Author: Helen OTUK

This week Aisling Durkin @ais_d will be hosting #OTalk.

In the past year the role of Occupational Therapists (OTs) in the critical care setting has been brought to the fore.  A number of OTs found themselves redeployed to ICU during the pandemic, working in both established teams as well as in units that previously had no occupational therapy presence.  Roles varied with OTs providing early assessment and rehabilitation (Borgstein, 2020), recruiting, training and organising proning teams as well as working in nursing support roles (Royal College of Occupational Therapists, 2020).  As business begins to return to normal in health services, many occupational therapy and critical care teams are looking at ways to establish and develop occupational therapy service provision in this setting.   

The importance of occupational therapy in the Critical Care setting has long been recognised by the Faculty of Intensive Care Medicine (2015, 2019) and early rehabilitation in this setting is clearly linked to better outcomes for patients (Tipping et al, 2017).  A recent article in the OT News (Borgstein, 2020) also explored the cost effectiveness of an occupational therapy service on ICU, identifying that the cost savings of 20 bed days on ICU would fund a single band 6 occupational therapist for the year.  Despite this, the evidence has not historically translated to funding for occupational therapy services (Firschman, 2019).  In order to explore strategies to establish these services we would like to put forward the following questions for discussion;

1.      What do you think the role of occupational therapy is in critical care? 

2.      What training have you had or do you think we need to work in Critical Care? 

3.      How can we raise the profile of occupational therapy in Critical Care Services? 

4.      How do we keep occupation at the centre of what we do in critical care? 

5.      What can we do to strengthen the evidence base for occupational therapy on ICU? 

Borgstein, C (2020) Occupational therapy in critical care – a case for change. OT News, July 2020. P- 44-46. London: Royal College of Occupational Therapists.

Firshman, P (2019). The occupational therapy role in critical care. OT News, April 2019. P16-18. London: Royal College of Occupational Therapists.

Intensive Care Society (2015) Guidelines for the provision of intensive care services. London: Faculty of Intensive Care Medicine.

Intensive Care Society (2019) Guidelines for the provision of intensive care services. 2^nd Ed. London: Faculty of Intensive Care Medicine.

National Institute for Health and Care Excellence (2017) Rehabilitation after critical illness in adults. Quality standard [QS158]. London: NICE. Available at: Overview | Rehabilitation after critical illness in adults | Quality standards | NICE

Royal College of Occupational Therapists (2020) New Occupational Therapy Team leads crucial critical care training, OT News, July 2020. P-9. London: Royal College of Occupational Therapists.

Tipping, C.J., Harrold, M., Holland, A., Romero, L., Nisbet, T. and Hodgson, C.L., (2017). The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review. Intensive care medicine, 43(2), pp.171-183.

Ward, G. and Casterton, K. (2020).  The impact of the COVID-19 pandemic on occupational therapy in the United Kingdom.  Education and Research. London: Royal College of Occupational Therapists.

POST CHAT

The Numbers

2.502MImpressions
497Tweets
81Participants
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6Avg Tweets/Participant

This weeks chat will be hosted by Laura Rossiter @OTTimeout1

It is understandable that upon entering clinical practice we can experience a plethora of emotions. These can range from excitement and pride to anxiety and fear. Working in the healthcare sector can be challenging and exhausting for anyone, regardless of how long they have been in the role. Limited experience and that little word beginning with C and ending with 19, can certainly exacerbate any concerns that newly qualified OTs (NQOTs) have.

In these uncertain and unprecedented times, many NQOTs are starting new posts working remotely, interacting with not only service users that they have never met but colleagues too. They are working in psychologically demanding, traumatic situations with reduced opportunities for supervision and support, and without a point of reference for knowing what that setting was like pre-COVID. How much does real-life Occupational Therapy practice during a pandemic differ from services pre-COVID and then again from the theory and models we are taught in our training?

The Elizabeth Casson Trust has awarded a grant to The University of Southampton to create a virtual support network for the 1,120 NQOTs across the UK. We have called this network OT Time Out. On two dates each month, OTs can attend meetings for free over Microsoft Teams with up to seven other OTs. Meetings are facilitated by members of the OT Teaching team at the University of Southampton. OTs can discuss any concerns – do they feel happy and well? Do they have a good work-life balance? Do they feel supported? Are they able to manage stress? Are they enjoying their role? This is a place for honest and supportive listening and discussion where every OT is welcome.

We invite you to attend our OTalk on 16^th March to talk about the needs of NQOTs and the network that we have set up.

1. What did it feel like when you entered practice as an OT?
2. What does it feel like (or what do you think it feels like) to enter practice during COVID-19? 
3. What would you like from a virtual support network for newly qualified OTs?
4. What can workplaces do to support newly qualified OTs?

