2.1 Advocates for clients who have been neglected or underrepresented in the system
While completing my Level 2B fieldwork at Huntsville Hospital, I was met with the opportunity to translate two different times for clients who could not be understood due to their Spanish-only speaking capacity. The first time, my fieldwork educator asked me to try and get as much information as possible for an evaluation when the Marty (a translation device often used in the acute setting) was not functioning . During this evaluation, I was able to gain the necessary baseline elements for the evaluation including but not limited to: orientation, pain level and location, and who the client lives with. I also was able to gain vital information from the client for dizziness and s/s of syncope while giving directions in Spanish for safe mobility to the edge of bed.
The second time, I was able to aid a nurse in the neurology unit who was assisting her patient with medications. I had heard the patient loudly calling for water in Spanish with no one paying mind. I alerted the nurse who asked for my assistance considering most of the staff had said the patient was confused. When I went in, the patient was confused but did not seem as disoriented as staff had made him sound. It is my belief that the language barrier between staff and patient had created a narrative that the patient was more confused than he actually was. The patient was able to tell me his name and some other information which helped the nurse understand who she was caring for better. I translated any questions the nurse had for her patient including telling the patient she was about to give scheduled pain medications to him.
Both of these instances allowed me to advocate for minorities who did not have anyone to aid them during a life-altering time of their lives. As a future Occupational Therapist, it is vital that I seek to fully understand each client so that no client is written off due to barriers in language, culture, or lifestyle.
While completing my Level 2B fieldwork at Huntsville Hospital, I was met with the opportunity to translate two different times for clients who could not be understood due to their Spanish-only speaking capacity. The first time, my fieldwork educator asked me to try and get as much information as possible for an evaluation when the Marty (a translation device often used in the acute setting) was not functioning . During this evaluation, I was able to gain the necessary baseline elements for the evaluation including but not limited to: orientation, pain level and location, and who the client lives with. I also was able to gain vital information from the client for dizziness and s/s of syncope while giving directions in Spanish for safe mobility to the edge of bed.
The second time, I was able to aid a nurse in the neurology unit who was assisting her patient with medications. I had heard the patient loudly calling for water in Spanish with no one paying mind. I alerted the nurse who asked for my assistance considering most of the staff had said the patient was confused. When I went in, the patient was confused but did not seem as disoriented as staff had made him sound. It is my belief that the language barrier between staff and patient had created a narrative that the patient was more confused than he actually was. The patient was able to tell me his name and some other information which helped the nurse understand who she was caring for better. I translated any questions the nurse had for her patient including telling the patient she was about to give scheduled pain medications to him.
Both of these instances allowed me to advocate for minorities who did not have anyone to aid them during a life-altering time of their lives. As a future Occupational Therapist, it is vital that I seek to fully understand each client so that no client is written off due to barriers in language, culture, or lifestyle.
2.2 Fulfills commitments to the professional community
When completing my cardiac acute/ICU rotation at Huntsville Hospital, I had the privilege of attending a lunch and learn for the Shepherd Center. The Shepherd Center is a special location focused on the rehabilitation of individuals who have undergone traumatic brain and spinal cord injuries. The center has many perks for clients and families alike including housing for family members, state of the art technology, and diverse recreational opportunities thanks to their recreational therapy team. It is important as I continue my professional journey to attend events such as this or to continue to learn for the benefit of the clients I will be serving. This lecture allowed to to not only gather another resource for possible rehabilitation, but also learn about the routes which neurologic rehabilitation entails. By fulfilling professional commitments, it not only increases our proficiency to treat these conditions but also can have a lasting effect on the field as a whole. |
2.3 Represents the unique perspective of occupational therapy when participating in inter-professional situations
While completing my rotation in the very medically modeled structure of the hospital, I was able to increase my proficiency in relaying, expanding, and engaging relevant knowledge to all different clinicians in this setting. Being able to gather information from relevant parties is vastly important in this setting because it can truly enhance the picture you have of a client prior to completing their evaluation or treatment for the day. Being able to communicate with nursing staff and to trust their information is the most important aspect in this area day to day since nursing has so much time for interaction with their patients.
