Nature. Nurtured. Nathan.

Nathan Chavez 1OT-A.#NurtureProject #XaviNiNathan #MabutingOT 

[thanchav]

[thanchav]

Where It All Began

As the last shift of the first semester began, my goal was to finish strong. College has been definitely challenging but I firmly believe that if you truly love what you’re doing, then nothing will l get in the way in achieving your goal. From my dwindling motivation to visit my plant the previous shift, I now changed my attitude. Since I am aware of my lack of effort, I took concrete steps to improve. Reflecting upon this right now, I think that this is really the main objective of these reflections. Only now did I fully grasp the rationale behind each reflection paper that we dreaded (initially) doing. Now, I’ve come to fully appreciate everything, at least from my point of view. All those questions of “So what?” and “Now what” all made sense. Reflection is not just stating what we felt or realized but at its core, it’s really about doing something about this realizations and emotions. Concrete action directed and based on these thoughts is what is required in the practice of Occupational Therapy.

This led me to another realization. The whole Nurture Project was about making action plans based on our realizations and feelings. Simply put, knowledge must be applied into practice. Similarly when I was preparing for our presentation about the future of our profession, I learned that occupational therapy and occupational science should go hand in hand. The former would be the diverse practices addressing occupation as both means and ends while the latter is the science concerned various research efforts addressing occupations. [5] The article then states that these two have the potential to be transformative in terms of the development of innovative ways to address occupational injustice as well as the expansion of occupational possibilities for groups who experience marginalization [5] ultimately leading to social transformation. These two must be applied simultaneously so that clients will attain the best patient care just like how my knowledge and realizations should be applied in real life situations.

During the times that I visited my plant, I found myself amazed realizing how caring for a plant can teach a person so many things. For the past semester, I wouldn’t have grasp my course better without doing this Nurture Project. “If caring for a plant can be so substantial, what more can a person, specifically our future patients, teach us,” I thought to myself. It just goes to show that as therapists, we must be open to our patients. Each one of them have their own client factors, performance skills, and performance patterns and is exposed to different contexts and environments [1]. Hence, there is no one strategy that would fit for all. It is for this reason that establishing rapport and having an attitude of empathy are significant in our practice. By knowing these things, the therapist is able to employ the just right challenge for the client’s interventions since he/she is fully aware of what the client wants and is capable of [3]. As occupational therapists, we must become creative and flexible in terms of the interventions and approaches that we employ in each session. This was seen more evidently in our visits. Therefore, I would expose myself more into the world of occupational therapy by joining in the different activities being offered by the OT Society, my upper classmen, or any organization related to our profession.

I cannot help but also feel satisfied in the fact that my plant didn’t die. Perhaps, it was partly because I picked a “low-maintenance plant” but then again it does not discount my efforts of caring for it. Likewise, some patients would only need a few interventions and that is enough. However, it is my duty to give them the best care regardless of their condition/economic status. It is an occupational therapist’s responsibility to give the client that services that they are due and that is only the best; nothing less. Competence is seen in the OT Code of Ethics and is one of the Thomasian Core Values. It is one’s duty to maintain high standards of competence [4] and as a student, I intend to do just that by dedicating my time and effort into studying diligently. I should not employ the mindset of “studying just to pass” or studying just for the grades” which at times I am guilty of. Rather, I must study to put myself in a position that would enable me to give the best services for my future clients.

Part of this process would be collaboration in the work setting – one of the things being instilled throughout the semester. As we designed our Nurture Project Area, I felt proud of the class for how much we’ve accomplished the past semester. From the panel discussion, to the visits, and now in our last agenda, I could see how much we’ve grown individually and collectively. We worked out our differences and decided that we contribute whatever we can to attain the goal. As occupational therapists, this skill is vital because this is what our profession is all about [2]. I intend to be a better team player, an empowering leader, and a contributing member by improving my collaboration skills regardless of the role assigned to me, setting aside my ego and emotions, and looking at things objectively.

