It still seems surreal to me that I am actually writing this as a qualified occupational therapist! I have spent the past two years dreaming and hoping for this moment and at times not believing I would actually get here, but here I am.
This week marks my first week as a fully qualified and HCPC registered occupational therapist and it has fallen upon occupational therapy week so it feels even more special. I have been in my first post now for 4 weeks and I began working as a band 3 while I found my feet within the role and got to know the service users and different staff roles.
My first role is a little different and non-traditional for an OT. I am actually titled an 'inpatient recovery practitioner' and I am working within a nursing team based within inpatient learning disability services. The role has been created to promote and enable a more 'recovery' focused model of care, which focuses very much on a person centred perspective and enables service users to make informed choices and decisions about their recovery and their care. I was very much attracted to this role as these philosophies reflect mine as an OT. This is reflected beautifully by Thew et al (2011):
"There is a strength & sense of empowerment that emerges from the fact our profession’s philosophy provides us with the knowledge and skills to follow many paths of need as indicated by those clients whom we profess to serve."
To promote a more integrated model of recovery, the role was also advertised to mental health and learning disability nurses. Although nursing staff within this role fit within the more traditional nursing role on the inpatient unit - I am essentially the odd one out!
It has taken the past few weeks for myself and staff members to develop an understanding of my role as an OT within the setting and this is very much still a work in progress, although it is becoming clearer all of the time. I have learned that I needed to approach this role with an open mind and be open to different opportunities and experiences as we are all learning together.
As I am based with the nursing team I am working full time on 12 hour shifts and night shifts... yep, night shifts! I have to be honest I was a little apprehensive of this at first! On the site they have a team of OTs working into the service already, so my role would not reside with them and this was hard to get my head around to begin with. Doing shift work means that no two weeks are the same, the days and nights I work are always different, which makes it difficult for me to plan any OT specific assessments or activities.
I was really worried that I was not utilising my OT skills and was working more as a nurse and from my learning as a student the risk of role blurring for OTs always in the back of my mind. We were graded on our competency on practice placements as students to specifically define the role of the OT to set us apart from other heath professionals. Now my definition has had to change to fit in with this more generic way of working...but this is not necessarily a bad or scary thing, it potentially has its negatives but it is actually a real positive.
In relation to this Thew et al (2011) discusses that there will always be parallels and blurring of roles but in the ever-competitive nature of this world, the continued confusion of what OT can offer as a profession can lead ultimately to its failure. The profession however, needs to demonstrate it’s worth and unique contribution to the health and wellbeing of human beings well beyond the boundaries of traditional health and social care.
...In a nutshell, I have to take this opportunity and grab it with both hands and do the best I can to promote my OT skills and show how they can be valuable within the team of permanent staff within the inpatient setting. I can do that right?
From a personal perspective I have been utilising supervision and guidance from my supervisor who is an OT and this has been extremely valuable. At times I have struggled a little and felt a little lost as it is all just such a new experience. I am a new OT, it is a brand new role for OT and I am still in my transition from student to practitioner. Through supervision I have been able to reflect on my practice so far and I hadn't actually realised how much I had been using my OT skills already! It is very subtle to me because I am trained to think and practice in a certain way - but that is not how everybody thinks and I am bringing a brand new perspective to the role and I think that is really exciting. From a professional development perspective I have enrolled on to a preceptorship programme which I will be completing with my OT supervisor and I will be attending meetings and training with the other OTs within the trust. I am also a member of the COT specialist section for learning disabilities and will be keeping my eye out for any CPD events which may be useful.
I have used a lot of theory from Role Emerging OT by Thew et al, 2011 as it was a really valuable textbook and support for me as a newly qualified OT going into a non-traditional setting. Here are some bullet points summarising some real positives that I can relate to my role:
- Opportunity to challenge yourself and create an OT role within a workplace.
- Work independently and creatively.
- Unique opportunity to further develop team working skills and an understanding of a diverse range of perspective of other team members.
- In role emerging settings the heightened awareness of the benefits of occupation-focused practice seems to open up opportunities for the profession.
The role has really opened up my eyes to the nursing role within inpatient settings and how intense this can be. On placements I was never based with the ward based inpatient staff but usually with the therapy team who worked off the ward and came in and out for assessments and activities. I am working shifts and essentially practicing within a traditional role that would normally be associated with nursing staff. I am responsible for leading shifts and co-ordinating the day ahead, I can be in charge of the safe keys and money coming in and out of the unit as well as doing observations for service users. I am also named practitioner to service users just as a named nurse would be and can practice within all of these aspects of my role offering my unique OT perspective.
kronenberg, Pollard and Ramugondo (2011) highlight that our profession’s contributions towards global healthcare are being challenged by factors such as competition for limited resources, other professionals widening their practice, and pressure for generic rather than specialist workers. My role somewhat reflects this statement. However, while it is viewed as a challenge it is not necessarily a negative. If this is the way that health and social care is changing then OTs are in a perfect position to adapt to that change. We are such a diverse profession and we can use this to our advantage within new, non-traditional roles. Pollard (2011) discusses that change is not an abstract process, it is something that is resourced by the natural skills and abilities that people already possess and I feel OTs have the ideal philosophies and skills to facilitate change and adapt to new challenges and environments.
I am only just beginning my journey in this role and it is all very new. I fully acknowledge that it is going to be a challenge however, I have recognised that as an OT I have the perfect skills and abilities to rise to this challenge and can use this as an opportunity to promote the skills of the OT profession as well as learning from other staff within the MDT to ultimately integrate our skills and provide a person centred, recovery focused service for individuals within our care.
References
Pollard, N. (2011) ‘Occupational therapists – permanent persuaders in emerging roles?’ in Kronenberg, F. Sakellariou, D. Pollard, N. Occupational therapies without borders, Volume 2, Towards an ecology of occupation-based practices. Edinburgh: Churchill Livingstone. pp. 143-152.
Thew, M. Edwards, M. Baptiste, S. Molineux, M. (2011) Role emerging occupational therapy: maximizing occupation focused practice. Chichester: Blackwell Publishing.
