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lindokuhlekhoza · 3 years

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Final chapter of community block 2021

“Embrace each challenge in your life as an opportunity for self transformation”- Bernie Siegel. We all are afraid of leaving our comfort zones, our safe spaces and often enough, we find ourselves in inner turmoil when we are thrown into unusual situations and resist them and label them as difficult. That’s exactly what happened to me at the beginning of this block. I was so nervous about it due to the negative stories I’ve heard from my classmates and previous year students. I found this quote by Bernie and stuck it onto my wall after my first week on the block, this quote reminded me of my experience at Grey’s Hospital. I was told negative stories about the hospital and it’s demanding nature, however when I was there I actually enjoyed it, yes it was very challenging, yes I did have emotional breakdowns, but that block was so amazing that I ended up applying to a clinic near it for my comserve next year so I can do my in-service training there as I believe it pushed me and showed me the type of therapist I want to be.

The community I was placed in presented the side of our country that not all of us want to face. It showed us the reality that most of the South African citizens live under, the aftermath of apartheid, the poor service delivery found in our government system, health care system and educational system. It was very challenging to see how some of my black South African brothers and sisters were living, it was disheartening and left me in tears. The burden of disease that Ardington and Boingotlo (2014) stated was found heavy in low socio economic areas was evident in the community I was practicing in. It became apparent to us that child and maternal health was a huge problem and has been neglected (le Roux et al., 2020). The majority of the clients we found at the clinics were mothers with children and through questioning them, most mentioned that they were single mothers and experienced stress. Through coming across mothers like this, I learnt the importance of listening, although the mothers would not come forward and express they are feeling stressed or have a low self esteem, through listening to what they had to say, I was able to obtain that information.

We also were able to see the amount of oppression that the women in the community endure. Gender based violence has been one of the main causes for women to contract the HIV virus (Dunkle, 2004), which was seen in the community. One of the clients I had, she contracted HIV from her abusive partner and he kept that information away from her until he passed on. This reason amongst many others have driven me to be a feminist, where I empower women I met, women who have been placed in an inferior position in both their families and communities (Mudau, 2017). The one woman who is my client, we had a session where we drew up a business plan on how she was going to start selling snacks as her CVA left her unemployed. Through that, I was able to see the impact women have on each other. Through the numerous encounters I have had with the women in the community, I have learnt a lot about what it means to be a compassionate human being. Although I am typically seen as the one providing intervention, the women in the community were pouring knowledge into me, this one woman I met taught me tips on how to make the perfect puthu for my family.

The community block taught me the importance of flexibility. I am an overthinker in nature and I rather not do anything when I can't come up with a solution. I am big on planning and when I am thrown in unpredictable situations, I crumble. This one day we were forced to have a session with 60 matrics. The plan on that day was to meet up with one of the teachers for her to come up with a suitable date for us to come see the children. However on that day, she had arranged for us to speak to the matrics. We had no time to prepare, we got there and had to start OTing. I was nervous however through the help of my colleagues, we were able to have an interactive and meaningful session with the matrics, which I was really proud of. Being flexible did not only mean being a quick thinker, it also meant that we were to adopt qualities of other health professions, i.e speech therapy. One of my clients required a communication board, I had to contact one of the speech therapists to assist me, and through that we were able to make a communication board for my client. This block taught me the importance of collaboration, in community practice it is vital as through that, the client gets the best intervention they need. In the community that I have been placed in, I had the privilege to work closely with the CCGs on a case, which helped as we were able to understand the client in a more clear lens as they asked questions that we have never thought of asking.

The community block has grown me as an individual. My positionality has been clouding my judgment and has impeded me from understanding my clients in a way that I have always wanted to. The concept was foreign to me, however when it was flagged, I became more aware of it and it helped change my perspective in a lot of things. I managed to build stronger and deeper relationships with my patients due to the concept. It has helped me understand my colleagues, family and friends. The TUTs have highlighted the importance of pausing and reflecting on the events that happen during the block. For a person like me whose mind is always in a rush, I benefitted, I was able to take note of my own growth, weakness and strengths. My supervisor highlighted to me how it is important to take care of my mental health, to take moments of self care where I focus on relaxing my mind and doing things that bring fulfillment to my life which has helped me to recharge.

Moving forward with my journey as an occupational therapists, I will cling on to the lessons that this block has given me and celebrate my small wins as well and work on my short comings, in hopes that it will help into pushing me to become a “world class OT” as my supervisor would say and help my clients achieve success in everyday life.

References

Ardington, C., & Gasealahwe, B. (2013). Mortality in South Africa: Socio-economic profile and association with self-reported health. Development Southern Africa, 31(1), 127-145. doi: 10.1080/0376835x.2013.853611

Dunkle, K. (2004). Prevalence and Patterns of Gender-based Violence and Revictimization among Women Attending Antenatal Clinics in Soweto, South Africa. American Journal Of Epidemiology, 160(3), 230-239. doi: 10.1093/aje/kwh194

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.shutterstock.com%2Fsearch%2Fsilhouette%2Bclimbing%2Bmountain&psig=AOvVaw1zBvfW-ail07_1cu4XC1Y7&ust=1635012744053000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCPDWnKfP3vMCFQAAAAAdAAAAABAD

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.womensvoices.org%2F2016%2F03%2F08%2Fcelebrating-international-womens-day%2F&psig=AOvVaw3ljIagU9TQqZdzkF8vUs4V&ust=1635012895162000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCIDnnfPP3vMCFQAAAAAdAAAAABAD

le Roux, K., Almirol, E., Rezvan, P., le Roux, I., Mbewu, N., & Dippenaar, E. et al. (2020). Community health workers impact on maternal and child health outcomes in rural South Africa – a non-randomized two-group comparison study. BMC Public Health, 20(1). doi: 10.1186/s12889-020-09468-w

Mudau, T., & Obadire, O. (2017). The Role of Patriarchy in Family Settings and its Implications to Girls and Women in South Africa. Journal Of Human Ecology, 58(1-2), 67-72. doi: 10.1080/09709274.2017.1305614

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lindokuhlekhoza · 3 years

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Incorporating Sustainable Development Goals into Community Occupational Therapy Practice

Global Goals, also known as Sustainable Development Goals, are the United Nation's policy framework of action designed to end poverty, protect the planet, and ensure peace and prosperity for all by 2030 (Gaffney, 2021). These goals were implemented as means of changing the world and making it better for all by ensuring that everyone who lives in it has equal opportunities. Observing the world at this current moment, it is evident that the goals are not easily attainable and the world, looking closely at South Africa, is not reaching the goals at a fast pace. Therefore as an occupational therapy student, who strongly agrees with these goals, I intend to work on 5 of them in the community that I am currently placed in, with hope that by the year 2030, this community will have attained the goals.

