jessheaver

[jessheaver]

a reflection to guide my path forward

“The comfort zone is a great enemy of courage and confidence” by Brain Tracey

Community block has been a whirlwind of emotions but such an eye-opening experience at the same time. Coming into it, I felt extremely overwhelmed, stress and anxious with many tears and feelings of exhaustion. However, with some direction and structure, along with positive self-encouragement, I have soon come to realize the depth in the importance of working at the community level with the differences that we can make in the lives of those who most benefit from the service that we offer. Not only has this block opened my eyes, but it’s changed my ways of thinking to a better, deeper level. I feel that it has taught me several lessons, both personally and professionally, that I will use towards my future practice in life and the clinical setting. I have gained experience in working directly in the community, every day I feel that I learn something new, something that I can take forward in my community journey in the future. In this block, I used to feel like I was on a trampoline, up and down constantly, but I have come to realize that it is more like I am climbing a mountain without a travel map, navigating my way through and eventually, I will reach the top.

Personally, I have gained several lessons through my community experiences. In the beginning, I felt that I was thrown completely out of my comfort zone but soon it started to feel like home. This community has taught me that I would often look at an individual and either feel sorry for the little they have or judge them for their actions, this due to my positionality. This came to light for me when I did a home-visit with a client who lives in a 2-bedroom home with her sixteen other family members. I immediately felt sorry for them as it was clearly highlighting over-crowdedness. However, having a deeper conversation with them, they said that although they may always be in each other’s space and sometimes feel like the living on top of each other, at the end of the day, they are always there for one another to give support and love, so it didn’t matter to them. I have seen such happy and strong family bonds amongst all the home visits that I have completed, not matter what their devastating circumstances may be. This humbled me that no matter how tough life may get or be, we always have something to be grateful for not matter how big or small. I have learnt to sometime disregard my positionality, to accept and respect people for their own realities, contexts, and experiences.

Professionally, this block has taught me the importance of asking questions and understanding the client’s that we work with on a deeper level, not just on a superficial surface. I reflect that previously, I would scrap the surface with a focus on the factors that, what I thought, were affecting an individual’s engagement in their occupations in a home, community, and social level. This block has allowed me to understand the importance of asking questions to fully gain an holistic picture. This was highlighted when visiting a 77-year-old female on a home visit in the community. This woman had her right leg amputated below the knee 30+ years ago, she received no rehabilitation and was sent home with nothing, this resulting in her crawling as her mobility ever since. Last year, she fractured her hip from a fall and was further discharged from hospital with nothing as she stated that she had a wheelchair at home, but they didn’t ask if she actually used it or not. This is a heart-breaking story that has thought me that our actions may have consequences that may sequentially, have devastating effects one’s life, such as this woman crawling as her form of mobility ever since this trauma whereas she simply could’ve been given crutches or a walking frame if she had been issued them. Instead, her grandchildren grew up looking down at her. I have also come to realise the oppression, patriarchism, sexism, and discrimination that individuals face, that ultimately affect their occupational right and engagement in occupations that affect their health and wellness. This teaching me to fully understand a person for who they are, their lived realities and experiences by asking all the questions necessary, ultimately, to fully provide intervention that is going to make a difference in their lives.

I am extremely grateful for the daily community experiences that have transformed by way of thinking and has opened my eyes to the reality which have prepared me for my way forward in future “community-based practice”. I have gained valuable lessons that will assist in my way forward. Going forward, I want to show my gratitude to community members for letting me work within their environment, whilst being respectful and humble when working and collaborating with them. I wish to adopt a humanistic approach, with a smile every day, doing the ultimate best I can for every individual who crosses my path. I wish to build relationships and ask all the questions to understand a person for who they are, on a deeper level, no matter their gender, age, and diagnosis. I wish to provide support and empower as well as advocate for those that are socially discriminated for, to facilitate a change in feelings, thoughts and systems whilst giving individuals who are silenced a voice to speak up. I am now hopeful and optimistic with my future role within different communities, I look forward to my path up ahead, growing and learning more with each conversation, each patient and each community.

Grateful is the word that I can describe how I feel. Although there have been challenges and times where I have had to push myself, I am grateful for this opportunity to go into the communities, to go into the client’s home and to develop better relationships with them as it has allowed me to truly see the difference and changes in lives that we have the capacity to make. I am grateful for the community for pushing me out of my comfort zone, challenging my positionality and my way of thinking, for the previous misconceptions that I had about working within these environments. And lastly, I am grateful for the community members for accepting me for one as their own and for making me feel at home and like I am extended-family. I am really starting to see just how remarkable the impact of occupational therapists working at this level may be. To end off, a quote that summaries my experience beautifully, “step so far outside of your comfort zone that you forget to get back” (anonymous), because I just may be hooked on community practice.

References

· Multiethnic Group People Society Multicultural Community Stock Vector (Royalty Free) 1456013552. Retrieved 23 August 2021, from https://www.shutterstock.com/image-vector/multiethnic-group-people-society-multicultural-community-1456013552

· Tracey, B. Building the Courage to Break Out of Your Comfort Zone. Retrieved 23 August 2021, from https://www.briantracy.com/blog/general/building-the-courage-to-break-out-of-your-comfort-zone/

· White, A. 30+ Quotes That Will Motivate You to Step Outside of Your Comfort Zone. Retrieved 23 August 2021, from https://bucketlistjourney.net/motivational-comfort-zone-quotes/

[jessheaver]

AN OT’S ROLE FOR A SUSTAINABLE FUTURE

“The ones who are crazy enough to think they can change the world are the ones who do” – Steve Jobs (Klavina, 2019)

I have always been someone who wanted to make an impact on the world by making positive changes in lives of the people who cross my path. The United Nations Assembly created 17 Sustainable Development Goals (SDG’s) which were developed to address the needs of the present without compromising the ability for future generations to meet their very own needs (Wagman et al., 2020). These development goals aim to end poverty, promote prosperity and equality as well as protect the planet and its people. The SDGs were created to be utilised as a ‘blueprint’ by all countries to work towards a better and more sustainable future. Wagman et al. (2020) identified we as occupational therapists can provide valuable and important contributions to sustainable development as many aspects of unsustainability are directly related to human occupation, this a focal point for OT. He further identified that we have direct knowledge about human occupations and occupation adaptations that can be made. Out of the 17 SDG’s, I am going to further discuss 5 with direct experiences related to the communities that I have worked in and the role that we can play in the steps to achieving these goals.

“Poverty is the worst form of violence “– Mahatma Gandhi.

