Code of Ethics and Social Media

Yesterday in class we did some retrieval practices on AOTA's Code of Ethics. This was learned once before, at the beginning of the year, but wasn't quite grasped. Learning about it again helps with the retrieval process and helps me get a understanding of why these principles are appropriate and important for my profession. While the purpose of the code of ethics and all the principles is to reflect the nature of our profession and prevent any ethical concerns, there is one principle that I find really important in today's society. The definitions of autonomy and confidentiality basically say we, as practitioners, should respect the rights of the client. What is important to know is that the word "rights" is such a broad term. This can be anything that describes or identifies a client (name, diagnoses, birth marks, physical looks). It can also be anything that a client possesses, says, wears, or practices. The reason I think this principle is the most important is because of the high use of social media. Social media is basically our "one click" link between privacy and total exposure. As young health professionals who are highly active on social media, I think that it's important for us to understand that privacy isn't something that comes easy in such a technology driven world. As the generation that started growing up without technology and slowly made our way into that world, we need to be the main educators and spokespeople for other health professionals that are currently surrounding us and will come after us. Most of us don't like our insecurities and imperfections to be exposed, so why should be expose others? (Even when we're not meaning to).

Cameron's Case Study - SCI

Cameron did an excellent job taking a fictional character and turning it into a real life situation. Even though there is a lot of controversy around the movie, the injury is very much real and so are the characteristics that Will Traynor portrayed. Even though Will's character saw a physical therapist rather than an OT, Cameron used his imagination and knowledge to change the story line a little if there had been an OT involved. We discussed things such as reasons for referral, short-term and long-term goals, assistive technology, and the role of the OT. One big thing that I took away from Cameron's presentation is that one of the overall roles of the OT, in this particular situation, was to be a friend. While he/she would aid in helping his physical ability, most of Will's problems were coming from his mental state of mind. As an OT, being a friend as a main role is very much realistic and might be the one thing that changes your client's mind about their quality of life.

NN#1 - Me Before You

Me Before You

The movie (and book) Me Before You is about a young man who was involved in a motorcycle accident and suffered from a complete spinal cord injury which paralyzed him from the neck down. Before the accident he was full of life and adventure and afterward he no longer saw the need for living. Because of the accident and his impaired way of living, Will Traynor also suffered from depression which had led him to attempted suicide once before. After many conversations and arguments with his parents, doctors, and therapists, he gave his life a limit of 6 more months before he was to admit himself into an assisted suicide facility in Switzerland. His parents hired a female "caregiver", Louisa Clark, in hopes to lift Will's spirits and change his mind about suicide. 

I had previously read this book and watched this movie before entering OT school, with only a basic understanding of the related topic. For the purpose of this assignment, and with a greater knowledge of the injury, I re-watched the movie over the weekend. The first time watching the movie, I only considered and felt empathy toward Will's role in the movie. But watching it again, and thinking like an OT, I considered Louisa's role in the movie as well. At first she minded her own business and was only doing the job to help her family with financial struggles. As time passed she realized that Will's quality of life was poor and as his "caregiver" she should (and could) make his life better and potentially change his mind about assisted suicide. Though not directly, I noticed that Louisa's way of thinking was the same as an Occupational Therapists would be when treating a client with a spinal cord injury. Because of doctors orders, and his nurse's help, Louisa knew there was little she could do to help him regain function in his limbs so instead she used the resources Will had to get him back doing the things he wanted and used to do. 

Even though the movie didn't have a happy ideal ending, some progress was in made in Will Traynor's life.  Something I gained from re-watching the movie is that as OT's, some of our clients may or may not want us being involved in their injury, and after a certain amount of time, they may not want to be involved with their own injury anymore. Because of the high risk of other mental disorders, such as depression, forming after traumatic injuries I feel as if it is important for meaningful treatment begin right after an injury. Because of the movie's small time frame we don't know the extent of his treatment, but Will Traynor could have been one of those clients who didn't have a meaningful experience with his therapist(s). Because of Louisa's OT way of thinking, if she had been introduced in his life two years before, instead of just 6 months, there is a possibility that Will's quality of life could have done a 360 rather than just a 180. 

As OT's we shouldn't just be involved with our clients because that is what we're getting paid for but because we want our clients to regain a meaningful life and we want them happy. Another lesson learned from this movie is that we may be their only hope. Others may have given up on them already but we shouldn't. 

Book: 

Moyes, J. (2012). Me Before You. (Kindle Edition). New York, N.Y.: Pamela Dorman Books/Viking. 

Movie:

Rosenfelt, K., Owen, A. (Producers), & Sharrock, T (Director). (June 3, 2016). Me before you [Motion picture]. United Kingdom: Warner Bros. Pictures. 

