What does an OT actually do?

This is a post all about Occupational Therapy (OT), and why I love it! I wrote about it previously (here). Some of this post is the same, so apologies for some repeated content, there is new bits in this one too though, so keep reading! (please)

This week is Occupational Therapy Week, in which we celebrate and promote OT. Promotion is the hot topic this year as the main focus is all about how we’ secure the future of our profession’. In today’s health and social care climate, there is an every decreasing budget and services are having to really fight to continue. We as OTs need to prove why we are a valuable asset to any service. We need to demonstrate why we offer a unique service that is definitely not the same as other professionals. We need to stand up for ourselves to prevent us becoming deskilled and labelled generic workers.

Many people ask me ‘what is OT?’ It’s actually really hard to define as it is such a varied job with many specialties. It is not occupational health, and as my husband likes to think, it’s not just about measuring toilets. It’s essentially about ‘occupation’, not just the work variety, but ‘occupation’ that describes every single part of a person’s being. Anything, from eating, walking, talking (and everything in between) is essentially occupation. It is the tiny things such as flickers of movement in the fingers (which can enable function) to the bigger things such as feeding yourself or getting washed. I was trying to find a proper definition, and really liked this quote from the homepage of the Royal College of OT website ‘Helping people to live, not exist’ I loved it and feel like it sums up my job pretty well. See their website (here) for more details.

I have been an Occupational Therapist for 11 years now, and I think I love it even more now than I did way back then. I think this comes from personal and professional maturity, and from having so much more experience and confidence. I went to uni to study OT straight from school/6th form at 18, so was very young without the valuable life experience that I think is needed for this job. I currently work in acute stroke care which involves assessing and carrying out rehab with people who have just had their strokes. Despite its challenges, it’s an amazing job, and I feel very lucky and privileged to be able to share people’s journey to recovery with them.

I love stroke rehab, it’s fascinating. I am a bit of a geek and love learning about the brain, and what it can do, how it works, and what we can do to aid recovery. I love working with patients and seeing them get better and able to achieve more. We see some people with massive strokes, and it’s such a delight to share their recovery with them. To help someone learn to sit up again, to see some movement regained, and to see them feed themselves again makes all the hard work so so worth it. To help someone express their feelings, to watch them learn to talk again, to see them take their first steps is wonderful. To enable people to make their family a drink, or to do a puzzle with their grandchild is amazing. To be able to advocate and fight for a patient gives a huge sense of achievement. To have worked really hard and see a positive outcome after a tricky case is great. To watch a patient walk out of hospital when they were unconscious when they came in is pretty special. To see them when they come back to visit looking so well reminds us that there is life outside the hospital. We don’t do it for the recognition and thanks, but when we do get it, it lifts the spirits of the tired team members.

I’ve learnt a lot about myself since becoming an OT. I’ve learnt that I am a good leader and teacher. I never thought I would make a good leader, but I don’t think I’m doing a bad job now I’m doing it. I love teaching students and seeing them learn. I love seeing them achieve and enjoy what they’re doing. It was such a pleasure to see the last student we had slowly come out of her shell and increase her confidence. With a bit of nurture and encouragement she did really well and gave some really nice feedback. I also bumped into another student I’d had about years ago, and she told me that she still uses some of the skills she learnt with us now she’s qualified all these years later. It’s lovely to know what a positive impact we had on her. It made me so proud. I am actually quite a shy reserved person, but somehow at work I can speak out and up. I have been able to step way out of my comfort zone, and have felt really good for doing it. I volunteered to be the department resus trainer even though I always got really nervous when I had to attend the training myself. I learned to really enjoy this role and was proud of myself for having the confidence to give it a go.

This year I’m the department audit lead. I was representing my team leader in a meeting and said I might be interested in the role. My manager gave it to me there and then without any discussion, gulp! Now I’ve got my head around what the role entails, I’m actually loving it. It suits my enjoyment of organisation and analysis well. It has challenged my communication and logistical skills, but I’ve got some nice feedback, which has been a massive encouragement. It’s also made me realise that I really do care about the quality of work that we do. It’s been really interesting to really look at how well we are doing what we say we are doing. I am passionate about delivering a quality service that meets the needs of our patients. As I’ve grown in experience I’ve realised that its really hard to balance this with the needs of the service. I’ve also been able to understand a bit more about the challenges of delivering healthcare in the current social and economic climate. I’ve been able to think about how we overcome some of these challenges.

Since becoming an adoptive parent I’ve seen that there are many qualities and skills of an OT that make a good parent, although I’ve also learnt that it’s often much harder to use them at home than at work. I always thought I was quite a calm and patient person, but since my little girl came home I’m not so sure… However, I have been able to use some of my skills at home as well as work. We do quite a bit of DIY art and crafts, and I’m sure some of my OT identity to use everyday things as ‘therapy’ has been in use there. Being a stroke OT, I know a bit about the brain, so I’m fascinated about the affect of (developmental) trauma on a child’s brain development and use. I know that as the brain is the body’s ‘control centre’, any part of daily functioning/being can be affected by brain damage. I know that the pathways in the brain can be to some extent ‘re-wired’, and am really interested to learn more about how this applied to children with development brain damage (such as those with Foetal Alcohol Spectrum Disorder or other ‘trauma’). A large part of my work involves working people with sensory (sensation, proprioception, visual) impairment, and helping them live with their impairment. I know that many children with ‘trauma” have some level of sensory impairment (may that be underestimulation or overload) I’ve explored sensory impairment more in other posts, (see Interception & Sensory processing for more info)

So, the focus of this week was what can we do to secure the future of the profession. I think we need to continue to be involved in research and leadership at the highest levels. But I strongly believe that we can use the most simplest of occupations/activities to have a huge impact on patient well-being. I think as OTs  we are very good at considering patients’ basic well-being and mental health, and that by addressing poor well-being we’re laying the foundations for positive engagements and participation. If patients engage in therapy because you’re working with them on something thats important to them, they get better quicker, which means they get discharged quicker, everyone wins! (Yes, I know that in reality it’s more complex). We can simply use our time, to listen to talk to problem solve together. We can address barriers to activities such as feeding, using the toilet, personal care. We all know that when we can achieve these activities, we feel so much better in ourselves. We can encourage someone to continue an interest or hobby in hospital which can lift mood and improve mental health. These are occupations in their most basic of forms, but they’re all what we normally take for granted. This week OT’s have been encouraged to make a pledge of how we will champion Occupational Therapy. Mine will be to try to use more well-being activities in my everyday practice. I hope that we never become too busy, or too advanced to forget that at the end of the day, our job is all about ‘Helping people to live, not exist’