Working nights is part of my role as an Inpatient Recovery Practitioner and it is the part of the role that tends to shock people the most and the part that I always get asked the question "what does an OT do on nights?"
At first I understandably felt quite negatively about this part of the role and was quite apprehensive! At first I, myself had no idea what an OT does on nights because it is not something traditionally carried out by OTs. You can see by the fact that I am wide awake at 12:30am on my day/night off that there are some negatives to working nights and it does tend to mess up my body clock a bit, however the positives and experience definitely outweigh the negatives. Working nights gives me an amazing opportunity to experience patients' evening and nighttime routines which gives me a rounded view of that person as an occupational being, how they function and how sometimes their night time habits and routines can affect their occupational performance during the day.
Evenings tend to be a lot more relaxed on the ward as week days during the day are busy with people having assessments, meetings, trips out etc. Being on shift in the evening enables me to engage patients in activities and groups in a much more informal way. I have realised that I have this sort of occupational filter in my head at all times when observing someone in a group or activity... like an internal MOHOST! I'm observing people all of the time and due to this I definitely document my activity notes differently to my nursing colleagues! Working nights and long days has definitely given me an opportunity to build really good relationships with the patients I work with and I feel that I have a better relationship with them in my role now when compared to if I was working off the ward.
Night shifts are a great opportunity to complete paperwork such as care plans and assessments and I'm thankful for the opportunity to complete these during a quieter time as a busy ward can be distracting in the day when completing care plans! I often get told that an OTs skills are wasted on nights and people do not understand what OTs can do on nights. However as part of the rationale for my role and the working hours it was discussed by management that even a nurses' skills are wasted on nights. This view is so true however, no professionals' skills are wasted at all but it is something that always sticks with me and when I get asked "what does an OT do on nights?" or get told "An OTs skills are wasted on nights, I don't see what you can do"
We can do anything.
Presenting at CWP's AHP day
Last week I co-presented at an AHP CPD event with my clinical lead OT. It is the first time I have done a 'proper' presentation at an event like this in front of a large number of people (or what seemed a large number of people to me!) and I was understandably very nervous! My presentation was an updated version of the one I discussed in my previous blog post and We discussed my role now 9 months on.
Attending the day and hearing about the current direction of health and social care really made me realise how important my job role really is. I don't really think about it much when I go about my day to day practice and the event really made me stop and reflect.
We heard from lots of inspiring OTs in non-traditional roles including cardiac rehab (Involving performing ECG's and blood pressure) and driving assessors! It was great to hear about how we as OTs can take our core skills and apply them to pretty much anything! The world is literally our oyster as the saying goes. Hearing other OTs talking about more traditional nursing aspects of their job role really made me reflect on my role and where I should be using this more as an opportunity to gain as many skills possible. So far I haven't undertaken roles such as physical observations (blood pressure, temperature and weight measurements) however, I have realised that I absolutely could do this and it will not stop me from being an OT and won't take away my OT core skills, it will only enhance them and enable me to apply these further to a different setting and a different skill set. This ultimately may make the service we provide a bit smoother for patients and my team as well as improving my knowledge of this aspect of the job.
Within my presentation I discussed some theory in relation to AHP's and I reviewed an updated systematic review:
Saxon, R. L., Gray, M. A., & Oprescu, F. I. (2014). Extended roles
for allied health professionals: an updated systematic review of the evidence. Journal
of Multidisciplinary Healthcare, 7, 479–488.
The research highlighted current pressures and barriers within health and social care including; An ageing population, pressures for funding, long waiting lists etc. As discussed, AHP’s are identified by commissioners and services as possessing
the key clinical skills and capability to bridge these service demand gaps
and act as first point of contact within a patients' healthcare journey. In the paper they referred to non-traditional roles as 'new extended scope AHP roles' and discussed that these are being trialled with
clinicians accessing specialised training outside the scope of their
discipline which really reflects my role. It is discussed that these roles may involve identified tasks traditionally undertaken by medical,
nursing, physiotherapy, speech therapy or other health professionals. Enhancing job depth by adding skills within a profession and
expanding job breadth by working across professional boundaries.
This paper made me really excited and made me realise how relevant my role and similar roles are in the current health care climate. However, there is very limited research but the available research suggests that extended
scope AHP’s could be a cost effective and consumer accepted investment that
health services can make to improve patient outcomes. In terms of OT there are a lot of initiatives ran by the RCOT such as the 'improving lives, saving money' campaign however I think it is important for us as OTs and AHPs in these 'extended scope' roles to get our voices heard out there and prove that we absolutely are the change that can bridge these service demand gaps in healthcare. I am currently involved in a research project in work evaluating the Inpatient Recovery Practitioner role and gaining the views of both staff and patients on the role which is very exciting.
The experience of presenting on the day was a brilliant one that left me feeling more confident about presenting and really quite proud. When I stood up there and talked through the experience of being newly qualified and going into a brand new role, basically leaping into the unknown it makes me realise how brave I was and how thankful I am for taking that leap because I absolutely love my job and all the experiences it brings. It was also a lovely experience to stand up there and see so many familiar faces too! I met with OTs who had been my mentors and educators on placements and had the chance to catch up with them and chat about my progress and their practice. It was really great and shows the importance and benefits of networking at events like that.
Presenting about my role 9 months on showed how far I have come in that time and that I am more confident in defining my job role and actually understanding it! It has developed well so far and I definitely have a good role on the ward in promoting meaningful occupation, care plan input focusing on person - environment - occupation and this is facilitated and enhances as discussed above with my working hours. The patients have a good understanding that I am an OT and will often approach me to facilitate activity groups or 1:1 activities such as arts and crafts, gardening and cooking. The role is still a work in progress and I am developing all of the time.
This week I have also been catching up with tweets from the RCOT annual conference which I couldn't make this year. The tweets have been great and some of the themes I have discussed in this post seem to be a running theme through the conference as well.
This tweet from @Helen_OTUK from a presentation by the inspiring Jennifer Creek was brought to my attention and it sums up this post perfectly:
This tweet from @Helen_OTUK from a presentation by the inspiring Jennifer Creek was brought to my attention and it sums up this post perfectly:
I was on shift last week for the first time as shift leader with nurses who were completely unfamiliar with our ward as we had staff sickness. I was told by the end of the shift by the nursing staff "Wow, so you're a qualified OT? I am impressed... you're as good as a qualified nurse"
And whilst you could take offence to that, to me it was the best compliment ever! Improving and developing our relationships with our health professional colleagues is an important step in the journey and bridging those stereotypes and gaps in the MDT is vital. As is sharing our own OT values and skills with our colleagues. Lets be practitioners on the margins!