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1.225MImpressions
378Tweets
93Participants
8Avg Tweets/Hour
4Avg Tweets/Participant

Hi, my name is Sarah (@SLawsonOT) I am an occupational therapist, PhD Candidate and lecturer @GlyndwrOT. Before I begin I would like to say a huge thank you to Dr Jenny Preston (@Preston_Jenny) for her time, support and encouragement in writing this blog.

In this #OTalk Research I’d like to explore what often seems to be a taboo subject – failure and rejection within research. That feeling of disappointment that I’ve let myself and others down, that I did not present the best of myself, that I could have, should have done better, that I and my research is not good enough.  

Evidence based theories of interpersonal acceptance-rejection theory acknowledge that some people are better able to cope with experiences of perceived rejection than are other individuals (Rohner, 2016).  Rejection is frequently perceived as a rite of passage as we transition into research careers.   

Since I began my part time PhD in 2017, I’ve been inspired by people like @NHopUTS whose pinned Tweet is a picture of his office door with copies of all his rejection letters for everyone to see.  On his website (NickHop.wordpress) Nick also includes a whole section of blogs about rejection. Then I saw a tweet from @raulpacheco also talking about rejection.  

Like many others I know that I have experienced rejection and a sense of failure in many aspects of my life, jobs I applied for and didn’t get, failed relationships, failed exams and viva’s.  This also extends to my research career with abstracts rejected, an unsuccessful grant funding application, presentations that didn’t go as well as expected, or aspects of my research that have challenged me.  Just as we use our life experiences to learn, grow and build resilience, how can we access strategies and resources to help us cope within our research careers and activities?  It may take a while, and with a lot of reflection but how do we use our experiences of each failure/rejection to enhance our opportunities and deepen our understanding of ourselves as both a researcher and a person.

Whichever term you prefer to use, rejection, failure, disappointment, frustration are all common features of engaging in research but they are often the areas which are rarely, publicly talked about – not only in research but in any walk of life.

1. What are your experiences of rejection or failure within research? 
2. Thinking about your research, how do you overcome the rejection? Did you respond, if so how? What was the outcome? 
3. How do you pick yourself back up and carry on? What strategies have you developed?
4. What have you learnt from your experiences of rejection or failure within your research?
5. What is your fear of rejection or failure stopping you from doing? 
6. What are you going to now? When are you going to do it? Who can you contact for support? What is your plan? 

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The Numbers

2.502M Impressions

419 Tweets

60 Participants

17Avg Tweets/Hour

7Avg Tweets/Participant 

This week’s chat is hosted by @ForensicOT_ELFT, the Official Twitter account for the East London Foundation Trust Forensic Occupational Therapy teams working at the John Howard Centre in Hackney and Wolfson House in Haringey.

Service users admitted to secure mental health services are typically defined as forensic patients. Based on the determination of what is both clinically appropriate and safe, forensic patients may be detained in mental health facilities or in the community. Forensic mental health services have a dual responsibility, to both treat the person with mental illness and protect the community, with a significant focus on safety (Whiteford G at al., 2019).

Forensic patients can be subject to lengthy admissions and may also experience stigma associated with their forensic status. Key outcome measures in current forensic mental health service provision include limiting the risk of relapse, readmission and engagement in unsafe behaviours. However, these foci may come at the expense of opportunities for occupational engagement and can result in occupational deprivation. Research suggests that the long-term effects on people living in occupationally restricted environments include social isolation and exclusion (Whiteford G at al., 2019).

The role of occupational therapy in any mental health setting is to enable people to maximise their independence in productivity, self-care and leisure through occupation. The ultimate aim of occupational therapy in a forensic mental health setting, however, is to enable patients to experience occupational enrichment and achieve optimal occupational functioning (RCOT, 2019). 

The focus of the occupational therapy teams working at the John Howard Centre and Wolfson House is to provide occupation-focused interventions which ensure occupational enrichment and reduce the risk of occupational deprivation, and the negative long term effects this can have on patients. 

Questions to consider

1. What are your perceptions of, or experience of working in, forensic occupational therapy?

2. What is your understanding of occupational deprivation?

3. What is your understanding of occupational enrichment?

4. What do you think the challenges may be working in a forensic mental health setting?

5. What do you think the occupation-focused opportunities are working in this setting? 

References

Whiteford G at al. (2019) Combatting occupational deprivation and advancing occupational justice in institutional settings: Using a practice-based enquiry approach for service transformation. British Journal of Occupational Therapy. Volume: 83 issue: 1, page(s): 52-61

Royal College of Occupational Therapy (2019) Occupational therapists’ use of occupation-focused practice in secure hospitals Practice guideline (Second edition)

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The Numbers

865.600K Impressions

490 Tweets

86 Participants

20Avg Tweets/Hour

6Avg Tweets/Participant