The first goal that I intend to work on is establishing good health and wellbeing. The goal is to reduce the number of people who die prematurely as a result of noncommunicable diseases by one third through health promotion and prevention.. According to the World Health Organization, health is, "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity." (WHO, 1946). As a health care professional practicing in a community based practice it is imperative that we promote healthy lifestyles in the communities that we are exposed to. In the community that I am currently working in, I have given a total of 3 health promotion speeches in the clinic, mostly looking at mental health as I have observed that community members are not well educated about mental health and as a result have neglected their mental health and have seemed to carry on with life without being aware that they are carrying heavy emotional traumas that present in later stages of their lives. Through these health promotion speeches, we have been exploring leisure activities that are accessible and affordable for the community members, for example zumba, playing “shumpu” which is isizulu dodgeball made from plastic packets for the youth. Through promoting a healthy lifestyle where community members are actively taking their own health into their own hands, it will prevent premature deaths and establish good health and wellbeing.

My third goal is promoting gender equality. Human rights violations committed against women are widespread yet little regarded, contributing to their deterioration of their mental and physical health. It's also an issue that depletes the energy of women, jeopardizes their physical health, and undermines their self-esteem (Heise, 2002). Considering that this is a feminist module, I saw it imperative that as an African woman who has witnessed the suppression of women’s rights, becomes an activist in advocating for their rights within the community that I am practising in. One of my clients at the community has a history of domestic abuse which has had a negative influence on her mental health. She is currently a mother who sustained a CVA four years ago and is unemployed. Last week, we collaborated with the nurses and CCGs to book her an appointment with the doctor so that she receives a letter to present to the SASSA office to appeal for a disability grant. We developed a strong rapport with this lady and have been engaging in self esteem activities to empower her. Next week we are drawing up a budget plan for a snacks shop that she will be running in her house to sell as means of receiving money to buy necessities for her baby. This collaborates with my fourth goal of decent work and economic growth. I saw it important that even though she has experienced such traumas in her life, they do not define who she is and they do not define her future, therefore it is important to accept and heal from the past experience and work on her strengths to ensure that her future and her daughter’s future is safe.

My fifth goal is reducing inequality as a whole within the community. The community I am currently practicing in, is one of the poorest communities in KZN where they have unequal access to healthcare services. Low-income persons are unable to access occupational therapy and other rehabilitation professionals, preventing them from receiving high-quality health care (Jejelaye, Maseko, & Franzsen, 2019) (Mandela, 2021). Today we came across an elderly female in her 70s who has had CVA for 6 years and is currently taken care of by her neighbour who comes to feed, bath and change her nappy. She expressed how life has been difficult for her as she has not been able to access health care services due to living far from the hospital. As occupational therapy students working at a community level, we have the privilege of having a bus that transports us to these homes where we are able to do home visits to bridge that gap and provide intervention to the patients who are unable to access the clinic. In doing so, we are able to ensure that the clients we come across have an improved quality of life.

The SDGs were implemented to ensure that everyone has the opportunity to live a good quality of life. Even though it seems as though the goals are unattainable due to economic changes, the new pandemic, corruption and other issues that affect the country’s well being, if we work together and work one community at a time, the vision that the UN had will come to life. As an occupational therapy student currently practicing in a community level, I will advocate for the goals I chose and will continue working on them in my future practice as it is our duty as occupational therapists to improve quality of life for our patients.

References

Education White Paper 6: Special Needs Education, Building an Inclusive Education and Training System (http://www.info.gov.za/whitepapers/2001/educ6.pdf)

Gaffney, O., 2021. Sustainable Developmental Goals Improving human and planetary wellbeing. [online] Igbp.net. Available at: <http://www.igbp.net/download/18.62dc35801456272b46d51/1399290813740/NL82-SDGs.pdf> [Accessed 15 October 2021]

Heise, L., Ellsberg, M., & Gottmoeller, M. (2002). A global overview of gender-based violence. International Journal Of Gynecology & Obstetrics, 78, S5-S14. Doi: 10.1016/s0020-7292(02)00038-3

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.un.org%2Fdevelopment%2Fdesa%2Fdisabilities%2Fenvision2030.html&psig=AOvVaw1oOtlc6XGHW4pG3KBwdtcK&ust=1634414922850000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCNiwnp6czfMCFQAAAAAdAAAAABAO

https://www.google.com/imgres?imgurl=http%3A%2F%2Fgroundup.org.za%2Fsites%2Fdefault%2Ffiles%2Fstyles%2Farticle_image%2Fpublic%2Ffield%2Fimage%2FIndigenousGames-3.jpg%3Fitok%3DPnxE_OgH&imgrefurl=https%3A%2F%2Fwww.groundup.org.za%2Farticle%2Fgames-township-kids-play_2450%2F&tbnid=t6VeNy9x62YshM&vet=12ahUKEwja68OGm83zAhUS_4UKHYahBdUQMygAegQIARA5..i&docid=QdX814OejcSyWM&w=600&h=400&q=shumpu%20&ved=2ahUKEwja68OGm83zAhUS_4UKHYahBdUQMygAegQIARA5

Jejelaye, A., Maseko, L., & Franzsen, D. (2019). Occupational therapy services and perception of integration of these at Primary Healthcare Level in South Africa. South African Journal Of Occupational Therapy, 49(3), 46-53. doi: 10.17159/2310-3833/2019/vol49n3a8

Mandela, n. (2021). ON THE ANNIVERSARY OF HIS PASSING, NEW HOSPITAL BRINGS NELSON MANDELA’S DREAMS TO LIFE [Image]. Retrieved from http://matclinic.com/2016/12/09/on-the-anniversary-of-his-passing-new-hospital-brings-nelson-mandelas-dreams-to-life/

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lindokuhlekhoza · 3 years

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One’s positionality and it’s implication in providing intervention: OT student perspective

I am a young African woman, who was born in an African township but moved to a suburban area when I was a teenager. I was raised by both parents and attended middle class schools. I am a Christian, student as well as a sister. These roles amongst other roles have had and still have a BIG influence on my perceptions on life, they govern how I think and how I live my life. The question that has been lingering in my mind since the beginning of the block is how has my judgment, perceptions, assumptions governed the way I interact and provide treatment to my patients? Am I biased towards a certain group of people? If so, am I aware?

