What is an occupational therapy placement like?

It’s the question I am asked time and again by family, friends and prospective students. To be honest, there isn’t one answer to this question. It depends on you as a person and what your interests and experiences are and of course the placement you are provided by your university. Of course, because occupational therapy students are still learning there is a limit to what duties they can carry out, but the more interest, understanding, and professionalism showed the more opportunities arise. There are many different clinical realities for occupational therapy because it is such a versatile and widespread vocation. As I have just completed my second-year placement I’ve decided to write a little bit about what that was like and what I learned from it.

Where was your placement based?

For this placement, I was working in an outpatient setting seeing people with Chronic Fatigue Syndrome or Myalgic Encephalomyelitis [CFS/ME]. It was quite a controversial placement in the fact it was labeled as mental health by my university but in fact was very focused on science and physiological symptoms – an ongoing issue in the diagnosis and treatment of CFS/ME.

CFS/ME is a diagnosis given by elimination of other possible and contributing conditions that present with the same symptoms. Health professionals are still unsure what causes CFS/ME and further research needs to be conducted, however, it can be diagnosed using the Fukuda criteria based on the presence of four or more characteristic symptoms including post-exertional malaise, chronic fatigue, generalised widespread pain and autonomic symptoms. All of which you can read more about here.

The service I worked alongside covered all aspects of CFS/ME from assessing symptoms and diagnosis through education and rehabilitation to planning for setbacks and discharge. The multidisciplinary team included nurses, dieticians, physiotherapists and occupational therapists to offer all aspects of care detailed in the BACME and NICE guidelines.

alexander-technique-and-cfs-me
Image credit: Alexander Technique London

What sort of thing did you do?

In the team occupational therapists triaged people referred to the service through a thorough clinical evaluation that takes full physical, mental and social history alongside the history of symptoms. If the criteria were met the therapists would then give a diagnosis of CFS/ME, however more complicated cases were taken back to the weekly meeting to be discussed with the wider MDT.

The service provided individual or group educational and rehabilitation focussed sessions for people to make sense of their condition and work towards the management of symptoms and recovery. This included information on pacing and grading, stress and quality rest, employment and diet amongst other areas with a view to meeting the individual’s goals and improving their quality of life.

What did you learn?

This is the first placement I have been on where occupational therapists were diagnosing people and I am aware this is a rarity which made it an extremely valuable learning opportunity for me. Alongside continuing to improve my core occupational therapy skills and meet my learning outcomes I was given the opportunity to discuss the impact and controversy of high profile research papers on the patient community and services provided and why evidence-based practice is essential.

Throughout the placement I increased my knowledge of the regulatory and immune systems, and how these impact on brain function as well as one another. I also did a lot of reading on common co-morbidities such as functional neurological disorder, hypothyroidism, fibromyalgia, inflammatory diseases and autoimmune conditions which helped to improve my clinical reasoning and reflect on my current practice.

I was introduced to more standardised assessments and outcome measures that are used across a variety of settings as well as condition-specific models and assessments.

Where can I find out more?

If you want to find out more about CFS/ME then the ME Association is a good place to start. It offers information, support, and advice as well as details of regular support groups across the country.

For more information on managing the condition and first-hand accounts of how CFS/ME can affect people I would recommend the following books, blogs, and documentaries:

Jennifer Brea – Unrest

Fighting Fatigue

Action for ME

A snoozie life

Occupy ME

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Blogging and Professionalism as an Allied Health Care Student

School time has rolled around again (just me or did that disappear really fast?) and I am once again back at university. We’ve been dropped in at the deep end – which I love – and I have loads to be getting on with. But one topic that kept coming up was that of professionalism and professional boundaries. Which got me thinking –

as a future health care professional, is talking about my mental health issues openly online a professional thing to do?