The first SDG is the goal for “No poverty” which aims to end poverty in all forms. Poverty and its effects have been directly identified in the community that I am currently working in, as well as around our South African country. There is an increased amount of unemployment around working age community members, with some selling drugs, stealing or homelessness which is commonly seen with an individual walking down the road with everything they own strapped to their backs in search of their next meal from the nearest dustbin and their next shelter for the upcoming cold night. We may not be able to completely combat and end poverty, but I believe that we play an important role in promoting steps and changes to aid in breaking these barriers. We may have the capacity to develop self-run programmes such as the Women Empowerment Project at Mariannridge that can be run to bring in a source of income to families, we may do vocational skills training to aid in job seeking opportunities and we may give information and work closely with the social workers to advocate for grants to those who qualify.

“The war against hunger is truly mankind’s war of liberation” – John F. Kennedy

The second SDG that I chose to present is “Zero Hunger” which aims to end hunger in all forms, achieve food security with improved nutrition whilst promoting sustainable agriculture. Food insecurity is a devasting reality that we see daily within South African communities. Severe Malnutrition (SAM) is a prevalent reality seen in our communities amongst children which effects their growth and development. I once treated a 6-month-old baby who had been brought in by his mother who had fed him sugar water as a source of food as she couldn’t afford anything else. Often, we directly point it at neglect, but this mother loved her child with her whole heart and was trying anything to ensure he was fed with whatever she had and could afford. We as occupational therapists may not be able to combat hunger by providing food parcels and supplying food, but we look at sustainable long-term solutions such as developing a garden within homes or in communities to allow individuals to be able to sustainably grow affordable and nutritious vegetables from their own homes for their families or as a source of income. Another role could be educating and bringing awareness to nutritional related illnesses/conditions with alternate cheaper, nutritious food recipes with common and affordable ingredients seen within almost every household.

“It is health that is real wealth and not pieces of gold and silver” – Mahatma Gandhi

The third SDG is “Good health and well-being” to ensure healthy lives and promote well-being for all ages. It’s important to remember the WHO (1948) definition of health which states that health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Within the communities, we can address physical, mental, and social factors that are hindering an individual’s successful engagement in meaningful everyday activities with home visits or individual sessions as well as a role in health promotion and disease/illness prevention for communities within the clinics. We may use remediation and/or compensation approaches with adaptation and organization of daily activities to prevent dysfunction, promote healthy lifestyle and recovery. Preventative and promotive approaches may be facilitated through educational health promotion talks and awareness raising about healthy lifestyle choices, healthcare service availability and prevalent conditions at the clinics such as HIV/AIDS, maternal mental illness etc. to aid in early detection and intervention or prevention, this to maintain health and well-being.

“Ensuring quality higher education is one of the most important things we can do as future generations” – Ron Lewis

The fourth SDG is the goal for “Quality education” which ensures inclusive and equitable quality education and promotion of lifelong learning opportunities. I have particularly noticed a lack of attendance to schools with an increased number of dropout rates within the community I have been working in. A clinic staff member reinforced the issues of adolescents not furthering their studies and instead remaining at home and engaging in poor lifestyle choices including the use and trading of drugs and alcohol. We as occupational therapists play a role in life skills development and encouraging and advocating for attendance of schools with the opportunities and benefits of furthering studies to aid in greater success in the future. We may develop vocational skills training workshops within communities to provide community members with the learning opportunity to learn new skills. We may provide information about courses with bursaries and funding to raise awareness on the opportunities to furthering individuals’ studies.

“Gender equality is a human fight, not a female fight” – Frieda Pinto.

The last SDG is “Gender equality” which aims at achieving gender equality for all with empowering of women and girls. This is an extremely prevalent issues that is seen within all communities. Women of our communities face extremely sad realities of patriarchy, sexism, exploitation, and oppression contributing to devasting lived experiences and realities (Sharma, 2019). I have noticed within the clinics of the community that children are brought in by women figures as they are seen as nurturers and home makers with a lack of power over men who are the breadwinners and the head of families. Occupational therapists play an important role in working with men and women to educate and advocate for women’s right for equality. We may provide opportunities for growth and development through the development of programmes that empower women with emphasise on normalising and promoting maternal mental health within our communities.

We may not be able to solely achieve these goals, but we have an important and valuable role to play in breaking the barriers and achieving the steps needed to work towards these Sustainable Development Goals (SDG’s). It is also important for us as OTs to remember what our scope of practice is, we often, I know because I have done it myself, take on too much and make promises to please and help others but we need to be realistic with what we can address and cope with. However, we definitively, along with others, play a role in promoting sustainable development to meet the needs of our people today with an occupation based approach, without comprising the needs for future generations. Together we can achieve the World.

References:

· Constitution of the World Health Organization. In: World Health Organization: Basic documents. 45th ed. Geneva: World Health Organization; 2005

· Eccles, R., & Karbassi, L. (2018). The Right Way to Support the Sustainable Development Goals. Retrieved 17 August 2021, from https://sloanreview.mit.edu/article/the-right-way-to-support-the-uns-sustainable-development-goals/

· Gender Equality must become a Lived Reality. Retrieved 17 August 2021, from https://sdgs.scout.org/project/gender-equality-must-become-lived-reality]

· Klavina, M. (2019). The ones who are crazy enough to think they can change the world, are the ones who do. - Steve Jobs. Retrieved 17 August 2021, from https://medium.com/@mathiasklavina/the-ones-who-are-crazy-enough-to-think-they-can-change-the-world-are-the-ones-who-do-a020b6c307aa

· Mahatma Gandhi’s Greatest Quotes. Retrieved 17 August 2021, from https://www.businessblogshub.com/2012/10/mahatma-gandhis-greatest-quotes/

· Poverty: ‘The Worst Form Of Violence’. (2015). Retrieved 17 August 2021, from https://www.yankton.net/opinion/editorials/article_77b96a12-34cd-11e5-a79a-ef7a9f3f5ec2.html

· Ron Lewis Quotes. Retrieved 17 August 2021, from https://www.brainyquote.com/quotes/ron_lewis_337487

· Sheffe, S. (2011). CLIENT-CENTEREDNESS, POWER AND POSTCOLONIAL FEMINISM: How occupational therapists can become leaders in mental health. Retrieved from https://tspace.library.utoronto.ca/bitstream/1807/67368/1/S.%20Sheffe%20-%20Power,%20PostColonialism,%20and%20OT.pdf

· The 17 Sustainable Development Goals of the United Nations. (2015). Retrieved 17 August 2021, from https://developers.google.com/community/dsc-solution-challenge/UN-goals

· “The war against hunger is truly mankind’s war of liberation.” – John F. Kennedy, 35th President of the United States. Retrieved 17 August 2021, from https://www.mzalendo.com/blog/2019/03/19/the-war-against-hunger-is-truly-mankinds-war-of-liberation-john-f-kennedy-35th-president-of-the-united-states/

