I changed jobs almost a year ago; after 19 years of working as an occupational therapist
in a large school district, I moved over to the world of academia, joining the
faculty at a university in the heart of the city in which I live.
I continue to provide OT services for patients, but now part
of my job also includes helping to shape the education – and the perspectives –
of future occupational therapists. I weave into what
I teach many of the things I learned as a result of what my dad, my family, and
I experienced after his diagnosis of brain cancer.
I feel compelled to impress certain things on the group of fledgling
healthcare professionals before they enter the clinical arena, in hope of maximizing
the positive impact they will have on their future patients and the families of
their patients. In the medical world,
these tips are sometimes referred to as “clinical pearls.”
I think there are a lot of lessons for the OT students to carry forward into their interactions with
patients from things I saw (or didn’t see) when I was with my dad while he
was in rehab. On one such occasion, the
occupational therapist came to my dad’s room and escorted us to the
rehab gym, where she set him up at a big table.
She brought over a bowl of many small items which she dumped onto the
surface in front of him, and she instructed him to use his left hand to sort the
items into piles according to their similarities. Before Dad could get started, she turned around
and walked over to another patient on the other side of the gym, presumably to
check in on that patient while Dad got going on the assignment he had gotten from her.
It was odd for me to be there in that setting as a caregiver
instead of a service provider; I tried to make a conscious effort to let the
therapist take the lead and not to prompt my dad too much during the
intervention. I watched him as he sat in
the wheelchair that the OT had positioned at the table. He looked at the stuff on the table for a
minute, glanced around the room for a couple of minutes, and then looked at
me. “I guess she wants me to clean out
her junk drawer,” he said to me in a stage whisper. “If it was up to me, I would just throw all
that crap away, but I guess if I do help her she will do something to help me
get better so I can go home.”
Of course, I knew that what she wanted him to do was for his
benefit, not to help her organize her junk drawer, but what I also knew was
that Dad hated junk and that he hated to do things that he saw as a waste of
time. The OT had not explained to him
why he was supported to perform the task.
I tried to explain it to him, but he was way past the point of listening at
that point; he just wanted to get done with what he saw as the worthless job
she had given him so he could get the hell out of there.
After about five minutes, the OT turned around and saw that
Dad hadn’t started on the activity. She
came back over to us, and I waited to see what would be communicated between
the two of them. “Bill,” she said,
annoying me with her assumed familiarity, “What did I tell you to do?” And then I was annoyed with her tone and her
attitude. Dad, in
maybe the first time in my life that I’d ever seen him do such a thing, offered
an excuse to get out of doing the work: “I have to go to the bathroom, and I
have a headache,” he told her.
She seemed all-too-eager to take the bait. “Oh, no problem,” she told him. “We can go back to your room so you can use
the restroom in there and then you can take a break.”
“Take a break from what – sitting on the
sidelines with a task he sees as a complete waste of time while you chat it up with
another patient??” I wanted to yell at her.
I knew what Dad was doing, but I also knew from past experience since
he’d been sick that if I started raising a stink it would either embarrass him or
scare him or both.
I tell this story to the OT students now because I want them to
see the big picture in the interventions they provide for their patients. “Always connect the dots for the patient and
for their caregivers,” I tell them.
“Don’t leave them to wonder why you are asking them to do
something. Talk to them about what their
priorities are; explain the purpose of the activity and clearly identify what
the patient will gain by putting forth effort in the session. Find out what their carrot is - what motivates and interests them - and incorporate that into your treatment plan.”
There are several more clinical pearls that can be taken from this story, too,
lessons that I think are important for healthcare professionals to
know. Through telling stories about
people with injuries or illness like my dad, I hope to cultivate the compassion
these students have so that they are able to connect the dots to effectively serve the needs of their patients for many years to come.
