Remarkable.

April rolls us into a month honoring and celebrating the profession of occupational therapy (OT).

A friend recently recommended (with enthusiasm) that I read a book titled, “Purple Cow” by Seth Godin.  Godin suggests that people discern and ultimately embrace becoming “remarkable” at what s/he brings the world.  (The reference to the Purple Cow is that you would remember seeing a purple cow because it would be... remarkable.)

In an effort to not only celebrate this profession and our journey in it, but to also encourage self reflection to promote a revolutionary year to come, I pose 2-3 questions today.

  1. What is there to celebrate and honor about what YOU do as an occupational therapist?
  2. What if, anything, makes YOUR OT remarkable?  
  3. Or if you find there is nothing yet remarkable about your current practices as an OT, what could you do different if you truly wanted to be remarkable?

I will risk sharing my own answers to stir the pot of a hopeful revolution into ...remarkability for us all, especially the people we serve.

What is there to celebrate and honor about what YOU do as an occupational therapist?

  • the ability to focus on what is most meaningful to a person's daily life
  • the true uniqueness and creativity of each day’s experiences
  • being a true advocate for health “care” and interdisciplinary approaches in the US healthcare system
  • helping so many adults either return home more engaged, safe, and/or independent or helping their caregiver understand ways to better meet daily needs
  • the use of teaching as a tool for therapy in the home
  • the use of a client’s own home setting as a tool for therapy
  • nearly 5 years of clinical experience working mostly with older adults
  • finding a new "OT Toolkit" that has truly helped me provide more client-centered education and training
  • being able to introduce cool and helpful equipment to people who could benefit from it

Or if you find there is nothing yet remarkable about your current practices as an OT, what could you do different if you truly wanted to be remarkable?

In all honesty, I felt I worked much of my last year as an OT “working” versus truly serving and being remarkable. I will admit that I often felt suppressed by and gave my power away to the area of practice that I had chosen for myself. After a recent switch to home health with a local non-profit, I find not only a renewed interest in occupational therapy, but in also being remarkable as I provide the service.  This one feels more like a position of service, not a j-o-b.  I digress. Now to answer the question.

Being truly remarkable=

  • carefully describing the value of occupational therapy at the start of each evaluation
  • providing and carefully reviewing appropriate handouts (OT Toolkit is badass)
  • asking at least one personal question when setting up appointments (even if it’s merely, “How are you today?”)
  • making at least one follow-up phone call per week to clients who are more sensitive
  • specifically affirming at least one team member per week
  • writing down client-centered interests or happenings to follow up with on future visits (i.e. a birthday, weekend event, etc) 

May we go forth and make this the most remarkable year as OTs yet!  The Force is with us;)

Happy OT Month!!

Living Life To It’s Fullest: Are You?

This, as you likely know, is the motto for the profession of occupational therapy.  It’s our tagline...and a powerful tagline at that. (Yes, I’m assuming that you, dear reader, are in the professional posse.)

So what do we do with this powerful motto?  We hold positions in which we are accountable as a life assistant to the people we serve so that s/he might live a more full life.  Our job is to help people live more fully.  This. Is. No. Small. Job.

Where do we even begin then?

I have a suggestion. Uh hem. I suggest we saddle up with Gandhi and start with the person in the mirror.

Gandhi encouraged us to start new legacies by “being the change we want to see in the world.”  More specifically, I am suggesting that the potent way we can BEGIN to help others live more fully is... to examine the fullness of our own lives, accept what is and is not working to create that daily fullness, and then take daily actions to BEGIN creating it or merely deepen currently experienced fullness. The fullness of our own life IS under our own influence and personal responsibility to address.

In future posts I will share a few of the most potent tips I have yet received that have truly helped me stir the pot of “full living” in my own life so that I might help more deeply and authentically provide that assistance to those I serve as an occupational therapist.

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For today: On a scale of 1-10 (1 = Not living my life to the fullest at all, 10 = Living my life to it’s absolute fullest!), where do you rate the current “fullness” of your life?  If a client were to give you the same answer, would you surmise you could help increase that rating?  What do you perceive needs to happen in order to increase your rating by 1 point?

Take a deep breath.  Life is about to inflate with even more fullness... if you are ready to allow it.


Eat It Up.

