Engaging in occupation through adversity.......

Last evening I sat down to watch the Proms at the BBC - a performance of  Rachmaninov's Piano Concerto No 2 - one of my favourite pieces (think - "Brief Encounter" ). The piano soloist was an extraordinary young Japanese pianist Nobuyuki Tsujii, whose blindness is no barrier to his musical talent. In his interview trailer before the performance he explained how he listens for the conductor's breathing in order to reach his cues and work together with the orchestra and uses muscle memory and touch and sound to learn the pieces rather than use Braille. A fantastic performance was given and then followed by an encore of  Liszt’s La Campanella - one of the hardest pieces to play and clearly a bit of well deserved showing off ensued.

 This reminded me of recent stories I had seen on Facebook or on the BBC news that seemed to all form part of a theme. How people continue to engage in meaningful occupations (whether for leisure or productivity) whilst experiencing illness or disability. It often amazes me how people overcome obstacles when they decide they are going to engage in an activity - and how the people around them enable and support them in any way they can by adapting behaviour and/or the environment. By doing this they often challenge the perceptions of others as to what is possible and can act as an inspiration to others by being their own occupational therapist.

Please see the videos below for some truly inspirational stories and ones that have great resonance for occupational therapists..........................

18 years ago a slight lapse in concentration crushed Pascale's dreams of surfing. With the help of a family friend and a roll of duct tape; she can now call herself a surfer.











 A Son asked his father, "Dad, will you take part in a marathon with me?" The father who, despite having a heart condition, says "Yes". They went on to complete the marathon together. Father and son went on to join other marathons. The father always saying "Yes" to his son's request of going through the race together. One day, the son asked his father, "Dad, let's join the Ironman together."

To which, his father said "Yes".

For those who don't know, Ironman is the toughest triathlon ever. The race encompasses three endurance events of a 2.4 mile (3.86 kilometer) ocean swim, followed by a 112 mile (180.2 kilometer) bike ride and ending with a 26.2 mile (42.195 kilometer) marathon along the coast of the Big Island.

Father and son went on to complete the race together!

An Isle of Wight teenager with cerebral palsy has completed a solo journey across the channel.

Natasha Lambert, 16, was born with atheroid cerebral palsy which affects her limbs and speech.
Her 21ft-long (6.4m) boat, Miss Isle Too, has been adapted by her father, Gary, and allows her to steer by sucking and blowing into a tube.







I wonder if these stories say as much about the families who support them as it does about the person themselves. Might this mean that those individuals experiencing occupational deprivation through disability and/or illness who do not have supportive family may be disadvantaged? It would be great to hear of your experiences if you would like to share. Thankyou.

Hitting the target....but missing the point?

There has been much debate, discussion and speculation about the impact the Mid Staffordshire public enquiry and the subsequent Francis Report is having and will continue to have on health care delivery. Today I was invited to attend a presentation by Professor Ian Cumming, Chief Executive of Health Education England the new organisation who explain their role as:

"We are the NHS engine that will deliver a better health and healthcare workforce for England. We are responsible for the education, training and personal development of every member of staff, and recruiting for values. We are England’s health and healthcare people service."

Professor Cumming describes a culture in many organisations (and certainly found in the Mid Staffs culture) of documenting at all costs, even over caring for patients and went on to describe a few scenarios he had witnessed where service user need was secondary to process requirements and meeting targets. The issue of record keeping, documenting client care and statistics recording has always been important but perhaps has  become more so over the last 20 years?

Since the early 1990's with the advent of the Access to Health Records Act 1990 and the free market principles of the Purchaser/Provider split  and subsequent changes with successive governments there has been more accountability, more business culture within the NHS coupled with a social change of a shift in greater litigation culture. This has all had an impact on how we practice as occupational therapists and how we educate and train occupational therapists. As a manager in the early 1990s I remember numerous conversations with practitioners who bemoaned the fact that documentation and statistic recording was time consuming and took them away from patient care - the mantra at that time was "If you don't record, it hasn't happened. If it hasn't happened then we are not a viable or valuable service to patients or to the organisation". Perhaps sewing the seed for the position many seem to be in today of shifted priorities detrimental to patient care.

As an educator of occupational therapists, one of the areas I teach is Legal and Ethical issues in practice. Students' awareness is heightened during these sessions of what could constitute harm, neglect and breach of Code that may result in being struck off the HCPC register or taken to a civil court for breach of duty in common law. These sessions are intended to create best practice, adherence to COT Code of Conduct and HCPC Standards of Practice and to ensure that the ethical principles of autonomy, beneficence, non-maleficence, veracity and equity are considered in everyday practice. I still believe that this is vital for a student to understand before they go out onto their first placement (one week observation not included). However, I would like to pose a question.......

Are we in danger of hitting the target and missing the point? Do we as occupational therapists spend too long on process and administration to the detriment of client contact? Whilst most of the discussion in the arena is currently focusing on nursing and medics, allied health professionals will not be excluded and I would be interested to hear what your experience of hitting targets and missing the point may be.

COT Annual Conference ---- and Occubuzz

Today sees me trying to return to "normality" following 3 days in Glasgow for the COT annual conference. Sarah and I were in attendance having had a number of abstracts accepted for poster facilitations, a seminar and an innovative technology stand. At the time of submitting abstracts (usually September time) it feels such a long way away to the following June - however it crept up on us and with the usual last minute flurry of activity ensuring posters were designed and printed, presentations were ready and we had material to make our stand "stand out".