It is important to maintain good rapport with nursing because they can either be extremely helpful or be complacent in what information they choose to share. For example, prior to seeing a client, Occupational Therapy/Physical Therapy/ Speech Therapy check with nursing to see if a client is appropriate to see for that day based on medical status. One day, a physical therapist told me that when looking at documentation for the client I was also seeing, they saw that one of the CT angiograms had shown a clot located in a deep vein which means it is contraindicated for us to move them. Even though nursing had said they were appropriate, it is an immense responsibility for us to check for ourselves if a client is appropriate.
When engaging with other practitioners in this setting, I would also make sure to subtlety educate them when comments were made such as, "y'all do upper body right"? To this I simply replied that we often separate upper body for OT because most Activities of Daily Living require fine motor control to manipulate objects for engagement in those self-care activities. The nurse understood what I was saying and hopefully that small explanation resonated with her as to why things are separated in certain ways between Occupational Therapy and Physical Therapy. Small bits of education can add up to a large impact for practitioners and eventually, change the perception of the field for others as we know it to be!
While completing my rotation in the very medically modeled structure of the hospital, I was able to increase my proficiency in relaying, expanding, and engaging relevant knowledge to all different clinicians in this setting. Being able to gather information from relevant parties is vastly important in this setting because it can truly enhance the picture you have of a client prior to completing their evaluation or treatment for the day. Being able to communicate with nursing staff and to trust their information is the most important aspect in this area day to day since nursing has so much time for interaction with their patients.
It is important to maintain good rapport with nursing because they can either be extremely helpful or be complacent in what information they choose to share. For example, prior to seeing a client, Occupational Therapy/Physical Therapy/ Speech Therapy check with nursing to see if a client is appropriate to see for that day based on medical status. One day, a physical therapist told me that when looking at documentation for the client I was also seeing, they saw that one of the CT angiograms had shown a clot located in a deep vein which means it is contraindicated for us to move them. Even though nursing had said they were appropriate, it is an immense responsibility for us to check for ourselves if a client is appropriate.
When engaging with other practitioners in this setting, I would also make sure to subtlety educate them when comments were made such as, "y'all do upper body right"? To this I simply replied that we often separate upper body for OT because most Activities of Daily Living require fine motor control to manipulate objects for engagement in those self-care activities. The nurse understood what I was saying and hopefully that small explanation resonated with her as to why things are separated in certain ways between Occupational Therapy and Physical Therapy. Small bits of education can add up to a large impact for practitioners and eventually, change the perception of the field for others as we know it to be!
2.4 Assumes responsibility for professional behavior and growth, in accordance with AOTA standards
To ensure growth in this setting, I studied and made notes of my own from the forms given to me by my Fieldwork Educator as well as from reading the OT in Acute Care book. I did this to create a wealth of resources for me to make reference to when I need guidance in future settings. As a highly visual person, it was difficult at first for me to understand the complex nature of the clients I was seeing in the acute setting. By reading and creating drawings with notes, I was able to connect the dots on what I was seeing clinically. Much of the acute setting was difficult to grasp due to the "unseen" nature of body functions which is irregular compared to other settings. With the being said, I wanted to not only understand the clients I was giving care to, but I wanted to ensure safety, personal growth, and optimal care.
Assuming responsibility in ways which increase our capabilities as practitioners is important from many viewpoints. It can encompass better mobility techniques, better understanding of body functions, psychosocial understanding, and cultural humility, to name a few. Due to the baseline knowledge and skills at the beginning of this rotation, I took it into my own hands to become a better student and hopefully better future practitioner. These skills were rudimentary coming from the classroom but were refined over the course of my fieldwork as I became increasingly more proficient in the care of individuals in the acute setting.
To ensure growth in this setting, I studied and made notes of my own from the forms given to me by my Fieldwork Educator as well as from reading the OT in Acute Care book. I did this to create a wealth of resources for me to make reference to when I need guidance in future settings. As a highly visual person, it was difficult at first for me to understand the complex nature of the clients I was seeing in the acute setting. By reading and creating drawings with notes, I was able to connect the dots on what I was seeing clinically. Much of the acute setting was difficult to grasp due to the "unseen" nature of body functions which is irregular compared to other settings. With the being said, I wanted to not only understand the clients I was giving care to, but I wanted to ensure safety, personal growth, and optimal care.
