Working as an Occupational Therapist

Karen Fitter gives the lowdown on being an occupational therapist.

What is it like working in an acute hospital?

In an acute setting there is rapid turnover of inpatient beds, so therapy is often undertaken within a short time. Staff on the wards have to make a rapid, person-centred assessment, providing appropriate therapy and advice to the multidisciplinary team and facilitating a safe discharge. However, many acute settings, such as ours, also house onsite rehabilitation facilities, providing slower-stream rehabilitation within a dedicated rehabilitation setting.

What sort of occupational therapy happens in an acute hospital?

The usual sort! Although turnover can be rapid, this doesn’t mean you can’t use all your occupational therapy skills. Individual patients will have abilities that have been interrupted by illness or disability, whether on a temporary or permanent basis.

What sort of support do you offer?

A key part of work in this setting is to identify people with rehabilitation needs and advise on suitable placements; be it at home, the home of a carer or intermediate care for further rehabilitation. The rapidly changing environment means occupational therapy skills are used quickly and to their full in order to facilitate treatment pathways for individuals.

What does this mean in practice?

I assess function, including dressing and washing, and I undertake cognitive and perceptual assessments to underpin this. Individuals are provided with treatment programmes to help them lead their lives, which can mean they have to practice their daily living skills or identify alternative routines, or even establish compensatory techniques. This can involve specialist interventions – splinting and upper limb retraining, for example – and the assessment, prescription and provision of equipment. Another part of my job is assessing a patient’s home environment and recommending home adaptations where necessary.

How do you have to engage with patients and staff?

Patient education is important. For rheumatology patients I would advise on joint protection and for those undergoing hip replacements I would offer advice on how to prevent dislocation. I would also undertake preadmission

visits, providing patients with information and equipment. My role also involves working with a team of hospital and external staff and I give advice on suitable discharge placements. I liaise with external agencies to meet patients’ rehabilitation and longer-term needs, such as intermediate care and specialist rehabilitation units and to provide specialist equipment.

What would a typical day be like?

There is no typical day! Activities range from clinical work to teaching and supervising staff and students, taking part in learning and development activities and being involved in audit and research…with the odd emergency discharge thrown in!

What qualifications are needed?

A degree in occupational therapy, which is a three-year course, and a strong desire to work with people. Previous care work experience is beneficial but not essential.

What sorts of skills are needed in this setting?

You need to make sound assessments and plan treatment. Problem solving skills are important, as is willingness to be assertive when advocating for patients and communicating with a multidisciplinary team, and occupational therapists need to be able to manage their time and caseload effectively. Strong verbal and written skills are also important, as we write reports, conduct presentations and provide feedback at meetings. Underpinning these skills is the ability to remind yourself and others of the philosophy of occupational therapy in order to maximise the benefits of therapy for patients.