Confessions of an Occupational Therapist

I enjoy stress to some extent. I’m not the sort of person who could be content with a straight forward job, and no excitement in my own life. At the moment though my stress levels are getting slightly higher than enjoyable as I enter the last 5 weeks of my current job contract, have no other job lined up, continue to plan my wedding, and also plan a trip around Japan. No point in pacing my self and doing one thing at a time I guess – what would I do with my time?!

 

So this week I’ve referred myself to an Occupational Therapist: me. I realise if I advise people 5 days a week I should be able to advise myself too – although I admit it is always much more difficult. So I tried to think as if I was a client approaching me, and think about what I tell myself (other than the fact I’m bonkers).

 

So this is my plan and my goals for the next 5 weeks:

I’ve completed my own interest checklist and my top occupations include (you guessed it) walking my dog Jed, swimming, reading, crafts, visiting friends, blogging, travelling.

  1. My 1st goal is to self care in order to reduce stress and to do this I will
  • Continue to walk Jed twice daily to maintain my role as a pet owner, and reduce my own stress levels. Exercise is really good for my mood – it’s like fresh air is my medicine. This also keeps me in a good routine and clears my head for or from the day
  • Each lunch time take a 15  minute walk to a green area near work. Record green areas visited through use of photography on my mobile phone. This way I can track my own commitment to this goal and hopefully improve my photography skills in the process as photography is a new occupation for me but one I think I might like
  • Eat a balanced diet and cook at least 2 recipes I enjoy each week – cooking for me is a great distraction, and as a food lover a tasty meal is like a reward in itself

2. My 2nd goal is to maintain responsibility for the deadlines I have to meet and to feel organised to reduce my stress. To achieve this I will:

  • Plan one stage of our trip to Japan per week. Keep a folder of all bookings to keep organised and to look through this to remind me of the lovely break that is approaching
  • Plan at least one thing from our checklist for the wedding each week by applying occupational interests to make this a leisure occupation not extra stress (see goal 3)
  • Blog using wordpress as a means of reflection

3. My 3rd goal is to achieve work life balance in order to feel life satisfaction and reduce stress. To ensure this I will:

  • Choose books that are easy reading and require less concentration as this is always impacted on for me when I am stressed. Read for 15 minutes each morning and each evening on the train – short periods of time are more achievable – again due to reduced concentration.
  • Swim once a week at least 30 lengths. Reward self with 10 minutes in the steam room – I am thankful to have found a lovely pool nearby which is a lovely place to relax.
  • Craft weekly either independently or with friends. Last week I started a giant dream catcher and completely lost myself in this occupation for a whole evening. Yesterday I had a craft evening with a friend and we started some wedding table decorations. A lovely chance to unwind and socialise.

 

I think that’s plenty to be going on with. For me some occupations bring instant relief. Swimming for example, which is a new occupation for me makes me feel instantly relieved and with each lap I swim I can feel the stress slip away. I try to be mindful when swimming, to not let my mind wander, and to be in the moment enjoying the relaxation this brings. Other occupations, I know are helpful but I really have to motivate myself to do, particularly after a busy day. I can much easier be mindless and play on my phone checking social media and emails on my way home than open my book. But I know that if I can just convince myself to read instead I can almost escape into the story I am reading, and this allows my mind freedom from worries, and then leads to me feeling more relaxed. So improving well-being through occupation takes a while to make habit but can be done.

 

It’s for these reasons occupations need to be very carefully selected because we are all so individual in our preferences. For some people my plan may in fact increase stress rather than reduce it. I would really like if us OT’s received Occupational Therapy ourselves. A bit like a counsellor might get counselling, I really think we would benefit from time out and a chance to reflect with support on our own occupational needs.

 

You don’t need to make your plan so public but have a think, if you were your OT what advice would you give yourself, and what might your occupation focused goals be to promote your own health and well-being? We need to put ourselves first sometimes so we can keep putting many others first 40 hours per week.

 

Rebecca Wint, Occupational Therapist

 

Advertisements

Reflections of an OTea Drinker

10 months into my 1 year contract at St Georges Crypt in Leeds I’m wondering where the time has gone. And how I ever managed to get so lucky and gain this job. I continue to thoroughly enjoy my work.