Clinical Observation and Documentation

When I was shadowing a hand therapist in undergrad, she would spend 15-20 minutes documenting notes after seeing each client and then at least an hour at the end of her day everyday documenting more notes. I remember asking her once why she spent so much time documenting and she told me it was beneficial for her in remembering who the client was, what their situation was, and what kind of activities were done on that day. I just thought it was for the purpose of her remembering ROM and client progress, but now learning about documentation first hand I realize it's so much more than that. Not only does clinical documentation provide observations by the OT, it also gives us a chance to justify our services (the why and the how) and its our opportunity to showcase our services and why we are important.

Like I said in the last post, I like having something laid out for me and organized. This is why I think I will enjoy goal writing and the SOAP note when I become a practitioner. Goal writing will help me keep myself organized when intervention planning for each of my clients, both short-term and long-term goals. It will also be a reminder of what my purpose as an OT is, to satisfy the client's goals wants and needs. I think the SOAP note method will also keep me organized in the manner of being able to locate things when I go back and look at my documentation. I'm excited to learn how to implement these things in a clinical setting.

The OT Process

When first entering into the program, one of the main questions I had in the back of my mind was "how does the process work, and how do the practitioners know what to do when a client comes in for the first time?". Even though that is still a question I have and will always have until I gain experience, learning the OT process really helped to clear up some thoughts. Having clear instructions and a plan laid out for me is the best way I get a job done and I think the OT process (even though it is subject to change) is organized in a way that I can be the best practitioner I can be.

Health Promotion, Literacy, and Prevention

I was excited when I learned that this lecture was going to be a part of the curriculum for this class! I took epidemiology in undergrad and found myself very interested in the topic and now I am even more interested that I can also apply it to my future career. Though this was a refresher lecture for me, in terms of OT application, the section on health literacy stood out the most. I think that being able to obtain, process, understand, deliver, and communicate basic health information is key to being a practitioner. I have encountered plenty doctors / nurses / health care providers that do not practice this way of thinking, and honestly it made me discouraged and wanted to frown upon health care providers.

For example, in the winter of 2015 my grandpa was diagnosed with lung cancer and was back and forth from hospitals, cancer treatment centers, etc. When I came home for Christmas break, I was responsible for taking my grandpa back and forth to his doctor visits while my parents were at work - meaning I was also responsible for interpreting information back and forth from my grandpa and the doctor, and the doctor to the rest of my family. (Keep in mind, I am also one of the few people in my family that has any medical background). There was one point in time that had I not have been there my grandpa would have undergone an extensive and crucial round of chemotherapy AFTER he had already told all the nurses and doctors that he did not want treatment. This ultimately happened for three reasons: 1) lack of information provided to my grandpa, 2) medical terminology was used instead of basic language, 3) lack of communication between health care providers in the same facility.

Because of encounters like this, other health care providers mistakes make me want to be a better practitioner. We, as OT's, need to know and embrace the fact that the majority of our clients are going to have the minimum amount of knowledge about what we do, why they are seeing us, and basic information on health benefits. It's almost pointless to deliver services to these clients without it being purposeful. And for it to be purposeful, they need to have a basic understanding and that is our job description as well.

TBI

Instead of reflecting on today's topic and what was learned, my mind is geared toward my personal experience with the topic and questions I have now that I didn't once have. When I was in second grade my dad had an ATV accident which caused swelling on his brain and required emergency surgery. Because I was so young and my dad has a hard time recalling all of the information the only thing I know for sure is that he now has a metal plate inside of his skull. I don't think he was "diagnosed" with a TBI but now knowing what I know, he often shows signs and symptoms of one. (And he could have easily had one and I just don't know about it because I was so young). From my perspective the symptoms have worsened but I thought this may just be because of stress from recent family misfortunes. These symptoms may have always been present and I am just now noticing them because of my medical experience and knowledge. He is slow to comprehend things, has difficulties expressing his words, and experiences confusion a lot. My question(s) for you would be can this be something that waits 15+ years to set in? And is this something I should address with him to seek a doctor for? Thanks for listening!

Response to ECS lecture

Empathy in the medical/therapeutic field is something that seems essential of the caregiver, right? Something that all people with a medical degree should be aware of and put into practice, especially occupational therapists who have a goal to look at a person holistically rather than just at their disability. With this assumption, it surprised me that the ECS mentioned that only 4% of the surveyed OT's took courses that were related to therapeutic use of self. With this in mind, Beatriz did an excellent job advocating that training in the empathetic process needs to be expanded and more focused on, especially in our career. I like how she addressed six positive interactions that she has experienced beforehand and turned those interactions into questions she or her client might have that relates to empathy of herself or her client. Along with empathy being a critical ingredient in practice, she stresses that learning never ends, exceptions are always happening, and hope should be a precursor to an outcome.