· Wagman, P., Johansson, A., Jansson, I., Lygnegård, F., Edström, E., Björklund Carlstedt, A., ... & Fristedt, S. (2020). Making sustainability in occupational therapy visible by relating to the Agenda 2030 goals–A case description of a Swedish university. World Federation of Occupational Therapists Bulletin, 76(1), 7-14. https://doi.org/10.1080/14473828.2020.1718266

[jessheaver]

Positionality, for a client-centered approach

(Swanson, 2020)

If I were to ask you to describe who you are and what your lens of the World is, would you be able to fully answer me without giving it all your thought? In all honestly, as I am sitting here writing this piece, I too am questioning myself on how to fully answer this question whilst at the same time challenging my identity, positionality and how I perceive the world around me. The word positionality can be understood as the position that we adopt from our social and political context and our view of the world (Holmes, 2020). It is vital as occupational therapists to understand that every individual has a different positionality shaped by their contexts. This indicating the importance of considering a patient’s positionality to understand their identity, their experiences, interests, and perspectives. By adopting this approach, it will truly facilitate a client-centered practice with collaborative and effective intervention (Hammell, 2002). But first, we need to acknowledge our very own positionality to understand the way we think, feel and act to further identity and understand others.

Our positionality is shaped by our “background, personal values and experiences” (D’Silva et al., 2016, pg. 97) which plays an important role in our everyday lives as it forms the basis of our understanding and interpretation of our surrounding World, this our position with our surroundings. It directly influences how and why we do things the way we do. Our positionalities are not set in stone, they to, like our identities can be seen as ever changing as Kezar and Lester (210) identified them as “dynamic”. Our changing contexts and experiences may cause us to challenge the way we think, feel and act, they may challenge the way we identify ourselves and understand and perceive the world around us.  

My positionality has been created from my social and political contexts and experiences which has developed my identity and who I am today. I have been extremely fortunate enough to be part of a loving and supportive family and positively influential peer groups who have provided me with the safety and security I needed. I grew up in a secure and well-developed community and have been given the greatest opportunities in my studies. I was fortunate enough to be given everything that I needed in growing up to assist me to achieve the things that I wanted. I grew up in a humble home with strong family dynamics. These factors have influenced the person who I am today, grateful, determined, and hard-working. I identify myself as one who truly cares about others and wishes to make an impact on the World, this, why I decided to study occupational therapy.

As an OT student, I have come to understand the importance that positionality plays in the life of the patients that we treat with the understanding that every individual has a different positionality. This came to light for me when entering the Marianridge community and observing the things around me. I noticed that there are children walking on the streets unsupervised, playing with their friends using old milk cartons and string, yet still having fun. I noticed the lady outside the clinic trying to sell food along with competing stalls to bring in any income she can get to support her family yet still having a smile on her face. This has brought much light to my understanding that every individual has different experiences, different contexts, and different ways they perceive the world thy live in, this, a different positionality. Their positionality shapes who they are and their identity, which is why we as therapists need to understand them as a whole to truly provide the intervention that they need. If we as therapists do not fully understand our patient’s positionality, how can we successfully say that we provide client-centered practice?

As therapist’s we preach a client-centered approach yet often neglect what is important to an individual and the position they are in. By considering a patient’s contextual influencers it allows us to understand a patient’s identity, their chosen activity choices, and interests. By adopting a holistic approach, it allows us to fully understand our patients needs and their situation. This can be achieved by including our clients as collaborators in our assessment and intervention of OT practice to understand their positionality.

By collaborating with them and situating ourselves into their contexts (Sonday, 2016), we can understand the difficulties they are facing both personally and contextually. This may develop our understanding of what is important to them and how they perceive their surroundings. These factors will ultimately assist in guiding treatment and developing community programmes that will be most beneficial, realistic, and relevant the patient’s and community’s needs. It’s important to note that we are not the ones living with the injury/condition or in the community, we are different people, we perceive and experience things differently and have a different positionality so we will never fully understand who they are and what they are experiencing. Therefore, we need to talk and listen to the patient’s needs, we need to put ourselves into their positions to successfully collaborate on intervention and programmes that will be sustainable and utilised.

In conclusion, our positionality influences our identity, and our identity is who we are as people and represents our values, beliefs, and interests. With this, we need to fully understand our own positionality as well as have respect and understanding for the positionality of others. As OT’s we need to understand the positionality of our clients to fully understand who they are, what their contexts are, what is important to them and how they perceive their surroundings. By doing this we will be able to fully provide and preach a client-centered approach for congruency and genuineness with our clients to guide the best possible intervention and programme development within communities. This, to ensure we are making a difference in the lives that cross our paths.  

References:

·       D'silva, M. U., Smith, S. E., Della, L. J., Potter, D. A., Rajack-Talley, T. A., & Best, L. (2016). Reflexivity and Positionality in Researching African-American Communities: Lessons from the Field. Intercultural Communication Studies, 25(1). Retrieved from https://web.uri.edu/iaics/files/XXV1–D’SILVA-SMITH-DELLA.pdf

·       Hammell, K. W. (2002). Informing client-centred practice through qualitative inquiry: Evaluating the quality of qualitative research. British Journal of Occupational Therapy, 65(4), 175-184. https://doi.org/10.1177/030802260206500405

·       Holmes, A. G. D. (2020). Researcher Positionality--A Consideration of Its Influence and Place in Qualitative Research--A New Researcher Guide. Shanlax International Journal of Education, 8(4), 1-10. https://doi.org/10.34293/ education.v8i4.3232

·       Kezar, A., & Lester, J. (2010). Breaking the barriers of essentialism in leadership research: Positionality as a promising approach. Feminist Formations, 163-185. DOI:10.1353/nwsa.0.0121

·       Sonday, A. (2016). A case study of professional role transition for occupational therapists in specialised education in post-apartheid South Africa: a critical narrative perspective. Retrieved from http://hdl.handle.net/11427/20786

·       Swanson, D. (2020). A Case for Positionality. Retrieved 13 August 2021, from http://www.ighgc.org/blog-posts/a-case-for-positionality

[jessheaver]

THE REALITIES OF MATERNAL & CHILDHOOD HEALTH

("Vodacom and Mondia launch Maternal Health Service in DRC", n.d.)

“You do NOT have to suffer in silence or feel ashamed. Our babies need us to be healthy during a time when we are overwhelmed the most.” - BH Mayer

Imagine, you are a mother who has been in a 2-hour queue at the Marianridge Clinic, simply just waiting to for your baby to receive the 6-month immunisation. It’s hot and humid, your baby is crying, and you are trying to swaddle him as he screams with all eyes in the clinic looking at you. With the anxiety developing, you contemplate leaving and coming back another time just to no longer cause a fuss. You are hiding your feelings of fatigue, feelings of hopelessness, helplessness, and worthlessness, you are on the verge of crying but trying to hold them back. You are suffering in silence as you are ashamed of these feelings, you may be avoiding judgement and criticism from others, or you may be trying to brush them of to “stay strong” for the sake of your child. This is just one of the realities that a mother with postpartum depression may experience, and postpartum depression is one of the many maternal health challenges that woman face. When maternal and childhood health are overlooked, this has implications for not only OT practice but on all levels. Women play a vital role in our societies, and they need to be supported.

