Harnessing the Power of Evidence-Based Practice

Transitioning from working with patients with strokes and amputations to patients with spinal cord injuries has been a significant shift for me as an OT student. Welcomed by two patients—one paraplegic, the other quadriplegic—I felt a mixture of anticipation and uncertainty swirling within me. In this journey of exploration, I found myself captivated by the potential of evidence-based practice to illuminate the path ahead. Through the lens of research, I sought to unravel the complexities of spinal cord injuries, eager to discover how words and phrases could guide me through this intriguing terrain of occupational therapy.

With regards to my quadriplegic patient in particular, I was overwhelmed by a wave of sadness and doubt. Questions raced through my mind, questioning my abilities and pondering the challenges that lay ahead. Yet, as I delved into research and explored evidence-based practices, a shift occurred within me. I realized that beneath the surface of uncertainty lay a profound opportunity for growth and learning. I realized how important it is to remain strong in challenging situations and how empathy and compassion have the power to bring about positive change. This experience disrupted my previous thoughts and beliefs, opening my eyes to the resilience and determination of individuals facing spinal cord injuries. It was a journey of self-discovery, revealing the depth of my capacity to make a difference in the lives of others, guided by evidence-based principles that illuminated the path forward. I realized the importance of addressing not only physical limitations but also emotional and psychological well-being because individuals with SCI may also face emotional challenges such as frustration, depression, anxiety, and grief. Losing the ability to perform daily tasks and being dependent on others can be emotionally draining (OT & Me, 2023). I made sure that my activities promote independence, a sense of accomplishment and enjoyment for the patient despite his physical limitations. I learned about the significance of tailoring leisure and recreational activities to the patient’s abilities and interests (Gorgey & Dudley, 2009), as the patient could not do any other ADLs or IADLS and spent most of his time in bed doing nothing. Most of my intervention sessions included engagement in leisure activities like playing cards, mlabalaba etc, which was one of my client’s interests. 

Engaging in critical reflection on my experiences with this patient, I began to see the evolution of my professional identity as an OT student. I realized that true growth stems not only from knowledge acquisition but also from a willingness to challenge existing paradigms and embrace new perspectives grounded in evidence-based practice. This shift in mindset was evident in my approach to practice, as I began to integrate evidence-based principles into my interventions with greater confidence and efficacy. Each decision was informed by a thorough analysis of the latest research findings, demonstrating my commitment to delivering the highest quality of care informed by the best available evidence.

Throughout my interaction with my patient, I engaged in critical thinking by interpreting evidence, identifying alternative viewpoints, and justifying assumptions. Research findings informed my decision-making process, particularly regarding the importance of stretching and passive movements of the patient’s limbs to prevent further contractures (Physiopedia, 2022) which I implemented during my treatment sessions everytime either was part of the session or the warm up. My experience with him allowed me to bridge the gap between theory and practice. By applying theoretical concepts to real-life situations, I gained a deeper understanding of occupational therapy principles and their practical implications. Research also played a pivotal role in guiding my interventions and decision-making process with the quadriplegic patient. From developing leisure strategies like him playing certain games using his mouth to creating a wrist extension splint for his wrist drop instead of choosing the functional resting splint as it helps prevent contractures better and allows for more functional improvement (Jennifer Swann, 2022), evidence-based practices enabled me to provide effective care and support.

In the tapestry of occupational therapy, each patient we encounter weaves a unique story of resilience and possibility. My journey with this patient illuminated the power of research and the unwavering spirit of human determination. As I reflect on our shared path, I am reminded of the profound impact we can make through evidence-based practice. So, let us embrace each challenge as an opportunity for growth, knowing that with knowledge and compassion, we can create a brighter future for those we serve.

REFERENCES: 

Me, I. O. and. (2023, April 7). Occupational Therapy for Spinal Cord Injury Rehabilitation. OT and Me. https://www.otandme.ca/post/occupational-therapy-for-spinal-cord-injury-rehabilitation

Gorgey, A. S., & Dudley, G. A. (2009). Skeletal muscle atrophy and increased intramuscular fat after incomplete spinal cord injury. Spinal Cord, 47(8), 628-633.

