Angela's Blog


03/05/2013

Hello and welcome to my blog. It has taken me a while to set this up but I am determined to write on it at least once a week from now on. I will be looking at Occupational Therapy (OT) mainly, although I will delve into other areas as well.

What can OT do for you??

This is a question I get asked whenever I tell someone what I do. I have been an OT for 22 years now and people generally still have no clue what it is! The usual response is, "Oh! Can you find me a new job?". Although I do work with clients in relation to employment, OT is not a job centre role where we look for work for people.

My job is a very varied one and presents lots of interesting challenges with each new client I see. The role of OT is to enable a person to reach their optimum, functional potential to allow them to be as independent as they want to be. I say want to be because that is very important. If a person doesn't want to be able to put their shoes on they will not try to do it and will not spend time learning skills to enable this. However, that same person may have suffered an injury meaning they can't put a ribbon in their daughter's hair. This is something important to them, that requires similar skills.

Sometimes the person is not able to communicate their wishes, due to age, learning disabilities or communication problems that have not yet been resolved.What then?

That is when we, as OT's, rely on the families and carers involved with our clients. We ask what a person likes/dislikes, how they demonstrate these likes/dilikes, how they express pain, what they did prior to their injury or illness (if their communication skills have altered as a result of injury or illness). We also rely on family members and carers to tell us who is important to the client.

This apparently very simple information can make the difference between a successful working relationship with a client. It also helps to develop a respect that helps the client to trust their OT.

Anyway, there are lots of different fields that OT's work in and lots of different ways in which they work. I will go into that in more detail on a future date.

Thanks for reading this.

 

08/05/2013

Hi

Thanks for coming back!

I thought that today I would talk a bit about my experience as an OT. I qualified from St Katharine's College at Liverpool Institute of Higher education in September 1991. (Wow! That's a lifetime ago.) I then began work at Manchester Royal Infirmary as a rotational basic grade. Having spent 3 years studying to be an OT and about a third of that in practice, I thought I was ready for the big wide world of OT. How wrong I was!

I now see that, no matter how much I have learnt, and taught, over the years, there is always lots more to learn. This is vital to remember when working as an OT. There is a constant change in what is professionally acceptable (e.g. in how to write our notes) as well as what is found to be dangerous or beneficial to the patient/client (e.g. how to move a patient safely).

That's another quandry in this, as well as other, health professions. What do we call the people we see? I have worked in both the NHS and Social Services and in each job there has been a differing view on this. In the health service there seems to be the idea that everyone you see is a patient. This stems from the idea that in order to need the health service you need to be unwell, hence you are a patient. That is all well and good, but what about if you are living in your own home with a long term disability. You may well be perfectly healthy but have cerebral palsy. This does not make you ill but may mean that you require the services of an OT. This could be in relation to equipment and adaptations in order to help you to be more independent or it could be for treatment to help you to function in a better way. You are not "ill" but you are seeing an OT. What does that make you? A patient? A client? A customer?

Personally, I now call the people I see clients. I am not offering any medical intervention in the form of medicine or surgery, although I am often offering support to the medical intervention a person receives. That is the conclusion I have come to after 21 years, but who is to say that it won't change with the tide.

Anyway, I have digressed! As a OT, when you qualify you are still not clinically ready to be an unsupervised OT. You have the basic foundations in place but you need to learn the next level to build your career. Generally a newly qualified OT will complete a roational post in their first role, where they are closely supervised and supported by a more senior OT. This can be purely in the physical field, purely in the mental health field or, although not so common these days, a mixed post incorporating both. My job in Manchester Royal was in physical areas including stroke rehab, rheumatology, cardiac rehab and care of the elderly. It involved working both on the wards with the acutely ill and in day centres and clinics with the chronically ill.

I initially used to get confused with the words acute and chronic in relation to illness. So, in case any of you reading this are confused, acute means short term and immediate whereas chronic means long term. A person can have a chronic illness that puts them in hospital due to an acute episode or flare up. An example of this is rheumatoid arthritis. A person with rheumatoid arthritis may see an OT for their chronic condition to look at joint protection or to make bespoke splints, but they may also see an OT due to an admission to hospital with a severe flare up or for post joint replacement intervention.

I haven't gotten very far in my career but i think I may have explained a few more things about OT.

Keep reading!

 

15/05/2013

Last Friday lunch time I went to an Acquired Brain Injury (ABI) network meeting. It was the first time I have been to such a thing and it was incredibly insightful. I had to stand up and give a one minute information presentation on me as an OT and In Fine Fettle. One minute has never seemed so long!

What it did do was make me consider what I have to offer and I realised I have a great deal of skills. As the meeting was to do with Acquired Brain Injury what can I do?

I have, over the years, spent a great deal of time working in paediatrics. More than three years was spent at Royal Manchester Children's Hospital (RMCH) where I treated many children who had various neurological conditions. Many of these were due to head injuries, brain tumours, or other traumas. It was very different seeing the children when they were at their most unwell, and seeing the progress they made early in their recovery. I was used to seeing them once they came home from hospital. The experiences I had at RMCH allowed me to be far better prepared when I returned to the community setting when I left.

They also made me realise just how delicate the life of our children can be. I worked with children who left home to walk to school but were hit by a car, children who woke up one morning with meningitis, children who developed tumours and other cancers.

I think working in this job can give you a certain separation from how horrible life can be. The things that you see may be horrific but your view becomes pragmatic. This sounds like a bad thing to happen. However, I would say that if it didn’t happen, anyone who works with sick people would go insane with the stress of the situations they see every day or they just wouldn’t be able to do the job. It is our protection against what we see to allow us to make the people we work with better.

I have moved off the subject of the things I can offer for clients with ABI. I have seen children move from needing fully supportive seating to allow them to be hoisted out of bed whilst unconscious on ICU to being able to manage to transfer with the help of a sliding board a few weeks later. I’ve been the person making that clinical decision about what type of chair they need, what type of sling they need to use the hoist, how safe they are to try the transfer without the hoist and what they will need next.

I have also gone into the homes of children and adults who may never have had any equipment before and been the person who has to introduce the equipment and/or adaptations to them and their families.

None of us would ever wish to have the need for help from another person or from a piece of equipment. But I am glad that I understand what is out there and what it can be used for. I am also glad I have gone through the experiences I have over the last through years. This has helped me realise that the smallest piece of equipment might be all that is needed by a person, but this can also be the biggest hurdle.

Optimising what the people I work with can do is what I do!!