Sunday, May 29, 2011

Challenging Behaviour

I thought it was time I reflected on what I percieve is a complex and common issue I have been experiencing whilst working in the spinal unit.
The topic of:

A good starting point is the definition...Good old wikipedia
Behaviour or behavior (see American and British spelling differences) refers to the actions of a system or organism, usually in relation to its environment, which includes the other systems or organisms around as well as the physical environment. It is the response of the system or organism to various stimuli or inputs, whether internal or external, conscious or subconscious, overt or covert, and voluntary or involuntary.

Then on a google search of "behaviour and spinal cord injury" -1,240,000 results

I have to keep reminding myself about the word "adjustment"
Adjustment is defined as adapting to a new condition. Everyone makes adjustments during their lifetime. Some of the conditions that you adjust to may be planned and you have time to think about how you are going to react to the situation. For example, you may have to make adjustments in your work hours when you start a new job. Other events may be a surprise, and you are forced to adjust to an unplanned event.

"Adjustment" and SCI...

A spinal cord injury (SCI) is one of the most devastating of all traumatic events. It results in a loss of some or all of an individual’s sensation and movement. It is common for individuals who are newly injured to have health problems. Plus, it takes time to build enough strength to be able to fully participate in daily activities.

Individuals who are newly injured will likely experience grief. This is a period of mourning that is similar to that following the death of a loved one. The difference is that you are grieving the loss of your sense of touch along with your ability to walk or use your hands. You will likely experience many different thoughts and feelings after injury. Some may seem extreme and others mild. There is no step-by-step grieving process, but some thoughts and feelings are common after injury.

Seeing that feelings are directly related to behaviour its obvious that almost everyone who has a SCI must have a change in behaviour at some stage post injury and during recovery.
Therefore it is vital that I am able to deal with behavioural changes/responses within a therapy session.

So where am I at now???
I get very frustrated when dealing with challenging behavours. I feel inadequately prepared to deal with behavioural outbursts, and I feel I lack the abililty to be assertive and respond to behavioural outbursts. It almost feels like Im too immature to deal with this - especially when working with client who have alot more maturity.

New Learning......
I feel everyday I am experiencing some type of interaction with clients that could have gone better - directly related to challenging behaviour usually impacted by environmental stimulus or as a direct result of the grief process.

How am I going to develop my professional skills?
Well firstly taking note of all of them and talking about them in supervision is key
Then analysing/relflecting on each experience and identifying how I could have dealt better with the situation in order to learn through my experiences.
Talking to the team psychologists - having a session or organising a session for the OT's about this issue.

I think its important to remember that i am probably not the only OT or team member that struggles with this issue and I want to remind myself that it is an important learning area and it will assist my professional development and growth.

Tuesday, March 29, 2011

Learning about OZ funding

Specialised Equipment Essential for Discharge (SEED)

The Specialised Equipment Essential for Discharge (SEED) commenced on 1 July 2008 to provide timely access to the essential equipment required to facilitate discharge to a community setting. SEED was formerly known as the Specialised Equipment Setup Program (SESUP).

SEED is available to eligible people receiving specialist inpatient rehabilitation for a catastrophic spinal cord, or acquired brain injury or illness in a NSW Public Hospital.

SEED is an enhancement of the Spinal Set-up Fund and has been developed in response to a recommendation made in the Review of the Program of Appliances for Disabled People (PADP), released in November 2007.

SEED will operate under the auspice of the PADP, administered by EnableNSW and will be available to eligible clients during the period of inpatient rehabilitation, until 6 months following discharge, for equipment required to facilitate discharge.

SEED will provide equipment such as wheelchairs, adjustable beds, hoists and shower and toileting aids. People currently receiving inpatient rehabilitation for a spinal cord injury or acquired brain injury interested in seeking further information about SEED should discuss their query with a member of their rehabilitation team.

Monday, March 7, 2011

Leaving one job and starting a new

So its been a while since I reflected on this blog.
I have resigned from my position as rotational occupational therapist after 2 years in rheum/rehab/acute/medical/ortho/surgical.
I reflect on the growth and professional development over the last 2 years.
I feel i have developed a wide range of knowledge about the OT role in acute and rehab settings.
I have developed fluent assessment skills and my clinical decision making is sound. I have worked hard on developing my commnication skills and maturity, and I have thrived in supporting and helping other colleagues.
I have developed into a strong driver and advocate for OT and interdisiplinary assessment/treatment. I have inititated and engaged in many quality projects and been praised for my ability to bring issues to senior members to activiely resolved problems.
I am going into a new position that will have its own set of clinical demands, with lots of learning and problem solving. One I am looking forward to alot

Will reflect again once commencing this position, but just for now i feel i have the necessary key skills to learn and develop in this specialised setting.

J x