All posts by sonyawilson

A day in Osaka

There are two things I really love doing – travelling and being an occupational therapist. During my recent dream holiday to Japan for the 2016 Cherry Blossom season I decided to try to combine these two great loves!

I was fortunate enough to attend the World Federation of Occupational Therapists (WFOT) Congress in Yokohama, Japan. At this conference I met many wonderful therapists and learnt about interesting new areas of practice. In particular I attended a fascinating talk by Professor Yoshimi Yuri from Osaka about a life goal setting tool for well-elderly to enhance engagement in meaningful occupations in retirement she had been developing. After the talk I nervously approached her and asked a few questions and we chatted about her work and talked again at the congress social function. We also met again two years later at the Asia Pacific Occupational therapy congress in Rotorua, New Zealand where she was presenting a poster and I was doing oral presentations and reconnected.
I have remained in contact with Yoshimi via Facebook and when I told her of my plans to visit Osaka on vacation in 2016 I asked if I we could meet and have dinner.  Yoshimi kindly invited me not only to meet for a dinner but to stay in her home with her family, to come and speak at her university to the undergraduate OT class and visit a central city hospital to talk about OT in New Zealand and go on a tour of their facilities. I happily accepted her wonderful invitation!

Rather nervously I prepared a talk about OT in New Zealand, how we train as therapists, shared stories that would show the complexity of work in an acute setting. I anticipated that not all the students or therapists would know where NZ was. I admit there was some bragging on my part about the beauty of New Zealand and the lifestyle that I am able to enjoy when I work close to beautiful west coast beaches and finish work at 4pm each day…

Yoshimi’s work is primarily in goal setting for community dwelling well-elderly (see her article here). I had a wonderful time staying with her and her family and we had many laughs making Takayoki (a traditional dish of Osaka) especially when I tried my hand at the rolling and turning of the lovely balls of yumminess!

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Yoshimi and I outside the University (with lovely Sakura in background!)

Kansai University of Welfare Sciences:
I was fortunate to meet the head of the university and several faculty members as well as a cheerful and respectful group of 43 3rd year OT students. I spoke with Yoshimi interpreting and spoke for about an hour with questions. I like talking to students and find them fun to talk with, and I know they enjoy hearing stories about life as an OT in any setting.  I was presented with a beautiful necklace as a gift for visiting and talking.

Higashi O Osaka Hospital:
I toured the Acute and Rehabilitation wards of this Central Osaka hospital talking to staff via Yoshimi and Yasu (an experienced OT working on the rehab wards). I was able to speak to patients via my informal interpreters as my Japanese language skills are not very advanced – I was gifted a real cherry blossom flower a patient had collected for me on a walk with her OT 🙂 . I was also able to discuss with their OT’s and PT’s the similarities and differences between our respective countries cultures, work cultures and practice styles. We discussed top up vs bottom down approaches, treatment approaches and life in general.

The OT team very kindly gifted me two exquisite origami flowers and the pattern so I could make them back in New Zealand. We talked at length before and after my presentation about the key differences between practice in a New Zealand Acute / Rehabilitation setting and a Japanese one. The key differences seemed to centre around the lifestyle and working hours.
In Japan it is quite common to work long hours, in the hospital I visited the therapists were rostered to work 10 – 11 hour days, 5 days a week (compared to the common 8 hour day / 5 days a week for most OTs in New Zealand). The final therapy session of the day could be completed between 6-7pm at night and a 7 day a week service year round is provided for by the health insurance system. Therapists can work split weeks and therapy is provided 365 days a year.
The occupational based assessments reflected common activities in Japanese culture – modified chop sticks can be used during the cooking or meal time groups, the therapy bathroom looked different to ours and origami and paper crafts were common activities practised in their craft groups.

My day of new experiances did not end after my hospital tour, Yoshimi organised for us to visit Osaka castle for special night viewing of the cherry blossoms illuminated with the majestic castle as an awe-inspiring background – unforgettable!

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16: The bitter-sweet moments of connection

This is a story about making a connection with a patient – and its kind of sad (am warning you in advance!)