To be honest, I don’t have a clue, I started blogging long before changing my career and it’s a very helpful part of processing and reflecting on my thoughts and emotions. Yet after a few discussions and a little reading I’m still in two minds about whether it’s a professional thing for me to do. It seems it’s a bit of a contentious subject.

The College of Occupational Therapists [COT] Code of ethics and professional conduct which regulates my study and future profession says:

4.1: As practitioners you are not just accountable for your competence, but also for your actions and behaviours, both inside and external to the workplace.

4.1.3: You must be aware of and take responsibility for your conduct when using any form of social media. The content of this Code should be applied to social media
use, whether for work or personal purposes.

To me, this implied that anything I share on social media (blog included) needs to be something I would happily take responsibility of and standby if it was discussed in a professional setting. So far so good, the things I write I feel are open, honest and clearly express my point of view.

However, it also states:

4.2: You must act with honesty and integrity at all times. You must not engage in any criminal or otherwise unlawful or unprofessional behaviour or activity which is likely to damage the public’s confidence in you or your profession.

Now, this is where it gets tricky. I openly discuss my mental health – the good and difficult aspects. For some people learning that I have a mental health condition will damage their confidence in me simply because of the stigma that exists in society. Others, of course, it won’t. Yet because everyone is individual and has their own thoughts, prejudices, experiences, and expectations of healthcare professionals there are bound to be a lot of differing opinions on the topic.

Still unsure on where I stood I had a chat with one of my lecturers about it. Her opinion was that as long as I am sharing my views in a professional manner (which I think I am, right?) then it is simply adding to the literature available and enhancing the lived experience dialogue. I did, however, need to consider that future employers will search social media when vetting candidates so I would need to be upfront about my condition.

That isn’t a problem for me, deciding to blog about my mental health meant that family, old school friends, work colleagues and new friends all had the ability to read about my experiences. Which is often extremely scary but for me worth it in the long run. I don’t believe that my blogging on this topic can be seen as unprofessional but as always I do still have those little niggling doubts.

Any other healthcare students that are also bloggers, what are your thoughts?

Mature Student Guilt

I don’t know if this is really a thing or whether it’s just me but the ‘mature student guilt’ has really been getting to me over the past few months – especially since summer came around and I’m no longer in taught lectures. What am I on about? The pervasive feeling of guilt whenever my husband talks about his career goals, we’re struggling for extra cash or we don’t have the disposable income to do something we really want to.

As someone who used to earn a crust I’ve been finding it more and more difficult to be a student in the financial sense. I have a part time job, a bursary (thank goodness I got the last year of them!) and a maintenance loan to see me through and technically we aren’t struggling, but it was my choice that took us from being a two income household that could afford a holiday and the odd night out to having to budget every last penny. At times it makes me feel like the worst person in the world. I can easily entertain myself for nothing, find ways to socialise without spending much and create a household budget that keeps costs low and I do any chance I get. Yet because I am no longer significantly contributing to our income I feel like a freeloader and a burden – not great when a marriage is meant to be a team.

You might already be aware that G (my husband) wants to become a commercial pilot – something which I support wholeheartedly, but it is an inherently expensive process. Had I stayed in my previous role he could have already made some serious steps forward but it may have cost me my mental health. The decision for me to go back to university was one we made together. In fact G encouraged me despite my concerns about finances, his career aspirations and our quality of life should I become a student again. He still supports my decision and honestly doesn’t complain, but each month as birthdays, family events and general life expenses get in the way his aspirations get pushed to the back of the list while he supports us.

It’s an incredibly bitter pill to swallow when I am fully committed to chasing mine and I’m really struggling with it at the minute. It’s something we talk about a lot and although there isn’t any resentment (that he shows me) and he consistently offers reassurance and support when I question whether it was the right decision, it’s difficult to see yourself holding back the person you love. It’s like trying to run a three legged race at different paces; you’re heading for the same finish line but you keep tripping each other up and just can’t get it right. If anyone has any advice on how to feel like less of a burden I’d greatly appreciate it because I just don’t know what to do with myself.