The theme for our Class Nurture Project was Dia De Los Muertos (Day of the Dead) which was inspired by the movie Coco since most of my classmates’ plants are already withered. On the surface level it may seem like just another beautiful garden but for me, it taught me a lot about letting go. I realized that the death of a patient can be viewed from another perspective – a positive one. In our context, it also taught me how to handle failure and it’s all about picking out the learnings and leaving the bitterness behind so that you can bounce back on the next time. As I brought my plant home, I’m happy and grateful for the whole Nurture Project experience for it has given me a better understanding and appreciation of my course. At the same time, I am nostalgic because this was our humble beginnings. These learnings are my foundation for the future but then again, it is not enough that I know; I must also act upon it. Therefore, I move on from this semester motivated to apply what I’ve learned and do better even on the next. My journey has just begun and this has helped me attain a good mindset. I will never forget my roots for this is where it all began.

Sources:

[1] American Occupational Therapy Association. (2014). Occupational therapy practice framework: domain & process (3rd ed.). The American Journal of Occupational Therapy, 68(1) 10-11 doi:10.5014/ajot.2014.682006

[2] Johnson, C. (2017). Understanding Interprofessional Collaboration: An Essential Skill for all Practitioners. Retrieved from https://www.aota.org/~/media/Corporate/Files/Publications/CE-Articles/CE-Article-June-2017.pdf

[3] Fortuna, J. (2018). The Art and Science of Occupation as Therapy. The Open Journal of Occupational Therapy, 6(1). https://doi.org/ 10.15453/2168-6408.1476

[4] Philippine Academy of Occupational Therapists. (1998). Occupational therapy code of ethics. Retrieved from http://paot.org.ph/pdf/profpractice/Code%20of%20Ethics%20(1998).pdf

[5] Rudman, D.L. (2018). Occupational therapy and occupational science: building critical and transformative alliances.

[thanchav]

[thanchav]

Thoughts of a Side-Tracked Mind

Entering into my second shift, all the emotional high from being a freshman has already left my system. I have now tested the waters and I know my course would not wait for me. It will keep moving shift after shift with or without me so I can’t help but be motivated to do better now that I have started to grasp the courses I am taking. Despite the challenges, I know I am pursuing this for a reason. I also started to adjust to its demands and I could say I have settled into my own routine and rhythm. Among these would be visiting Xavi, my plant. I noticed that my plant is very much well and alive so I became complacent that it would be fine even without me watering or checking on it. After a while, I completely lost track of when I last went to see my plant. As high as my motivation to bounce back from the first shift, the motivation to take care of the plant dwindled. This was the complete opposite from what I’ve experienced in the first shift. Thinking about it right now it is very similar to how patients experience lack of a drive to undergo therapy or they already have a mindset that nothing’s going to be any better. It is as if they’ve hit rock bottom.

In the Model of Human Occupation, it seeks to explain occupation as something that is motivated (volition), pattered (habituation), and performed. Volition is one of the subsystems that is highlighted. This essentially is responsible for motivating behavior and choosing what behavior will be pursued by a person. Specifically, this is under a person’s interests because this is the likelihood that a person would enjoy a specific occupation [3]. I then realized how important it is to look for activities that would interest a patient rather than just going for the easy, conventional option. I remember one discussion in class where the faculty said that they just let the kid play while they observed what activities he/she wants or when talking to the geriatric patient, the OT would count in Mandarin to elicit a response. Again, different patients call for different strategies for this is not a “one size fits all” profession. The Occupational Therapy Practice Framework further reinforces this by stating that it is by observing the client engaging in various occupations that the occupational therapist is able to create adaptations and modifications that would best promote participation and performance [1].

As I realized that my motivation was dwindling, I wanted to come out of this slump. What I did was I talked to my friends so that I had someone to share my experience with. They also had the same sentiments so we decided to go to our plants together. Truly, having other people around you can spell the difference even in the smallest of things. This was the moment I came to realize what the Person- Environment-Occupation Performance (PEOP) Model was stating regarding the social extrinsic factor because its presence or absence can enhance or limit the individual’s performance [2]. In addition, there is also the so called disability prevention which is an intervention approach. This could be applied for person with or without disability who may be at risk for occupational performance problems [1]. An example of this would be promotion of group participation to prevent social isolation of employees.

