Inspires confidence in clients and team members.
During OT school, my professors stressed the need to establish rapport with a client, as well as the rehab team, to ensure success when carrying out the plan of care. Creating a strong therapeutic relationship by building rapport with a client is important because it inspires confidence in the entry-level practitioner when the therapist and client collaborate on goals, interventions are applied, and motivational factors are utilized in the process. The same is true for team members. By having a working relationship with the rehab team, the entry-level practitioner can build trust and confidence with the other members, which is necessary for providing the best therapy to the client and ensuring client safety altogether. In order for the rehab team to provide the most holistic and appropriate treatment, everyone needs to be aware of the clients goals in all disciplines and how they can efficiently work together to achieve those goals. I believe that to "inspire confidence" in both my client and teammates, I need to produce a sense of trust and respect. Just like any relationship, I feel that if someone is not trustworthy, then more than likely I will not have a lot of confidence in that person. I believe the same holds true for respect. These characteristics are vital to produce a sense of confidence in anyone, but especially as an entry-level practitioner. For example, while working at the skilled nursing facility (SNF), I learned that I had to earn the trust and respect from both my clients and team members before we moved forward in the therapeutic process and safely return my client to her home.
I managed to gain confidence from my clients by respecting my client's wishes, explaining my reasoning for doing what I do, and preserving his or her dignity throughout the entire process. For example, a 56-year old African American female had been released from the hospital to our facility following a unilateral knee replacement. Based on what the hospital had promised her, she would be leaving our facility in 2 days. Unfortunately, this would be nearly impossible to manage because most people coming off this type of surgery require at least a week before they can return home safely, and based on her evaluation, she was no different. However, she had her mind fixed on leaving the facility by the upcoming weekend. Once I arrived on Monday, I noticed she was still listed under my care. I confirmed with her PT that she was still on their caseload prior to us going to her room to check in with her. She was not thrilled to see us. My client wanted to know why she couldn't return home. The PT gave a vague response, then left the room. My client bluntly told me she had been getting herself out of bed to go to the bathroom on her own all weekend and didn't have any problems with her new knee. I asked if she had been using her cane and she confirmed that she had. She then looked me square in the eye and asked me again why she couldn't go home. I asked her, "Honestly?" to which she replied with a sober nod. I then explained that no one over 50 usually goes home right away because these are the most critical hours to getting movement back in the knee in order to safely participate in activities of daily living like toileting and showering. I went on to tell her that that was our #1 priority at this facility: patient safety. I asked her several questions regarding her ability to lower herself down onto a bath bench without breaking her knee protocol (not bending it past 90 degrees). She sat silently, and let her breath go, then stated, "You're right." After a moment of silence and scratching my head, I asked if she would be open to a showering activity. I explained that she can wash and clean herself at her own pace, with her own soaps, and at her own desired water temperature. I also added that if an OT or OT student were able to observe her ability to bathe herself and deemed it safe, then that would expedite the process to going home. As she thought on it, I asked her to let me double check on the activity with my fieldwork educator. I stepped out and made a call to my fieldwork educator. She thought it was a good idea and I returned to my client to find out what she thought of it. It didn't take long for her to agree. We scheduled it for the following day but I told her on one condition: we needed to keep moving her knee until then. The PT used an OptiFlex 3 Knee CPM, which means a machine that continuously and passively moves the leg at the knee joint for several hours to prevent stiffness, but my client found it to be very uncomfortable. Nevertheless, this machine was necessary for my client to be able to lift and lower herself onto a shower bench. After much thought, my client consented. The next day we gathered her soaps, lotions and clothes to get ready for the day. She was practically singing she was so happy to bathe herself! As an OT student I have to assess my client's ability to bathe for current and future safety purposes (and functional independent skills), so I stood by, with my hands ready, as she transitioned from sitting to standing in the wet tub and transferring from the tub to the wheelchair. She was able to do both of these tasks safely and independently. When she got back into her wheelchair, she had the look of a new woman she was so happy. My client looked at me and told me "thank you" because I had respected her wishes, I had reasoned with her the best that I could, and I had maintained her dignity during the showering activity. In short, I had earned her respect and trust which ultimately inspired her confidence in me as a clinician.