Upon my research on positionality, I uncovered that positionality is not only an individual’s position in life but how their experience forms how they perceive the world (Misawa, 2010). Positionality is intertwined with social location. It is said that characteristics that influence an individual’s social location are gender, color, socioeconomic class, age, ability, religion, sexual orientation, and geographic location (Benness, 2021). As I reflected on myself, my decisions regarding what’s morally right is governed by my religion, my decision in which treatment principles to apply is based on my education and my decision on how I spend my money is governed by my socioeconomic status and so on. Now when it comes to treating patients, since first year, I always found it easier treating black people. It was easier for me to understand and build a stronger bond with, whenever I was treating them, it felt as though I was treating a family member. When it came to treating the other races, I always found it difficult to understand them on a deeper level, yes I was treating them with the same level as compassion as the African patients but understanding their social location such as their religion, culture and the deeper aspects that form who they are was challenging. However, when I was at Grey’s this year, I became fond of one of my client’s, who was an elderly Afrikaans speaking man. He would often tell me stories about his wife, leisure activities they engaged in and how he grew up. The number of life lesson stories he told me are countless. So I began thinking, in the county that we live in, where we have the history of apartheid, our inherited thoughts that came from our parents regarding different races subconsciously shaped the way we relate ourselves to them and how we perceive they see us. To my Grey’s client, I was almost like his grandchild to him, but during the first two days I was scared of treating him because of what I thought he was going to think of me. But once I got to spend more time with him and learn more about him, my positionality changed whereby my biases and assumptions towards treating people of a different race from mine was as fulfilling as treating my own

I've learned a few things about positionality and how it affects how researchers engage their participants(Bourke, 2014) , and how occupational therapy students engage with their clients.In my experience, I have learned and realized that while our positionality may sometimes help a situation, it can also hurt your personal growth and impact on others. I remember at Inanda when I saw two young men standing in the soup kitchen cue, they were staring at us and I immediately thought, I better greet and move fast as I suspected they wanted to ask me out. After I entered the bus, the young men asked the driver what we were there for. I was so shocked, mostly embarrassed about my reaction. Those young men could’ve easily been recruited for a teenage group educating and empowering them cause they looked school going but were not at school.

In a community setting it is important to look at one’s positionality and evaluate if it’s going to work in your favour or not. It is important to understand the community that you are working in, their needs, strengths and weaknesses which will ensure that the treatment you provide is contextually relevant whereby the members are benefiting(Meyers, 2009).

As I reflect on my positionality while working at Inanda. I have discovered that it has affected my intervention positively as I am drawn to working more with women and I have found that most of the patients at the clinic are black women. I have seen myself going above and beyond for these females ensuring that I give them the correct referrals and advocate for them. With the males I have been working with, they all remind me of my late father and brother, I treat them with the same courtesy and respect as I would treat my family members. Taking a look at the sessions I have with my paeds patient, I have intertwined their needs and wants with those of my nephews and use the same lingo and approaches that I would use with nephews to get maximal participation from them and it has shown to work on my favour.

Our positionality as people can have a negative and positive influence on our intervention. It is therefore important for us as occupational therapy students to question our positionalities whenever we are faced with a client and examine the implications that it could have on our treatment. It is important to critically analyse why we see the world in the lens that we are seeing in and how can we adapt it to make it less biased and more client centered.

References

Benness, B. (2021). Social location: what people mean. Retrieved 12 October 2017, from https://medium.com/@bennessb/social-location-what-people-mean-27dd94c29dd5

Bourke, B. (2014). Positionality: Reflecting on the Research Process. The Qualitative Report, 19 (How To Article)(18), 1-9. doi: 10.46743/2160-3715/2014.1026

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.annmurraybrown.com%2Famp%2F2015%2F10%2F31%2Ftake-a-step-back-and-check-your-privilege&psig=AOvVaw2t9vNX89V01Jth-MLZIfg0&ust=1633812270328000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCOCGqpTXu_MCFQAAAAAdAAAAABAD

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.lifehealthcare.co.za%2Fnews-and-info-hub%2Flatest-news%2Fphysiotherapy-vs-occupational-therapy-which-is-for-you%2F&psig=AOvVaw08WOGapmCt9-Ivqx4SgUEd&ust=1633812409095000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCNj-75LYu_MCFQAAAAAdAAAAABAD

Meyers, S. (2009). Community practice in Occupational therapy: What is it. In S. Meyers, Community Practice in Occupational therapy: a guide to serving the community (p. 32). LLC: Jones and Barlett Publishers.

Misawa, M. (2010). Queer Race Pedagogy for Educators in Higher Education: Dealing with Power Dynamics and Positionality of LGBTQ Students of Color. International Journal Of Critical Pedagogy, 3(1), 26-35.

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lindokuhlekhoza · 3 years

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Occupational Therapists role in maternal and child health in a community level

“Far too many women, infants, and children around the world still lack access to basic health care and education, as well as clean air and water, proper sanitation, and nutrition.” (Health, 2020). Where is the equality in that? Maternal and child health has not only been a local problem in Southern Africa, but a problem globally. According to statistics there are more women than men in the whole world, however women remain the most oppressed. Since the emergence of COVID 19 which led to a national shut down, the numbers of gender based violence against women and child abuse increased drastically (Mittal. S, 2020). The question is, why are children and women not considered as the main priority as life is formed through women and children are considered as the future leaders?

On my second day at Inanda, my collegues and I went to a home visit to see to boys who have been referred to OT from the previous students due to suspected autism and ADHD. When we arrived at the home, we were greeted by two small boys who appeared to be 6 and 7 years old wearing baggy, dirty clothes and appeared to haven’t bathed for the day and malnourished. The children were accompanied by an older lady who didn’t greet us and seemed to be disorientated. Later on another woman came, who also was wearing baggy clothing and appeared to be under weight, which happened to be their mother. When interviewing the mother, we learnt that the mother was unemployed and that she has been the head of the house for nearly 5 years. It is common in South Africa to find households that are headed by a female figure and according to South Africa Stats in the Mbalo Brief, 47% of these household are run by women.

The house was surrounded by compacted sand and a few patches of grass, there was an outside toilet with a seat made out of a crate used to pack cooldrinks, the inside of the house consisted of two rooms, one which had storage and an empty one which had a box t.v, and 4 chairs. There was electricity but no indoor plumbing. During the interview process the mother explained that the children were not receiving any sort of education due to one being excluded from creche and the other one not having a birth certificate. The mother also stated that she stopped attending school in grade one. Their only source of income that sustains the house of 4 was the child grant the mother receives for her one child and she expressed that on frequent occasions they go without having a meal. When queried, the mother showed little to no insight in her children’s condition and her own condition and has no knowledge about social workers, she has been neglected by her family and is at risk of losing her home. Which raises a question of, why has this family been overlooked? Why has no one addressed this issue? Why has the community not intervened? Are these children not suppose to have a future?

The concept of a child's well-being is intricately tied to the social and economic circumstances in which he or she lives. Household income, community and social support, access to health care, access to housing and housing quality, access to education, and access to child care services are all key factors that have an impact on the child’s physical and emotional development (Tomlinson, Cooper, Stein, Swartz & Molteno, 2006). I 100% agree with this statement, which therefore leads into the role OTs have in child and maternal health. Occupational therapy practitioners can better address environmental and contextual barriers through using a health promotion approach (Piyonyak, 2014). Through this approach the OT can implement health promotion talks which specifically targets child and maternal health. This week when we went to the clinic, in the line, we came across 3 mothers who had come with their infants to the hospital. Upon assessment, my colleague and I discovered that the mother had no idea what developmental milestones were and which age the child is expected to crawl, stand and walk. Through this approach, the mothers were educated on milestones and what to expect and to immediately come to the clinic if they notice any delays.

