Hello Danielle:
Thanks for writing. I wish to follow your message with a question and
comments:
1) Will you tell us HOW your experience has included focus on
occupation? For example, did you take course work on human occupation?
2) As Joan pointed out, NRG conservation needs to be seen within the
context of person's occupational needs. For example, if a patient
becomes fatigues while bathing, there may be SPECIFIC issues related to
how the patient bathes that can be addressed. Case in point:
a. Does the patient need to sit ~vs~ stand?
b. Is shower steam interfering with breathing?
c. Does the time of day the patient showers hamper his
successful completion of showering? Will they be better served
by showering in the AM ~vs~ PM, or vise versa
d. Is the patient holding their breath when transferring? Will
different transfer strategies reduce their fatigue?
e. Will a different mobility device (i.e. rolling walker ~vs~
wheelchair)reduce the patient's fatigue PRIOR to showering.
f. And the list goes on...
>From an occupational perspective NRG conservation MUST only be addressed
as to how it improves SPECIFIC occupational performance. Ultimately,
this comes down to identifying occupational goals and as Joan points
out, the COPM is a GREAT tool for this.
Take your MG patient. MG is a progressive disease, so what an OT needs
to know is HOW IS THE MG IMPAIRING SPECIFIC OCCUPATIONS. Or to put it
another way, what are the patient's occupational goals? What does he
want or need to do better than he is currently doing? Once you identify
their goals, you then begin identifying factors impeding successful
performance of those goals. These factors include: physical, mental,
emotional, social and environmental.
As you can tell, approaching patients from an occupational approach is
NOT easy. It requires considerable skill and understanding of the
multi-factors impairing occupational performance. And this leads me back
to my first question.
Thanks,
Ron
--
Ron Carson MHS, OT
www.OTnow.com
----- Original Message -----
From: Danielle C. <[email protected]>
Sent: Wednesday, April 01, 2009
To: [email protected] <[email protected]>
Subj: [OTlist] What the heck is wrong with our profession?
DC> Hello all,
DC> I am a graduate student finishing my last year to become an OTR. I
DC> feel my experience as a learner has largely included a focus on
DC> occupation based and client centered practice. Myself and other
DC> classmates do have some trouble coming up with goals and relevant
DC> treatment strategies though. I think these areas are difficult for
DC> students because they require clinical knowledge and expertise that
DC> come from actual experience with clinical practice. This is where I
DC> agree with the previous post that states that there is a grand
DC> disconnect between school/ theory and practice. As students we are
DC> armed with our OTPF and we can choose an effective treatment
DC> strategy that is within our domain and is focussed on occupation.
DC> But when it comes to specifics of making a treatment plan with goals
DC> we dont have anything to draw on because we don't have the
DC> experience. This is where I think mentorship is so important as
DC> well. Does anyone have any suggestions for
DC> how to find more case specific examples for treatments for example
DC> energy conservation for an individual with myesthenia gravis ? I
DC> know occupational therapists are independent learners but it helps
DC> to have concrete examples when you are relying so much on book
DC> knowledge and paper patients. So many times we can research a
DC> treatment method or a clinical condition and find articles or fact
DC> sheets that state for example; occupational therapists can work with
DC> ... condition in the area of self care or with energy conservation
DC> strategies but there is no specific example of what is being done.
DC> Not that I am looking to be given answers too easily but it would
DC> help to see what an occupational therapist would specifically do in a
given situation.
DC>
DC> --
DC> Options?
DC> www.otnow.com/mailman/options/otlist_otnow.com
DC> Archive?
DC> www.mail-archive.com/[email protected]
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