Reflecting on work and how I interact with it has been a common theme lately.  Here's a recent revelation.

Perhaps the best thing I can do is go to work with a) a positive, grateful and willing-to-serve attitude, b) look good, c) be physically ready and fit to handle the demands of my day and d) take a relaxing lunch break at least 3 days per week.

This last option, taking a relaxing lunch break, seemed to come through too many serendipitous recommendations within a 3 month period of time.  The universe seemed to be nudging me to do the unthinkable...sit down, relax and just enjoy some good food around noon. Yes (gasp), even in the middle of my work day.

The result was a hopeful return of the passionate, energized and compassionate attitude that carried me to this profession in the first place, as well as an increase in inspiration for client-centered and team oriented service.

(Side note: A recent Ayurvedic course (as part of a yoga training) revealed the immense importance of digestion on overall health, leading me to explore my own habits around meals.  And for some reason, I entered this profession with the subliminal training and often through the ‘example’ of those who had gone before me to “eat while you work.”  Quite frankly, it just hasn’t been working for me.  I noticed increased stress and detachment in an overwhelmed-type-of-way. Plus, a whole meal would disappear before me in a matter of minutes, leaving me almost forgetful of what it was that I had just had the fortune to eat. Where was the pleasure of eating one of only 3 larger meals in my day?)

So here comes the one week (or more) experiment*: Just take a pure lunch break to chill with co-workers/sit in solitude and enjoy lunch without doing notes, checking the phone or sitting at the desk.

*I do not claim this to be an easy experiment, but I do guarantee it to be worth it.

Just for today: Will you just try enjoying your lunch and only your lunch?  If not, why?

Let’s do this. Eat up the true enjoyment of life, not just the work of it. Cheers to letting the enjoyment truly digest.

Words spoken. Hope emerged...during working hours.

Always remembered will be the day that a written letter read aloud guided me through a tough conversation with a boss.

Tension lingered between us.  Unknown to me was the reason why. Other scenarios baffled and angered me, leaving me in a rage of confusion with one foot turned towards the door for other options.

Not knowing where else to go with the confusion and anger wrapped around a desire to merely love what I do and do it with kickass quality, I reached out to mentors.  Wisdom came like a boomerang reward.  Suggestions included: talk it out, communicate, write out your concerns, be objective and specific, avoid “you” messages, get clear about what you want, own your side, clarify and discern intentions, be compassionate, ask for time to talk in a place that is NOT the office.

Follow these suggestions, I did.  And what resulted was one of the most pivotal and memorable career moments leaving behind a lingering scent of hope for what can come of conflict and the ability to dance through it.

Questions were answered.  Misunderstandings were not only evident, but appeared to be forgiven. Clarity rose.  Relief swelled. Perfection has been bypassed... on purpose.

Had this been a “perfect” position or relationship, I would have never been given the opportunity to grow skills of communication, clarity, advocacy, confidence and professionalism. Moving forward with these recently polished skills, a stronger and clearer purpose have rallied energy that was previously and heavily covered by anger, confusion, resentment and ambiguity.

Amidst it all, inspiration for specific program development sprouted right up, despite the previous covering.  Leaves me even more devoted to suggesting and following these ideas (that I do not claim to be my own): be who you are, be where you are, and embrace your truth... with compassion and clear communication, include those most near to you who are part of the concern and listen to understand their perspective.

Just for today: What does it feel like to be where you are? If there is a feeling of being blocked, who could you talk to about ideas for unearthing possibilities or at least addressing the specific concerns? How willing are you to move into the truth?

You deserve hope. And welcome to perhaps your first step of it, or high-fives if you’re already livin’ in it.

Back to blogging, beginning with seclusion and restraint

I have taken a pretty long break from blogging, due to a job change and a new baby on the way! But, I am finally moving past the vomiting and settling into my new work at a state psychiatric hospital. After working in physical rehab, the transition to mental health has me thinking about all kinds of different facets of Occupational Therapy. I am definitely hoping to find an online community of Mental Health OTs to share curriculum with, swap ideas on reducing seclusion and restraint, and learn what assessments etc. they are finding helpful in their settings!  

I was emailed a video on seclusion and restraint in the schools that definitely is worth sharing. It seems like a great video to show at employee trainings! The video is by filmmaker Dan Habib and is part of the Stop Hurting Kids campaign. 