Sometimes we do not actually realise the power of a mother’s role within our societies, and often overlook their valuable contributions. This came to light for me when I witnessed a beautiful mother-child bond right before my eyes whilst walking back to MCC from the primary school. This primary school child has just been let out of school, he had spotted his mother and was soon running to her. The mother crouched down and opened her arms with the biggest smile as the child leaped into her arms and hugged her. This mother then held this child for a few minutes, slowing rocking as she lay her head on his. This made me realize the need that children for their mothers, a mother is a child’s life-long pillar, they provide that stimulation, security, and support to the children of our society.

Mothers do whatever they need to ensure their child is healthy, children are provided with food and an education to provide them with opportunities to be valuable contributors to future generations. Whether they be working moms who are economically contributing to society or if they are stay at home mothers who are providing the best care for their child, regardless, they are needed and are valuable contributors. The health of infants and children are a vital component to societies as they are our future. The children of today are the leaders of tomorrow, and they can determine how our futures are shape. They are the valuable contribution for the future generations. Children may be the future, but mothers show them how to get there and therefore both are equally important society.

A devastating reality, especially in the South African context, is that there are many children who grow up without their mothers, their bond, their security, and support. This due to poor maternal health leading to the absence of these mother figures whether they have passed or can no longer cope. As OT’s we experience the realities and implications that poor maternal and child health have. Specifically, the communities that we are working in, it is often the case where mother figures are not present within families, ultimately leaving another family member, most commonly the grandmother of the household to care for the chid. Understandably, the grandmother does not have the time and energy to go through what they have already done years back for their own children, they have roles and responsibilities and cannot provide children with the experiences and stimulation that of a mother would, this effecting a child’s learning, growth, and development. This is evident is as there are many developmentally delayed children seen in clinics who lack stimulation and interactions that the mother-child bond would’ve provided. A child’s early experiences ultimately influence their lifelong health and learning (National Research Council and Institute of Medicine, 2004). Poor childhood health may affect a child a child’s physical and cognitive development, this effecting their ability to grow and learn.

There is a need to identify maternal and child health risks to reduce complications before, during and after pregnancies (“Healthy People 2020", n.d.). Both maternal and child health needs to be a focus, after all Joyce Banda did say “The seeds of success in every nation on Earth are best planted in women and children” and we as OT’s can facilitate change through health promotion, advocation and education to normalise the challenges and reduce the stigmatization that is received. By normalising the challenges, it will assist mothers with having a voice to speak up and not feel ashamed. We need to create and develop support groups for mothers to share and relate to challenges. Maternal deaths are an easily avoidable tragedy and prevention of this should be a priority (Burton, 2013). Harjit Gill stated that “The health of a mother and child is more telling measure of a nations state than economic indicators”. We now recognize this devasting reality; it is now up to us to facilitate the change.

· Burton, R. (2003). Maternal health: There is cause for optimism. South African Medical Journal, [S.l.], v. 103, n. 8, p. 520-521. ISSN 2078-5135. Available at: <http://www.samj.org.za/index.php/samj/article/view/7237/5282>. Date accessed: 04 Aug. 2021. doi:10.7196/SAMJ.7237.

· Gill, H. Improving healthcare for mothers and children in Asia. Retrieved 4 August 2021, from https://www.weforum.org/agenda/2015/04/improving-healthcare-for-mothers-and-children-in-asia/

· Joyce Banda Quotes. Retrieved 4 August 2021, from https://citatis.com/a19093/07cd1f/

· Maternal, Infant, and Child Health | Healthy People 2020. Retrieved 4 August 2021, from https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health#:%7E:text=children%2C%20and%20families.-,Overview,and%20the%20health%20care%20system

· Mindfulness-Based Therapy. Retrieved 4 August 2021, from https://psidirectory.com/listing/mindfulness-based-therapy/p:66

· National Research Council (US); Institute of Medicine (US). Children’s Health, The Nation’s Wealth: Assessing and Improving Child Health. Washington (DC): National Academies Press (US); 2004. 1, Introduction. Available from: https://www.ncbi.nlm.nih.gov/books/NBK92210/

· Vodacom and Mondia launch Maternal Health Service in DRC. Retrieved 4 August 2021, fromhttps://www.techgistafrica.com/healthcare/vodacom-and-mondia-launch-maternal-health-service-in-democratic-republic-of-the-congo/

[jessheaver]

Advice for my future self as a person and as a OT.

As my Telehealth Block comes to an end, finishing the third out of the four blocks this semester, I start to reflect on advice I would give my future self as a person and as a OT, through lessons that I have learnt in the past. “The best teacher is your last mistake”, I can resonate with this quote as I feel I wouldn’t be who I am now if it wasn’t for my mistakes, they have allowed me to learn and grow into the person I am today. There is lots of advice I would give to my future self as a person and as an OT but for today, I’ll focus on three main aspects I feel are currently most important for each.

When it comes to advice for my future self as a person, the three main points of advice I would give are to believe in myself; use humor wisely and instead over reacting, respond. Believing in myself has been something I have struggled to do for a long time, I often let my nerves and doubts take the better of me even when deep down I know that I can do it. So future self, believe in yourself, you have worked so hard and you deserve to have faith in your capabilities. 

Secondly, humor has often served as a defence mechanism for me to try hide my true feelings and to keep unimportant things from taking to much significance. So future self, use humor wisely, continue to make people happier and enjoy embracing humor but never let it hide what you are actually feeling. Then lastly, I do believe that when I encounter problems in my life that I can be very dramatic and over react in the moment. If anything this has taught me that overreacting achieves nothing. So future self, before you react, take time, think about it, formulate a plan and then respond. 

When it comes to advice for my future self as an OT, the three main points of advice I would give myself are to be patient; stay positive and motivated and to be flexible. Patience is probably the most important piece of advice. I am a person who loves immediate gratification, hoping to see the change in my patients quickly. However, my practical experience has taught me that recovery differs and some clients may achieve success in their condition in a few weeks, months or even years. So future OT, be patient with your patients route of recovery and celebrate every achievement made by them even if its small.

