1. Appreciates the influence of socio-cultural, socioeconomic, political, diversity factors, and lifestyle choices on engagement in occupation throughout the lifespan.
My time at Methodist South has given me perspective in a way that I would have never imagined. I saw patient's who considered themselves homeless, relied on public transportation, suffered from assault/tragedy, and had no family to help support them. These life experiences forced me as a practitioner to look outside of my normal “go to” interventions for an outpatient setting, and provided me with the opportunity to support patients in their current occupations. For example, we had an elderly man on our caseload who suffered from multiple CVAs, lived alone, and demonstrated decreased cognitive skills. This patient’s primary barrier to occupation was utilization of public transportation. This is an occupation of his that is very difficult due to his decreased mobility, aphasia, and increased time to complete transfer in and out of the bus. I considered his lifestyle through treatments and assisted him to be as independent as possible by implementing interventions that simulate transferring in and out of bus as well as focusing on increasing endurance to facilitate independence while at the bus stop. When beginning this rotation, I did not have clinical experience with public transportation and the difficulties that could potentially arise utilizing this source. This revealed to me that no matter my patient's sociocultural/economic status I must incorporate their current occupations into practice.
2. Communicates effectively with a wide range of clients, peers, and professionals both verbally and non-verbally.
I have been given the opportunity to communicate with a wide range of clients, professionals and peers during my time at Baptist Health for my mental health rotation. The clients come from various walks of life struggling from various mental illnesses. I held one on one treatment sessions, evaluations, and administered assessments with clients at this facility that gave me the opportunity to communicate verbally by addressing goals. I have communicated effectively with professionals through both verbal and non-verbal communications. I worked closely with social workers, physicians, and nurses to assist in discharge planning, choosing appropriate treatment, and collaborating periodically on patient’s progress. This was completed through electronic documentation system (Epic) that allowed us to create sticky notes where we communicated with other disciplines. I communicated most frequently with social workers by assisting in discharge planning and stating our (occupational therapist) perspective of the patients’ status for independence. During my time at Baptist Health, I had the opportunity to effectively communicate with peers to train OTAs on the computer system, one on one treatment sessions, and evaluations. I have attached a worksheet that I completed with numerous patients during one on one treatment sessions.
evaluation_completed_by_educator__communication_.png
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3. Collaborates with clients and caregivers in establishing and maintain a balance of pleasurable, productive, and restful occupations to promote health and prevent disease and disability.
There where numerous patients who were assigned leisure goals during my time at Baptist Health (inpatient psychiatric). When a leisure goal was created for a patient I administered a treatment session, and discussed the patients involvement in pleasurable activities that helped promote a healthy lifestyle. I educated patients on positive aspects regarding involvement in leisure activities that will assist in prevention and/or maintaining mental health they were striving to overcome. The patient and I would collaborate on realistic interests and engagements. Below I have attached a leisure checklist that I completed with patients to increase their engagement. Once the leisure activities are identified we then discussed realistic goals for activites and potential barriers that could arise jeopardizing the patient's leisure engagement. Overall, the goal during leisure treatment sessions was to determine their interests/values in relation to leisure and educate the patient on benefits of participating in healthy activities while discussing the balance between leisure and productive requirements.
interest_checklist.jpg
4. Inspires confidence in clients and team members.
Inspiring others is such a pleasure, and I personally would not have identified this specific example except that another team member expressed that I provided her with confidence. During my second fieldwork rotation I worked very closely with nursing, patient care techs, and social workers. There was a newly graduated nurse on the unit that I built a rapport with throughout my time at this facility. Through conversation this nurse expressed she did not feel confident in confrontational situations.
One day while on the unit this nurse was having to address a very angry and unhappy patient. The patient wanted to leave against medical advice and began to become hostile towards the nurse. The patient did not understand why this process could not happen immediately. The nurse continued to remain calm and professional while reiterating that discharging is a strenuous process that requires approval of a physcian. When the conversation was over I expressed to the nurse I was impressed with her professional behavior. The nurse then explained how much it meant to her that I provided her with positive feedback. She stated that I was able to “boost her confidence” by verbalizing my feedback on the situation. She thanked me for taking the time to tell her, because she did not feel professionally confident in confrontational situations. This experience not only inspired confidence in her, but it provided me with a great example of handling a confrontational situation in a professional manner.
