It’s probably about time I told you this, but I’m employed, and not as an OT.

Hi there.

It’s been a while. I’ve been keeping something from you all.

I have a job!

A permanent job, no less. I didn’t want to say anything until I’d passed the one month trial that they asked me to do, as they were taking a very big risk hiring me. I passed, if you haven’t guessed, and I’ve been there now for six weeks.

Now, I didn’t get an occupational therapy job. In fact, my job title is Technical Customer Support Agent, and I spend most of the day answering phone calls and helping people with ‘electronic point of sale’ software. It’s a customer support role that requires a lot of technical know-how in hardware, software and web development, none of which I had too much professional experience in when I applied. In my first month, I had to show them that I had the capacity and willingness to learn, and apparently I did really well! Being a small company, I also had to fit in with the team, and I’m so happy to find that I get on really well with my team, and I feel like I’m contributing something worthwhile to them and to our customers.

The job is intense; it can get both busy and sometimes emotionally draining, but I love it. I want to learn more, fix more on my own, improve the existing systems so that customers don’t have to call in about everything. I guess it’s my OT training talking, but I want to help our customers become as self-sufficient as possible, and that means creating a support network for them, including the existing customer support staff, as well as help videos and guides, better initial training and so on.

It’s strange, though, thinking I’ve got HCPC-registration and a degree in occupational therapy, and yet I’m not even in a health or social care job. I’m definitely using the skills I learned during my studies, but I didn’t go to university thinking I was going to end up working with computers. It makes sense now, as I learned during my studies that I enjoy working with technology and figuring out ways to make situations more enjoyable and/or efficient. I still want to eventually study for a Masters in something like human-computer interaction or user experience, but I don’t know where that’s going to lead me considering how my idea of the future has changed so dramatically since I was in high school.

Tuesday’s #OTalk on Twitter is about the transition from OT student to OT practitioner, but I feel I have something to contribute despite not following that path. In today’s climate, not everyone who graduates with a degree in OT will end up working as an OT. At least not initially. I bet most of those who don’t get an OT job get a related position as a carer, mental health worker, OT assistant, etc. However, I want all those graduating in the next few months to realise that you don’t have to limit yourself to OT. You’ve developed brilliant skills in analysis and can understand people and occupations in ways that many others can’t. These skills are so, so useful to employers in other fields. My desire to help others be independent, which grew as an OT student, is now appreciated in a technical customer support role. Customer service is just one path to try, though. Figure out what you enjoy and what your personal strengths are, add in those many skills you developed at university, and try new avenues.

My final piece of advice is to not give up. I couldn’t find an OT job. In fact, I was struggling to get any job that was mildly of interest while I worked part-time at a customer service desk in a retail chain. After four months there, I handed in my notice without a job lined up because it simply wasn’t right for me. I took a chance because being unemployed for a short while made me happier than the job I only spent 27 hours at a week. Around the same time, I’d gone to a few interviews, with positive results, and despite having a job offer, I took yet another chance. I held out for the role I have now, having three interviews in total. And I got it. You see, it all worked out, and all I had to do was wait a little while, take a few chances and be open-minded.

Stroke and splinting

At Bethesda, I met my first person who had had a recent stroke. You would think that, having theoretically learned about strokes during my course, I would have met a person with signs of a stroke sooner (not only after my graduation).

She was a lovely elderly lady – let’s call her Ms X – who was absolutely determined to be independent. Her symptoms were entirely motor, with hemiplegia on the left side. Four weeks on, she had already learned how to walk again, and I was allowed to work with the occupational therapy assistant (OTA) as she helped Ms X walk across the room and back. A lot of the focus was on reminding her to shift from side to side as she walked. I thought a good idea for increasing standing tolerance and practicing weight shifting would be to bring in a radio onto the ward so that the people there could dance, or at least sway from side to side, with help from a healthcare assistant, family member, OT, PT or even just a walking frame. It would have certainly made the ward a little more fun and engaging!