While assessing the mother’s, when asked about their mental and emotional health, they stated that they were “okay” without any thought behind it. It’s either they are used to disregarding their feelings due to habitual thoughts and way or living or they are in denial of their own feelings. They are unaware of the importance of their mental health and that postpartum depression exists amongst women and how it has a negative effect on child health and development (Tomlinson, Cooper, Stein, Swartz & Molteno, 2006). Which is where OT role is vital as the mother’s emotional health has a negative effect on her role fulfilment in being a mother and carrying out the occupations needed of being a mother with providing intervention that is occupation based and is contextually relevant.

My stand point is that, maternal and child health is important as mothers and children play a huge role in society and that there are numerous ways in which us as a people can benefit by making women and children a priority in our communities. Therefore in my journey at Inanda and as an occupational therapist, I will ensure that the women I am in contact with are empowered and that their health and wellbeing is of my main priority and in that light improve their occupational engagement.

Bibliography

Health, A. P. (2020). Maternal and child health. Retrieved September 30, 2021, from https://www.apha.org/topics-and-issues/maternal-and-child-health

https://www.google.com/imgres?imgurl=https%3A%2F%2Fgazettengr.com%2Fwp-content%2Fuploads%2Fmalnourished-children-.jpg&imgrefurl=https%3A%2F%2Fgazettengr.com%2Funicef-to-screen-3-million-malnourished-children-in-north-east%2F&tbnid=J3QNybDSw_9YkM&vet=12ahUKEwjk2dns3qnzAhXT0OAKHRdOBRsQMyg2egQIARBZ..i&docid=zi3kPyQAZ7NooM&w=710&h=400&q=malnourished%20child&ved=2ahUKEwjk2dns3qnzAhXT0OAKHRdOBRsQMyg2egQIARBZ

Mittal. S, S. T. (2020). Gender based violence during COVID 19 pandemic: A mini review . Frontiers in global women's health , vol 1, 2-3.

Piyonyak. (2014). Occupational therapy and breastfeeding promotion: our role in societal health. The American journal of occupational therapy, vol. 68(3), 90-96. Retrieved from https://doi.org/10.5014/ajot.2014.009746

SA 2031 plan, N. d. (2018). Mbalo Breif. Pretoria: Statistics of South Africa. Retrieved September 30, 2021

Tomlinson, M., Cooper, P., Stein, A., Swartz, L., & Molteno, C. (2006). Post-partum depression and infant growth in a South African peri-urban settlement. Child: Care, Health And Development, 32(1), 81-86. doi: 10.1111/j.1365-2214.2006.00598.x

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lindokuhlekhoza · 4 years

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Advise for my future self as a person and as an OT

A letter to Lindo from Lindo

Dear Lindo chocolate (as your favourite high school teacher would say)

You’ve come such a long way but there is still a long way to go. You first started this OT journey with the assurance that you will make it out strong and be like Andiswa Gowa but along the way, when second year came, you started losing that spark and drive. You felt demotivated, unsure of yourself, had such a low self esteem that it started showing in your clinical performance and academics. But one thing you were always sure about is that God will always be there, the holy spirit will continue hovering around you. There is a verse from the Bible that you always hung up in your room which is found in Proverbs 3 vs 5-6 which says, “Trust in the LORD with all your heart, and do not lean on your own understanding. In all your ways acknowledge him, and he will make straight your paths.” (New International Version, 1984) I advise you to use this word to motivate you and help you to keep pushing forward cause guess what, you’re almost at the end of 3rd year.

Do not be afraid to try new things, don’t let academics be your entire life, live your life. be free, enjoy your youth days. There’s a famous quote by Daniel Zechariah that says “Enjoy your youth, you’ll never be younger than you’re at this moment.” This year you decided to start going out on small lunch dates with your friends, you’ve become a regular at the beach, lastly, you’ve become a Kdrama fan which is totally the best thing ever. Do the little things that you enjoy, such as being with your family and friends and being at church. Don’t allow yourself to focus on only one thing because “time wasted can never be regained.”

Believe that God placed you in this degree for a reason, it wasn’t by chance. Always remember to trust in Him and allow yourself to be his servant through this degree. OT has proved itself to be a rollacoaster, one time you’re up before you know it you’re back down again. This degree has shown that it’s not for the weak, you have to be strong, be strong for your patients. In everything that you do, think about your patients, there is nothing more satisfying then hearing a patient say, “thank you for your help.” There is nothing more rewarding than that. Don’t allow criticism to defeat you. In telehealth you had one of the smartest and toughest supervisors, true definition of tough love. She’s one of the first supervisors that has made you cry. You dreaded prac days just because of her. You always came with a write up you thought was perfect and she would just write one word only, a word that could ruin your entire week which was, “WHYYYY??” Under each principle, she would write, “why” “be specific.” You did not like that at all, you spent hours on a single write up, writing huge explanations, answering the whys of the whys just to ensure that you prove her wrong, that you know what you’re doing. Just like that you started learning, just like that you started improving your write ups, you got a “good” “well done” “yessssss” “you’ve grown and well done for your improvement” “I want you to be a world class OT.” Did that not feel great? After that block, you liked that supervisor even though she grilled you and did not give you the opportunity to be lazy. Be open to constructive criticism, don’t allow yourself to be overly sensitive, use that criticism to be better, take all the feedback that you receive from your superiors, be angry for one hour then after that WORK to prove them wrong.

Lastly don’t forget that you are a human being. You are allowed to make mistakes. Don’t strive to be perfect, perfection is not real. Perfection is a scam. Rather work every single day to make this world a better place, it doesn’t have to be a life changing thing, you can do so by choosing to be a bigger and better person every single day. When you fall, dust yourself and get back up. Be proud of getting yourself up. There is power in being able to lift YOURSELF off the ground without relying on anyone else. You have BIG goals for yourself, one of which is making it into medico legal, and driving that white Jaguar and buying your supermom a car. Use that to bring yourself up, use your gaols to be a ladder that assists you to step into big and higher places. There is a word in Jeremiah that says, “I know the plans I have for you declare the Lord, plans to prosper you and not you harm you, plans to give you hope and a future.” (New International Version, 1984) Use that word everyday, use it when you fall, believe that there is a greater power found in you and that you are worthy to be alive and to be a GREAT occupational therapist.

Your younger self in 3rd year

Bibliography

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.yourquote.in%2Fdaniel-zechariah-f36q%2Fquotes%2Fenjoy-your-youth-you-ll-never-younger-than-you-re-this-cboz9&psig=AOvVaw1EBHUvfOWQHh3z-qs1ax2Z&ust=1606749796542000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCKjnss2HqO0CFQAAAAAdAAAAABAD

The Holy Bible, new international version. (1984). Grand Rapids: Zondervan Publishing House.