5. Considers client motivation when using occupation based intervention to maximize functional independence.
During my time at Methodist South, I was able to consider the motivation of clients. I observed a treament session that my fieldwork educator implemented with a thirteen-year-old female who was diagnosed with a brachial plexus injury. Through my observation she expressed to the therapist that she was bored with therapy and was tired of completing the same exercises every week. She also stated that she was tired of focusing on reading comprehension from the same lower level book. She felt that it was too “babyish” for her. This patient had goals to increase reading comprehension and found the repetitive tasks mundane. After talking with the patient I was eager to help motivate her by utilizing an aspect of her role as a thirteen-year-old while still maximizing her functional independence. During the first session I observed that the patient brought slime with her. She expressed how much she loved to feel it, and was utilizing both upper extremities to engage in it. We talked about the various recipes for creating homemade slime.
I had the opportunity to plan a treatment session for this patient. As I began to brainstorm, I wanted to incoorporate her passion for slime. So, I created a slime recipe. During the session the patient was able to follow the recipe and created slime step by step. As the patient created slime she was required to use her right upper extremity functionally by stabilizing the bowl while mixing, grasping ingredients while reaching in various planes, etc. Through this treatment session I addressed the patients’ occupation as a thirteen-year-old female into the outpatient occupational therapy session. By incorporating her occupation into the therapy session, I was able to focus on the deficits and maximize the goal of increasing her reading comprehension as well as increasing functional use of her right upper extremity while making slime.
how_to_make_slime.jpg
6. Applies theory regarding the therapeutic use of occupation and adaptation to screen and evaluate, plan, and implement intervention, while establishing and maintaining a therapeutic relationship with the client.
During my time at St. Jude I have utilized three theories the most frequently: Occupational Adaptation, Rehabilitation, and Model of Human Occupation. These three theories have guided my therapeutic use of occupation during evaluations and implementations of interventions. Many patients require adaptations during their treatment due to side effects of chemotherapy and radiation. For example, we provide equipment such as tub transfer benches, shower chairs, grab bars, weighted utensils, adaptive pencils etc. Occupational Adaptation is a theory I utilized throughout treatment sessions as I built rapport with patients. By providing adaptations for patients I deepened rapport by discussing additional modifications/adaptations that could be made in order to promote independence and safety. Rehabilitation is a theory that was applied throughout the treatment sessions. The focus of this theory for treatment sessions was to rehabilitate the patient to their prior status and beyond. The treatment session we applied this theory to was specifically for children who were weak and experiencing decreased endurance due to treatment they were receiving. Specific examples of interventions during treatment sessions were the following: quadruped positon while engaging in fine motor activity, ball toss with forearm weights donned, yoga, etc. Lastly, utilizing MOHO assisted therapeutic relationships with clients in regards to volition that the theory emphasizes. I implemented motivating interventions for patients based on their interests and hobbies. This allowed me to build rapport with the patient even stronger and establish a therapeutic relationship with the client. One patient specifically continually expressed her desire to cook cupcakes again. This patient had not completed this cooking activity due to cognitive deficits and physical limitations. Toward the end of my rotation we were able to hold a cooking session with the patient. Addressing this motivating factor allowed the patient to perform dynamic standing and progress toward her goal for endurance. The three theories I discussed allowed me to use occupation and adaptation throughout the OT process while establishing a therapeutic relationship.
Below I have attached links to articles and references regarding theories that have guided my treatment sessions and approaches throughout my time at St. Jude. Below the links are the APA references for each article provided.
www.aota.org/~/media/Corporate/Files/Secure/Publications/SIS-Quarterly-Newsletters/DD/DDSEPT02.pdf
www.aota.org/~/media/Corporate/Files/Secure/Publications/SIS-Quarterly-Newsletters/EIS/SSSISJUNE04.pdf
There where numerous patients who were assigned leisure goals during my time at Baptist Health (inpatient psychiatric). When a leisure goal was created for a patient I administered a treatment session, and discussed the patients involvement in pleasurable activities that helped promote a healthy lifestyle. I educated patients on positive aspects regarding involvement in leisure activities that will assist in prevention and/or maintaining mental health they were striving to overcome. The patient and I would collaborate on realistic interests and engagements. Below I have attached a leisure checklist that I completed with patients to increase their engagement. Once the leisure activities are identified we then discussed realistic goals for activites and potential barriers that could arise jeopardizing the patient's leisure engagement. Overall, the goal during leisure treatment sessions was to determine their interests/values in relation to leisure and educate the patient on benefits of participating in healthy activities while discussing the balance between leisure and productive requirements.
interest_checklist.jpg
4. Inspires confidence in clients and team members.
Inspiring others is such a pleasure, and I personally would not have identified this specific example except that another team member expressed that I provided her with confidence. During my second fieldwork rotation I worked very closely with nursing, patient care techs, and social workers. There was a newly graduated nurse on the unit that I built a rapport with throughout my time at this facility. Through conversation this nurse expressed she did not feel confident in confrontational situations.