Holding Hands With Client-Centered Practice

"Will you hold my hand?"

That’s actually all she wanted. With my careful assistance, she had just moved from the edge of her bed to the commode. She was in the midst of explosive diarrhea, yet delightfully demented.

Resting on her new throne, she sat totally contented and stumbled for her final wording of the question that (in an OT-kind-of-way) made my day, “Will you, will you, will you...hold my hand?”

Without hesitation, our hands just rested together. So there i stood, holding her hand while she sat on the commode. (Can't say that I'd predict this scenario would make my day.)

Sometimes being client-centered leads us far from expected engagements in our typical day, yet it always feels so good to reach out to the challenge.

Just for today: How can I be more present to my client’s needs?

Occupational Profiles: Long term & Residential Pediatric Care Facility

I am very happy to introduce a new series, Occupational Profiles, with a guest post from Meredith Daly. The hope of the series is to expose readers to different occupational therapy settings, perhaps to spark interest in pursing a specific speciality or perhaps to find commonalities between seemingly very different practice ares. Afterall, as Meredith writes below, we are all working to give clients as much control over their lives as possible.

Q&A with Meredith  

What is your current practice setting?

I work at the Massachusetts Hospital School in Canton, MA, which is a long term & residential pediatric care facility. It’s a really unique model in that a majority of the patients live on campus for a traditional school week; they go home to their families on Friday afternoon and return on Sunday evenings.  I work on the hospital side of the facility (vs the school side) and so get to focus on pediatric physical disabilities without being bound by IEP goals. It’s the best of both worlds!  

Who is your typical clientele? 

MHS services children aged 8-22 years old with multiple physical & cognitive disabilities. There are 5 OTRs on site and we each have our own unit.  We have 2 COTA/Ls that share responsibilities across units as well! My unit is home to 19 patients aged 14-21 who have severe cerebral palsy, spina bifida, seizure disorders, mitochondrial disorders, various chromosomal abnormalities and/or genetic conditions. All but two are non-verbal and five are AAC device users!  

How did you land in this practice area? 

I have always loved working with kids. For a long time I thought I’d be a teacher, but I always had an interest in physical disabilities & rehabilitation. I ended up volunteering at MHS as a high school student in the therapeutic recreation department.  Once I was in, I never left (even while in NYC for grad school!).

How are you specifically poised, as an OT, to help clients in your practice area? 

Really what these kids want to do is have as much control over their lives as possible… luckily that is something that we, as occupational therapists, specialize in (not to mention get joy & satisfaction out of)! Simple things like choosing which book to read next, participating in turning the page, and choosing nail polish colors are a HUGE deal! The training that we got at NYU with focus on client-centered practice, activity analysis, & assistive devices/tech has prepared me with the foundation & confidence I need to help these little guys out.

OT is such a great profession because it allows you to collaborate with your patient to find areas that are motivating & special to each individual.  Since these kids really just want to do “typical things” my goal is to create opportunities for them to make choices & direct their care as often as possible. Obviously as an OT in a hospital setting, many interventions are centered around ADLs & grooming. One of my favorite activities with one of my favorite little chickies is having her use her Dynavox to direct a grooming task. Without doubt she always chooses “paint my nails” or “pick out clothing”. These tasks allow her to work on finger & wrist extension without the use of her very stylish black & hot pink Beniks splints, so while she feels great & proud of herself, she is simultaneously (and secretly!) refining communication skills, directing care, establishing a sense of self/personal style, AND working on upper extremity coordination goals.

What advice would you give to someone interested in your practice area?

Become familiar with wheelchair seating, assistive tech, and AAC devices! When working with kids with severe physical disabilities, it’s important to be educated on current assistive technology approaches! Become as comfortable and familiar as you can with these devices, and then remember that the kids are just kids!  

What areas of growth would like to see in the profession, with regards to your practice area? 

Many standardized assessments are motor based & difficult to administer to students who are wheelchair users, particularly those with all limb involvement. Some of the motor free assessments are difficult due to the communication skills require. I would also love to see more advanced course training for assistive technology as it relates to access & participation in daily life especially at group homes or day programs! Tools for transition preparation & assessment!

Photo of Meredith and a client by the Massachusetts Hospital School