1. Advocates for clients who have been neglected or underrepresented in the system.
In today's world, so many people "fall through the cracks" and as a result are neglected or underrepresented. It is a personal and professional value of mine to represent said individuals. Although I feel it is my duty as an OT to provide the best possible care for all individuals, equity shall not be confused with equality. Many individuals will require additional advocacy and such should also not be confused with favoritism or preference. Advocacy in any form ensures all individuals receive the best possible care and opportunities. Below is a discussion post of an experience about a client that fell through the cracks. She was told that is all she had plateaued and was discharged. It was not until almost 2 years post op that a hand surgeon referred her to hand therapy. I talked to the physician and hold him she would be a good candidate for OT. She could possibly regain some motion and learn to adapt by making modifications to her daily activities.
2. Fulfills commitments to the professional community.
For my rotation in hand therapy, the clinic I was at had a need for FM tasks for adults. They had the theraputty for strengthening; however, they needed a functional task for manual dexterity. I decided to make a board with certain shaped holes that required the patient to properly place the keys in the hole. They also could be taken out, flipped and placed on the opposite side of the board working on in hand manipulation, tip to palm/palm to tip translations, manual dexterity, etc.
3. Represents the unique perspective of occupational therapy when participating in
inter-professional situations.
inter-professional situations.
Although occupational therapy has now been around over 100 years, it's still frequently misunderstood during inter-professional situations. Others may be under the impression OTs just work with hands, sensory issues, dressing, etc. In outpatient pediatrics, I had the opportunity to co-treat with PTs. During these sessions, I was able to share different techniques with the PTs. For example, one child we treated was a sensory seeker and a "toe walker". During each session, the PT would let him swing on the platform swing where he would spin himself. I shared with her how spinning disorganizes and excites the sensory system. Linear swinging would be best to organize his sensory system so that he would have more attention during the session.
4. Assumes responsibility for professional behavior and growth, in accordance with
AOTA standards.
AOTA standards.
During all fieldwork rotations, I represented the UTHSC OT program and the profession of occupational therapy. I aimed to uphold the values of the entities I represent by demonstrating ethical and professional practice. I upheld these values by always arriving well-prepared, being engaged with my fieldwork educator and clients, treating all employees and clients with respect, and responding positively to constructive feedback. On my first rotation in outpatient pediatrics, my educator commented many times on how UTHSC students consistently seem more prepared than students from other programs. In this moment, I was proud to represent the UTHSC program and was driven even more to uphold this standard that was set by previous students at this particular fieldwork placement! I have provided a quote from my Level II FW fieldwork educator from my fundamentals of practice section of their evaluation of my rotation.
5. Functions autonomously and effectively in a broad array of service models.
I feel that both of my Level II fieldwork placements were very different, but complimented each other very well. On both rotations, I used many different approaches to therapy depending on each client’s unique needs. While I was able to carry over some knowledge and skills from my first rotation to my second, they required a unique set of skills due to the different service models used at each setting. During my rotation in outpatient pediatrics, I used approaches such as Sensory integration, Neuromuscular Re-education, PEO Model, and Neurodevelopmental Treatment (NDT) to help re-train the client’s brain to perform familiar tasks. My rotation in outpatient hands primarily used the biomechanical frame of reference to treat clients. I mainly treated the impairments that limited occupational performance through manual therapy, modalities, and guiding clients through therapeutic activities and exercises. By the end of each 12 weeks, I was evaluating and treating independently, demonstrating that I can function autonomously while utilizing a wide array of service models.
6. Upholds the AOTA Code of Ethics in practice.
Upholding ethical standards ensures safety and moral treatment for both patients and practitioners. Although most ethical standards coincide with general good moral values, there are times in practice when the lines become blurred and one must refer to the AOTA Code of Ethics to guide practice as they are a written standard for our profession. Below is a Blackboard post I had written during my rotation at outpatient pediatrics. The scenario below is about a time when myself, my fieldwork educator, and the site coordinator met to discuss a patient who we felt was being overlooked by the insurance system. Although the insurance company is not obligated to adhere to the AOTA Code of Ethics, we felt as though our patient was not being treated with justice and that we needed to advocate for a more appropriate plan of care. The site coordinator agreed with our decision. This relates to the AOTA Code of Ethics principle Justice, specifically the following related standard of conduct that states occupational therapist shall, "Advocate for changes to systems and policies that are discriminatory or unfairly limit or prevent access to occupational therapy services."
7. Serves as a role model for honesty, integrity, and morally grounded decision making.
As mentioned in the standard above, there are instances in practice that are in the "gray area." More often than not our moral compass leads us to the appropriate decisions, although when in doubt the AOTA Code of Ethics is the guiding document for our profession. Many of my fieldwork educators have been role models for myself for their honesty, integrity, and morally grounded decision making. I hope to do the same for others! Below is a situation I faced on Level II FW rotation that I had to be morally grounded when making a decision.