Making a Difference, Teamwork and Coping: The Meaning of Practice in Acute Physical Settings

Abstract

Occupational therapists in acute physical settings face challenges and tensions between their holistic professional values and the often reductionist focus of their work. A hermeneutic phenomenological investigation explored the meaning of practice for nine occupational therapists in an acute National Health Service trust in England. Semi-structured interviews were analysed using a framework for interpretive analysis of phenomenological data. Critical reflective evaluation enables readers to judge the quality and relevance of the research. The three main themes described in this paper – making a difference, gaining strength from the team and coping strategies – illustrate the tensions, stresses and rewards of practice. The occupational therapists wanted to make a difference to their patients' lives. Although they could not always do as much as they would have liked, making an immediate difference by the provision of equipment was rewarding. Relationships with multidisciplinary colleagues generated both stress and satisfaction, but membership of the occupational therapy team enabled the therapists to cope with difficult situations. Effective coping strategies included acknowledging the realities of the acute setting and using reflection to identify those aspects providing value and satisfaction. Overall, the therapists experienced pride, excitement, reward and enjoyment from their work in the acute setting and were convinced of the value and importance of their role.

Occupational therapy practice in acute physical hospital settings: Evidence from a scoping review

“…The timeliness of home assessments in the discharge process was raised as a concern by Robertson and Finlay (). Therapists reported feeling under pressure to complete home assessments urgently to continue the rapid throughput of clients.…”

Occupational therapy assessments used in acute physical care settings

“…Bridging the gap between hospital and home is basic to the occupational therapy role in acute care practice and crucial to safe discharge (35), so assessment processes must ensure that this role is carried out successfully. Providing the means to identify the environmental difficulties that impose restrictions for clients is crucial to problem-solving (35).…”

“…Providing the means to identify the environmental difficulties that impose restrictions for clients is crucial to problem-solving (35). Therefore assessment processes need to allow for developing rapport with clients to ensure effective identification of home-based problem areas.…”

Exchanging Knowledge Within a Community of Practice: Toward an Epistemology of Practice in Occupational Therapy Paediatric Hospital Care

“…Occupational therapists have also indicated that hospital work environments tend to favour reductionist practices that are in tension with the profession's commitment to holistic and person-centred approaches and values (ROBERTSON;FINLAY, 2007).…”

“…Occupational therapists' views about their work in hospitals frequently express concerns about being devalued or disregarded by the other members of the health team, and a lack of understanding about their professional roles (ATWAL, 2002;GALHEIGO;TESSUTO, 2010;GRIFFIN;MCCONNELL, 2001;ROBERTSON;FINLAY, 2007). Wilding andWhiteford (2007, 2008) have also noted occupational therapists' difficulties in explaining their unique and valuable contributions in hospital contexts.…”