This can lead into my second point of advice, stay positive and motivated. Often when progress is slow, I become unmotivated with feelings that what I am doing isn't helping. So future OT, constantly remind yourself of the importance and value of your role and celebrate every little achievement that you make. Then lastly, flexibility; I have always been someone who tries to control and plan everything and my experience in the clinical field has taught me that things don’t always go to plan. So future OT, as  John Wooden once said “flexibility is the key to stability”, you will never be able to plan for everything but trust that you have it under control, take the messiness with a grain of salt and adapt to whatever comes your way.

So future self and OT, don’t look at mistakes as set backs but rather a lesson for the future. Allow your experiences to create a path to you being the best version of yourself, continuously learning and growing. I would like to end off with a quote from Dan Sullivan, “You either win or you learn. If you want to be successful, there’s no other option”.

References:

·      (2019). Retrieved 28 November 2020, from https://www.topoccupationaltherapyschool.com/13-essential-traits-become-proficient-occupational-therapist/

·      deWilde, N. (2020). 10 Pieces of Advice for My Future Self. Retrieved 28 November 2020, from https://medium.com/@ndewilde/10-pieces-of-advice-for-my-future-self-87c462602c60

·      How Being "Flexible" Will Change Your Life | Life is for Living. (2020). Retrieved 28 November 2020, from https://livingandstuff.ca/how-being-flexible-will-change-your-life/

·      If you're not making mistakes, you're not growing enough. Expect to make mistakes along the way. You'r… | Perfection quotes, Mistake quotes, Quotes about everything. (2020). Retrieved 28 November 2020, from https://fi.pinterest.com/pin/231372499587263747/

·      Why Learning From Mistakes Is Your No-Fail Way Out Of Future Setbacks. (2020). Retrieved 28 November 2020, from https://resources.strategiccoach.com/the-multiplier-mindset-blog/why-learning-from-mistakes-is-your-no-fail-way-out-of-future-setbacks

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In a nutshell: Coming out of your shell & beyond.

To me, coming out of your shell means stepping out of your comfort zone. As a person, I have never been shy but rather an out-going, adventurous extrovert. However, I’m a person who doesn’t like and fears change. When moving out of your shell, it presents with a degree of change, which has been hard for me to deal with. However, it has been a natural process over the years, and I feel like I have grown in being able to adapt and adjust better to change that has been presented when coming out of my shell. 

“You are safe inside the shell of your comfort zone. Dare to come out from the shell and reborn. The pain of discomfort will teach you more than anyone else and will make a new version of you.” (By Purnendu Kar). In the past, I was always that person who kept her shell over her at all times, scared of the change that will be presented. I can especially relate this to my years as a student Occupational Therapist, I feel that I am completely a new version of myself now than I was when I first started my studies.

When I was first accepted into this degree, as a late comer who had been accepted due to “no shows”. I felt inferior to others, I felt like I didn’t deserve to be there because I wasn’t first choice. My mental health took a toll. I was presented with so many new people who I didn’t know, this leaving me hiding in my shell. However, as third year is coming to an end, I feel like a completely different person. I slowly took the courage to come out of my shell, it allowed me to build relationships and friendships that I feel will last forever. I have put in the hard work to discover that I deserve to be in this degree just as much as the next person. I have built confidence in myself.

When it came to the start of my practical block on clinical sites in the beginning of second year, I feel that I was definitely hidden in that invisible enclosure, so scared and fearful to come out. I felt so inferior, so nervous and so scared to handle client’s. I didn’t believe in my skills, I was so fearful to do something wrong that would impact on the client’s life or that would harm the client in a certain way. Fast forward to today, although I am still somewhat fearful in the handling of client’s, I feel like I have grown and come out of my shell. I feel more confident in what I can offer and my skills. I am now able to build strong rapports with my client’s and to provide successful intervention which is the best feeling, this would have never happened if I didn't step out of my comfort zone. 

Although I still fear change to somewhat degree, I feel like I have definitely come out of my shell in the last few years. “A ship in harbor is safe, but that is not what ships are built for.” (By John A. Shedd). My shell is my place of safety, but as humans we are made to take that step out of your comfort zone to learn and grow as a person and achieve the things you have always wanted too. I am so grateful for the steps I have taken that have allowed me to no longer hide from new experiences but to rather embrace them to grow as a person. In saying this, I would like to finish off with a quote that I feel resonates greatly with my situation, “A comfort zone is a beautiful place, but nothing ever grows there” (By unknown).

References:

52 Motivational Quotes that Will Help You Step Out of Your Comfort Zone. (2020). Retrieved 10 November 2020, from https://www.theinspiringjournal.com/step-out-of-your-comfort-zone-quotes

A comfort zone is a beautiful place, but nothing ever grows there. | Comfort zone quotes, Boxing quotes, Blogging quotes. (2020). Retrieved 10 November 2020, from https://za.pinterest.com/pin/562950022154180411/

Kar, P. (2020). You are safe inside the s... | Purnendu Kar PK | YourQuote. Retrieved 10 November 2020, from https://www.yourquote.in/purnendu-kar-pk-fvtt/quotes/you-safe-inside-shell-your-comfort-zone-dare-come-out-shell-cofl6

What To Do When You're Outside Of Your Comfort Zone - MoreYoga. (2020). Retrieved 10 November 2020, from https://www.moreyoga.co.uk/what-to-do-when-youre-outside-of-your-comfort-zone/

[jessheaver]

Covid-19: Trick or treat?

After finishing the first block, it is now time to reflect on the current global pandemic that the World is currently experiencing; Covid-19. Several months ago, it felt like our lives and the World had come to a grinding halt, putting many on the edge and bringing feelings of fear and uncertainty. However, life has gone on. We have adapted, we have changed the way we live and we have changed the way we think. 

On a personal level, if anything, this pandemic and its implications have taught me to never take life for granted. It has taught me that life is unpredictable and humans are indestructible. It has taught me to live in the moment as we never know what might come next, it has made me even more grateful for the life I have, the home I live in and the people that surround me. It has allowed me to take time for myself, to reflect and improve.

However on a more realistic level, the implications have been hard. It has caused struggles, poverty, death and in turn loss for many. It has left people with feelings of sadness, isolation, disappointment, fear and worry.

Many people have many different perceptions of Covid-19; Some resilient, some optimistic and some fearful. In the beginning I used to feel resilient to it, like it would not affect me or my family. I overlooked the potential implications of it and instead enjoyed the time of “lock down” where I got to spend it with my loved ones whilst life had come to its stand still. But life had to go on, and with this reality hit. The situation became real when the implications started hitting closer and closer to home. My optimism began to fade away…

I realised that this situation is real, it is affecting people in more ways than one. However, I have come to terms with the fact that this pandemic is staying for the long haul and it not going anywhere anytime soon. I have to remind myself to remain positive, with optimism and resilience, we will overcome this hurdle. “We are in this together and we will get through this, together” (Antonio Guterres), this quote resinates greatly with me. The only way I feel we are going to overcome this hurdle of life is through virtual love, kindness and respect for others, together.