I’m thankful that the NHS South East CCG through Leeds Community Foundation Trust funded the pilot project. As I accepted my 112th referral to the Occupational Therapy service this morning, I stopped to think how wonderful it has been that this group of individuals, who are so often difficult to reach, have had the opportunity to access healthcare.

It is thanks also to St Georges Crypt being willing to host a clinical service like this within the centre. It’s been clear to me that St George’s Crypt is a place where so many vulnerable people feel comfortable accessing. And not just for meals. But for a range of services. Meals, a bed, a shower, clean clothes, dignity, a chance to explore who they are and what they might enjoy; through training and engagement opportunities. This is home and community for many vulnerable adults in Leeds and because they feel so comfortable accessing it, seeing an Occupational Therapist too whilst they are here is no bother for them.

I have been named the ‘OTea drinker’ by one client, and I can’t argue – I drink many cups throughout each day. But it’s been so helpful being based within this centre, where I can almost blend in within the dining room each lunch time as that’s when people really start talking. That’s when they open up, express a little bit of themselves, and decide that a little bit of support would be really helpful.

Working in this setting has allowed me to be flexible. There’s been no need to schedule appointments for those who aren’t yet ready to commit to a set time and day. It’s been nice to be able to tell people to just pop in for a cup of tea once they feel ready, or at a day and time that suits them. Once we’ve casually formed therapeutic relationships, individuals are more likely to feel ready for a more scheduled and structured appointment. Due to many not having a structured routine it is difficult to be orientated to day and time. That’s why them being able to knock on our office door when they feel up to talking helps.

As people who have read before know, I struggle to write without mentioning my PAT dog Jed. I can’t thank my partner in crime enough for being by my side and promoting the engagement of people who trust animals much easier than humans. Jed was welcome within St Georges Crypt from week one, and working within a setting that is open to these quirky sidelines to therapy is refreshing. It also means the OT service is accessible, and attracts the engagement of clients who would otherwise perhaps not have the confidence to speak. A recent referral was one example of this: ‘come back when you’ve got your dog with you please, I’d really like to meet him’.

It has been a great opportunity to raise people’s understanding of Occupational Therapy, even if I have repeated what an OT is many hundred’s of times! I hope that the people who have accessed support have also gained an understanding of the profession, of how it can support them in such a variety of ways. Leeds Beckett University have completed an evaluation of the service which I will remain ever grateful for and this gathered client perspectives of Occupational Therapy at the Crypt all of which were very positive: “I didn’t know that I wanted an OT so I didn’t go to the doctor about it […] If I hadn’t lived in the Crypt, I would never have found out even that I wanted OT.”

For me personally this journey has been one of learning, and of enjoyment. Prior to this I had mainly worked in mental health and personality disorder services, but now, in terms of areas of practice I can add to my experience neurology, brain injury, stroke, palliative care, dementia, learning difficulty, amputations, substance misuse, orthopedics, and working with individuals released directly from the criminal justice system. I have loved the variety. I have appreciated that every individual in unique, and has their own life experiences and strengths to bring to the therapeutic relationship. I don’t think I would have gained such broad experience even on a rotation.

I have obviously faced challenges daily, as much of the above was unfamiliar to me but I think working in a pressurised environment in a past job helped me feel ready for this challenge. It has been difficult being the only clinician at times because within another setting I may have referred directly to another multi-disciplinary team member. It has been important for me to liaise with other professionals around the city for advice and support.

I have most of all enjoyed the opportunity to be creative, to be innovative, and to create a service for the people of Leeds who are so often overlooked. I feel progress has been made in terms of long term functional issues being resolved for some individuals who previously didn’t know where to turn for support for such difficulties. I also have cherished working alongside people when they’ve engaged in that occupation they’ve always been interested in but never had the chance to try: golf, recording music in a studio, pottery.

There continues to be a long way to go. If I had the time and capacity I could probably assess each person who accesses the service should they wish. Because I have been a lone clinician in this post I have had to prioritise need through careful assessment so I appreciate it is likely there will still be many who have been missed. Being an optimist I’d like to change as much as possible for each and every person but the realist in me understands only so much can be achieved in a one year pilot project.