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.redbubble.com%2Fshop%2Ffuture%2Bot%2Bstickers&psig=AOvVaw16M5ON82FjMiYeMVEKbHcp&ust=1606749925664000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCPCWiIuIqO0CFQAAAAAdAAAAABAD

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lindokuhlekhoza · 4 years

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In a nutshell growing out of my shell

In a nut shell growing out of my shell. When I think of this saying, what immediately comes in mind is a picture of a snail. A snail is always under it’s shell, when it’s in a new environment or feels that it’s in danger, it quickly hides in it’s shell. According to snail anatomy, the snail shell “s made up of calcium carbonate which makes it strong and remains that way as long as the snail consumes food with calcium.” (Williams, 2012) so you can imagine how strong they are.

I can clearly remember my very first day on prac in first year. We went to Hillcrest and, honestly speaking, I did not enjoy it at all. I was nervous, mostly terrified, because the clients were at a chronic phase and the whole environment was just depressing, baring in mind that I have never seen people that were severely, physically disabled. My supervisor at that time was quite strict, she had set really high expectations and as a group we took turns doing write ups. When it was my friend’s and I’s turn, we stayed up all night calling all the 4th years we knew, seeking for help as we didn’t want to feel humiliated. Luckily our supervisor was impressed with our write up. We were grouped in pairs and were given one client to do a case presentation on. During interview sessions, my partner did all the talking as I was still quite uncomfortable with the whole environment. When it came to activities, I was always part of the group or was the co therapist. Pretty awkward for someone who was a drama student right? as I would be expected to be the outspoken, bubby person, who was not at all self conscious. But at that time, I just felt like I wasn’t good enough because it seemed like everyone knew what was going on and had everything put together besides me, I mean, I was STRUGGLING with anatomy, while my best friend was thriving in it. So you can pretty much imagine how scared as a snail I was, going back into my shell, my shell at that time being my best friend and partner who would do all the talking while I stood in the background occasionally throwing in some, “yeah year sure” here and there.

Second year was HELL, I had my first emotionally breakdown INFRONT of my supervisor. I was crumbling under the pressure that was placed on me, I was so overwhelmed and the minute my supervisor said to be, “Lindo, I’m really disappointed in you, I had such high expectations from you.” After she said that, the tears started pouring, I called my friends and asked them where I must go to deregister for this degree because I felt like an absolute failure. I didn’t understand why my supervisor expected so much from me and so little from my other group mates. Moving forward with second year, I decided to refrain from being the talkative one and just remain in the background and not give my supervisor the opportunity to set some expectations as that would harm me in the end, and like a snail, I went back in my very strong shell.

And then came third year, were I actually started to befriend some of the very smart kids in 4th year. They played a huge role into the type of therapist I want to be in the future. This one day at thye beginning of the year, my friends and I had a conversation with one of them. My best frined and I said, “ we don’t want to stress too much, a simple 50% will do and we will move to the following year and be happy.” And then he said. “ wow, I wouldn’t trust you guys to treat my grandfather knowing 50% of what you’re suppose to know, I wouldn’t even think twice s you would harm him.” Whenever I think of underachieving, that statement always comes in mind as now I’m actually realizing that it’s not at all about me, but about the helpless person who is putting all their trust in me and my knowledge and believing that I will make their lives better. I applied that statement when I was onsite, I put the marks aside and focused more on what the client actually wanted and what would be beneficial for my client, I attempted prevocational skills training, without even studying it, no one in my class had done it before, we’ve never been lectured on it but my supervisor convinced me that it’s what my client needed, and I did it. The snail finally left it’s shell.

Moving forward with my treating in psych, I’ve been learning about the importance of always being client centered and making my treatment session unique to my client and not always relying on universal ways of treatment. Hiding like a snail can be self harming as it hinders growth, as Maslow stated, “One can choose to go back toward safety or forward toward growth. Growth must be chosen again and again; fear must be overcome again and again.” (Maslow, 2018). Even though growing can be really uncomfortable, it brings about a lot of change and forces you to be a better person. I for one can vouch that, if you are feeling as if things are not working out, always look at the bigger picture and remember that things are always going to work out as Bennet once said, “Real change is difficult at the beginning, but gorgeous at the end. Change begins the moment you get the courage and step outside your comfort zone; change begins at the end of your comfort zone.”

Bibliography

Bennett, R. T. (n.d.). Retrieved from goodreads: https://www.goodreads.com/quotes/7706642-real-change-is-difficult-at-the-beginning-but-gorgeous-at

Maslow, A. (2018, January 5). EverydayPower.com. Retrieved from EVERYDAYPOWER: Abraham Maslow

Williams, Peter. Snail. Reaktion Books, 2012.

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.researchgate.net%2Ffigure%2FOrientation-of-the-shell-in-relation-to-the-snail_fig1_233727104&psig=AOvVaw1xY5DMCDG0UuIGCVWcYhFs&ust=1605378244637000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCOCjj5eSgO0CFQAAAAAdAAAAABAP

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lindokuhlekhoza · 4 years

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COVID-19 National Crisis Helpline

0800 029 999

COVID trick or treat?

Will 2020 be a memorable year you ask? Yes of course, COVID 19 happened and it took the whole nation on an roller-coaster ride. It was so unexpected, so uncontrollable, that it took 6 months of our lives just like that, was a trick or a treat?

According to the World Heath Organization, COVID 19 is, “ COVID-19 is the infectious disease caused by the coronavirus, SARS-CoV-2, which is a respiratory pathogen. WHO first learned of this new virus from cases in Wuhan, People’s Republic of China on 31 December 2019.” (Organization, 2020). It can be transmitted from person to person through small droplets from the mouth or nose of a person who has it. The three main symptoms are fever, dry cough and fatigue. Sanitizing, washing your hands with soap, maintaining social distancing and always wearing a mask is our norm to protect ourselves from the virus. A mouthful right?

It honestly started off as a joke until we all started losing loved ones. I for one lost my brother to the virus, which was devastating for my family and I. Shortly afterwards, my mother and sisters got the virus but they managed to survive through the grace of God. Where was I through this time? I was at school trying to make a future for myself. At school, we weren’t allowed to have visitors, we had a curfew which was 8pm, there wasn’t a lot of people on campus because not everyone had received permits yet. We didn’t have a lot of venues to go on prac. In prac we had to learn how to always abide in the safety protocols, which made assessing and treatment really difficult because you know, there’s no such thing as personal space/ social distancing in OT especially in physical. I must say I was struggling, the two most important things in my life were not working out, my academics and my family. You know the saying “God gives his toughest battles to His strongest soldiers” ? Well I didn’t believe in it at that time. I was questioning my faith and the presence of God in my life. I must say, I have never felt so alone in my entire life.

