1. Advocates for clients who have been neglected or underrepresented in the system. Advocating for clients who have been neglected or underrepresented in the system is vital to providing exceptional care. As occupational therapist, we view the clients holistically and strive towards ensuring our clients are functional, independent, and have a good quality of life. In order to treat them holistically, we often have to advocate for our clients by contacting other disciplines to provide care for their needs that our outside our scope of practice. In turn, when the client receives the care they need, it helps improve their overall quality of life. Fortunately, I have experienced mostly exceptional patient care during my fieldwork rotations. However, there was one client that had been neglected on my mental health rotation. This client is difficult to understand. He speaks quickly, quietly, and does not articulate his words. Unfortunately for him, he is on a ward with a nurse that does not have a lot of patience. I noticed that the staff on his ward would frequently dismiss him because they could not understand him. Once you are able to sit down and closely listen to him, you realize how smart he is and that he does provide relevant, insightful feedback. The client was telling me that he was having difficulty seeing. I informed him that if he spoke to his nurse she could set up an eye doctor appointment for him. He reported, “she don’t talk to me.” After inquiring further, I discovered he has been telling her about his eyesight for the past 3 weeks. I ensured him that I would personally speak to her and make sure she schedules him an eye doctor appointment. I called the nurse, and she told me she would put in the order for an appointment. A week later, I talked to the client and asked him when his appointment was. He told me he still did not have an appointment. That same day, I saw his doctor and told the doctor personally about scheduling an eye appointment for my client. I also informed the doctor about the nurse not advocating for the patient’s needs. The doctor apologized and ensured me he would speak to the nurse. A couple of weeks later, the client finally got new glasses and was very appreciative towards me. He stated, “thanks for getting my glasses, nobody would listen to me.” I also began to notice the nurse having more patience and actively listening to her patients. I feel like this is a good example of representing clients who have been neglected or underrepresented in the system because without my efforts and persistence the client would not have received his eye glasses as quickly-if at all. My client was overall in a better mood and happier because he no longer had difficulty seeing and could better participate in group activities. I have learned that just because someone is difficult to understand, it is just as important to sit down and listen to their needs. Everybody appreciates being heard and helped.
2. Fulfills commitments to the professional community. During the past three level II rotations, I have maintained professionalism and fulfilled my commitments to the professional community by being timely, completing all required assignments, following fieldwork guidelines, and promoting occupational therapy in a health fair. While I was at ELMHS, I had the opportunity to promote occupational therapy in a hospital wide health fair. My job responsibilities were to gather commonly used interventions to display, print off bulleted list about OT interventions for common mental health diagnoses, and answer questions that other medical staff may have had when they visited our booth. I was successful in explaining the role of OT to other staff members who stated, "I just thought y'all did the same thing at rec. therapy." Below I have attached a discussion board post regarding the health fair. The following quotes are from my supervisors discussing my ability to fulfill commitments. Carrie Hoing, OTR/L stated, "Maggie has consistently arrived on time to the facility and has stayed late to complete work when necessary." Megan Brack, OTR/L stated, "Incredibly flexible given fast paced setting and is always willing to step up and help whenever needed." Stacey Dupre, OTR/L stated, "Assignments are early and always done well. You produce timely and quality documentation." Being able to fulfill professional commitments is an essential trait of being a successful occupational therapist.
3. Represents the unique perspective of occupational therapy when participating inter-professional situations. Fortunately, throughout my pediatric and mental health rotation, I had many opportunities to participate in inter-professional situations. While I was on rotation at North Mississippi Medical Center (NMMC), many of the clients received speech, PT, and OT all in one day. This gave me the opportunity to frequently collaborate with other disciplines and explain how we were addressing our client's goals in OT. I have attached a discussion board post discussing a situation about a client that was having difficulty during therapy that shows how all the disciplines came together to collaborate in order to be able to better serve the client and his family. During my time at ELMHS, I had the opportunity to attend daily morning report. In these meetings, an OT, nurses, social workers, and occasionally a physician were present. One morning a nurse reported that one of my clients had been placed on ward restrictions due to inappropriate behavior. I used this as an opportunity to promote the unique perspective of occupational therapy by educating the nurse on the coping cards that we were using with this client during group therapy sessions. The nurse asked me to provide a copy of the client's coping card so she could use it on the ward when the client began acting inappropriately. Later that week, the nurse stated in morning report how she was so appreciative of the coping card and reported how the client's behavior has improved since initiating the coping card on the ward. Having opportunities to participate in inter-professional situations when discussing client care helps ensure that everyone is on the same page and can work as a team to provide better client care.