When I checked on my plant, I noticed that some of my classmates’ plants were already withering while mine was still alive and healthy. I thought to myself that this was probably because different plants require different treatment due to their different composition. In the occupational therapy practice, no two clients are the same. Persons and context are said to have a reciprocal impact on each other because the same context may have a unique meaning to a certain individual while that same individual also acts differently in different contexts as mentioned in the Ecology of Human Performance Model [2]. The intrinsic and extrinsic factors which make up a person affect his/her occupational performance to a certain experience [2]. This is exactly why occupational therapists need to be creative in thinking of activities best suited for the patient.

Putting things into another perspective, I could also be one of my classmates whose plant is currently withering. Based on my dedication on checking on my plant this shifting period, I know I could’ve gave more effort. Virtually, my plant probably wouldn’t have withered if I took care of it more. I was just fortunate enough to have a plant that was easy to grow and required very little maintenance. I’m glad I learned this lesson now rather than later in practice. I must put in my one hundred percent in everything that I do especially in the context of my work because it defeats the purpose of what I’m doing right now. This is also part of demonstrating a professional behavior towards my clients and the oath that I will swear upon, if by God’s grace, I become an occupational therapist. This would be under Principle 1 of the Occupational Therapy Code of Ethics or Beneficence which entails the occupational therapist to demonstrate concern for the well-being of the person receiving their services [4].

As the second shift comes to an end, I am inspired to apply Principle 1, along with the other principles stated, not only as an aspiring occupational therapist but also and more importantly, in life. This nurture project made me realize that finding a patient’s motivation and interest is equally important as including them in a group if it helps them achieve the optimal occupational performance. This happens because of the different client factors that are present both intrinsically and extrinsically. Hence, the occupational therapist must be creative in making various intervention plans that would help the patient reach the desired outcomes. When I become one, I will apply these concepts and it starts with studying diligently, my main responsibility as of the present. I must do my part into becoming a good occupational therapist. It all begins now.

References:

[1] American Occupational Therapy Association. (2014). Occupational therapy practice framework: domain & process (3rd ed.). The American Journal of Occupational Therapy, 68(1) 10-11 doi:10.5014/ajot.2014.682006

[2] Cole, M. B., & Tufano, R. (2008). Applied theories in occupational therapy: A practical approach. Thorofare, NJ: SLACK.

[3] Kielhofner, G. (1980). Model of human occupation, part 1. conceptual framework and content. American Journal of Occupational Therapy, 34 572-581. doi:10.5014/ajot.34.9.572

[4] Philippine Academy of Occupational Therapists. (1998). Occupational therapy code of ethics. Retrieved from http://paot.org.ph/pdf/profpractice/Code%20of%20Ethics%20(1998).pdf

[thanchav]

[thanchav]

The Fazed Freshman

As I enter into a new chapter in my life, I am fazed with so many different questions which continually come just out of nowhere. Among these many questions would be, “What is the course that I got into?” and “What exactly does an occupational therapist do?” Prior to my entry in college, I had a vague picture of what they did because of my relatives but yet again the definition was just “out there”; something that was to abstract and not close to the heart. In class, Occupational Therapy was introduced to us using the definition taken from the World Federation of Occupational Therapists which states that it is a client-centered health profession concerned with promoting health and wellbeing through occupations. This would then enable the patient to participate in the activities of everyday life and ultimately help them enhance their ability in doing occupations that they want to, need to, or are expected to do by modifying the occupation or the environment (World Federation of Occupational Therapists [WFOT], 2012). Upon hearing the prescribed definition and listening more to the lecture, some of the blurry parts of my vision on what occupational therapy is started to clear up but it still wasn’t that concrete.