You thought it was going to be a sad story right? Well not on this BLOG! I managed to pull out of my dark hole with the help of my friends, family, my academic leader and God. I passed my physical block. Currently I am on my psych block, which I would be lying if I say I’m not enjoying it. This time around I am not doing it for my marks even though they are important. I am using this time to learn and see if I actually like this profession. I was at Pathways for my first block. Oh man oh man, I absolutely enjoyed it. It was the first time I was exposed to autistic patients and my client had OCD, ODD, ADHD and Tourette and ehlers syndrome. I was able to learn and implement prevocational skills training for the first, and it was exciting as my supervisor was with me every step of the way. I managed to build a good rapport with my client and I saw a little of growth in her, she was couldn’t believe that she could draw up a CV and do an interview. At the facility we engaged in a lot of leisure and social participation programs which I also needed myself, so I was basically providing and receiving treatment.

The country is currently open, we are on level 1 and seems as if everything is back to normal and people are starting to live their lives much better than before. According to WHO, currently in SA, there are a total of 713 156 cases 634 000 recoveries and 18 843 deaths. The numbers are growing and will continue to grow if we don’t abide to the safety protocols.

COVID 19 made families grow closer, the world became cleaner, nature was healing herself, people learnt new skills, online learning emerged and most importantly people starting discovering who they truly were as there was a lot of time for self introspection. Also COVID 19 took away a lot of loved ones, families tore apart, there was GBV, bread winners lost their jobs and a lot of businesses closed down. What do you say, was COVID a trick or a treat? Because I am conflicted.

Bibliography

Organization, W. H. (2020). Retrieved from World Health Organization: https://www.who.int/emergencies/diseases/novel-coronavirus-2019?gclid=CjwKCAjw_sn8BRBrEiwAnUGJDkfE7K9XSdxLv0ilO3xLIwpEfLgPSf_UZbrUGL_4zHWiIE_eXSVTvRoCTpAQAvD_BwE

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lindokuhlekhoza · 4 years

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COVID trick or treat?

According to the World Heath Organization, COVID 19 is, “ COVID-19 is the infectious disease caused by the coronavirus, SARS-CoV-2, which is a respiratory pathogen. WHO first learned of this new virus from cases in Wuhan, People's Republic of China on 31 December 2019.” (Organization, 2020). It can be transmitted from person to person through small droplets from the mouth or nose of a person who has it. The three main symptoms are fever, dry cough and fatigue. Sanitizing, washing your hands with soap, maintaining social distancing and always wearing a mask is our norm to protect ourselves from the virus. A mouthful right?

It honestly started off as a joke until we all started losing loved ones. I for one lost my brother to the virus, which was devastating for my family and I. Shortly afterwards, my mother and sisters got the virus but they managed to survive through the grace of God. Where was I through this time? I was at school trying to make a future for myself. At school, we weren't allowed to have visitors, we had a curfew which was 8pm, there wasn’t a lot of people on campus because not everyone had received permits yet. We didn't have a lot of venues to go on prac. In prac we had to learn how to always abide in the safety protocols, which made assessing and treatment really difficult because you know, there’s no such thing as personal space/ social distancing in OT especially in physical. I must say I was struggling, the two most important things in my life were not working out, my academics and my family. You know the saying “God gives his toughest battles to His strongest soldiers” ? Well I didn’t believe in it at that time. I was questioning my faith and the presence of God in my life. I must say, I have never felt so alone in my entire life.

Bibliography

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lindokuhlekhoza · 4 years

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Clinical Reasoning And Cultural Humility...

First week back at prac post COVID 19, it has been three months of not engaging with my school work and not getting exposure that will help me grasp the essential skills that an OT should possess. And I must say, it was difficult getting back on my feet more especially adjusting to the new normal.

It was my first time being at Entabeni and I must say it’s a luxury compared to the other hospitals I’ve been to. I was given two CVA clients Mr M who is a 57 year old Indian man and Miss P who is a 44 year old African Isizulu speaking woman. Growing up in an African home we were taught to respect our elders and not address them as our peers by calling them their first names, but by “mah” meaning mom, “baba” meaning dad, “mkhulu” meaning grand father and “gogo” meaning grand mother. Those terms are even used on strangers as a sign of respect. So when I first saw Miss P, I greeted her by saying “sawubona mah” despite her condition and her not being a relative showing her that she has not lost her role from her disability. Mr M is an Indian man and from having male teachers from high school we often referred to them and “sir” which is exactly what I did with Mr M, taking into account his age as well as it play a huge role. In every culture introducing yourself is a sign of respect as well as and I made sure to do that in every session as well as ask their permission to work with them.

As a student health practitioner little thing that we do has a meaning behind it, one of my lecturers Miss Christopher said that “clinical reasoning is the reason behind your intervention, find out what your focus is and ensure that you back it up with correct findings.” The clinical reasoning cycle includes 8 steps, considering the patients situation, collecting and processing information, identifying problems, establishing goals, taking action, evaluating, reflecting on process and new learning. According to Rubenfeld and Scheffer, (2006). “ It is also important that students learn to recognise, understand and work though each phase, rather than making assumptions about patient problems and initiating interventions that have not been adequately considered.” I used an interview as well as the client’s file to obtain all the information I need in terms how the client arrived and how the intervention provided by the hospital has benefited the client thus far. Speaking to the client and conducting my own assessments helped me set goals with the client making sure my treatment is client centered as Tanner (2006) said that critical reasoning is “ never as an objective, detached exercise p.209). I started taking action on Tuesday when I provided my first treatment of UL dressing, I used this activity as an occupation as a means to treat specific client factors such as decreased AROM of the client’s left shoulder adductors and I used occupation as an end to help the client learn a new method of dressing his upper body with minimal assistance. The feedback I received from my supervisor helped me evaluate and reflect on my session and it was focused on how my warm up exercised should correspond with my main activity which will make my clinical reasoning stronger and how every single movement the client does must aim at improving the affected client factors.

Going forward I have learnt how clinical reasoning alongside cultural humility helps us focus on how our treatment should always be client centered. It helped me understand that after I have received all the information I need and have conducted my assessments I must identify the problems, establish goals with the client, take actions that will help achieve those goals and evaluate and reflect on whether or not the session has improved the affected client factors.

Bibliography:

Rubenfeld, M. and Scheffer,B. (2006). Critical Thinking Tactics for Nurses. Boston: Jones and Bartlett

Tanner, C. (2006). Thinking like a nurse: A research-based model of clinical judgement in nursing. Journal of Nursing Education, 45(6), 204-211

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lindokuhlekhoza · 5 years

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Reflecting on my communication skills.....

Do you think walking around your workplace while on your phone looks professional? especially in hospitals where it's always busy, potters transporting patients, food trolleys and linen trolleys always passing by. I went to a strict school in high school and all my life I was taught that using your phone while in the presence of adults and walking while texting is not appealing is seen as a sign of disrespect. So here I am, tiny me in a BIG hopsital and the only way of getting hold of my supervisor and colleagues is through my phone. I've been practicing this since last year but till this day I still find it very uncomfortable. I always have to excuse myself from my clients and explain to them why I am on phone and surprisingly they always understand. I've also observed that I'm not the only one who's always on my phone, even doctors and other medical staff are always on their phones except nurses. I think because our world is changing and is becoming more advanced technologically, things that were not socially excepted a few years ago are now a social norm. According to (Dragan et al, 2018) education is one of the fields that greatly benefited from technology in both learning and teaching. And I guess that as time goes on I'll get more comfortable with using my phone during prac.