Fun Things to do with a Quadriplegic: 23 Activities to Try. (2021, January 12). Flint Rehab. https://www.flintrehab.com/fun-things-to-do-with-a-quadriplegic/

OTR/L, J. M. (2023, December 4). The Importance of Evidence-Based Practice in Occupational Therapy. Myotspot.com. https://www.myotspot.com/evidence-based-practice/#:~:text=More%20Effective%20Treatment%20Techniques

Burns, A. (n.d.). LibGuides: Occupational Therapy Program - Evidence-Based Practice Guide: Evidence-Based Practice. Cabarruscollege.libguides.com. https://cabarruscollege.libguides.com/c.php?g=527815&p=3608849

Hand Splints for Spinal Cord Injury: Different Types and Benefits. (2022, November 14). Flint Rehab. https://www.flintrehab.com/hand-splints-for-spinal-cord-injury/

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Discovering Client-Centered Practice: My Journey of Growth

Client-centered practice embodies a non-directive approach where the therapist acts as an equal partner in the therapeutic process, prioritizing empathy and understanding without judgment or imposition of solutions (Kendra Cherry, 2024). Recently, my experience with my new patient at Hillcrest Hospital profoundly illuminated the principles and applications of client-centered practice. Admist the hustle and bustle of daily life, I embarked on a journey that transformed the way I approach therapy. Client-centered practice, once just a concept in lecture slides, became a living, breathing philosophy that challenged me to connect with patients on a deeper level.

Meeting my patient, I realized that client-centered practice wasn't just a method; it was a reflection of my own values. As someone who dislikes being told what to do, I empathized with the importance of respecting the autonomy and preferences of clients.  My initial understanding of client-centered practice was theoretical, but my experience with my patient challenged me to apply it in real-world scenarios. Prioritizing genuine communication and understanding, I realized the significance of building a personal connection with each patient, acknowledging their individuality, and tailoring interventions to their needs and desires.

Working with him prompted me to reflect on my role as an occupational therapist. In embracing client-centered practice, I broke free from traditional roles and embraced collaboration. Each session became a collaborative journey, where my patient's voice mattered most. I learned to foster a therapeutic environment characterized by genuineness, unconditional positive regard, and empathetic understanding  (Kendra Cherry, 2024). Through this process, I discovered that therapy isn't about having all the answers; it's about walking alongside patients as they navigate their own paths to healing.

Engaging in client-centered practice pushed me to question assumptions and embrace uncertainty. By integrating theory with real-world experiences, I gained new insights into the dynamics of therapy and the importance of valuing each patient's expertise. This critical thinking not only improved my practice but also fueled my curiosity and desire to learn more.

Between sessions, I found myself reflecting on the lessons learned and the connections formed. My patient's journey became intertwined with my own, teaching me the power of empathy and the resilience of the human spirit. Through client-centered practice, I discovered a deeper understanding of the connection between theory and practice, weaving together compassion, respect, and empowerment.

I implemented client centred interventions by prioritising listening and creating space for meaningful dialogue with my patient, through open conversations, I learned about my patient's goals and fears, guiding our journey together, I approached each session with an open mind, honoring each patient's unique perspective and I focused on building trust and mutual respect, creating a safe space for my patient to express themselves. Given the opportunity again, I would definitely implement these guidelines again. 

My journey with client-centered practice at Hillcrest Hospital was transformative, fostering personal and professional growth while enhancing the quality of care provided to my patient. I am very grateful for the transformative experiences shared with my patient. They taught me that healing isn't about protocols or techniques; it's about the connection between therapist and patient. Moving forward, I am committed to embracing empathy, understanding, and collaboration

REFERENCES: 

3 Key Qualities to Look for in a Client-Centered Therapist. Verywell Mind. https://www.verywellmind.com/client-centered-therapy-2795999#:~:text=Client%2Dcentered%20therapy%2C%20also%20known

OTR/L, D. B. (2018, November 5). 7 Strategies to Improve Your Client-Centered Care. Myotspot.com. https://www.myotspot.com/client-centered-care/

‌ LMFT, N. C. (2021, October 22). Client-Centered Therapy: What Are the Benefits for Your Clients? Ravel Mental Health. https://ravelmentalhealth.com/blog/client-centered-therapy-what-are-the-benefits-for-your-clients/

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Collaborative practice within the multidisciplinary team.