 

If you would like to hear more about the 1 year pilot Occupational Therapy project at St Georges Crypt we are hosting a sharing session 6.3.17, 11am, at St Georges Centre. The link to the event can be found below:

https://www.eventbrite.co.uk/e/occupational-therapy-at-st-georges-crypt-tickets-31409931952?aff=efbnreg

Made redundant for a donkey

So today I felt rather smug when after our morning walk my housemate told me I’d be having the day at home. Call me a part-timer but it was too cold to be commuting to central Leeds today even with a thick coat like mine. I happily retired back to bed, enjoyed a mid morning Bonio and dreamt of my recent adventures at work – memories of the bacon scraps on walks with one of my favourite clients always makes my nose twitch in my sleep.

When 6pm arrived and my housemate returned from work with a spring in her step I knew it hadn’t been the average sort of day. Being a dog my sense of smell never fails me, she reeked of donkeys! My smugness soon turned to jealously. It was clear I’d actually been made redundant for the day and that some other 4 legged folk had filled my place.

I wouldn’t have minded so much if she wasn’t so giddy about the day chatting away about how much fun she’d had on a visit to the local donkey sanctuary with another person we regularly work with. Despite my envy I reassured myself these animals were probably novices compared to me. Credit to her though, my housemate did raise some valid points yet again recognising that us 4-legged folk are actually often much more therapeutic than human therapists. And we don’t even have to do a degree or get in debt to acquire our expertise.

Turns out the person we support had been so excited to arrive at the donkey sanctuary they could barely wait for the taxi to stop before hopping out. Usually they would find it difficult to concentrate but much like with me they enjoyed photographing the donkeys and took great interest in them. They met not one, but a tribe of rescued donkey’s and spent time listening to their histories. Much like in my puppy years of life they’d been abused too. The person particularly took a liking to a donkey with a bit of a phobia of people. They were able to identify that similarly to them-self, the donkey had also suffered a life time of abuse and neglect but had come out the other side – a survivor.

I think us animals are best for this line of work who have gone through a rough time ourselves as we give people who are struggling hope that things do get better. My housemate often tells people about a magazine article she read where it recommended battery hens were used for animal assisted therapy in a mental health rehabilitation hospital. Evidence showed that when people saw the chickens recover e.g. their feathers growing back and their confidence growing, it gave them belief they could recover from different aspects of their own illness such as past trauma, self harm, and times of crisis.

Despite my disappointment I was left behind today, me and my housemate at least agree on one thing and that’s our view that pets as therapy should be made more accessible to people who would benefit. I love the fact my housemate gives me credit that some people we both work with would never have engaged with her should it not have been for me. I’m sure there’s not many places the person who visited the donkeys today would feel comfortable visiting and staying for a 2 full hours either so I’m glad they felt at ease there.

I rest my case, us pets are powerful. I’m hoping I can return to my day job tomorrow and the donkeys appreciate theirs was just a temporary contract.

 

Jed (Pet’s As Therapy Dog) with help from my housemate Rebecca Wint (Occupational Therapist)

Perks of the job

Over Christmas I unfortunately had to visit my 88 year old Mama (Nottinghamshire slang for Grandma – not a posh word for Mum) in hospital as she fell and fractured her hip and therefore needed an operation.

This caused me to reflect on my own job as I saw staff at the hospital go about their day to day work. I can’t say many of them looked filled with joy. And neither would I if I were effectively locked in a ward for 12 hours, with no natural light. They were doing their very best with the circumstances they were working in, and we can’t fault the care she received, but each time I visited, I left feeling a sense of relief I was not working in a setting like this.

I’ve been working as an Occupational Therapist for St George’s Crypt since April 2016, so 9 months now. This is a charity which supports people who are homeless and vulnerable. As my 1 year contract reaches the end (it is to be reviewed and the funders confirm if it will be continued); I feel a sense of dread considering where my options would lie in terms of my Occupational Therapy career and cannot help but wonder if actually I may be better off following my other dream of starting a dog walking business or training assistance dogs.

This is my first time working for a charity and I cannot tell you how good it has been. Staff seem happy to be there (or they’re very good actors!), and there’s a real team spirit. They take time out each morning to pray as it is a Christian charity, but religion aside this is a fantastic way of checking in with colleagues to see how they are in general and to feel more equipped to support each other throughout the working week. This informal support is vital given the amount of heart breaking information we hear from the people who are living it first hand on a daily basis.