The other way of communicating in my work place is through the medical file. It's a simple way of "talking" to the MD team without physically doing it. I've taught myself to read the file before my session and after my session when I write notes so that I know who exactly my client has been seeing and their medical prognosis. The handwriting is always a problem, sometimes I find it really hard to read but I've noticed that asking the nurses help a lot. My supervisor happened to read one of my client's files, she questioned me if I knew that my client has type 2 diabetes and hypertension and I said no. She asked why and I told her I didn't know the code names i.e T2DM. She then emphasized to me the importance of knowing them and how I should use my notes from last year to learn them. SOAP notes are not my favourite. I usually take time writing them cause I want to make sure I don't leave anything out and that I use the right terminology. It gives me anxiety to be honest because I know that qualified medical practitioners will read what I wrote there and having to report on how your client is doing is also stressful because that's when you realize the importance how well you need to know your client. Referring from the first day you met them till the last minute you see them because this can determine if your client is getting discharged or not. So back to my CVA client, fortunate enough I was able to be involved in the ward round. I've never felt so small in my life. I was around qualified people and they were using terminology that I've never came across. While I was trying to figure out what the doctor was saying. He turned to me and asked "so how do think Miss X is doing?" then all eyes turned on me. My ears literally started burning and my heart was beating really fast. I wanted to say that she was improving and is now able to actively flex her MCPJ, PIP and DIP joints but she also had increased tone of her shoulder and elbow joint which were flaccid the first time I saw her. But all I managed to say was "she's able to make a fist now and has increased tone of her shoulder and elbow." I couldn't believe it, I knew there's a medical term used for making a fist but for some reason I couldn't remember it. But the doctor was so kind and then he reminded the rest of the team how flaccid she was and said how impressive it was that she has some active movement and thanked me.

On Monday my supervisor did a tut on a treatment session using my CVA client. She did a warm up and dressing activity. She made it look so easy. Miss X has global aphasia and struggles with understanding instructions. I noticed how my supervisor gave her physical and verbal cues. I also payed attention on how she handled her key points of control. I also observed how when she's doing warm ups she made sure to do full movements. When she was doing shoulder flexion of my client's affected arm, she made sure to do full PROM and counted together with the client. Later on the day I decided to do exactly what she did and added more NDT mobs and I noticed how activating the muscles help with making it easy for the client to do the dressing activity. Today I did the same warm up and did a bathing of the ULs and LLs and my client managed to do it, she managed to apply on lotion and put on her hospital gown. This time she managed to grasp her lotion without me helping her open her hand and facilitating cylindrical grasp, she did it all by herself. Which made me happy.

Miss S has paraperisis caused by multiple myeloma. She had pitting oedma of the plantar side of her right foot, she also experiences pain on that foot and has hypersensitivity. She has type 2 diabetes and kidney failure. My supervisor asked me to read up on neuropathy and myeloma and how it's linked with her hypersensitivity. Neuropathy is damage to the nerves resulting in pain and can be caused by diabetes, myeloma and kidney failure. Why you ask?? High levels of glucose and fat can cause nerve damage (Brown, Ashbury, 1984). Kidney failure results in wastes and fluids being accumulated in the body therefore causes imbalances of salts and chemicals causing nerve damage. Multiple myeloma has a protein which is produced by plasma cells and causes direct nerve damage (Grammatico et al, 2016). I did a washing of feet activity to improve her dynamic sitting balance as she would have to reach for her toiletries and to wash her feet and desensitization of her foot whereby she'll be using a cloth to wash with and warm water. She was hypersensitive to the water and said it was too hot but as time went on she said the water was fine. She lost her balance twice when she was reaching for her feet but I was able to support her. For the following session I'm planning on doing desensitization as well as transferring as she doesn't know how to transfer from her bed to a wheelchair.

I believe that everyday my communication skills are improving. From engaging with my client to the medical team at the hospital. Communication helps with knowing the procedures of the hopsital and finding out more about your client and planning a client centered intervention program that will benefit the client as well as you as the therapist to become a better clinician.

Bibliography

1. Dragan, I., Dalessandri, D., Johnson, L., Tucker, A., Walmsley. (2018). Impact of scientific and technological advances. Https://doi.org/10.1111/eje.12342

2. Brown, M., Asbury, A. (1984). Diabetic neuropathy. Https://doi.org/10.1002/ana.410150103

3. Grammatico, S., Cesini, L., Petrucci, M. (2016). Managing treatment related peripheral neuropathy in patients with multiple myeloma. https://www.oncologynurseadvisor.com/home/cancer-types/multiple-myeloma/managing-treatment-related-peripheral-neuropathy-in-patients-with-multiple-myeloma/

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lindokuhlekhoza · 5 years

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What client centered means to me..

“What do you think is the meaning of client centeredness?” My supervisor asked us. I answered simply by stating that, it means planning your intervention based on your client’s needs. My supervisor proceeded by giving us an example and told us the importance of drawing up a prioritized problem list and communicating with the client what they want to work on before going home. She then told us how we should in cooperate both in our intervention plan ensuring that we are realistic with our client but also basing the whole plan on them. This made me realize how egocentric we tend to be as students. We always put our needs first before the client’s, we don’t spend enough time listening to the client, we just rush into doing our assessments and reading the file in order to get all the information we need for our case studies. Forgetting that we are the voice of our clients and that if we don’t cater to their needs who will?