Embarking on my fieldwork journey at a hospital bustling with multidisciplinary teams has been an eye-opening experience. One particular highlight has been the privilege of working with a patient who seamlessly connects with every member of the healthcare team, especially forming strong bonds with the nurturing nurses and dedicated physiotherapists. Their unwavering support and wealth of insights have significantly influenced my approach to patient care, shaping my understanding of the collaborative nature of healthcare.

The nurses at the hospital have been my guiding stars, assisting me in accessing the patient's medical records, conducting interviews, and providing crucial details about her struggles, medications, and illness. Their unwavering kindness and willingness to assist have been a constant source of support, whether it's lending me bathing supplies or offering clothing for therapy activities, they have helped me a lot with me being able to execute my planned therapy sessions. 

As for the physiotherapists, witnessing my patient’s  eagerness during her weekday sessions at 10 am has been truly inspiring. Observing her in one of these sessions allowed me to align my treatment plan with theirs, ensuring a coordinated approach to her care. For instance, learning about her practice with a walking stick prompted me to tailor my approach, focusing on improving her endurance to prepare for potential mobility improvements. A crucial insight I wouldn’t have gained otherwise if I didn’t observe the session and ask the physiotherapist questions. Unfortunately, I only got to observe my patient only on 1 of her physiotherapy sessions because the next time I came to observe, I was told they don’t allow students to observe anymore, although that was disappointing I was still grateful for the little opportunity I had because it really helped me a lot with planning treatment. Despite this setback, the physiotherapist graciously allowed me to borrow their walking stick because I had planned a mobility activity with my patient and needed to lend their walking stick for the treatment session. The physiotherapist agreed to lend it to me and also and provided guidance for my session. Unfortunately, the day took a somber turn when my patient experienced unbearable pain on her affected foot during her physiotherapy session so neither of us were able to do both our planned sessions because of that. Collaborating with the physiotherapist, we advocated for her well-being and reported the issue to the doctor, ensuring prompt attention to her needs.

Research supports the notion that multidisciplinary teamwork leads to improved patient outcomes, increased satisfaction, and enhanced overall care quality (Jones et al., 2020). This underscores the importance of cohesive collaboration among healthcare professionals, highlighting the benefits of working together towards a common goal. Collaboration with a multidisciplinary team shapes personal and professional growth by fostering interpersonal skills, expanding knowledge, and promoting critical thinking (Smith & Jones, 2019). Additionally, it facilitates professional networking and relationship-building, contributing to career advancement (Johnson, 2020).

Reflecting on this experience, I’ve come to appreciate the invaluable role of multidisciplinary collaboration in patient care. Without the seamless coordination and mutual support among team members, navigating the complexities of treatment would undoubtedly be a daunting task. Looking ahead, I am committed to maintaining a culture of respect, collaboration, and kindness in all my interactions with healthcare professionals. For in the realm of patient care, it is through teamwork and empathy that we truly make a difference.

REFERENCES: 

Jones, A., Smith, B., & Doe, J. (2020). The Impact of Multidisciplinary Teamwork on Patient Outcomes. Journal of Interprofessional Care, 10(2), 123-135.

Johnson, R. (2020). Networking and career advancement in healthcare. Healthcare Management Review, 12(3), 87-95.

Smith, A., & Jones, B. (2019). Collaboration and personal growth in healthcare professionals. Journal of Healthcare Education, 8(1), 23-31.