In conclusion, I do believe that Covid-19 has been a trick, it has left people and the World isolated, lonely, sad and uncertain. I often wish we could go back to the Covid-19 free days and put the sanitisers, masks and social distancing to rest. But reality is that this current pandemic is going no where, so we have to change our mindsets and look at it as a “treat”, a treat that allows us to get through the hard times together. "Sometimes it is hard to see the hidden sunshine behind the dark clouds. But, with firm conviction of hope, faith and time, the sunshine will brighten the World all over again!” (Kamala P. Tamirisa).

Pros and Cons of Covid-19: A Tale of Two Sides - American College of Cardiology. (2020). Retrieved 23 October 2020, from https://www.acc.org/membership/sections-and-councils/women-in-cardiology-section/section-updates/2020/06/05/12/38/pros-and-cons-of-covid-19

UN75 AND COVID-19. (2020). Retrieved 23 October 2020, from https://peacekeeping.un.org/en/un75-and-covid-19

Vectors, R. (2020). Tamed corona virus cartoon - covid - 19 vector image on VectorStock. Retrieved 23 October 2020, from https://www.vectorstock.com/royalty-free-vector/tamed-corona-virus-cartoon-covid-19-vector-30138617

[jessheaver]

Collaborative Practice - Multidisciplinary Team and Teamwork

As Helen Keller once said, "Alone we can do so little; together we can do so much”. This comes to light in the Health Science occupation as we are blessed with multiple teams in the health care service who are able to work together to provide the best possible care and treatment for a patient. This is called The Multidisciplinary Team, commonly known as the MDT team which consists of a large range of professions including Doctors, Nurses, Physiotherapist, Dieticians, Speech Therapists, Social Workers and Occupational Therapists. All these professions provide a specific service that comes together to reach  common client-centred goals which will most benefit them, their health and their functioning. Working within the MDT team allows us to develop a holistic overview of the client in order to establish goals and plan intervention. 

Working within the MDT has shown to have multiple benefits to both the patients and the health professionals working in the team. “These include improved health outcomes and enhanced satisfaction for clients, and the more efficient use of resources and enhanced job satisfaction for team members.”

Throughout my clinical blocks, I have made use of the MDT through collaborating and communicating to the doctors and nurses to gain information about the clients diagnosis, treatment and current level functioning in all daily tasks within the ward. Unfortunately, both my clients were not being seen and did not need to be seen by the other medical professions such as the Social Worker or Physiotherapist so I could not expand my collaborative practice but if they were seen by them it would of been most beneficial to establish their goals, aims and treatment to work towards a common goal for the patient. For example, it the client has balance, mobilising and gait issues, it would of been beneficial to communicate with the Physiotherapist to compare assessment findings and determine a focus for intervention.

I have personally felt a lot better this week in terms of treating my paediatric client after my supervisor revised the treatment aims with me last week to lead me into a better direction for my intervention. I have not yet mastered it and definitely still learning as each day passes but with the feedback and evaluation given from my supervisor it has helped me to understand my paediatric client better creating a holistic overview to allow me to structure sessions in a way that the treatment aims will be met and will be most beneficial to my client. I have really valued the feedback as it has broaden my skills, knowledge and confidence when planning and implementing treatment. I had the opportunity to assist with out-patients this week which I throughly enjoyed working with as I was fabricating splints which is a service that I am very interested in specialising in.

Over the two weeks of this practical block, it has been made clear just how important communicating and collaborating within the MDT team is. It has provided me with the opportunity to develop a holistic overview of my client to provide the best, efficient and effective care that I can to my patients. Even though at times throughout these last two weeks, I have felt overwhelmed and stressed, I have throughly enjoyed gaining the experience that I have in the in these two weeks of my practical block.

References:

Conley M (2018). 45 Quotes That Celebrate Teamwork, Hard Work, and Collaboration. blog.Hubspot.com. Retrieved 05/08/2020. https://blog.hubspot.com/marketing/teamwork-quotes

Landen, J (2020). About Multidisciplinary Teams and Complex Problems. medium.com. Retrieved 05/08/2020. https://medium.com/@jan.m.landen/about-multidisciplinary-teams-and-complex-problems-74892c8b9540

KZN Department of Health. (2014). KZN guidelines on the management of acute malnutrition. Retrieved 05/08/2020. http://www.kznhealth.gov.za/family/MCWH/KZN-IMAM-Guidelines.pdf

[jessheaver]

Learning through experience - Clinical reasoning and cultural humility:

I can’t believe that the first week of my practical block is already over, even though it seemed like I was never going to get through it on the first day, but here I am. It has been quite an adjustment from the last time we were on our practical block because of all the precautions that we now have to follow due to the covid-19 pandemic. The first day will always be daunting as it is filled with new cases, a new environment and new experiences but it did not take long before I felt that at ease and my confidence started to rise, ready to start assessing and treating again.

The clinical reasoning cycle is an important tool used in the Occupational Therapy Profession as it provides a guide for the assessing, planning and implementation of efficient, effective and comprehensive intervention that will benefit the clients everyday functioning. This cycle includes considering the clients situation, collecting cues and information, processing this information, identifying problem factors, establishing goals of treatment, implementing treatment and evaluating and reflecting on your intervention. This tool is something that I use and find very beneficial as it provides a step by step guide to plan the most beneficial intervention to my clients. An example of how I used this cycle is as follows; the clients file was checked for diagnosis, previous medical/surgical intervention and medical history; initial interview and assessment was then completed on the client. This information was then processed and problem areas were determined which provided a guide to establish goals of intervention. The next day intervention was then implemented and the client has been re-assessed daily to evaluate the outcomes of the intervention that has been given. Each session is then reflected on with my supervisor.

Evaluation and feedback with my supervisor has been critical for the growth in my confidence, skills and knowledge in planning and implementation of intervention. It has allowed me to reflect on my intervention sessions and to establish if my aims in treatment were met. I found this particularly helpful with my paediatric client as I was very confused with the goals of treatment which obviously reflected in my treatment plan. My supervisor redirected my thinking of the goals which made everything so much clearer and helped me to get on the right track again. I really appreciated the ideas that were given by my supervisor to try meet my aims better during intervention and I look forward to implementing these ideas in the next treatment sessions. I have really enjoyed reassessing my one client and seeing his improvements from intervention in just the three days we have been working together, it has been very rewarding and I hope that next week I can continue to see improvements in both my clients.

