Reflection: The non-negotiable aspect of OT

My experience through a journey in physical rehabilitation changed my general viewpoint on people that I see on the streets. Usually, I would always wonder about their life stories, for example, what are their jobs, what kind of family they were raised in, what are their beliefs and values, etc. The questions were more related to psychosocial but not to their physical abilities. I remember that after the first year of the OT program, I started to notice people’s posture, gaits, and muscle tones since I just finished taking the human movement class. When every time I see someone limps or has misalignment, I would wonder which muscle was causing the problem or what kind of disease or disorder that they had. I tried to analyze their body mechanics and function, but I didn’t make any connection to their physical problems and occupations.

During the second year, as I took OAS 1 and 2, I started to connect their physical disabilities to their ability to participate in ADLs and IADLs. When I see people with physical disabilities, I started to use my clinical reasoning and brainstormed intervention plan. I also tried to categorize the intervention plan to 5 tier OT intervention. This became a little habit of mine, and I started to analyze a character from a movie or videos on Youtube. Since I enjoyed watching documentaries, reality shows, and medical journey shows, I used my OT lense and observed the character to find any barriers that character might stumble upon in his or her life. Then, I tried to come up with my own intervention or what I would do differently for the character. Through the journey in physical rehabilitation, I earned the knowledge to analyze the physical problems and relate to their occupations. Also, along with that, I learned to apply how I can incorporate family support and other social support into the intervention plans.

The journey helped me to learn and experience on the bottom-up approach and create an intervention that is related to people’s meaningful activities and occupation. I really enjoyed OAS 1and 2 because I really got to learn how to incorporate meaningful occupation into an intervention based on their physical ability, levels, and stages of their recovery. I believe all OT can create an intervention that will improve a client’s physical condition, but I think there is another level of OT who can create a holistic intervention that includes all aspects of a client’s physical, psychosocial, and meaningful occupations. Throughout the school year, I learned that when OT successfully makes a connection with a client’s meaningful occupation with an intervention plan, the client’s self-efficacy increases. That will highly affect the client’s rehabilitation process. Also, I learned that an adaptive approach is not the only answer for a client with physical disabilities but the remedial approach must be incorporated into the intervention to improve or restore the client’s affected physical function.

Also, I learned that a client’s cognition should be considered to plan an intervention. Based on the cognitive level, the activities can be graded and tailored for the client. By using a standardized assessment, getting a baseline of a client’s cognitive level is important during neurological and cardiac rehabilitation. Because not only the intervention can be graded up and down for the client, but the way to approach using adequate communication skills can be adjusted to increase the efficiency and efficacy of the treatment. Through observation and evidence-based research, I learned many OT professions do not take cognitive assessment but just think that as some other health professional’s duty, like a nurse or SLP. Though it may not be OT’s role to measure clients’ cognitive level, I learned that it is OT’s duty to check the level and adjust intervention based on the result by using clinical reasoning. Before the courses, I also didn’t think measuring or checking a client’s cognitive level as an OT’s responsibility. But through the journey, I learned that assessing the cognitive level may also help OTs to detect physical changes within clients. For example, if a stroke or heart failure clients behave differently, OT may re-assess the client’s cognitive level to see any difference from the previous result. By comparing the result, OT may do some detective work to find any deterioration or symptoms for another stroke. I learned that it is important for an OT to notice any changes, especially declining, within the client’s physical and cognitive function in occupation to prevent further injuries.

After I graduate, I will enter into a new world with a new identity as a licensed OT. One of the important things is that I will always have to remember the true meaning of OT. In the new world, I may have to follow certain rules and meet the productivity of an organization, or I may run into ethical dilemmas that are connected to my employment. These issues can affect my judgment on a certain decision that I’ll have to make. Whatever the issues or dilemmas that I will run into, I will always have to think about the safety of clients first and the true meaning of OT, that we are practitioners using a holistic approach to help people in need to live life to its fullest by participating in meaningful occupation. Keep in mind the true meaning of OT will distinguish me from other health professionals.

Personally, I am quick-tempered, rigid, and have difficulty to show sympathy towards people. I sometimes freeze and do not know what to say to people who are in desperate situations, and when I get upset, I show my emotions through my facial expression. So, I am always inspired by people who can control their temper and good at sharing their warm consolation to comfort others. I would like to become an OT who knows how to properly show sympathy and able to share the feelings of others. I would like to be able to control my temper and resolve issues with my colleagues and future clients. I tend to be passive and don’t know how to share condolences. This may require practice and I may need to learn by observing how other OTs respond to certain situations or to people. While I was working as an accountant, I knew how to handle or respond to the clients. Since I am new in the OT field, I may need adjusting time and learn from how others do it. I wish that I will meet a mentor that I can learn all these through observation.

Since I am a DACA recipient and minority, I hope that all OTs to be sensitive to this matter when they interact with clients. Since I am in the shoes, I always hated when someone asked immigration status questions publicly. I wish that OTs and any other health professionals to be considerate when they ask this kind of private questions. Since we are living in California, we don’t know what kind of immigration background clients have, so we always need to approach this matter privately and carefully. I also hope that OTs are equipped with knowledge on this matter and be able to provide adequate services for people in need. Many people with undocumented immigration status or any legal-to-stay status are not getting proper health care services because they are afraid that getting certain services may put them in danger. I just wish that all people who are in need able to receive proper services, and OTs to be an advocator on this matter and knows how they can help the people in need by through the systems.

As a newly graduate, I may face barriers to become a responsible practitioner. One might be documentation skills and time management. Even in school, I always had a hard time writing SOAP notes and/or documentation assignments. Since it’s a school assignment, I work at my own pace using all the time that I had at night. If I start to work, I will have to finish the documents within a certain time and won’t be able to use all my time at documentation. Documenting the therapy session within a time is OT’s responsibility. I am hoping that my documentation skills will improve throughout the rest of the school year and be able to manage my time in documentation during the level two fieldwork and in future jobs.

The thing that I learned from school is to find evidence-based research and apply it to interventions. As a new future practitioner, I will keep practicing to find evidence-based intervention method and apply to my OT practice. I will also share what I found with my colleagues so clients can benefit from the OT services.

The OT school journey was fun accompanying a lot of hard work. I learned so much throughout the years, but I know that I will keep educating myself to learn more and experience more to build my knowledge. Like what I said earlier in the paper, I should never forget who I am, an OT that provides services for people to live their lives to the fullest through participating in meaningful occupation. I hope to keep this motto in my mind and heart will lead me to a responsible, reliable, and dependable practitioner.