As the first week progressed, my class was tasked to bring a plant for a project. I brought with me a Fortune Plant because it was the only one available at home. I was under the perception that if the plant died, I would get a failing mark so I really checked on it everyday. I saw the plant as a requirement or another thing I had to place in my to-do list. I saw it as a burden to be honest.

During the next laboratory session, we were being oriented about the Nurture Project. The professors said that I should view the plant as a metaphor of what happens during work. This was a training ground for the real world and the plant was my patient. They also said that it was fine with them if the plant died because in the real world, this happens to your patients. It was then that I came to realize that I was gravely mistaken and it gave me a whole new perspective.

One of the things that really stood out to me in that discussion was when they asked us to name the plant and for some reason one name came into mind instantly: Xavi. This was the name of my sibling who died due to a miscarriage. Being the young boy that I was at that time, all I understood was that I lost someone whom I loved and it was disheartening for me. By naming the plant after my sibling, it made the project easier to do. Personally, I it is already more than a project, I now view it from a stand point of a kuya because it gave me an avenue to take care of someone who was important to me. I started to see the beauty of really dedicating my time and effort towards the betterment of that certain individual and there is joy that comes with it. I realized that for me and the patient to achieve our set goals during therapy I would need to establish a relationship and good rapport.

This brought the concept of art in the practice of occupational therapy clearer and easier to grasp. Without art, “occupational therapy would become the application of scientific knowledge in a sterile vacuum” (Peloquin, 1989). It is because of this realization that I come and check on Xavi every time I’m in school to make sure that its practical needs are met because science would dictate that plants need water, soil, and exposure to sunlight which then leads me to my second realization. I came to recognize the importance of learning not only the art but also the science in occupational therapy.  Prior to the project, I would tend to catch myself thinking about why I even need to study the human body if all I would be doing is designing occupations for patients so that they may be able to do the things that are important to them. But then again, occupational therapy is a creative process coupled with the application of biomechanics (Fortuna, 2018). Art and science in this profession is compared to the warp and weft in a tapestry because when woven together, the two are inseparable. (Wood, 1995).

Another epiphany moment for me occurred right after the discussion of the different OT Processes. I came to notice that recently, while I was visiting Xavi and I didn’t have to water it because of the rainy weather. I just checked on it to see if it was still well and despite just being there, I could still see its growth. The OTPF-3 Model suddenly made more sense because it states that there must be a collaboration with both the practitioner and the client. The Teaching-Learning Process is reciprocal (American Occupational Therapy Association [AOTA], 2014). Meaning, there should be times that I would let the patient teach me and I would learn what activities interest him/her and from there, I would note these observations for the following sessions.

From the fazed freshmen with many questions, I have come to understand little by little what Occupational Therapy really is through Xavi. It is always about one complementing the other like how biomechanics (science) is seen into fruition via the creative process (art). In the same way, it is also best seen the cooperation of both the therapist and patient. It is a two-way street between the two persons. I must, however, keep my mind open for learning and not be commit the same mistake of having prior perception regarding a certain activity. There are still lots to learn for this is just the tip of the iceberg.

References:

American Occupational Therapy Association. (2014). Occupational therapy practice framework: domain & process (3rd ed.). The American Journal of Occupational Therapy, 68(1) 10-11 doi:10.5014/ajot.2014.682006 

Fortuna, J. (2018). The Art and Science of Occupation as Therapy. The Open Journal of Occupational Therapy, 6(1). 3-5 https://doi.org/ 10.15453/2168-6408.1476

Peloquin, S. M. (1989). Sustaining the art of practice in occupational therapy. American Journal of Occupational Therapy, 43(4), 219-226. https://doi.org/10.5014/ajot.43.4.219

Wood, W. (1995). Weaving the warp and weft of occupational therapy: An art and science for all times. American Journal of Occupational Therapy, 49(1), 44-52. https://doi.org/10.5014/ajot.49.1.44

World Federation of Occupational Therapists. (2012). Definition of occupation. Retrieved from http://www.wfot.org/ aboutus/aboutoccupationaltherapy/definitionofoccupationaltherapy.aspx