4. Assumes responsibility for professional behavior and growth, in accordance with AOTA standards.
During my pediatric rotation, I quickly realized how much I needed to learn about handling skills and incorporating dynamic surfaces into interventions. I was very overwhelmed when working with infants because I felt like I did not know how to position their body to help facilitate movements to address their goals. Because I identified this as an area of growth for me, I discussed my concerns with my supervisor, who provided me educational resources to enhance my knowledge of handling techniques. At midterm, Carrie Hoing, OTR/L stated, "she asks questions appropriately to gain increased understanding of positioning and handling techniques. An additional goal for Maggie is to increase her competence in handling techniques and the use of dynamic equipment prior to the end of the fieldwork." The following statements provide evidence that I successfully assumed responsibility for professional behavior and growth regarding my handling and dynamic surface skills. At my final evaluation, Carrie Hoing OTR/L stated, "She has improved her ability to incorporate use of dynamic surfaces into her treatment approaches as noted. Maggie's positioning and handling techniques of individuals with neurological impairments have improved, but continue to be an area of growth for Maggie." I am happy I was able to improve my handling technique, but I understand that it takes longer than twelve weeks to be able to master handling. I was very fortunate that I had the opportunity to have a supervisor who had been practicing for 15+ years, and was able to help me improve my handling skills.
professional_growth.pdf 5. Functions autonomously and effectively in a broad array of service models. Throughout my past three rotations, I have been able to successfully adapt and orient myself to each of my different fieldwork sites. Each rotation had a completely different documentation system that I was quickly able to learn and utilize to function autonomously and effectively at each fieldwork site. During my pediatric rotation, the evaluations were mostly narrative requiring you to document clinical observations. My first evaluation on this rotation, I was very anxious and realized when I sat down to type the information, I had missed so many observations that I should have observed. In order to prepare for my second evaluation, I created my own hand-written template with reflexes, postures, skills, etc. to ensure that I was able to gather all the information to successfully document my evaluation. During my final evaluation, Carrie Hoing, OTR/L stated, "She has assessed ROM, strength, coordination, and muscle tone. She has demonstrated improved accuracy in administering and scoring the assessment since midterm. She has shown an ability to identify the patients' functional activity strengths and functional activity limitations." During my mental health rotation, the facility used paper charts! I was quickly able to adapt by learning how to make my documentation concise, while ensuring all relevant information was documented. Stacey Dupre, OTR/L stated, "great job with evaluations and reassessments!! You were able to adjust your methods to fit the client's abilities/needs, and put them at ease when doing so :). Great documentation! You are successfully utilizing the BIRP method and thus showing the efficacy of your interventions." During my final rotation at an outpatient hand clinic, the evaluations were mostly biomechanical requiring many strength and ROM measurements, while interviewing client's about their occupations. Megan Brack, OTR/L stated, "Maggie uses excellent clinical judgment to select appropriate assessment tools and then translate results into her documentation." I feel like the above quotes provide evidence that I was able to function autonomously and effectively in a broad array of service models.
6. Upholds the AOTA Code of Ethics in practice. Being an ethical practitioner is vital to providing effective, safe, and quality client care. During my rotation at ELMHS, I experienced a situation that required me to uphold the AOTA code of ethics. During one of my group sessions, we were having a Christmas party where the clients were watching the movie ELF, drinking hot chocolate, and making crafts. The craft required the use of tweezers. At the end of the session, the clients were cleaning up. I made a point to place the tweezers inside my student's documentation binder during clean up to keep everyone safe. As the clients were walking back to the van to be transported back to the ward, my supervisor asked me a quick question. When I went to pick up my binder, the tweezers were missing! I ran outside and stopped the van. The security guard stated to my clients that he was not going any further until I got the tweezers back. One of my clients admitted to taking the tweezers because she wanted to groom her eyebrows. Even though the client did not intend to do harm with the tweezers, it was my ethical duty to ensure that she did not have them on the ward because tweezers are considered contraband. During the next group session, my client and I discussed how it is not appropriate to steal items, and I educated her about how grooming falls under OT's scope of practice. During the next free choice day, she asked if she could use the tweezer's to groom her eyebrows under my supervision. I practiced beneficence by preventing harm from others and not allowing contraband on the ward. I practiced autonomy by having an honest discussion with my client about why she took the tweezers, and we were able to collaborate on how she could groom her eyebrows during a free choice group session. I practiced fidelity by treating the client with respect and continuing to provide quality care despite the fact that she admitted to stealing the tweezers. I practiced nonmaleficence daily by keeping my client's well-being as the foundation of her care. I practiced justice by working in a timely manner to report the incident to the nursing staff and documenting the incident for OT records. I practiced veracity by introducing myself to the nurse that I reported the incident to as Maggie Pohlman, an occupational therapy student to ensure that the nurse was aware of my credentials and qualifications. Through this experience, I was able to successfully uphold the AOTA code of ethics.
7. Serves as a role model for honesty, integrity, and morally grounded decision making. I strive to serve as a role model for honesty, integrity, and morally grounded decision making in the work place and within the community. These are all qualities that I believe are vital to uphold in order to be a successful healthcare professional. During my psychosocial rotation, I had the opportunity to work with clients that had lower education levels and decreased insight into their behaviors. During each group session, I strived to model respectful, appropriate behavior during all my interactions with group members even when client's would behave disrespectfully towards me. Because I served as a model of appropriate behavior during group sessions, client's greatly progressed towards their goals. Stacey Dupre, OTR/L stated, "your consistent and encouraging interactions with your clients, allowed them to trust and actively engage in treatment. They have definitely progressed towards their goals under your guidance." Due to the speciality nature of hand therapy during my final rotation, I was always honest with my clients whenever they had questions that I was not completely sure about how to answer. I would frequently say, "Honestly, I am not sure, but I can look it up or I will ask my supervisor." I ensured to never provide a false answer just to make the client think I knew everything because hand therapy protocols are very strict and I did not want to permit them to be able to do something at home that could re-injure a tendon repair. Megan Brack, OTR/L stated, "good judgement when it comes to safety and precautions."