Week 9: Under the Microscope

Reaching the final week of fieldwork, it's time to take to shift the lens away from my clients and on to myself, to a look back and scrutinise my development over the last 9 weeks, what skills I've developed, and what aspects I still have to work on.

Over the time I've been at hospital, I've found that I am able to assess much rapidly than previously, through having learnt how to select appropriate assessments, use observation accurately and work through assessment forms faster. This is no doubt the result of having the opportunity to be in an acute setting, where rapid assessment ensures more time available for intervention.

I've found improvements in my ability to build rapport with a client in the limited window of time, allowing them to open up more during therapy, and actively assist in the treatment process.
I've found that simply asking a client what they perceive to be their biggest problem, using listening skills and well-timed questions, often goes a long way towards building a holistic view of the client, instead of running through the set list of interview questions, in which more time is spent writing down every word the client says than actually listening.


Over time, I've found that it has become easier to select relevant therapy for the client. There are still many instances where I have to refer back to textbooks and the Internet (the saviour of students everywhere) to get a better idea of the condition and appropriate OT intervention, but slowly, my small knowledge base is expanding and I can see things starting to fall into place within the OT lobe of my brain.

It still takes me a while to sift through the assessment findings, organise them into a comprehensible whole and develop a relevant programme, but that has been slowly improving. There are times when I miss things completely, like in the case of phantom limb sensation of my current client during the sensation assessment, and have to go back and check on aspects again in subsequent sessions. Over time, I am sure that experience will be the best teacher.

Another thing I have to work on, also a difficulty related in part to limited experience, is on-the-spot grading within treatment. Often, clients change at varying degrees from one session to the next, therefore it becomes crucial that I make allowances for these changes in my grading plan. I still find it difficult to come up with adaptations rapidly within the session, meaning that until I develop this skill, a lot more thought needs to into drawing up my grading section of the session write-up.  


My time-management skills, having never been a strong talent of mine, have shown improvement, as I'm no longer rushing to scribble forms or complete activities during the last ten minutes of the day. It helps that filling in patient files takes me a lot less time now that SOAP notes are more familiar to me, and that I have a better idea of the nursing schedule, so much less time is lost waiting for bandage changes or feeding time.





Overall, I am confident that I have benefitted from fieldwork, and it has been invaluable in adding to the skills I will need to be a successful OT one day. Although there are still many weaknesses I still have to address, I can see that I have begun to develop already, and hope I will continue to do so throughout the next 18 months of my course (I pray) and the many years of practice that lie ahead.