One day while on the unit this nurse was having to address a very angry and unhappy patient. The patient wanted to leave against medical advice and began to become hostile towards the nurse. The patient did not understand why this process could not happen immediately. The nurse continued to remain calm and professional while reiterating that discharging is a strenuous process that requires approval of a physcian. When the conversation was over I expressed to the nurse I was impressed with her professional behavior. The nurse then explained how much it meant to her that I provided her with positive feedback. She stated that I was able to “boost her confidence” by verbalizing my feedback on the situation. She thanked me for taking the time to tell her, because she did not feel professionally confident in confrontational situations. This experience not only inspired confidence in her, but it provided me with a great example of handling a confrontational situation in a professional manner.
5. Considers client motivation when using occupation based intervention to maximize functional independence.
During my time at Methodist South, I was able to consider the motivation of clients. I observed a treament session that my fieldwork educator implemented with a thirteen-year-old female who was diagnosed with a brachial plexus injury. Through my observation she expressed to the therapist that she was bored with therapy and was tired of completing the same exercises every week. She also stated that she was tired of focusing on reading comprehension from the same lower level book. She felt that it was too “babyish” for her. This patient had goals to increase reading comprehension and found the repetitive tasks mundane. After talking with the patient I was eager to help motivate her by utilizing an aspect of her role as a thirteen-year-old while still maximizing her functional independence. During the first session I observed that the patient brought slime with her. She expressed how much she loved to feel it, and was utilizing both upper extremities to engage in it. We talked about the various recipes for creating homemade slime.
I had the opportunity to plan a treatment session for this patient. As I began to brainstorm, I wanted to incoorporate her passion for slime. So, I created a slime recipe. During the session the patient was able to follow the recipe and created slime step by step. As the patient created slime she was required to use her right upper extremity functionally by stabilizing the bowl while mixing, grasping ingredients while reaching in various planes, etc. Through this treatment session I addressed the patients’ occupation as a thirteen-year-old female into the outpatient occupational therapy session. By incorporating her occupation into the therapy session, I was able to focus on the deficits and maximize the goal of increasing her reading comprehension as well as increasing functional use of her right upper extremity while making slime.
how_to_make_slime.jpg
6. Applies theory regarding the therapeutic use of occupation and adaptation to screen and evaluate, plan, and implement intervention, while establishing and maintaining a therapeutic relationship with the client.
During my time at St. Jude I have utilized three theories the most frequently: Occupational Adaptation, Rehabilitation, and Model of Human Occupation. These three theories have guided my therapeutic use of occupation during evaluations and implementations of interventions. Many patients require adaptations during their treatment due to side effects of chemotherapy and radiation. For example, we provide equipment such as tub transfer benches, shower chairs, grab bars, weighted utensils, adaptive pencils etc. Occupational Adaptation is a theory I utilized throughout treatment sessions as I built rapport with patients. By providing adaptations for patients I deepened rapport by discussing additional modifications/adaptations that could be made in order to promote independence and safety. Rehabilitation is a theory that was applied throughout the treatment sessions. The focus of this theory for treatment sessions was to rehabilitate the patient to their prior status and beyond. The treatment session we applied this theory to was specifically for children who were weak and experiencing decreased endurance due to treatment they were receiving. Specific examples of interventions during treatment sessions were the following: quadruped positon while engaging in fine motor activity, ball toss with forearm weights donned, yoga, etc. Lastly, utilizing MOHO assisted therapeutic relationships with clients in regards to volition that the theory emphasizes. I implemented motivating interventions for patients based on their interests and hobbies. This allowed me to build rapport with the patient even stronger and establish a therapeutic relationship with the client. One patient specifically continually expressed her desire to cook cupcakes again. This patient had not completed this cooking activity due to cognitive deficits and physical limitations. Toward the end of my rotation we were able to hold a cooking session with the patient. Addressing this motivating factor allowed the patient to perform dynamic standing and progress toward her goal for endurance. The three theories I discussed allowed me to use occupation and adaptation throughout the OT process while establishing a therapeutic relationship.
Below I have attached links to articles and references regarding theories that have guided my treatment sessions and approaches throughout my time at St. Jude. Below the links are the APA references for each article provided.
www.aota.org/~/media/Corporate/Files/Secure/Publications/SIS-Quarterly-Newsletters/DD/DDSEPT02.pdf
www.aota.org/~/media/Corporate/Files/Secure/Publications/SIS-Quarterly-Newsletters/EIS/SSSISJUNE04.pdf