As OT’s our assessments centre on meaningful occupation, and we often get wide ranging answers when we ask what our clients / patients enjoy.
Frequently for older adults it seems that TV is a common leisure activity – but not always one that holds special meaning, however…

Today I was talking to a lovely woman in her 90’s discussing, of all things, our mutual love of old UK TV shows that had us both trying to remember the name of a particular comedy show … it had Judi Dench in it … she played an ex-nurse opposite an actor who played an ex-solidier…. they were in love but never quite able to connect with each other properly until the last episode …. ANYWAYS …. I asked why she like it so much and she told me this:

It was her favourite show to watch with her late husband, who had passed away a few years ago after 60+ wonderful years together, they would laugh so much watching it, and they would repeat their favourite lines to each other occasionally and chuckle. She told me that even though it is painful she still watches the show and cries, that it hurts alot, but that it’s worth it to feel close to him again for a little while.
She looked me with tears in her eyes, and said “why, why would such a lovely man and husband be taken away from me? it doesn’t make sense! You can’t imagine how awful it is! it’s not right!”
As I sat there opposite her (with tears in my eyes too), I could think of no response that could ease her pain and simply reached out and held her hand.
We sat silently for a minute holding hands, shaking our heads slowly at how unfair it felt.
After a minute she sighed, looked up at me, patted my hand, and said ‘there, there my dear there are no answers to these questions – now how about we look for the name of that show’ and her moment of grief passed.

As I wound up our session, she thanked me for listening to her story and sharing her pain and patted my hand gently… and made me promise to Google the TV show, watch a preview and report back tomorrow!

 

2016 – A new year!

A new year has begun, one that is going to be bigger and better for OTDiscussions.com! Now that my post-graduate studies have finished I will be focussing out producing more content for passionate OT’s to enjoy for free 🙂
I will also be expanding the range of private-practice services that I am offering (see here for details)

Coming in 2016:

Exciting Workshops:

  • Core skills for Occupational Therapists (Parts 1, 2 and 3) – an excellent grounding for therapists and students new to the physical health setting
  • Interview practice – Late February (date to be confirmed) – great for therapists wanting a refresher on writing a great cover letter, customizing your CV and practising your face to face interview skills!
  • Introduction to posture management (July – date to be confirmed) a 6 hour course teaching the fundamentals of posture management and its importance to occupational performance.
  • Introduction to pressure care
  • See tasters / samples of workshop content on the Workshops page to decide if the course is for you!

“5 In 5 “

I will be uploading short video segments covering 5 key points on a given topic in 5 minutes to my YouTube Feed – topics will include elements of neuro-rehabilitation, neuro-plasticity, rehabilitation, motivation, running a sensory group, over toilet frames and much more!

100 lovely things about being an OT continues!

More training materials and resources to come…

Its going to be an exciting year! I look forward to sharing my love and passion for OT with you all!

Sonya

#15 “The spirits are everywhere, all around us, they are right here between you and me”.

“The spirits are everywhere, all around us,
they are right here between you and me” 

For a post-grad paper in 2014 I needed to research the Maori perspective of spirituality and health for an assignment (for those of you reading who are not from New Zealand, the Maori are the people native to New Zealand).

After several fruitless days of reading I decided to go to the source and meet with my organisation’s Kaumatua (a respected Maori Elder) and ask my questions about Maori culture.
Our Kaumatua is a kind gentleman for who there are no dumb questions, where questions of ‘but why?’ are welcomed as an opportunity to build therapists knowledge.

I had been struggling to understand the concept of the spirit world that I had been reading about, and our Kaumatua explained it in the way described above. I love his explanation and it gave me an ‘Ah ha’ moment and helped me to understand more fully what I have been reading.

I think we should take advantage of our access to cultural support workers to build our insight and understanding of the cultures of the people that we work with.

14: Conferences

I am relatively new to conferences with only having been to two – WFOT in 2014 and APOTC in 2015.

Both conferences have been great opportunities to learn about settings that we would not normally hear about, opportunities to meet like minded OT’s and talk about Occupational Therapy all day every day!!!

I was fortunate enough to meet up with several OT’s I met at WFOT and catch up and talk OT!

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Met this lovely OT again from Osaka, Yoshimi Yuri a lecturer at Kansai University of Welfare Services.

APOTC – Day one afternoon session

Relationship Between Self-awareness and Employment Outcome in People with Cognitive Dysfunction: By Keisuke Kawahito and Emi Ito.

  • Important factors for employment – interaction between personal factors and self-awareness
  • Self awareness  – as a hierarchy, has evolved.
  • Postulated a like between self-awareness and employment outcome
  • Importance of insight and problem solving in ability of people post injury to return to pre-accident work or locating a new job.
  • OT role proposed to evaluate self-awareness and providing interventions for build self awareness especially in strategy generation – be an external assist to help our patients build self awareness.

Navigating Many Worlds: Occupational therapists providing short term loan equipment:  By Marie Chester and Clare Hocking.