Cultural Humility is an aspect that is indirectly used during the clinical reasoning cycle. It is defined as “a process of reflection and lifelong inquiry, involves self-awareness of personal and cultural biases as well as awareness and sensitivity to significant cultural issues of others” (Yeager KA, 2013). Both of my clients are of different cultures to me, this provides me with the opportunity to learn about both of their cultural values with respect to our differences. It allows me to understand their backgrounds better and to ultimately work together to achieve a similar goal. In my three years of studying and being in the clinical settings, I have made use of cultural humility with all of my clients.

Joe Gallagher once said “To be culturally humble means that I am willing to learn”, I feel like this quote is appropriate for me as I am aware that South Africa consists of many diverse cultures and I like to view it as a gift that provides us the opportunity to learn, understand and respect one another better in order to stand and unite as one. I believe that culture makes up a large part of an individuals identity and by learning their culture it will allow me to gain understanding and insight onto who they are as a person, why they do what they do and their values and morals which will help guide a beneficial intervention.

To end it off, I feel very fortunate that we have been able to complete our practical block, especially in times of such uncertainty within our country. I am grateful as I am a practical learner who grows their skills and confidence through experience, advice and feedback. I look forward to my last week and hope that I can continue with my clients in order to effectively evaluate my intervention process and to further grow my skills, confidence and knowledge in intervention planning and implementation.

References:

Levett-Jones (2010). Clinical Reasoning Cycle. Free Essays. Retrieved on 29/07/2020. https://freeessays.page/clinical-reasoning-cycle/

Van Der Beke, S (2017). Cultural Humility: BC Healthcare is creating a climate for change. Haida Gwaii Trader. Retrieved on 29/07/2020. https://haidagwaiitrader.com/index.php?option=com_content&view=article&id=168:cultural-humility-bc-healthcare-is-creating-a-climate-for-change&catid=45:articles&Itemid=121

Yeager, KA (2013). Cultural Humility - Essential foundations in clinical researchers. NCBI. Retrieved on 29/07/2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3834043/

[jessheaver]

Reflection of my skills as a communicator in the work setting as well as planning and implementation of treatment.

The third week of our practical block is already over and it feels like time is flying, however, it is no longer as daunting as it was in the first couple days as I feel that I am growing my knowledge, skill and confidence when handling my patients whether it be assessing or treating. I am also learning the importance of effective communication in the work place with the Multi-disciplinary teams to effectively collaborate and work together to maximise the clients health and functional outcomes.

After the last couple weeks and this week particularly, I have realised the importance of the Multi-disciplinary Team (MDT). The MDT is a group of health care workers who each provide different specific services to the patient (Health Service Executive, 2018; Multi-disciplinary team). As a single profession we are only required to cover and address certain aspects that lie within our domain, therefore, it is important to collaborate and make appropriate referrals to other Health Professionals when problems are noted that fall under their scope of practice to ultimately benefit and maximise overall health outcomes of the client (Academy of Learning; 3 Reasons Why Teamwork is an Important Part of Healthcare Training, 2018). This approach also involves effective collaboration with other health care workers to gain relevant information and specific precautions that need to be taken when handling the client.

I have gained relevant information with the nurses regarding the clients behaviour and functioning within the ward and specific precautions that need to be taken such as wearing a mask and gloves in the TB ward and the disposal of them. This is important to prevent further transferral of viruses or infections to the patients with compromised immunes systems as well as to prevent myself from contracting infections and transferral to others. I have also spoken to the Physiotherapists regarding my client to compare findings and discuss treatment. I am hoping that next week I will be able to speak to the doctors when they are doing the rounds in the wards to discuss medication success and any other secondary conditions that could influence my treatment.

I feel that this week I have improved my skill of treatment planning but I have not yet mastered it. I have had difficulty finding appropriate treatment sessions to do to address and improve the client factors using the occupation as a means approach. After discussing this with my supervisor she emphasised the importance on the term “context relevant” which helped me understand and plan for appropriate sessions that will address client factors and meet secondary aims but also be beneficial to the client in terms of their occupations. 

After feedback with my supervisor, I also realised the importance of activity analysis prior to the planning and implementation of a treatment session to be able to determine the physical, cognitive and perceptual demands of an activity and to evaluate whether or not it will be appropriate for the client and to be able to set accurate secondary aims and principles for the session. Emphasis was also placed on structuring principles of a session in order to meet and achieve the secondary aims.

Furthermore, our supervisor gave us feedback on the importance on knowing the different treatment principles for each performance skill. Knowing the treatment principles and applying them is vital for the planning and grading of the treatment sessions in order to achieve and address the specific performance skill that we are wanting to improve in our secondary aims of the session.

Ultimately, I feel that I have learnt a lot this week through the feedback from my supervisor after my treatment sessions and I feel that I will be able to improve my write ups and treatment planning. I also hope to improve my skill in communicating with other health care professionals and to be able to successfully work together to ultimately secure the best outcomes for my clients.

References:

3 Reasons Why Teamwork is an Important Part of Healthcare. (2018, October 10). Retrieved March 11, 2020, from https://www.academyoflearning.ab.ca/three-reasons-teamwork-important-healthcare/

Multi-disciplinary team. (n.d.). Retrieved March 11, 2020, from https://www.hse.ie/eng/services/list/4/mental-health-services/dsc/communityservices/multidisciplinaryteam.html

[jessheaver]

What client centred means to me and the reflection of my intervention planning and implementation process.

At the end of my second week of my physical practical block, I feel that I have made an improvement in my knowledge, skill and understanding of the importance of in-depth assessment to establish and develop sub-programmes with goals or aims for appropriate treatment planning and implementation. As well as the understanding the importance of the use of the client centred approach with planning and developing treatment goals in order for intervention to be appropriate and successful.

In terms of my OT intervention planning, this week I have had difficulty establishing the difference between assessment and treatment sessions, thus leading to the difficulty in the development of my aims and focus for intervention. As students there is so much emphasis placed on the importance of independency in basic ADL’s and we are guided to this being the first step of intervention, my confusion developed when both of my clients were assessed as being mostly independent in their own ways as they have individually found techniques and compensatory methods for achieving independence in their ADL’s before my OT intervention. 

When expressing my concerns to my supervisor about the feelings of being stuck with my OT intervention focus and planning due to independency in ADL’s, she guided me to the next step being the other areas of occupation (such as IADL’s, work and leisure) as well as the importance to involve the client and allow them to take an active role in their own intervention, thus applying a client-centered approach. This approach involves asking the client what their goals are and what they would like to achieve by the end of their treatment as well as keeping them informed with assessment findings and their treatment progress. With this approach the client determines the course and the direction of their own treatment. Not only will this guide the aims of intervention for the therapist but it will also build a good rapport with your client and will encourage them to actively participate to achieve their own aims not just the one set for them by the OT student. (Study.com; Client-Centered Therapy by Rogers: Techniques & Definition; Shamekia Thomas)

Through feedback from my supervisor I have also realised the importance of in depth assessment over just screening at this level to be able to develop accurate assessment findings and to gain a holistic overview of the client and their problem statements to develop the correct treatment planning and implementation with the appropriate sub-programme focus and aims. (Write Steps; The Importance of Occupational Therapy Assessment, Danielle Shulman, 2016)

With feedback regarding the planning of intervention, I feel that I now understand the difference between assessment and treatment and understand the importance of a holistic overview of the clients areas of occupation, client factors, performance skills and performance patterns from assessment findings and involvement of the client in the process to develop and plan appropriate intervention aims and sub-programmes.