Highlights of the 3 days:

a) Meeting so many people in "real world" that we had met and connected with through our social media networking - in particular a number of our Post graduate students on our online MSc programme that we have never actually "met" before. Watching people move and hearing them speak is a fascination that never wanes - so now, when we return to virtual space we can have a more rounded picture of our connections. So if you came and found us to say hello - thanks - we loved meeting you.

b) Of course catching up with everyone was great.

c) Introducing Michael Iwama to Occubuzz and almost having a preview of his dance moves perfected for the evening's gala - Michael -we may not have been there to see them - but we now have eye witness accounts and photos - so we know it happened - and good reports have been filed :-)

d) Coming away with potential collaborations to explore further including being approached both by a publishing company to consider writing a book and a USA recruitment agency interested in our online training capacity and capability.

e)

OCCUBUZZ - the interest generated out-performed our expectations. We were swamped everytime we were on the stand by people wanting to talk about the app and it's potential. Our "sticky bee" stickers became cult with people coming to ask for one - however they had to listen to our spiel before we would give one out.
You can find out more about this on the Occubuzz tab at the top of the page. Please download the app and play with it - it is a prototype and there are some gremlins but your feedback is vital to our development of version 3 which we are then hoping to use in some research with practitioners and the general public. We hope to have a blog and a facebook page just for Occubuzz coming very soon......



f) Attending the Student presentations where 2 of our students were presenting their experiences of a volunteer project using occupation as the focus for a Carer Support group we have worked on with a local Trust. Sam Tozer and Louise Hesketh - you were great, professional, clear and extremely interesting in your reflections and what you shared -great experience for the CV. (Of course not forgetting Helen Hampson and Maria Lynch who were part of the project too). More information about this project can be found on our poster (Evaluating an Occupation Focused Group for carers of people with mental health conditions). Click here

g) Dare I mention the free food and drink copiously provided on the first evening back at the hotel by the recruitment agency that over-predicted numbers of delegates. Our gain I believe :-).

h) Making some headway in the development of social media guidelines for health and social care professionals. Our seminar on Professionalism in the Digital Age was well attended (even at 9am!) and we received some useful comments on the risks and challenges ahead that need to be addressed. Watch this space as we work with our national and international colleagues on this project.

At the moment this is about all I can remember. I return to be swamped in emails, admissions queries, marking and other bits that don't seem to care that I have been away - I will attempt to follow up with more info very soon - and yet again I make a resolution to be a better blogger.
Any hints and tips on how to be a more regular blogger would be well received. Thanks for your continued support.

Reminiscing ..... how about you?

My student room 1980

 Having recently taken on the role of Admissions Tutor I have been learning the ropes as I go along and also considering what, if any, changes we may need to make in light of the recent Francis Report which recommends we consider values and attitudes of new recruits with particular reference to dignity and compassion. After a few consultation sessions with staff, students and service users, I am in the process of writing up my report to present to the team in a few months time.

Last week saw the last of our interviews for next year's BSC (Hons) Occupational Therapy full time  students so I now have the hard task of selecting 56 students from the 120 students invited for interview... phew - I may need lots of coffee and chocolate over the next few days. Luckily I have Heather Davidson to help me as the experienced admissions tutor I have taken over from.

As my current focus is on this process, a small period of reminiscence raised it's head as I discussed with a colleague our own interview for OT training and our subsequent experience of being an OT student. The difference between then (dare I say my interview was 33 years ago now ?!) and today is rather extreme and I thought it may be something to share here. I would be interested to hear your comments and to read about your own experience, whenever that was.

One of things that stick in my mind at interview was being asked "what does you father do?" and "do you have a boyfriend?". I imagine that the former was to see what my background may be and the latter to see whether I was dedicated to study or if I was going to have a distraction in the form of a relationship. Can't imagine asking these questions today!! I seem to have vague memories of a group discussion and certainly a written task where I had to choose between writing about a holiday I had taken and what I knew about learning disability. I chose to write about a holiday - but have no recollection what I actually said. I got offered a place though and started September 1980 so I must have done something right.
The letter of acceptance asked us to bring certain things to college (wasn't university in them days!) which included:
a) tape measure
b) scissors
c) an apron
d) a travel rug (never did find out what this was to be for).

I arrived  at St Andrew's School of OT in Northampton (in the grounds of a very grand Psychiatric Hospital) and was given accommodation in the Nurses' Home with all the other first year students (we had to source outside accommodation in year 2). Meals were provided in the hospital canteen - although we were allowed kettles and toasters in our rooms (at least I think we were allowed - we did anyway).  Our timetable was full Monday through Friday 9am-5pm with 2 nights of evening classes at a local FE college for touch typing and woodwork.
Our days in college were taken with lectures (psychology, sociology, medicine, surgery and orthopaedics, communication and management and then anatomy and physiology which was an all day event every Thursday at Nene College - a local polytechnic) and practical activities of weaving, basketry, stool seating, lathe and fretwork, metal work, cookery and printing. We also had to put on a show for the resident patients within the hospital at the end of the first year - I remember dancing a hornpipe and singing a solo (don't ask!!).
Unlike now where our students have placements throughout each level and sourced locally,  our placements were mainly in final year and we could be sent anywhere in the country. We had a one day observation placement running through 6 weeks of first year, one month at the end of second year (I was sent to Hounslow Social services and lodged with an Archdeacon and his family) and then the final year was totally out on placement - returning for one day periods through the year to sit exams and then a final 6 weeks back in college for revision and final exams. My placements were in London, Poole and Norfolk - so every 12 weeks or so I would be packing up and moving to the next placement with very little contact from College at this time (as far as I remember).
I left with a Diploma and a clear desire to work in Norfolk in Mental Health - and one that I achieved.
So, just a little indulgence there - thankyou for allowing me this - but I really would like to hear what your training was/is like whether in the UK or anywhere in the world.

PS: Oh, and my student uniform was blue!