I feel valued as a person here and I love that everyone in the building is valued too. Everyone has a name, and everyone has an identity which is something many people who access the service feel they have lost through the depersonalising circumstances that go in hand with homelessness. This is worlds apart from when I did a shift at a general hospital a few years ago when working for an agency as a career and was asked to wash bed 7. Does the bed have a pulse and a personality? I had asked the staff doing the handover. I didn’t return to that place to work.

There is opportunity to be human, and to allow people to feel human too. Prior to my current job, in a different temporary role, I had sat down with a patient to eat breakfast as a way of building rapport with someone who was difficult to engage after experiencing a life changing time in terms of disability to be told ‘if you’re going to eat that toast it will be 40p’ by a staff member. In my current role no one questions when I sit and drink tea, or eat toast with a resident. The power of tea/ toast is a wonderful thing, and if acting human, and offering a kind gesture like a cup of tea or company over breakfast creates a pathway in to a therapeutic relationship then it’s a tool I’ll keep using.

We’re lucky to have a beautiful garden, tended to by generous volunteers who began their journey at the Crypt as residents and it’s a nice place to sit to gather thoughts after a difficult conversation or a busy morning to re build strength to go back out and keep on working. Similarly the chapel which I can only liken to the nicest cave I’ve ever seen is a perfect place to reflect. People don’t question the 5 minutes out, there’s a common respect that we’re all only human and sometimes just need that time out to recuperate. I think it makes us all work harder in many ways as feeling respected makes us respect the organisation.

My wellbeing is met daily through my job. I am active and get to support people to do the occupations that are meaningful to them; it is not uncommon to see me walking, climbing, playing golf, or wood-turning whilst at work. I practice mindful listening as each person I am fortunate enough to work with grasps my full attention and this allows me to switch off from my own worries and fully embrace the working day. I feel working here gives me a great chance to connect with such a variety of people. The social area is buzzing each lunch time and whilst I am working and offering support to clients it feels more of a homely environment because for many people who visit, these are the only connections they have got. I feel I am contributing my time to a group of people who deserve much more, and who have been let down time and time again by the healthcare system. And I am learning so much! This jobs gives me a rotation type experience as I am meeting people with many different interests, from all walks of life, who have experienced many different circumstances impacting on their ability to do the occupations that are important to them.

I am fortunate I know. I will certainly be mindful as my career progresses to ensure I am in a job that is helpful to my own well being, but most of all is in line with my values, and my moral compass.

Rebecca Wint, Occupational Therapist.

 

Calm your nerves: PAT dog to the rescue

So recently I’ve been working with a person who’s a little anxious, a bit like I was all those years ago when I was abandoned at a roadside in the snow. They have had a rocky ride in life and it’s not surprising they were debilitated by anxiety by the time me and my housemate met them. In a nutshell they’d mentioned how through various life events they’d lost all confidence in going out in public and were getting to the point where they felt prisoner at the centre we work due to no longer daring to go out.

On leaving the building they’d experience severe panic and it had got to the point where they could not find a good enough reason to go out anymore, it was easier to avoid the anxiety and stay in. My housemate, being an occupational therapist spent time talking to them about their hopes and dreams and it turns out their main wish was to visit a local park. Rather than her bombard them with anymore questions interview style, the following week when we all met again she made the wise move of supporting us to visit a lovely park together as a 3 which meant I could lap up the smells and flirt with lady dogs whilst my housemate continued to talk to this person about the things they were struggling with and formulate ways to help them overcome difficulties and meet their goals.

This is the point I realised she’d not only be lost in her own life without me, but that in her working life she’d be pretty stuffed too. I was shocked to hear her refer to me as ‘the dog’ but it was a Friday and we were both pretty rough looking by this point in the week if I’m honest.

So the following plan was agreed (she didn’t ask my consent but I was happy to comply). For the next 6 weeks, we would meet weekly as a 3 for the person to gradually regain independence in accessing the local community to participate in occupations that were important to them. They love walking. They love pets. But this was the best bit – they love going out for coffee and BACON sandwiches for breakfast.