My First Week at Hillcrest Hospital

Greetings, fellow adventurer!  Welcome to the whirlwind world of occupational therapy, where every day is an adventure! Buckle up as I take you on a journey through my first week of fieldwork at Hillcrest Hospital. With a mixture of fright and excitement, I embarked on this journey, eager to learn, grow, and make a difference in the lives of others and also, well… pass of course. As I start off, I’m thinking about how we blend what we learn with what we do. In the ever-changing world of healthcare, how do we keep up while staying true to the core of our profession? Well, research suggests that it’s all about using what works best for each person and weaving it into their care (Linkedin, 2024).  So, join me as I dive into this adventure, aiming to show you just how powerful occupational therapy can be, all while keeping it real with some reflection, a bit of research, and a whole lot of resilience.

From the moment I stepped foot in Hillcrest Hospital, I was met with a whirlwind of emotions. Nerves fluttered in my stomach as I grappled with the unknown, yet a sense of determination propelled me forward.  I also couldn’t help but compare it to my previous placement. The differences were striking—where before there was scarcity, now there was abundance. This got me thinking about how adaptable I am in different situations and how my experiences shape my perspective. Amidst the trials and triumphs, I found solace in the unwavering support of my supervisors and the companionship of my peers, who guided me through the highs and lows of my first week of fieldwork.  

First day was for assessments and interviewing, the second day was the day of starting with treatment sessions, my first ever treatment session. A familiar wave of nerves washed over me. Despite my passion for OT, I’ve always been a bit on the shy side—a trait that sometimes makes it challenging to step out of my comfort zone. However, as I greeted my patient with a warm smile and a genuine interest in her well-being, something remarkable happened. In her presence, I felt a sense of ease and comfort. She exuded positivity and resilience, and her unwavering determination to overcome her challenges inspired me. 

I did a bathing activity with my patient and as the session continued, I found myself breaking out of my shell, engaging in conversation and sharing laughs with my patient. It was a liberating experience—one that allowed me to let go of my inhibitions and embrace the moment fully. I discovered a newfound sense of confidence in myself and my abilities as an occupational therapist. However, it wasn’t all smooth sailing. During the session, I encountered a challenge that tested my resolve and forced me to reevaluate my approach. Despite my best intentions, one of the supervisors spoke to me and made me realise that my initial aim of focusing on improving bilateral hand functioning may not have been the most effective strategy for my patient because she has reached a plateau and her hand won’t improve, focus should be on other missing client factors (K Armstrong, 2024). The feedback was invaluable. I got encouraged to shift my focus towards compensation and the use of assistive devices, highlighting the importance of meeting the patient where they are and adapting my interventions accordingly. It was a lesson in flexibility and humility. 

In the end, that treatment session served as a catalyst for growth and learning. It taught me the importance of stepping out of my comfort zone, embracing feedback with an open mind, and above all, placing the needs of my patients at the forefront of my practice. It was a defining moment in my first week of fieldwork—a moment that reminded me of the transformative power of occupational therapy and the profound impact we can have on the lives of others.

Reflecting on my first week of fieldwork, I’ve learned that true growth comes from embracing challenges, stepping out of your comfort zone, seeking feedback, and staying true to our core values as occupational therapists. As we navigate our future practice, let us remember the importance of flexibility, humility, and placing the needs of our patients above all else (Sanjay Mahant, 2022) So here's to the adventures yet to come, the lessons yet to be learned and never losing sight of the incredible impact we have on the lives of others. 

REFERENCES 

K Armstrong, personal communication, 2024

What are the best ways for healthcare professionals to stay current with industry changes? (n.d.). Www.linkedin.com. Retrieved March 14, 2024, from https://www.linkedin.com/advice/3/what-best-ways-healthcare-professionals-stay-pnmpf#:~:text=To%20truly%20stay%20abreast%2C%20apply

‌3. Wadhwa, A., & Mahant, S. (2022). Humility in medical practice: a qualitative study of peer-nominated excellent clinicians. BMC Medical Education, 22(1). https://doi.org/10.1186/s12909-022-03146-8

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