The flip side

I love my job. I'm incredibly passionate about it, and I am fortunate to have found work that makes me feel so fulfilled at the end of the day, and so early in my working life. But as much as I often describe my job in a fun and upbeat way (and this is how I usually perceive it), it can also be an incredibly emotionally trying position to be in.

I see children who have such potential to progress but do not have the social support or environment to facilitate this.

I have families who tell me "I want my child to walk," and I know that the possibilities are slim to none. And I have to be the one to tell them they need to start thinking about a wheelchair. 

I see children who have progressive diseases and watch them as they become imprisoned in their own failing bodies.

I have children who pass away, leaving their families devastated and me as a therapist feeling like you are part of a completely useless profession.

Of all my experiences, working in pediatrics has been the most rewarding but also the most difficult. And I've even worked in palliative care where the patients were basically given a prognosis of 6 months or less. For me, knowing that my clients are but children makes it that much more heartbreaking. Yet I still manage to maintain a very positive outlook, and I'm able to stay the perky, bubbly and happy OT that I am.

Here are just some ideas on how to deal, or at least things that I do:

• Be positive. It's often difficult, and sometimes you have to look REALLY REALLY hard. Think needle in a haystack. But squint your eyes, use a magnifying glass, ask someone to help you find it, I don't care - just find that silver lining. It's there.  Despite the lack of support, think about the fact that this child has an hour with you and you have the opportunity to BE the change agent. Despite being the bearer of bad news, think about the fact that the family is in fact hopeful. Despite watching a child slowly losing skills, think about how the child has a loving family who knows him so well they can decipher every grunt. Despite a death, think about how much love the family gained while having the child with them. 

• Do something that makes you happy everyday. This can be anything. For me, it's dance, it's the gym, it's a long run on a sunny day, it's the guitar or the piano, it's seeing my best friend and her little daughter. You can take a bubble bath, bake, go play some hockey, garden spend time with a loved one... really just ANYTHING that makes you feel good. Do at least ONE thing to keep you going.

• Exercise. I say this only because it really does help to take your mind off of things. It also increases your levels of endorphins, and puts you in a better mood. Plus, you'll get into great shape!

• Talk to your colleagues. You can spend hours mulling over it in your head. You can lose sleep. You can talk about it to your significant other or your family. This last one might work for some, but home should be a place to relax and remove yourself from work. I don't mean don't talk to your family at all about these things that happen at work, but don't let that be the only thing you bring home from work. Talk about some of the great things too. 

• Know that the reason you feel so crappy is exactly what makes you a great therapist - You actually give a damn. At the end of the day, this is what matters the most. 

Early Intervention: A Job Description

If you have read the previous post, you know what the general definition of an OT is. However, you will also understand now that each area of practice is specific, that our role is different depending on where we work and who we work with. I can only share my own experience:

I fell in love with pediatrics at a little reverse integrative preschool in Toronto. Mind you I fell in love with stroke rehab too, so I might just be a bit fickle. Or perhaps it is because these two areas are in fact very related. Developmental delays in children are often accounted to neurological impairment, and the knowledge about neuro rehab that serves as a foundation for working in this field. The brain is incredibly complex and fascinating, and that's exactly what makes the job as a pediatric OT so challenging.

But what do I actually DO?? I am a community OT working in early intervention - that means the kiddo's aged 0-5, before they head off to kindergarten. I often tell people I play with kids for a living. And in fact, that is precisely what I do. However, there is always an ulterior motive. I colour with kids to ASSESS their pencil grasp. We play with plastic food with velcro attachment as an INTERVENTION  for improving bilateral skills. Or, I blow bubbles... simply because I know they like them. Even this is to make the therapeutic experience a positive one. The key thing here is that most everything you do hands on with a child is through play, so you've got to get incredibly creative to get what you want out of that interaction.

Here are few of the things I work on with my kids:

• Fine motor skills (Colouring, pre-printing, bilateral skills,scissor skills, reach, grasp, etc.)
• Sensory processing
• Dressing
• Toileting
• Feeding (The mechanical difficulties of chewing and swallowing, as well as picky eating)
• Positioning (Wheelchairs, strollers, bathseats, you name it)
• Play
• Safety
• Sleep

This is my toolbox

I'd give more details about my job but "report-writing" and "case-coordinating" hardly seems worth delving into further detail. But for you OT's out there, we actually use the COPM where I work. It's actually not collecting dust on the back shelf!