.
The following day, I ran into an employee from Adult Protective Services who
wanted to speak with this particular client. I gave him the clients room number and then
went to inform my CI and ask for guidance about my role in the situation. His response to
my question was very vague and did not indicate a clear course of action. I decided to
inform the APS employee of the clients memory deficits, as they would inhibit her
ability to accurately report on the quality of her living conditions. I also passed along the
information from my conversation with the clients son and discussed the situation with
the facilitys social worker.
This event was significant to me because it was a more critical and intense
situation than I had experienced so far at fieldwork. We had discussed elder abuse in
class, which I found very unpleasant. It was even more upsetting to actually see a

vulnerable person being taken advantage of by a family member in practice. Therefore, I


considered this a very high stakes situation and wanted to do the right thing for the client.
Retrospective Strand: Record your feelings during the incident, what new knowledge
was discovered? What other influences contributed to your experience?
I felt very overwhelmed and unprepared to discuss this client with the Adult
Protective Services employee. I was frustrated that my CI provided little guidance in
what I viewed as a very high stakes situation. His laid back reaction also caused me to
wonder if I was not placing enough confidence in my current abilities to interact with
other professionals. During our conversation, the APS employee stated that he was
previously unaware of the safety concerns present in the clients home. In hindsight, I
was glad that I decided to speak up about all of the information I was aware of as it
provided the APS worker with a more comprehensive picture about the clients situation.
My emotional response to working independently in this high states situation was
influenced by prior experiences with my CI. Prior to this incidence, I had been feeling
anxious about the amount of independence I was given so early on in fieldwork. My CI
had just given me his full caseload at week four and I was feeling overwhelmed by all my
responsibilities (treatment planning, documentation, Medicare standards, etc.). This new
responsibility added to my anxiety more than it may have if I had been given less
independence or fewer clients on my caseload.
Substratum Strand: What past experiences influenced your actions? What beliefs and
values underpinned your behavior?
I know from previous experience that I learn best by observing others do a task
and then doing that same task myself. I found this strategy effective in my level II
fieldwork during ADL training, documentation, administering modalities, etc. I also

know from previous experience that I need some degree of affirmation and guidance to
feel confident in what I am doing. When my CI did not provide some feedback after
treatments I often assumed that he did not think that I did a good job.
I realize that this situation is not a good fit for my preferred learning style of
observing and then doing. It would have been unprofessional and awkward if I observed
my CI interact with APS worker and then completed that same discussion myself a few
minutes later. Therefore, I need to find value in other learning styles and be willing to
utilize them when it is more appropriate.
I also need to accept varying styles of feedback and guidance while being willing
to advocate for my needs as a student. There are times when it is beneficial to problem
solve a situation independently, as this is what is required of an entry-level practitioner.
However, feedback and guidance are also essential for students to improve in weaker
areas so that they can progress to entry level. My CI did not frequently provide feedback;
therefore, I needed to ask for it when I felt unsure or uncomfortable about a given
situation.
Connective Strand: How has this experience influenced your future practice? What have
you learned from this? Where do you need to grow?
This experience revealed two areas in which I need to grow. First, I wanted
guidance from my CI, however, I was able to handle the situation professionally and
responsibly with little feedback from him. I need to recognize that I will not always be
able to observe other professionals or seek guidance before completing the task myself.
Most importantly, I need to recognize that I may not always need this level of guidance,
as I am capable of successfully handling some novel situations independently. Therefore,

I need to develop greater confidence in my abilities to problem solve independently.


Second, I need to take more initiative to receive guidance in situations where my
abilities are not at the level they need to be to successfully handle the situation. Although
there are circumstances that I can handle independently, there will be situations in which
I need guidance and constructive feedback in order to do what is best for the patient. I
need to recognize these situations as they arise and be intentional in seeking input from
someone with more experience. This person may be my CI on my second level II or
colleague or rehab manager when I start my first job as an entry-level practitioner.