ETHICALLY GROUNDED PROFESSIONAL WITH A STRONG OT IDENTITY
^ OT recommendations handout created by Payton Johnston, MOT/S to post at infants bedside for other healthcare, volunteers, etc. to keep in mind when working with the infant in the NICU.
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2.1 Advocates for clients who have been neglected or underrepresented in the system.
In the NICU, proper positioning is crucial for the development and well-being of premature infants. Occupational therapists can advocate for proper positioning of the infants to prevent complications like muscle contractures, asymmetries, etc. Supporting and creating positive sensory experiences for these infants is also an essential component of promoting developmentally appropriate care. The NICU environment, with its medical equipment and constant activity, can be overwhelming for these medically fragile infants. The nurses have a large number of responsibilities in the NICU with multiple infants at a time. Sometimes they have to do the best they can with what they have to be able to take care of their caseload for the day. I noticed an older infant who was sitting in a Bumbo seat asleep while her head was slumped over and looked uncomfortable and not in midline with her body. This can cause torticollis, and many other complications, including delays with the head positioning improvements made during her long stay in the NICU. I created a handout to post at the bedside and reviewed it with one of the nurses to educate her on positioning techniques and other recommendations on how to support the infant's sensory systems and experiences. During my experience, I continued to advocate for the proper positioning of these babies and educate the nursing staff on the benefits of promoting normal muscle tone and movement patterns. It is important to have good communication skills and build collaborative trusting relationships with all the healthcare professionals involved, to provide the best possible care for the neonates and their families. Above, I have attached the handout I created. |
Me in PPE gear ready for OT with a patient!
Written by FWE Madison Campbell, MOTR/L - Encompass Health Rehabilitation Hospital of North Memphis
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2.2 Fulfills commitments to the professional community.
Toward the end of my fieldwork experience at Encompass, there was an unexpected COVID outbreak. To the left, I have attached a picture of me wearing PPE before walking into my first treatment session with a patient who had COVID. My FWE was pregnant at the time and therefore unable to treat or come in contact with the COVID patients. I quickly stepped up to the plate and was able to treat these patients in the isolation rooms for the required 1-1.5 hours of therapy, with minimal supervision from my FWE while still being able to message her on my documentation laptop. I followed proper procedures for donning and doffing the PPE to ensure effective protection against contamination. This included ensuring a proper fit, avoiding cross-contamination, and maintaining good hand hygiene before and after using PPE. Below the picture of me is a screenshot of comments written by my FWE, Madison Campbell, MOTR/L on my final evaluation where she mentions my "high level of resilience" during my rotation, specifically during the COVID outbreak where I treated patients in isolation rooms in full PPE with minimal supervision. |
^ Discussion post written by Payton Johnston, MOT/S
2.3 Represents the unique perspective of occupational therapy when participating in inter-professional situations.
While at Encompass, I had the valuable opportunity to represent the unique perspective of occupational therapy in inter-professional situations, such as team conference meetings involving patient updates and discharge recommendations. In place of my educator, I was able to independently provide patient updates regarding their occupational performance and any durable medical equipment recommendations for their discharge home. In these meetings, the rehabilitation MD, social worker, PT, OT, nursing manager, and therapy director attend to ensure and enhance patient care. The first few times I communicated in these meetings I was nervous, however as time went on, independently treating and assessing patients, along with guidance and support from my FWE, I felt more comfortable speaking up and essentially showcasing the vital role of OT in holistic and client-centered care. Above I have attached a screenshot of a discussion post where I mention this experience regarding leadership and collaboration on our first fieldwork experience.
While at Encompass, I had the valuable opportunity to represent the unique perspective of occupational therapy in inter-professional situations, such as team conference meetings involving patient updates and discharge recommendations. In place of my educator, I was able to independently provide patient updates regarding their occupational performance and any durable medical equipment recommendations for their discharge home. In these meetings, the rehabilitation MD, social worker, PT, OT, nursing manager, and therapy director attend to ensure and enhance patient care. The first few times I communicated in these meetings I was nervous, however as time went on, independently treating and assessing patients, along with guidance and support from my FWE, I felt more comfortable speaking up and essentially showcasing the vital role of OT in holistic and client-centered care. Above I have attached a screenshot of a discussion post where I mention this experience regarding leadership and collaboration on our first fieldwork experience.
Written by FWE Kalyani Garde, MOTR/L, CIMI, CNT, NTMTC - Baptist Women's Memorial Hospital
