Occupational Therapy News OTnews April 2019 | Page 48

FEATURE STUDENT EDUCATION
Impressions of an
American student
in the UK
L
©GettyImages/Ultima_Gaina
ast August, Joanna Reid, an occupational
therapy student from Temple University, in
Philadelphia, US, was facilitated to observe five
occupational therapists working for Newcastle
upon Tyne Hospitals NHS Foundation Trust, at the Great
North Children’s Hospital, Freeman Hospital, and Royal
Victoria Infirmary.
Joanna observed occupational therapists working
across diverse settings including adult and pediatric
oncology, pediatric respiratory, cardiology, neurology,
orthopedics, and community practice.
‘During the three-day shadowing intensive, I was struck
by the differences in care between the UK and the US,
many of which are made possible by the NHS system,’
Joanna reflects.
‘Most notable of these differences were the flexibility of
therapist-client time, therapist implementation of the use of
self, and interdisciplinary co-operation within the therapy
teams.’
Joanna believes that her shadowing experience
‘has lead me to the hypothesise that the NHS model of
“healthcare coverage for all” gives hospital therapists in
the UK more freedom in the time they are able to see their
clients’.
She says: ‘I was particularly impressed with the
attention the NHS occupational therapists gave to their
clients’ psychosocial needs. In every session I observed,
the mental health needs of each client were analysed and
addressed.
‘Within physical disability settings it is easy to focus
on biomechanical intervention, but these occupational
therapists gave consideration to the cognitive health of
both their clients and their clients’ caregivers.’
As an example, Joanna says that the pediatric
oncology occupational therapist she shadowed
‘advocated for her 11-year-old client with leukemia to get
her own wheelchair, so that her mother would not need to
carry or push her in her sister’s stroller’.
48 OTnews April 2019
Following a short shadowing
experience at Newcastle
upon Tyne Hospitals NHS
Foundation Trust, American
occupational therapy student
Joanna Reed shares her first
impressions of the NHS, as
compared with the American
healthcare system
‘When I watched the client see her wheelchair for
the first time, the large smile on her face showed her
satisfaction with her gained independence and autonomy,’
Joanna remembers.
‘Another occupational therapist I shadowed was
able to check in with an oncology patient receiving
chemotherapy between formal treatment sessions. The
NHS freed this occupational therapist from [any] stress
surrounding billable units of service, allowing her to
visit this patient in a time of need that fell outside of a
scheduled session.’
Joanna refers to Punwar and Peloquin (2000) and
adds: ‘Therapeutic use of self, or “practitioner’s planned
use of his or her personality, insights, perceptions, and
judgments, as part of the therapeutic process”, is another
strategy implemented throughout my observation period
and made possible by the NHS system.
‘Though this approach is considered integral to
occupational therapy practice in both the US and the
UK, I was surprised to learn that the majority of current
research on the use of self is found in North American
literature, because each occupational therapist I observed
illuminated therapeutic use of self during their treatment
sessions (Solman and Clouston 2016).’
Joanna stresses that her observation of these sessions
furthered her understanding of this concept.
‘In one neurology ward, I observed a dressing and
grooming session between an occupational therapist
and a pre-teen female patient with cerebral palsy. The
client was hesitant to dress, and asked the occupational