Assuming responsibility in ways which increase our capabilities as practitioners is important from many viewpoints. It can encompass better mobility techniques, better understanding of body functions, psychosocial understanding, and cultural humility, to name a few. Due to the baseline knowledge and skills at the beginning of this rotation, I took it into my own hands to become a better student and hopefully better future practitioner. These skills were rudimentary coming from the classroom but were refined over the course of my fieldwork as I became increasingly more proficient in the care of individuals in the acute setting.
2.5 Functions autonomously and effectively in a broad array of service models
The acute setting truly challenged me and became an amazing learning experience that shaped me into becoming a holistic practitioner with honing of skills that were once not able to be used proficiently. With that being said, the growth I underwent was tremendous and allowed me to take charge of many aspects in this setting including managing the full caseload, relaying important information to nurses, deciding which evaluations were more important to see due to time constraints, and gathering important information from different healthcare providers.
Functioning autonomously is so important to the emerging clinician and with each fieldwork experience serving as an in-depth learning experience, it provides guidance to increasing skills and understanding regarding each setting. In the future, I hope to provide stability and clinical reasoning to my students so that they too can learn how to be an ethical, caring, and skillful practitioner while in their fieldwork rotations.
The acute setting truly challenged me and became an amazing learning experience that shaped me into becoming a holistic practitioner with honing of skills that were once not able to be used proficiently. With that being said, the growth I underwent was tremendous and allowed me to take charge of many aspects in this setting including managing the full caseload, relaying important information to nurses, deciding which evaluations were more important to see due to time constraints, and gathering important information from different healthcare providers.
Functioning autonomously is so important to the emerging clinician and with each fieldwork experience serving as an in-depth learning experience, it provides guidance to increasing skills and understanding regarding each setting. In the future, I hope to provide stability and clinical reasoning to my students so that they too can learn how to be an ethical, caring, and skillful practitioner while in their fieldwork rotations.
2.6 Upholds the AOTA Code of Ethics in practice.
While completing my Level 2 A Fieldwork at Ortho South Occupational Rehab, I was asked by a classmate what the evaluations look like in my setting. Prior to showing my classmates what the evaluations look like, I made sure to blot out every identifiable factor which would make the client identifiable. I also had permission from my Fieldwork Educator to leave his name untouched. This adheres to the AOTA code of ethics in many areas but mainly in areas of Justice and Dignity. Justice is defined by AOTA as upholding moral and legal principles. The legal principle being that of HIPAA violations whereas the moral principle being my character when relaying information to others who do not have this client on their caseload. Choosing to uphold ethical and moral values of the systems which are placed before us will guide me to be a better practitioner and healthcare professional by intentionally following and modifying what I do so that no person is hurt by my actions. |
2.7 Serves as a role model for honesty, integrity, and morally grounded decision-making.
Throughout my clinical experience, I reasoned through the various nuances that a therapist must attend to via discussions with my Fieldwork Educator so that I may better understand how to be ethical in my decision making according to federal, state, and site regulations. Things such as correctly billing for time of services, being truthful in our services, and being honest about hard discussions are just a few of the various things in which I became well-versed. The code of ethics and the core values clearly dictate how as a practitioner, we must do no harm when faced with tough decisions.
Doing no harm is more than just a simple "do what is right" when other people are present. It also means identifying potential risk to how my actions may impact others in the near or extended future. Thinking of only the present-most risks without thinking of the foreseeable future nullifies the decisions one makes. We must think of all the possibilities of impact when making decisions so that we can truly go forward with the best and most informed decisions possible
Throughout my clinical experience, I reasoned through the various nuances that a therapist must attend to via discussions with my Fieldwork Educator so that I may better understand how to be ethical in my decision making according to federal, state, and site regulations. Things such as correctly billing for time of services, being truthful in our services, and being honest about hard discussions are just a few of the various things in which I became well-versed. The code of ethics and the core values clearly dictate how as a practitioner, we must do no harm when faced with tough decisions.
Doing no harm is more than just a simple "do what is right" when other people are present. It also means identifying potential risk to how my actions may impact others in the near or extended future. Thinking of only the present-most risks without thinking of the foreseeable future nullifies the decisions one makes. We must think of all the possibilities of impact when making decisions so that we can truly go forward with the best and most informed decisions possible