Miss P had left CVA and told me that the first thing she wanted to learn was to dress herself. We did the upper body washing and dressing activity but I was not happy with the quality of the end product. I had difficulty handling her and I wasn’t sure why she took time understanding my instructions, I thought it was because she’s Xhosa and I’m Zulu. I did the activity again this week because I wanted her to practice more weight bearing and the use of her right arm and work on her postural alignment as well. Pedretti stated that client’s who will not regain sufficient function in their affected side need to focus first on their BADLs. (Pedretti L.W, Pendleton H, Schultz-Krohn W, 2018,p.g 834). During the activity the client gave me the same problem then I figured out that she has global aphasia. She was unable to complete the task without me having to prompt her, she focused more on getting her left side clean instead of her right side and I had to prompt her to wash and lotion her right side. It was then that I noticed she has mild hemineglect then I thought it would be beneficial to give her instructions from the right side therefore making her more aware of it. Throughout the activity she complained of shoulder pain but she presents with normal tone of the shoulder muscles and I questioned whether the pain was an indicator of subluxation. Pedretti stated that literature does not support the relationship between pain and subluxation, but the shoulder joint should be taken care of and that if the client is in bed a pillow should be used to maintain alignment. (Pedretti L.W, Pendleton H, Schultz-Krohn W, 2018,p.g 832). Then I planned that on our next session I will do a positioning education and the client will have to cut and paste pictures making a board that she will take home with her. to treat her postural alignment, I made the client reach for items high up and therefore elevating her trunk and correcting her posture. I used static weight bearing whereby I applied pressure on the shoulder joint. During a group activity whereby the client was instructed to use both hands to pass the ball I noticed she had difficulty again with understanding instructions which confirms global aphasia but the I didn’t know how I would treat or compensate for it. My group members and I had a hard time handling her and this ended up causing us to pay more attention to her than the other client’s in the group. I felt a of pressure from my group members as well as from myself because she was my client and I felt as though the responsibility of handling her was on me and that I should know how to handle her. This resulted in me not paying enough attention on the group and instead try think of handling principles I should use to help my client. While doing that I was not communicating with her and her making sure that she was enjoying the activity as this was part of our aim. At the end of the activity my client told me personally that she did not enjoy the activity because it was difficult for her and this made me really sad because I wasn’t a good therapist. When I was taking her back to her ward I realised that she did not smile, not even once during the activity and that confirmed to me that she really did not enjoy the activity.

For our group feedback, our supervisor told us that we need to work more on our handling principles because she saw that we struggled. She then demonstrated facilitation techniques we should use. She said that I should focus on perceptual motor training and focus on one activity with my client for 2 weeks and add upgrade it week after week. This will then help my client with improving her function. Which is what I will focus on and I will do a psych evaluation more especially Beck’s depression scale because I found out that she had 4 miscarrigaes and lives with HIV and now that she has lost function of her right side, it made me wonder would she have any mental illness.

Bibliography

Pedretti L.W, Pendleton H, Schultz-Krohn W. (2018). In Occupational therapy practice skills for physical dysfunction, eighth edition. St. Louis, Missouri: Mosby, Inc.

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lindokuhlekhoza · 5 years

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From theory into practice..

I woke up in the morning of the 24th feeling quiet nervous and scared. It was going to be my first time setting foot at King Edward Hospital and working in an acute hospital. My mind was everywhere, I was thinking of the different diagnosis I was going to see, how my supervisor was going to be like? was I going to be able to cope with the fast turn overs? Am I ready to treat? will my clients be willing to interact with me? Am I going to be able to help them feel a little better or worse? But as soon as I talked to my group, I then realized that I was not alone and that made me feel a bit better.

In the morning we had a meeting with our supervisor and she was briefing us on what she expects from us and practically walked us in pretty much EVERYTHING. It was like she gave us a month’s lecture in a few minutes which helped me feel a lot at ease as I had a picture in my mind of what I was expected to do.

I received 2 client’s, both females one with right CVA and the other one with right below the knee amputation. I went to see my CVA client as I was familiar with the diagnosis and with the AMP I would have to do a quick research on it. So I arrived at the ward and as soon as I saw my client it felt as though everything I had prepared just left my brain. I kept paging through my file with all my assessment forms and I forgot that the client was there. My supervisor arrived and I felt as though the situation got worse. I forgot the littlest things such as wearing gloves, not sitting on the bed, how to transfer the client from laying down to short sitting, which we had done on the Friday prior. My supervisor stepped in and helped me, but even though she did, in my heart I honestly thought I had failed myself, how was the client going to trust me after that and what will my supervisor’s first impression of me be like? I started with assessing my client’s tone which according to Pat, “is the amount of resistance to passive movement of the part, in other words to stretch or elongate.” (Davies,1985,p.87). This was easily done and my client score a 2 for elbow flexion. I screened ROM and noticed that the client’s left side works properly and has full ROM but for her shoulder on the right hand side she started feeling pain in 100 degrees during flexion.She has no AROM of her right side. The MoCa helped in terms of showing the client’s cognition, she takes a while to process what is being said to her and ans her visuoperceptual skills are poor as she scored 1/10 in that section. It was my first time conducting the MoCa as at Hillcrest I conducted the Adenbrooke more.

For the AMP client who had surgery on the 15th of Feb, I was only able to spend 15mins with her as she had a visitor. During my assessment the client was very kind towards me, I was able to conduct ROM of the stump and which was 30 degrees for hip flexion. It was pretty cool for me to witness the movement because I have never seen it before. I was able to pick up that the client has poor static sitting endurance as she rushed me when I was measuring. In muscle strength of the left leg she scored a grade 4. I was able to find out that she has physio sessions and was able to stand for only 2mins using a standing frame.

For the 26th which was treatment day, I was feeling a little confident because I had spent the whole day and night on Tuesday planning the sessions, I was fortunate enough to receive help from my academic leader and my CP. But the nerves of treating for the first time were there and I did not want to repeat the same mistakes I had made on my first day.

For my CVA client, I conducted a upper body bathing activity as well as lotioning and dressing. I had planned to use the client’s clothes which I sadly had to find were not there but I decided on using her hospital gown. I was using occupation as a means and an end. As a means to correct her sitting posture and weight bear on her right UL. According to Pedretti, “Weight bearing through the hand and forearm with an extended elbow is a pattern used during ADLs and mobility tasks.” (Predretti, 2018, p.830). Occupation as an end because she did not know how to dress her affected upper limb.I prepared for the activity by using NDT principles, I used trunk activation movements and shoulder and elbow flexion and extension. My highlight was using the tapping on the triceps technique to achieve elbow flexion as it went perfectly on the first try. During the activity the client improved on her weight bearing techniques and she managed to finish the activity. I was happy with my handling skills and how I facilitated movements on the affected UL like we had practiced in class.

For my AMP client I had planned out a sandwich making and dish washing activity that was going to be conducting by the side of her bed. And a stump management educational session. Here I was using occupation as a means to improve her static sitting endurance from 3mins to 5mins. When speaking to my supervisor about it she made me realize that the activity was inappropriate as sandwich making is done in the kitchen and not the ward. So I ended up picking face washing. My supervisor advised me on exercising techniques I should focus on, which are to mobilize the stump and to implement desensitization techniques which I had read about in Pedretti. She advised me on how I should structure the environment so that she moves out of her base if support to improve her dynamic sitting balance. When I arrived at the ward the client had to be quickly ran into the bathroom as she had a runny stomach. When she came back I focused on stump management and care. I addressed her on phantom limb pain and explained to her why it occurred. The client was asking questions which I was able to answer as I had read about it on Pedretti. She told me that the MD team was planning on prescribing her a prosthetic. I then emphasized the importance of desensitization techniques and how OT’s can help with the shaping of the stump by bandaging and pressure garments.

Even though I was sad that I wasn’t able to proceed with the initial activity plan, I was happy with the way the day turned out. I was able to teach my CVA client to weight bear and dress and addressed my AMP client on her lack of knowledge on stump management.

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