My housemate through around some lingo about a graded plan and it turns out as the weeks progressed I actually had to walk further and further to earn my titbit of bacon mid session. So week one we walked to the nearest cafe (10 minutes – which is plenty after a long working week). But by week 6 we walked 30 minutes as their confidence improved in leaving their comfort zone. The smells in the park we had to walk through were divine and it was a nice escape from the city so I’m not complaining – particularly as the bacon was cooked to perfection this time.

It was nice to hear from the person I’ve been working with they look forward to our outings together, they feel more relaxed when I’m around, and they feel motivated to walk further each time because they know I enjoy it. I kept quiet about preferring my 4 poster basket in front of the fire and acted like an athlete trotting along by their side. When we stopped to rest I’d lean on them just to remind them I was there and everything was ok. They stroked me and complimented me on what a good lad I was which I obviously already know but hey it’s nice to hear.

Unfortunately for me my work with this person will be reducing now but I feel accomplished in knowing that in a difficult time I could be there, be walked, be stroked, be fed bacon…. oh and be making a difference to some one struggling with anxiety. I wish them all the best as they continue their recovery and start going out without me by their side – at least during these cold weeks they’ll be able to eat breakfast inside a cafe where us 4 legged folk aren’t welcome.

Jed (Pets As Therapy Dog and Rebecca Wint’s housemate)

The power of us 4 legged friends

Whilst enjoying our Sunday morning walk, me and my housemate came across a man walking with 2 elbow crutches with a lad I can only describe as my twin – handsome, 4 legs, luscious black coat  – in our favourite park. Me and ‘twinny’ dashed around like loons for a few minutes whilst my housemate talked the hind legs off my new pals housemate.

I never look like I’m paying attention but unlike blokes of the 2 legged variety I can actually multi-task. So turns out my pal was also dumped at the side of a road but he was much younger – only 8 weeks old when he was found by his housemate.

His housemate went on to tell mine that 2 weeks previous to finding ‘the pup’ he’d been given an ultimatum by medical specialists: get walking, or lose your legs. He’d apparently racked his brains as to how he could ever make this happen as at the time he’d been howling in pain and had lost all motivation, almost resigning to the fact he’d be in a wheelchair for the rest of his life. He’d asked his specialist how?: to which they’d been blunt and said ‘find a way’.

Then in the nick of time, my pal (who I’m now learning is a bit too boisterous for a lazy mutt like me) with his irresistible puppy dog eyes had sat abandoned at the roadside and this poor man in crisis had spotted him as he drove past. He picked him up and the rest is history. From that day he walked, he had to, us dogs don’t need advising 30 minutes exercise, 5 days a week is good for us – we’d walk 30 miles if only we could motivate the 2 legged variety a little more. So this man went on to compliment my pal a bit like my housemate does me. He mentioned how he’d given him a lease of life, motivated him when he had nothing left, and he believes it’s a miracle they found each other.

 

Now I don’t mean to be bragging here but my housemate is pretty similar, but it’s not her legs that are fragile, it’s her mind – not that she’d admit it. I made a similar appearance to my pal, 7 years ago tomorrow actually, and me and my housemate have been by each others sides ever since. She found me at the side of a road. I’d suffered concussion so to this day we’ve not figured out how I got there but apparently they think I was dumped. I prefer my version; I was on a gap year travelling the UK and I’d taken a minute to rest after fighting off a polar bear in the winter snow.

She kindly put me up for a couple of nights whilst we waited for my old owner to feel guilty and come back for me but turns out they never did. So because I wasn’t micro-chipped, I was full of worms, and I didn’t get on very well with the lead (I was a free spirit previously), she took pity on me and got me ‘trained up’. I’d just had a rough start and needed some gentle guidance. It worked out well. Every time I learned a new trick e.g. sit/ lie down/ play dead, I got a treat. Not the cheese I’d hoped for but I suppose the dog chocolates weren’t bad. Once I was trained I made a career for myself and even managed to bag my housemate a few interesting jobs too.

