1.1 Appreciated the influence of socio-cultural, socioeconomic, political, diversity factors, and lifestyle choices on engagement in occupation throughout the lifespan. During my time on Level II fieldwork, I was apart of a grant called RISE-CAY. This grant provided us with in-services we could attend throughout fieldwork. My favorite in-service that was given was on the topic of cultural humility. During this in-service we practiced using aspects of the deliberate practice model by identifying my thoughts, feelings, and body sensations when speaking to a client different than myself. Throughout my last Level II rotation in pediatrics, I have continued to use this model of practice to ensure I am prioritizing other's personal information about roles, routines, rituals, values, beliefs, and cultural influences. This has been extremely useful during evaluations in order to gather social, medical, developmental, and occupational histories. I reflected on my responses to the client and their caregivers when documenting after the evaluation and wrote down ways to grow in client-centered practice.
1.2 Communicates effectively with a wide range of clients, peers, and professionals both verbally and non-verbally. While working in acute care, I had many opportunities to expand my communication skills. On a daily basis, I was communicating with RN's, MD's, other therapy staff, MA's, family members and clients, and more. One experience that sticks out the most is when I had a patient that was non-verbal due to having a trach while in the intensive care unit. I was able communicate via the notes section of his phone because he had functional use of hands. For similar patients I saw during this rotation that could not use their hands, I would write on a notepad two options. I would ask the patients to blink when I pointed to the correct option that they were trying to communicate about. My rotation in acute care also helped me grow in my confidence in talking about patient progress, making discharge and DME recommendations. During my second rotation at an outpatient pediatrics facility, I frequently incorporated music as a form of communication for my clients that were non-verbal. One client in particular loved the song "Pink" from the Barbie movie. When I would play the soundtrack from the movie, he would become more motivated to engage in play or purposeful activities with me. This helped me establish rapport because I incorporated something he enjoyed and that brought him joy into our therapy sessions. Below, I have attached feedback from my FWE that expressed my abilities to communicate effectively with clients, families, and professionals.
1.3 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. During my time in acute care, I spent a lot of time assessing how safely and independently clients' were able to engage in their chosen occupations - especially activities of daily living such as toileting, bathing, and dressing. Due to the nature of the setting, many of my patients did not take much convincing to get cleaned up after being in the bed. For my patients that were not as mobile, they enjoyed engaging in bed baths, changing of gowns, combing hair, and brushing teeth. I loved how I was able to help them engage in activities of daily living while also helping to promote health and wellness. Through the use of these activities we were able to target their fine motor skills, standing balance and tolerance while also doing tasks that made them feel more confident during a hard time.
1.4 Inspires confidence in clients and team members. During many of my treatments in acute care, I incorporated ADL's at the beginning of my session. I did this because I noticed that many of my clients had more motivation and participation if they felt good about themselves. The saying "if you look good, you feel good" rings true, especially in a hospital where feeling good is few and far between. I used ADL's to motivate my clients to improve their independence, activity tolerance. and independence with ADL tasks. During my experience in acute care, I can recall one very significant instance where confidence as a key component to a client's overall improvement while in the hospital. I worked with a client who had undergone a total hip arthroplasty, over 400 pounds, and was an ex police officer. He did not enjoy working with female therapist's because he did not trust that we could support him if he were to fall. I knew it was my job to be supportive of this client and push him no matter how difficulty it was. I typically would co-treat with PT who was a male to ensure no precautions were broken. Therefore, the client felt more comfortable engaging in tasks with me. This client always enjoyed doing a full body wash up during our sessions. After the second session, I noticed this and made sure to prepare for the session by grabbing wipes and towels. Assisting my client to feel his best during our sessions really made a difference in his motivation and participation throughout the rest of the session. I believe this helped me establish rapport with the client and show how much I cared. I believe it is important for us to express to our client's how important it is to us as therapists for our patient's to succeed and reach their goals!
1.5 Considers client motivation when using occupation based intervention to maximize functional independence. I have ensured that motivation is the forefront of my treatment sessions within acute care and outpatient pediatrics to ensure buy-in during our treatment sessions. In acute care, this looked like performing ADL tasks such as toileting, grooming, and getting dressed. In outpatient pediatrics this includes using interventions such as using toys during the occupation of play, dressing boards to learn buttons, snaps, and zippers or creating routine schedules based on showering, brushing teeth, and more. I learned in both of these settings that as occupational therapists we must be flexible with our schedule. The best sessions are the one's that are client-led and are full of things that bring the client enjoyment. Creativity is such an important skill to hone into as an occupational therapist!
1.6 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. Within both the acute care and outpatient pediatric settings, establishing rapport with your patients is crucial. Within these setting, I used occupations to evaluate where the patient had short-term or long-term deficits due to their medical diagnoses. Based on the results of my evaluation, this helped me plan and implement interventions that are occupation-based and client-centered. I use my clinical observation during treatments to notice if a task was too difficulty or too easy for the client. Based on my observation, I would either grade the task up or down (make it easier or more difficult). This assisted me in making sure the treatment sessions were always challenging and engaging to the patient. When I noticed a patient getting frustrated if the task was too difficult, I would step in to assist or show an adaptive way to complete the task. This helped me establish and maintain a therapeutic relationship with the patient because they knew that I was there to challenge them, but also to help modify or simply tasks for them to encourage independence in their daily lives. Below, I have attached feedback from my FWE that expressed my abilities to implement client-centered and occupation-based treatments.