  • Acute hospital loan equipment provision both rental and loan pool sourced.
  • Highlight sources or tension / implications for OT leadership
  • Identified a missing link between CMDHB and MoH strategies / approaches. CMDHB documents seemed to focus on fiscal responsibility and decreasing incidence of key disabilities versus living well with a chronic disability.
  • We also need to balance the increasing expectations of consumers with the limitations of funding and equipment availability.
  • How does an OT on the floor balance strike a between all of those things…
    • Get political – know the DHB policies and get involved in decision making projects and bring OT views to this.
    • Alternative interpretations to health – build OT focus on occupation
    • Build strategic links with others looking to make a change.
    • Become a navigator… Help therapists navigate their way through the equipment quagmire
  • Question why or why not to issue equipment……
  • Be understanding, we cant please everyone all the time 🙂

Turning knowledge into practice: An exploratory study into the use of PRPP in Aotearoa New Zealand practice: By Frank Lu and Linda Robertson.

  • Key question being do therapists use PRPP  after training, and what factors influence the uptake of???
  • influences on OTs using PPRP in practice post training
  • Descriptive / exploratory method via an on-line survey
  • PRPP is predominantly used in community and mental health settings
  • Strengths of the assessment – clear communication, occupational focussed
  • Limitations – report writing seems time consuming, hard to describe to those not trained.
  • Influences on use: Time constraints, opportunities to apply in practice, managerial support, length of time since training.
  • How do we go forward? Suggested speaking to our managers to get time allocated / opportunities for OT’s post-training to consolidate and build confidence and apply to practice after the course.

Occupational Therapy: the promise and paradox.  By Dr Grace O’Sullivan.

  • Cites the guardian article ‘punching above their weight’
  • Medical model has a narrow focus with cause and effect type approach
  • Paradox  presented – we have allowed medical professionals to define what is considered to be good health (Gawande, 2014)
  • People want a life worth living with choices / activities with meaning.
  • For people with Dementia it isn’t the detail of the visit / experience that sticks with them – its about the good feeling that will remain, even if the cause fades or is forgotten…
  • The shifting paradigms of healthcare – call for integrated care and inter-professional care
  • Grace shared a lovely story about a client she worked with too.

Please note the full slides of each presentation will be available after APOTC is over!

APOTC Opening ceremony:

The morning dawned bring and clear in Rotorua, the steam rising from the grates in the street as I drove the 5 minutes from my humble hostel to the Rotorua Energy Events Centre.

The opening of the Congress started at 9am with the powhiri with a formal Maori welcome to the congress and a selection of Maori cultural performances.

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I had chills with the epic haka:
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Poi’s, songs, and a haka from a local kapa haka group welcomed us to New Zealand and Maori Culture – I loved it!

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#11 Runaway shower hoses, wet feet and other OT mishaps…

Imagine this… a small hospital bathroom, a patient showering, an OT supervising, much talking and general laughter is heard coming from the steam filled room, the patient’s focus wanders, control of the shower head is lost, the OT is hit with a full blast of warm water from head to toe, the patient and OT shriek with laughter, the shower head skitters along the floor of shower further spraying the OT (and if very unlucky the patients clean clothing is also saturated), the OT is soaked, the patient is relaxed and happy with their showering achievements, patient returns to bed space to continue their day, the OT squelches down the corridor in wet shoes, wet socks and wet scrubs with a smile on her face… Its 9.10am.

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Over the years I have amassed a veritable treasure trove of anecdotes / funny stories and not-so-funny stories that I use as teaching tools for students / new staff (while protecting patient privacy).

Further pearls of wisdom I have learnt over the years:

  • Chocolate chip cookies should not be put in toasters, it does not soften them! (In my defence I didn’t actually know what would happen when the person put the biscuit in the toaster, it seemed kind of plausible that it would soften it so was easier to eat… BUT… What happens is smoke, lots and lots of smoke, smoke issues from the toaster, smoke alarms go off, the house fills with gross burnt chocolate smelling smoke, windows get opened, neighbours look over fences, patient and OT agree that perhaps it wasn’t the best idea after all, OT is red faced and wondering how on earth she was going to write this debacle up in the clinical notes without looking like a dork…. SO! Lesson learnt: Chocolate chip biscuits do not go in the toaster!
  • There is a difference between top and bottom dentures…. enough said!
  • You need to always remove the wheelchair seat belt before trying to transfer someone out of a wheelchair…
  • Knocking the red button on the front of the hoist causes it to stop… its not broken or flat, just release the emergency button to get it working again (had a wee panic the first time that happened to me with a patient in the air!)
  • Powered wheelchairs will not work if they are set to manual mode…. (sigh)

These are but a few of the cautionary tales I use when training or comforting other OT’s… Hopefully I am not abnormal and others have similar stories….. Right?!?!