Fellow mature students – is this a common feeling or is my situation a unique one?

Year 1 as a Mature Occupational Therapy Student

Once again I’m in the position of completing my first year at university, but this time it’s different; I’m older and possibly wiser (although I wouldn’t bank on that) and I absolutely adore the subject I’m studying. If I haven’t mentioned it before I’m at university to become an Occupational Therapist. These wonderful human beings focus on any issues or concerns that individuals have in completing ‘normal’ day to day activities (mental and physical) and work with them, using activities they find interesting and engaging, to enable and maintain a good quality of life. It is by far the most interesting and rewarding subject I’ve ever come across – light years from my previous digital marketing job.

However, because of said job (which I enjoyed in it’s own way I suppose) I have found the pace of student life to be extremely slow. I’m used to having to having to juggle 2 or 3 projects simultaneously as well as attending to daily updates, and even though I’ve learned to relax into the new routine I still feel like I should be doing more. The feeling disappears entirely when I am on placement though, just being around OTs and putting the skills learned into practice is an amazing feeling. Plus the fact there’s always something to do to help clients, even if it’s just engaging them in conversation and finding out more about their life and interests. I’ve had two placements this year – one in a neurological rehabilitation unit and one in a functional mental health assessment unit. Both were completely different but created the same excitement and feeling of accomplishment. I didn’t want to leave either of them so surely that’s a sign that I may have finally found the right career!

The assessment side of being a student hasn’t really phased me. I enjoy writing (why else would I have a blog?!) I completed a Journalism degree and I was used to writing proposals and reports as part of my job. The referencing took a few goes to get my head around especially as YSJ have their own style. I still get it wrong from time to time but I think that’s more the styling – this should be a comma not a full stop etc. – rather than the actual layout. I’ve found all my essays have just reinforced my learning and asked me to sum up what iv’e learned over the semester – the only one I found awkward was a video assignment in which we had to show professional behaviour. Not particularly difficult but as someone that hates being the centre of attention my performance was definitely stilted.

I didn’t end up joining any clubs (with the exception of the OT society and I don’t believe I actually went to any of their meetings) because my mental health kept getting in the way and I would end up having panic attacks as I went to leave. Not overly clever really but just the way it was. I doubt I’ll join any next year either to be honest, although I will be joining SW5 again where we get to join in social sports for just a £5 for the year. Easy to dip in and out and keep fit without having to compete or commit to something weekly. Obviously I made some fabulous friends on my course and met some incredible professionals too. I’m told that next year will be a big step up in terms of workload and pace which I’m looking forward to and until we get access to our modules at the end of June I’m planning on spending as much time as I can relaxing and enjoying the sun in my back yard.

My First Student Placement

As you may or may not know I went back to university this year to study Occupational Therapy. I have loved it so far (even if it is really slow compared to the world of work) and have met some truly incredible people. Throughout the first few weeks of November I went on my first ever placement as an OT student. I won’t bury the lead – I passed with flying colours – and it completely reinforced why I have chosen this path. I loved every single second and didn’t want to leave.

That wasn’t how I felt before I started it though. The two weeks running up to starting my placement were hell. I was scrambling around reading everything I could get my hands on, drafting email after email to my educator (thankfully I only sent two and reading them back they sounded professional) and repeatedly telling myself that everything was going to be fine while dreaming up the most ridiculous scenarios in my head. I tried to play it cool while I was at uni, I mean I didn’t want to be the kid freaking out before we got there, but I know I wasn’t the only one worrying.

When I finally got there on my first day and was shown around I started to wonder why I had made such a fuss. I had been in the world of work before, I knew how to be professional and act appropriately, but for some reason this had been way scarier than starting a new job or even changing career. Perhaps it was the idea of being constantly watched and assessed that had freaked me out. But my educator was lovely and certainly didn’t make me feel like I was under surveillance. She answered all of my questions honestly, explained patiently when I queried anything and steered me in the right direction – I was very lucky to have such an experienced, friendly educator for my first placement.

