Sunday, December 12, 2010

Personal Update: Two More Weeks to OT

Jeez, it’s been a long road, but the end is finally in sight. I’m talking about my decision to return to school to acquire my degree in occupational therapy, or OT. I have two weeks—just TWO weeks—left in my final clinical rotation, then all that stands between me and a new career in healthcare is the national board exam (NBCOT). Once I pass that, I’ll be a COTA, or a “certified occupational therapy assistant.”

It’s a weird feeling. After roughly eighteen years working in niche markets throughout the publishing business, I’m going to be able to rely on a totally different career and one that I’ve been trained for. In the publishing trade, I could afford to have slack days, but as a COTA I have patient outcomes that rely heavily on my job performance. Early on, this was a daunting prospect. But now that I’ve been through almost 800 total hours of clinicals—in addition to eighteen-plus months of classes—I’m feeling confident that I’m fully able to shoulder the responsibility.

One of the odder challenges OT practitioners face on a constant basis is the mere question of “What is Occupational Therapy?” I couldn’t tell you how many times my own friends and family refer to me as a physical therapist, or PT. But there’s a vast difference between the two disciplines, and it goes well beyond boiled-down simplifications such as “PT is lower body, OT is upper body,” or “PT is gross motor, OT is fine motor,” or even the dramatized remark: “PT teaches you to walk, OT teaches you to dance.”

So, in order to shed a little more light on the topic here on “Ranting and Raven,” I asked my current clinical instructor, Mrs. Brenda Cain at Mercy Hospital Western Hills, for her permission to post something she wrote about OT regarding “task analysis,” and here it is:

LOOKING THROUGH THE EYES
OF AN OCCUPATIONAL THERAPIST

When someone observes an Occupational Therapist working with a patient, it may appear at times, that we are “just having fun”, “just playing a game” or “just making a craft”!

We ARE making a craft and having fun! BUT, it is most certainly not ALL we are doing! Occupational Therapists are experts in what is called TASK ANALYSIS.

We are trained to look at a task, a craft, a job and/or activity and identify the physical and cognitive components necessary for successful task completion.

So, for example, when you see an Occupational Therapist working with a patient to complete a beaded bracelet, it may appear that we are making a beautiful craft and simply having a good time while we make a pretty accessory!

But, when an Occupational Therapist chooses to make a beaded bracelet…

THIS is what WE see!

1) Can the patient follow the directions to complete this task? Does it help if I provide them with a sample? Do I need to provide the directions one step at a time? Or do they need hand over hand assist?

2) Do they have the physical ability to manipulate small objects? Does it help if they are provided with larger beads?

3) Do they have the visual ability to see the lacing? Does it help if I darken the tip of the lace or does the whole lace need to be exchanged, darkened or thickened?

4) What is their frustration tolerance like? How do they handle it when the beads accidentally fall? Can they problem solve a way to secure the beads more effectively to the string?

5) What do they do when they are faced with not having enough supplies to complete the task? Do they ask for help?

6) How do they do with the sharing of the supplies? Are their social interactions with both staff and peers appropriate?

7) Are they able to attend to the task at hand or do they have trouble concentrating on the tasks completion? Does it help them to concentrate if environmental distractions are decreased?

8) Do they enjoy doing the task? Does the task help them to relax or give them a functional, purposeful way to structure their day? Is this a potential new hobby for them that might increase their life satisfaction?

Various interventions and techniques are applied throughout the craft to see what is most effective in helping the patient perform the task with the most independence and greatest success. And all the while, problem solving skills, leisure exploration, coping skills, social appropriateness, cognitive skills and self-esteem components are being observed and discussed as indicated.

See? And you thought we were just “making a bracelet”!

Hope that was enlightening, because there’s no way I could have said it any better. Wish me luck in these final two weeks. What a Christmas this will be!


”Looking Through the Eyes of an Occupational Therapist” was written by Brenda L. Cain, OTR, in December, 2010, and is reprinted with permission.

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