As for my teammates, I had produced a sense of confidence in other ways. One example that comes to mind was one day I was working with a client who was taking a break from her exercises, and I just happened to look over at a client with Parkinson's who had slumped forward because he was experiencing upper extremity tremors. His arms were shaking so hard that I was afraid he would fall out of his chair. Simply reacting, I jumped off my chair and stood in front of the man with my hands guarding his upper chest area, preventing him from going forward further. When his tremors ceased, he seemed surprised to see me instead of his clinician holding him up. I noticed his clinician had stepped out of the room briefly. I remained by the man's side until his clinician returned and I explained everything that had happened. I didn't realize it at the time, but all therapists in the gym at that time saw what I had done and took note that they could trust me with their clients. From that moment on, I had earned their respect and they treated me like their other teammates. They would ask me to watch their client if they needed to go get a piece of equipment or needed to clean something off. It was an awesome feeling earning that respect and trust, but it was even more exhilarating knowing that I had inadvertently inspired their confidence in me.
I managed to gain confidence from my clients by respecting my client's wishes, explaining my reasoning for doing what I do, and preserving his or her dignity throughout the entire process. For example, a 56-year old African American female had been released from the hospital to our facility following a unilateral knee replacement. Based on what the hospital had promised her, she would be leaving our facility in 2 days. Unfortunately, this would be nearly impossible to manage because most people coming off this type of surgery require at least a week before they can return home safely, and based on her evaluation, she was no different. However, she had her mind fixed on leaving the facility by the upcoming weekend. Once I arrived on Monday, I noticed she was still listed under my care. I confirmed with her PT that she was still on their caseload prior to us going to her room to check in with her. She was not thrilled to see us. My client wanted to know why she couldn't return home. The PT gave a vague response, then left the room. My client bluntly told me she had been getting herself out of bed to go to the bathroom on her own all weekend and didn't have any problems with her new knee. I asked if she had been using her cane and she confirmed that she had. She then looked me square in the eye and asked me again why she couldn't go home. I asked her, "Honestly?" to which she replied with a sober nod. I then explained that no one over 50 usually goes home right away because these are the most critical hours to getting movement back in the knee in order to safely participate in activities of daily living like toileting and showering. I went on to tell her that that was our #1 priority at this facility: patient safety. I asked her several questions regarding her ability to lower herself down onto a bath bench without breaking her knee protocol (not bending it past 90 degrees). She sat silently, and let her breath go, then stated, "You're right." After a moment of silence and scratching my head, I asked if she would be open to a showering activity. I explained that she can wash and clean herself at her own pace, with her own soaps, and at her own desired water temperature. I also added that if an OT or OT student were able to observe her ability to bathe herself and deemed it safe, then that would expedite the process to going home. As she thought on it, I asked her to let me double check on the activity with my fieldwork educator. I stepped out and made a call to my fieldwork educator. She thought it was a good idea and I returned to my client to find out what she thought of it. It didn't take long for her to agree. We scheduled it for the following day but I told her on one condition: we needed to keep moving her knee until then. The PT used an OptiFlex 3 Knee CPM, which means a machine that continuously and passively moves the leg at the knee joint for several hours to prevent stiffness, but my client found it to be very uncomfortable. Nevertheless, this machine was necessary for my client to be able to lift and lower herself onto a shower bench. After much thought, my client consented. The next day we gathered her soaps, lotions and clothes to get ready for the day. She was practically singing she was so happy to bathe herself! As an OT student I have to assess my client's ability to bathe for current and future safety purposes (and functional independent skills), so I stood by, with my hands ready, as she transitioned from sitting to standing in the wet tub and transferring from the tub to the wheelchair. She was able to do both of these tasks safely and independently. When she got back into her wheelchair, she had the look of a new woman she was so happy. My client looked at me and told me "thank you" because I had respected her wishes, I had reasoned with her the best that I could, and I had maintained her dignity during the showering activity. In short, I had earned her respect and trust which ultimately inspired her confidence in me as a clinician.
As for my teammates, I had produced a sense of confidence in other ways. One example that comes to mind was one day I was working with a client who was taking a break from her exercises, and I just happened to look over at a client with Parkinson's who had slumped forward because he was experiencing upper extremity tremors. His arms were shaking so hard that I was afraid he would fall out of his chair. Simply reacting, I jumped off my chair and stood in front of the man with my hands guarding his upper chest area, preventing him from going forward further. When his tremors ceased, he seemed surprised to see me instead of his clinician holding him up. I noticed his clinician had stepped out of the room briefly. I remained by the man's side until his clinician returned and I explained everything that had happened. I didn't realize it at the time, but all therapists in the gym at that time saw what I had done and took note that they could trust me with their clients. From that moment on, I had earned their respect and they treated me like their other teammates. They would ask me to watch their client if they needed to go get a piece of equipment or needed to clean something off. It was an awesome feeling earning that respect and trust, but it was even more exhilarating knowing that I had inadvertently inspired their confidence in me.