Another suggestion I had that the OTA actually used was to test just how much sensation Ms X had in her affected side. She insisted she could feel everything, she just couldn’t move her hand that much; the OTA was a little skeptical. So I said that Ms X should close her eyes and the OTA should stroke different materials across her palm or put different objects in it to see if Ms X could identify them. She got everything but one material wrong – she thought my leather glove was the same as one of the hospital gloves. I have to admit that I was quite pleased with myself about this idea, as it showed the OTA that Ms X was more intact than originally thought.

Ms X was constantly stroking her affected hand and repositioning it. I actually noticed the same behaviour in some of the other patients on the ward who’d had a stroke. She described how her hand was always stretched out and relaxed while she slept, but as soon as she woke up, the tone would start to increase, hence why she continuously tried to stretch her fingers out. She said it got tiring after a while having to pay so much attention to her hand. I thought a resting splint would help for a few hours during the day so that Ms X could relax, so I asked the OT about it. She informed me that a splint would only stimulate the palm and increase the tone, something that’s intrigued me for a while.

I asked the Twittersphere earlier about it, and @kirstyes kindly explained to me that splinting could in fact increase tone in some people, and that encouraging normal bilateral movement and positioning was more important in the earlier stages. This is definitely something I should investigate further, and I’ve done a preliminary search on the topic in the AMED database. I guess I have some reading for a few days!

I met another woman, and I actually visited her home on my first day volunteering, who’d also had a stroke at a similar time. She didn’t seem as determined, and she wouldn’t let anyone touch her arm, saying it hurt too much. When the OTA tried to stretch the arm, this woman could be heard across the wards. She insisted that she wanted to be independent, but her actions did not appear to match her words. Compared to Ms X, she seemed to need a lot more psychological support on top of the standard rehabilitation. I’m very glad I was able to meet two very different women in terms of their experience with stroke.

I’m also very grateful to have finally had the chance to go on a home visit! I even think I made a contribution, discussing different bathroom and kitchen modifications with the OTA, and pointing out certain practical considerations that she didn’t think of, like the turning circle in the bathroom.

Overall, I thank Bethesda for allowing me the opportunity to apply the theory I learned in university to real situations. (This also applies to my chance to work with the babies in the inpatient ward – absolutely loved it!) I also thank @kirstyes for passing on her experience to me.

Tonight’s #OTalk – Using Skype as a professional tool.

Now, I have been a bit absent from OTalks for a while, partly due to university, then due to being tired from work, and more recently because I’m an hour ahead and like to spend evenings with my family while here in South Africa. But I decided to tune in to tonight’s OTalk because it intrigues me. The discussion is about using Skype as a tool in our work as therapists. I wanted to just go through my thoughts prior to the discussion so as to have a basis to reflect on afterwards.

First off, what uses can I think of for Skype in occupational therapy?

  • Remote monitoring of clients between sessions, both in mental and physical settings, particularly with clients living in rural areas
  • Interviews, initial and follow-up
  • Remote counselling
  • Including an expert from another location in a discussion or therapy session
  • Meetings with other professionals
  • Supervision for lone workers who have no appropriate supervisors or mentors
  • Clients in inpatient settings or care homes can contact family and/or friends

What are the advantages of Skype?

  • Time saver – instead of driving miles for a short visit, you can check up on someone from your office while they can be in the safety of their own home
  • As with above, also a money saver
  • And you can then see more clients in a day
  • Video allows you to look out for body language and/or changes in physical appearance
  • Allows for easy contact with clients, carers and/or other professionals

What are the disadvantages?

  • Possible to miss out on environmental issues
  • Possible to miss out on peripheral body language changes
  • Not as personal as face-to-face contact
  • Cannot utilise touch, such as a hand on a shoulder when someone is upset
  • Can get distracted easily if you have a computer in front of you
  • Client may notice that you aren’t giving them your full attention

Relevant links and articles:

I’ll update this following the discussion, but feel free to add to any of these in the comments!!!