1. Appreciates the influence of socio-cultural, socioeconomic, political, diversity factors, and lifestyle choices on engagement in occupation throughout the lifespan. The goal is always the same for occupational therapists: work with individuals to help them safely achieve their highest level of independence when engaging in tasks that are meaningful to them. Each person we encounter is unique with different goals, values, and beliefs. While I may not always agree with every single person, I have a duty to provide the best care with my full respect for that individual. Throughout my fieldwork experiences, I have been in many different settings, including outpatient pediatrics and adults, acute care, inpatient rehabilitation, and behavioral health. I have encountered many different cultures and beliefs that impact the valued occupations of individuals I have worked with. I have tried my best to educate myself on anything that I am unfamiliar with to assist with providing the highest level of care possible. During my most recent level II fieldwork, I experienced multiple families from different cultures, including Haitian, Hispanic, Vietnamese, and more. It was important for me to understand the specific values and beliefs of each family when planning interventions, discharge plans, or even just daily communication. Below is a comment from my fieldwork educator on my final fieldwork performance evaluation where I received the highest score in how I demonstrated respect for diversity factors of others by being professional and engaging well with staff and families:
2. Communicates effectively with a wide range of clients, peers, and professionals both verbally and non-verbally. I have always taken pride in my communication skills as that is one characteristic that individuals always comment on. One of my main goals when working with clients and caregivers is to build rapport through effective communication. Throughout my fieldwork experiences, and in daily life whether it be inside or outside of the classroom, I have really tried to hone in on my active listening skills. While verbal communication is important, non-verbal communication is just as important. Body language when responding to other can greatly impact interactions. Throughout both of my level II fieldwork rotations, I have been given multiple opportunities to increase my communication skills with other occupational therapists, physical therapists, and speech therapists as there were many instances where we shared clients or performed co-treats. I think I have improved my skills when speaking with co-workers to effectively participate in treatment sessions, as well as speaking with clients and caregivers to collect necessary information and educate them on treatment plans. The image below is a comment from one of my fieldwork educators regarding my communication skills where I received an exemplary performance rating for my professionalism and ability to easily build rapport with patients, families, and staff members:
3. Collaborates with clients and caregivers in establishing and maintaining a balance of pleasurable, productive, and restful occupations to promote health and prevent disease and disability. During my last level II fieldwork rotation, I was in a children's hospital where I came across families of various backgrounds. Ensuring that each child was able to engage in their valued occupations at their highest level of indepence was crucial in my treatment and discharge planning. Two things that were always important to each family were bathing and dressing as I always received questions about how those occupations would be performed following major surgeries or traumas. Many clients needed equipment to be able to engage in these occupations, but not every client had insurance that would cover the cost of equipment. For my fieldwork project during this rotation, I made a handout with various equipment recommendations with pictures, prices, and locations of where to purchase these items so that we could provide clients with the means to easily obtain equipment in a more cost-effective way. By providing this resource, clients were able to safely engage in meaningful occupations with increased independence and a decreased cost burden on the family.
4. Inspires confidence in clients and team members. While at my second level II rotation, I was in a level one trauma center where I encountered multiple clients with life-changing injuries. I worked with many children who were in motor vehicle accidents that led to significant injuries. Inspiring confidence in these children was crucial in helping them achieve their goals. While I was able to see progress in these children, it was much more difficult for them to see progress due to the weight of the difficulties that now faced their daily lives. Their whole worlds were turned upside down in a split second, and they had to learn an entirely new way to engage in their daily activities. I found that sometimes the greatest thing that I could do was to sit with them and just talk, validate their feelings, and meet them where they were at in that current moment. I also asked what activities each child preferred doing to increase engagement in sessions. Taking the time to truly listen to a client's feelings made such a difference in increasing independence when engaging in meaningful activities. One example of how I inspired confidence in one of my clients was when I worked with one of my clients who underwent a craniectomy and was required to wear a helmet when engaging in out of bed activities. She loved crafts, so I always incorporated those into my sessions with her. One day when I arrived to her room, she was feeling very discouraged about having to wear a helmet when out of bed. I suggested that we use stickers to decorate her helmet to make it unique, and her face immediately lit up with a smile. I had her work on fine motor skills, sitting balance, functional reaching, and crossing midline to retrieve stickers to place on her helmet. After decorating her helmet, she was so happy and stated that she felt much more confident. She agreed to engage in more activities during that session and was excited to get to wear her helmet from that moment on. Getting to see these children come into the hospital so defeated and then go home with a new found confidence and independence is something that I will never forget.
5. Considers client motivation when using occupation based intervention to maximize functional independence. As occupational therapists, we strive to help individuals gain independence in their valued occupations. This can look different for everyone as no one person is alike. We have the unique skill-set of being able to incorporate functional tasks into treatment sessions to work towards independence. I had many opportunities to utilize occupation-based interventions during my time at the children's hospital during my second level II fieldwork. Below is a discussion post from that rotation where I described how I utilized occupation-centered practice while considering client motivation for a client who was unable to leave her hospital room, so I incorporated her ideas into my treatment session and graded my activities based on her level of fatigue by having her engage in games that targeted increasing fine motor skills utilizing her weaker hand while sitting rather than standing due to increased lower extremity fatigue:
6. Applies theory regarding the therapeutic use of occupation and adaptation to screen and evaluate, plan, and implement intervention, while establishing and maintaining a therapeutic relationship with the client. A theory that I frequently used throughout all my fieldwork experiences was the Model of Human Occupation, or the MOHO. The MOHO theory utilizes a holistic approach that centers around clients’ occupations and how they participate in those occupations within their environment. The idea of the MOHO is understanding what occupations are meaningful and necessary to our clients and being able to integrate those into our treatment plans. When first meeting clients, I always aimed to identify what occupations are meaningful to them to then incorporate those into my sessions and increase engagement. This always proved to be very meaningful to each client and their families as I was one of the few members of the medical team who truly identified what mattered to them rather than just looking at a diagnosis. One example of this was when I worked with a two-year-old boy who was admitted for failure to thrive. When I spoke with his mother on my last day, she stated that she appreciated how I was never focused on just her son's diagnosis like many of the doctors and nurses but that I actually worked to increase age-appropriate play skills and development by incorporating toys and activities that he enjoyed. She stated that she had never seen someone so patient with him and that she could see growth in his overall strength and play skills after I worked with him.