So it turned out I needed her that day she found me in the cold January frost but I don’t think she’d mind me letting on that she’s needed me equally as much since we became such good friends.  There have been days when she’s been difficult to motivate to say the least. I’ve heard other humans plead with her that things aren’t that bad, things will get better, that she should get out of bed or off the sofa. For some reason when she’s this way out the only thing that will motivate her is me. I’m taking full credit for this one. I play the sympathy card when she’s down in the dumps and look at her and whine just to remind her there is a reason to get up and that she can be useful even when she thinks she’s no use to anyone. Whilst she starts off like a sloth, whenever I convince her to have a walk the dark cloud seems to lift slightly and the spring returns to her step gradually. Being responsible for me makes her realise she is important. Without her I couldn’t survive, and she tells me she’d struggle without me too. So it is true what they say. Us dog’s really are a (wo)mans best friend.

Jed (PAT dog and Rebecca Wint’s housemate)

Occupational highs

During supervision yesterday I tried to describe the amazing transformation I’ve seen in people through the use of meaningful occupation. It’s something I’ve recognised over the years since working with people who have been de-energised by life and lost motivation for almost everything. With these people I am always determined to find hope. A colleague once joked that I would only assess and continue to work people if their motivation was so low they’d only leave their bed for smoke breaks. There’s something motivating for me to see how enabling engagement in occupation that is truly important to people, that makes them individual and gives them a reason to leave their beds for more than 5 minutes at a time inspires me.

The only term I’ve found for this glint of hope so far is ‘the sparkle you see in someone’s eyes’ when they get to engage in an occupation that awakens their energy. My supervisor hit the nail on the head yesterday when she said it’s like an ‘occupational high‘ as I described to her a few individuals I’m currently working with.

Last week I found myself at an 18 hole golf course (slightly out of my comfort zone as I’ve never even won at crazy golf) with 2 men who’d identified a love of the sport, but not played for years. Both identify with having difficulties with feelings of anger and agreed taking these feelings out on golf balls would be much better than anti-social options already tried.  We spent a couple of hours there and lost every ball we bought but all 3 of us had fun and the 2 guys seemed incredibly ‘high’ after getting this occupational fix. On the way home they were discussing other ideas and one man quickly decided go karting would be his dream occupation to try next – I’m excited already.

This week during a 1:1 session with a lady I’m working with we went to a lovely local park to help her de-stress and spend time in the outdoors which she loves. We were pleased to find a pretty decent playground suitable for people of all ages with a climbing wall. We spent ages trying to climb this and see who could get to the top – let’s just say I didn’t win. She’s already excited for next week and has already identified a taller, more challenging looking climbing tower for us to tackle.

At times I’ve worked with other Occupational Therapists and questioned my own approach – feeling inadequate in some way and like I’ve not quite developed into my role. I remember discussing with a colleague their specialist training in moving and handling/ hoisting and them questioning why I would waste my time after doing a degree running a breakfast club on a ward within a secure hospital. At the time I reflected that this had brought structure to these people’s days who had very little to get up for, brought the ward ‘community’ together, allowed people to develop skills of independence in cooking food of their choice (something you don’t get very often when you eat from a set menu). I still believed my role was of use but I felt a little flattened and wondered if my role really was so undervalued and if I should too find a specific remit.

I discussed this within supervision yesterday – how can a job be so fun, how can I get to try all these things I’d never normally do; have these opportunities and call it work? Maybe I should specialise in hoisting, Bobath, sensory integration. But I won’t. I want to remain OCCUPATION focused in my practice. This is and will continue to be my specialism because I’ve never seen occupation fail anyone – even those who have felt most lost and waved goodbye to what they thought was their final bit of hope. And I am of course an Occupational Therapist so if occupation isn’t my therapeutic tool what is?! (Aside from Jed, my PAT dog of course).

So if anyone asks what Occupational Therapists do what better answer than to say we enable occupational highs? My highs this weekend will be seeing fireworks at a bonfire tonight (one of my favourite days of the year), walking my lovely dog Jed tomorrow at the local park and meeting a friend for coffee, having dinner and drinks at the local pub with my Dad tomorrow evening, and a day bargain hunting in charity shops, cooking some good food and spending time with my boyfriend on Sunday. How do you get high through occupation? I bet we all do something different and that’s the beauty of it: through occupation we can be us, we can be individual, and we can say that we found meaning to our day. We got high – we didn’t just scrape through.

Rebecca Wint, with thanks to Mandy Graham for inspiring me with the term ‘occupational highs’.