A commissioner asked me, "What does an Occupational Therapist (OT) do in a mental health Trust that can't be done by generic community OTs?" His question was, in essence, why employ an OT in a community mental health team for older adults when you could employ a nurse (who can do generic mental health work but also do RNCC assessments, administer depots, undertake independent prescribing etcetera).
We have OTs in our teams and on our wards. Still, I had vague ramblings but when stopping to think, couldn't really give a compelling reply.
Thoughts?
8 comments:
When I read the title, I thought, yep MH staff could deffo do with some of that.
I dunno what an OT could do that a generic nurse couldn't do...but without the professional savvy to answer that properly, I would guess that nurses are busy doing lots of other things...some of which bare relevance to nursing (the other 75% revolving around bits of paper).
My only experience of OT has been in acute care units. Best experiences of it in the old style asylum where there was whole building dedicated to it including, a gym, sewing room, art room and a n other room for guess what complementary therapies. What has changed? Downsizing has taken place and now there seems it is down to 1 or 2 people and lots of cutty outy bits and glue. Now I like cutty outy bits and glue but as part of a healing process for a variety of people, I don't think it hits the mark.
I don't know what an occupational therapist does that can't be done by a nurse - but that's because I'm a lay member of the public, not a nurse or an OT. I suspect that if given the chance, both professions could sum up the particular strengths of their training with as much passion as the doctors around on the blogosphere are currently describing the difference between doctors and nurses (although hopefully without quite so much venom as some are employing).
I do know that one of the staff within the VERY small specialist team I have had most contact with is an OT, but interestingly they work so collaboratively that I don't know which member of staff it is.
Our local inpatient unit apparently employs OTs. They describe how "Service Users are supported by a variety of healthcare workers including nurses, doctors and allied health professionals including art, physio, occupational and sports therapists" and have a nice picture of some people with some cutty outy bits and glue.
I'm not sure whether it's applicable or not, but we've had many OTs trained in sensory issues working with my autistic kids, and many of them also do work with mental health clients on their sensory issues. They can help with the sensory integration issues which often seem to go along with schizophrenia (among other things), so maybe that would be applicable?
Its an interesting question. I can say what I've observed OTs doing, but I can't really see what they do that couldn't be done by a nurse. Perhaps its one of those things that they are cheaper than nurses since they don't need all the other training that nurses get.
Or maybe I'm being too simplistic and nurses can't do kitchen assessments and music sessions etc.
I'm not sure either- But i know that I spend hours with patients and I can see if they are able to make themselves a cup of tea, climb the stairs or make toast. It didn't need an OT to show the blindingly obvious.
I suppose if does take some of the strain off nurses though. If they weren't there we would have to do it. And go to peoples houses to look at if they needed handrails up?
I love OTs - they are my heros. I think nurses and psychiatrists, while they do such essential work, can often lose sight of the individual's social and occupational needs in the midst of depots, prescribing, monitoring. OTs can really give people the opportunity to do something that isn't to do with their illness.
I know my clients in inpatient units consistently do better when OT are involved. Without them, I think things could become way too medicalised.
I would like to see the reaction of an OT. I love to work with OT's. I think they are very creative in making life of people easier and seeing possibilities that other disciplines don't see, and that is what they have trained to do ( at least in The Netherlands). More people can live independant, thanks to OT's. I don't think every nurse could do this job.
I'm keen on OT, I have OTs on my wards and in my community teams. I've asked their opinions. The crux of it is that it seems that beneficial outcomes are soft, not robust or measurable.
They couldn't give a clear answer to present to commissioners 'bout why an OT instead of a nurse should be employed within a specialist mental health team, hence why I sought the views of you goodly folk!
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