2.4 Assumes responsibility for professional behavior and growth, in accordance with AOTA standards.
Above is a screenshot from my final evaluation written by my FWE at Baptist Women’s Memorial Hospital, Kalyani Garde, MOTR/L, CIMI, CNT, NTMTC. She mentions my efforts in reading and researching during personal time to increase my knowledge of the scope of practice within the NICU setting. From the time I found out I would be in the NICU to my last day, I spent any time I could expanding my knowledge regarding occupational therapy in such a unique and challenging setting. In the article Occupational Therapy’s Role in the Neonatal Intensive Care Unit, The American Occupational Therapy Association (AOTA) addresses exactly how advanced neonatal practice is. “Extensive continuing education; mentoring by an occupational therapist experienced in neonatal care; and graded, closely supervised, mentored practice are recommended for any occupational therapist entering neonatal practice” (AOTA, 2018). According to the National Association of Neonatal Therapists, The essential knowledge base that an occupational therapist must possess when working in a NICU (NANT, 2014) includes the following:
• Dynamic systems theory
• Family-centered care
• Synactive theory of development
• Basic anatomy and physiology of the neonate
• Neurodevelopment (motor, sensory, autonomic)
• Atypical and typical preterm infant development
• Typical neurodevelopmental outcomes of preterm infants
• Embryology
• Fetal and neonatal brain development
• Acute and chronic stress
• Acute and chronic pain
American Occupational Therapy Association. (2018). Occupational therapy’s role in the neonatal intensive care unit. American Journal of Occupational Therapy, 72(Suppl. 2), 7212410020. https://doi.org/10.5014/ajot.2018.72S204
National Association of Neonatal Therapists. (2014). NANT professional collaborative. Retrieved from http:// www.neonataltherapists.com/ICMCalls/Neonatal-Therapy-Core-Scope-of-Practice_final.pdf
Above is a screenshot from my final evaluation written by my FWE at Baptist Women’s Memorial Hospital, Kalyani Garde, MOTR/L, CIMI, CNT, NTMTC. She mentions my efforts in reading and researching during personal time to increase my knowledge of the scope of practice within the NICU setting. From the time I found out I would be in the NICU to my last day, I spent any time I could expanding my knowledge regarding occupational therapy in such a unique and challenging setting. In the article Occupational Therapy’s Role in the Neonatal Intensive Care Unit, The American Occupational Therapy Association (AOTA) addresses exactly how advanced neonatal practice is. “Extensive continuing education; mentoring by an occupational therapist experienced in neonatal care; and graded, closely supervised, mentored practice are recommended for any occupational therapist entering neonatal practice” (AOTA, 2018). According to the National Association of Neonatal Therapists, The essential knowledge base that an occupational therapist must possess when working in a NICU (NANT, 2014) includes the following:
• Dynamic systems theory
• Family-centered care
• Synactive theory of development
• Basic anatomy and physiology of the neonate
• Neurodevelopment (motor, sensory, autonomic)
• Atypical and typical preterm infant development
• Typical neurodevelopmental outcomes of preterm infants
• Embryology
• Fetal and neonatal brain development
• Acute and chronic stress
• Acute and chronic pain
American Occupational Therapy Association. (2018). Occupational therapy’s role in the neonatal intensive care unit. American Journal of Occupational Therapy, 72(Suppl. 2), 7212410020. https://doi.org/10.5014/ajot.2018.72S204
National Association of Neonatal Therapists. (2014). NANT professional collaborative. Retrieved from http:// www.neonataltherapists.com/ICMCalls/Neonatal-Therapy-Core-Scope-of-Practice_final.pdf
2.5 Functions autonomously and effectively in a broad array of service models.
Both of my Level II fieldwork experiences were very different from one another. Everything including the diagnoses, service models, documentation methods, delivery of services, etc. Both were challenging and rewarding in their unique ways and as a result, shaped me into a well-rounded future OT practitioner. For my first 12 weeks, I was at Encompass Health Rehabilitation Hospital of North Memphis, an inpatient rehab facility (IRF) for adults that provides three hours a day of therapy for individuals who have experienced a new major injury or illness impacting their independence and overall occupational performance. I enjoyed working with this population a lot more than originally thought I would. One of the main professional goals I made for myself during my time at Encompass was effective time management. In this setting, and at this particular facility, the documentation was completed in real time during the treatment sessions. I wanted to be able to complete my documentation by the end of each session with accuracy while also maintaining and establishing a therapeutic relationship with my patients. By the end of the 12 weeks, I was treating, documenting, and evaluating all independently and efficiently while building memorable therapeutic relationships. I gained confidence in communicating with my patients, their families/caregivers, and other healthcare professionals without any hesitation. The second 12 weeks I spent in the NICU at Baptist Women’s Memorial Hospital. Transitioning to the NICU was a unique and eye-opening experience that exposed me to the specialized care of premature infants and critically ill newborns. Working alongside neonatal nurses, nurse practitioners, cardiologists, and other healthcare professionals, I observed the meticulous care and attention required to support the development and well-being of these infants. This setting presented unique challenges and complexities, highlighting the importance of individualized family-focused, and supportive care. Here I made a goal to improve my therapeutic handling skills and abilities with medically stable newborns and premature neonatal infants. This is something that just takes hands-on practice! These skills gradually improved by the end of my rotation, but require more hands-on experience and mentorship to become a specialized neonatal occupational therapist. Overall, my fieldwork experiences in IRF and the NICU were instrumental in shaping my clinical skills, professional growth, and commitment to serving my future clients. |
Written by FWE Kalyani Garde, MOTR/L, CIMI, CNT, NTMTC - Baptist Women's Memorial Hospital
Written by FWE Madison Campbell, MOTR/L - Encompass Health Rehabilitation Hospital of North Memphis
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Written by FWE Madison Campbell, MOTR/L - Encompass Health Rehabilitation Hospital of North Memphis
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2.6 Upholds the AOTA Code of Ethics in practice.
To the left, is a screenshot of comments written by my FWE on my final evaluation during my time at Encompass where she acknowledges my “strong sense of ethical reasoning” in daily practice as an OT student. With sound knowledge of the AOTA Code of Ethics, I was able to consistently make ethical courses of action throughout both of my fieldwork experiences. |
2.7 Serves as a role model for honesty, integrity, and morally grounded decision-making.
Serving as a role model for honesty, integrity, and morally grounded decision-making is crucial in upholding the AOTA code of ethics for the profession. I always remained honest and transparent with my patients, fieldwork educators, and other healthcare professionals I interacted with. I always made ethical courses of action or considerations when faced with any dilemma or circumstance. I consistently abided by HIPAA confidentiality in all patient interactions and documentation. To the right, I have attached a screenshot of comments made by my FWE on my final evaluation at Baptist Women’s Memorial Hospital where she mentions my “good understanding of beneficence and nonmaleficence” in the NICU setting. |
Written by FWE Kalyani Garde, MOTR/L, CIMI, CNT, NTMTC - Baptist Women's Memorial Hospital
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