I was placed in a neurological rehabilitation unit and it really sparked my interest. It was so varied. I learned more than I ever thought I could in the few weeks I was there. I got to see the full spectrum of OT (with the exception of acute admissions) as well as spending time with various members of the multidisciplinary team and getting to better understand their job and how it could relate to my future profession. It’s ignited my love for this area of work and I can’t ever believe I used to work behind a desk!

Adjusting To A New Routine

So I know I said I’d try and post a bit more and I have once again been a bit rubbish but I’ve been having a bit of trouble adjusting to my new routine. Well if you can call it a routine that is. Things have yet to settle down with all the changes going on and it’s kinda (read definitely) thrown me off pace and made me feel a bit floopy.

Because I don’t do anything by half (I mean who doesn’t love a good challenge) I have started university, become a student representative, changed my job and applied for a volunteering role. I’m waiting on some things coming back, other things beginning and trying to keep track of all the work that I need to do. Whilst it’s all super exciting and interesting it has left me feeling a bit lost and insecure – not the best thing for my mental health – so I thought I’d share a few little tips I’ve picked up for adjusting to a new routine.

Keep your hobbies

Whether that’s going to a certain gym class once a week, setting time aside to relax with a book or ensuring you have an evening to catch up with friends. It’s easy to get swept up in all the new, exciting things going on but it’s important to stop, take a breath and do something that helps you relax and unwind.

Talk about it

If something is worrying you or even if you’re just feeling a bit lost talk to someone about it. Expressing a concern doesn’t mean you’re not enjoying all of the changes, it means that you’re human. You’re allowed to be irritated that such and such hasn’t emailed you back or that your forms haven’t come through yet.

Know your limits

Change is great. It’s exciting, exhilarating and gives us something to look forward to, but too much can send us (definitely me) into a spiral that we eventually lose control of. Only take on what you think you can handle and remember that there may be unexpected changes that you didn’t consider alongside everything else.

So that’s what has helped keep me grounded over the past month, and once I’m back working (part time obviously) and have an idea of what my free time really looks like I’ll be sure to pick back up on here.

Is there anything you’ve found really helpful when adjusting to a new routine that I can try?

Mature Student: Starting my second degree

So things have been a bit quiet on the blog recently (dust ball rolls past). OK so maybe super quiet – I’m sorry my life got in the way; between preparing for my second degree, working all the hours available and jetting off on holiday I’ve been kinda busy.

I guess my biggest news is starting my new degree! Whoop whoop! 12th September saw me enrolling on a whole new course, trying to make some new friends and attempting to get my head around everything.

I’m almost at the end of my first real week at Uni and I have to say I’ve been loving it. It’s a bit of a slower pace than I’m used to but maybe I just spend my days dashing around. I’ve already learned so much more and it’s all helped make sense of my job too.

We’ve already found out about our first placement (eeek scary!) and I’ve already bought my uniform – even if I do say so myself I don’t think I look too bad in it. And just to add to all that excitement I’ve gone and bought a moped (named Vera) to get me to and from placement as well as to and from uni – it just seemed a bit much cycling with really heavy books.

It’s not all been plane sailing though, in fact on my first day I nearly had a panic attack as I left the house and spent the entire walk across York texting Mr G telling him I was going to be sick. Then I figured the more I push myself to be involved and social the more I’m going to get out of it, so when the opportunity arose I became a course rep for our year too!

So there’s a quick update from me, I’ll be trying to get back into a routine which includes blogging more regularly. Hope you’ve all had a great summer!

Career Changes, Paperwork & Relationships

Firstly if you follow my blog a HUGE thank you to you all for your likes, comments and shares. As you’ll know I’ve decided to change my career and vlog about the progress. Today I’m talking about the paperwork and checks you might have to under-go when changing career and how the delays caused by these can effect your relationships.

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