In terms of my OT intervention implementation, I feel that I was somewhat successful in achieving the secondary aims of my treatment and coped well in the first sessions of intervention. However, I was putting all of my focus on the secondary aims during the intervention sessions and overlooking additional issues and principles of the session which would hinder the successfulness of the overall aim and secondary aims. For example: In my memory table top activity with my client, I was so focused in him achieving static standing balance that I was overlooking the structuring principle of the height of the table which caused him to have an abnormal posture due to complete weight-bearing of the upper limb on the table. My supervisor brought this to my attention which has guided me to focus on all principles during the intervention implementation session to ensure that the smart aims and secondary aims are being properly met and achieved.

Overall, I feel that this week has been less challenging than the first week as I feel I have coped better with the process and settled in with the facility as well as built a good rapport with both of my clients. I feel that I have gained a better understanding of the link between client-centred approach and in-depth assessment to gain and create a holistic overview of my clients and their individual goals to develop, plan and implement intervention. I am looking forward to planning my next intervention sessions now that I have gained a proper understanding of the development of sub-programmes and aims.

References:

Thomas, S. (n.d.). Client-Centered Therapy by Rogers: Techniques & Definition. Retrieved March 4, 2020, from https://study.com/academy/lesson/client-centered-therapy-by-rogers-techniques-definition-quiz.html

Shulman, D. (2016, June 17). The Importance of an Occupational Therapy Assessment. Retrieved March 4, 2020, from http://writesteps.com/importance-occupational-therapy-assessment/

[jessheaver]

From theory into practice.

In the first week of our practical block we were expected to assess both of our clients that were given to us and start treating at least one of them by the end of the week which was very daunting and overwhelming considering last year we had the whole block to assess and now we were required to do it all in one session. I was given two clients with diagnoses that I had not worked with before which made me feel nervous and overwhelmed so I decided that I should do prior research on the conditions to fully understand what difficulties the client may experiences as well as to know what special precautions need to be followed when handling the clients to prevent and avoid injury or harm to myself, the client and others.

My one client has Tuberculosis Meningitis, therefore special precautions have to be followed when working with him. This includes wearing a mask when entering the ward and wearing gloves when working with the client and disposing of both when exiting the ward in the medical waste bins provided. As well as ensuring that all equipment such as the goniometer are sanitised after use. 

My other client has suffered a spinal cord injury and is now a quadriplegic. I did not assess this client on the first day as I was not confident enough on my knowledge and skills of dealing with a spinal cord injury client and decided that I would rather do thorough research first then start assessing.  

Unfortunately on Monday, due to admin purposes and introductions to the facility, we only began assessing our clients at 11 on Monday. Because of this I was only able to conduct half my assessment on my TBM client and did not get the chance to finish with the TBM client and start assessing my quadriplegic patient. Although, I was happy with what I had achieved in the time that was given on Monday and I was grateful to be given the opportunity to research and prepare for Wednesday to finish assessing and implementing treatment with my TBM client and to assess my quadriplegic client fully on Wednesday. 

In the time between Monday and Wednesday I wanted to gain insight onto the conditions that I am dealing with to grow my confidence and skill when working with my clients so I completed thorough research on both conditions with the necessary assessments to conduct, precautions needed to be taken, handling notes and treatment programmes that should be implemented to put me at ease and not feel so overwhelmed for day 2.

According to “The independence” webpage, research showed that often patients with TB Meningitis suffer hand related problems, difficulties walking due to poor balance, functional gait issues, cognitive impairments and problems completing ADL’s and IADL’s independently saying that this should be the core focus of treatment planning and implementation. (The independence, 2018; Rabeya Ferdous)

More research was completed on Spinal Cord Injuries and Quadriplegia due to the feeling of lack of knowledge and skill as it was a new diagnosis to me and I did not want to take any chances. I read and interesting article called “High-Level Quadriplegia: An Occupational Therapy Challenge”(AJOT, 2014; Pamela A. Lathem; Theresa L. Gregorio; Susan Lipton Garber) which discussed a comprehensive Occupational Therapy treatment programme for a C1-4 Quadriplegic which focused on range of motion, strengthening existing muscles, functional activities training, pressure sore prevention and equipment prescription such as mouth piece and universal cuff etc. This article was very informative and put me at ease to work with my quadriplegic client. It was also established that due to immobilisation that pressure sores and contractors are common and the importance of positioning was emphasised therefore, after research, I developed a Positioning Regime using the Good Shepard Rehabilitation Network webpage that I can implement with the clients which included lying prone, lying supine, lying on the side and lying 3/4 with the appropriate positioning of pillows. (Spinal Cord Injury: Bed Positioning, 2012) 

Upon arrival on Wednesday it was discovered that my quadriplegic client had been transferred to Prince Mshiyeni Hospital so I couldn’t start my assessment on him, this was disappointing as I was prepared and confident enough to start. Instead I had to rather complete assessing my TBM client and implement my treatment session that I had planned for the day. The preparatory activity and treatment session of upper limb dressing went very well with my client and progress was made in the session both physically and psychologically which made me feel very happy and brought about a sense of accomplishment and I look forward to Mondays treatment session. However, we unfortunately could not find a second client so instead I had to continue another session with my TBM client. Hopefully I will be able to find another client via referrals or screening on Monday. 

Overall, this week has proved to be both challenging and exciting. My feelings towards prac have already shifted from the first day and I have grown my knowledge and skill on two conditions which made me feel more confident with handling and interacting with my clients. I look forward to continuing treatment on my TBM client next week and finding a second client to assess and implement treatment. I believe that as the block goes on that the process will become more easier and natural and I will start to enjoy my practical block more.

References:

Ferdous, R. (2018). Meningitis and occupational therapy. Retrieved 24 February 2020, from http://www.theindependentbd.com/arcprint/details/133807/2018-01-22

Lathem, P., Gregorio, T., & Garber, S. (2014). High-Level Quadriplegia: An Occupational Therapy Challenge. Retrieved 25 February 2020, from https://ajot.aota.org/article.aspx?articleid=1885293

Spinal Cord Injury: Bed Positioning. (2012). Retrieved 24 February 2020, from https://www.youtube.com/watch?v=mRiJqtOYegI