I think it's finally sunk in...

... I am an Occupational Therapist.

I am excited every morning when I wake up and realise I get to put on my (very flattering) green trousers and tunic and do the job I have trained for the past 3 years. I get to work and there's the usual office chat but there's also an underlying tone of professionalism and passion for the job and it's great. I feel like I fit in, I am not the OTGeek any more, I am one of 26!!

My average day starts with me checking what tasks I had written in my ward book and what needs carrying over to the current day, I then head down to the ward with the OTA and discuss the tasks and assessments etc and allocate who is completed what. After that I review the medical notes of my priority patients to ensure I am up to speed with any changes, and then I go to hand over. OT, physio, nursing staff and the discharge team meet to discuss any complex discharge needs and assessment/rehab progress of patients. Here I get given any referrals or people I need to re-review.

Working in medicine I get to see many different conditions, but I also see many of the same condition, which allows me to have a greater understanding of how a person may be affected in terms of functional level, and I am getting better at deciding whether to pick up a patient and start to assess them, or to hold off in anticipation of the issue resolving itself.

Initial interviews and information gathering is completed by me or the OTA as able, once a need may have been identified, I complete a functional assessment based on the information gained (for example if a patient reports have a certain bit of equipment in their bathroom, I will attempt to assess mobility and transfers using that equipment). Following that, depending what has been indicated by the patient I may or may not contact the family or carers, with the patients permission; if appropriate further functional assessments will be done such as a wash and dress or kitchen assessment. These assessments give an indication of a patient's level of function at present, changes to baseline ability and indicate any need for increased input on discharge.

If a change in baseline function is noted I can do one of several things, I can refer someone for a period of rehab, refer them to the intermediate care team for reablement at home, put in place a package of care, or be involved in a 24 hour placement.

The biggest jump from student to practitioner is that massive amount of responsibility that you don't have as a student, making decisions about the amount of support a person requires to facilitate a safe discharge is daunting at first, because even as a third year student all of your decisions are okay'd by your practice educator. But it's ok, it's not as hard as it feels at first, because you do know what you are doing, you have enough knowledge and some experience to make professional judgements backed by clinical reasoning...and it's still ok to ask for help, as a band 5 no one expects you to know everything, even if you expect that of yourself!

I am getting lots of great experiences, I'm taking on a few little 'projects' at the moment with the other band 5, such as 'revamping' one of the already established groups, and auditing the inappropriate referrals and looking at what can be done to decrease them. I have been given my competencies/ksf/proceptorship stuff to crack on with so all of the above will help to demonstrate these. It's really nice that myself and another band 5 started together, so we are going through that transition from student to antonymous practitioner together, and can provide peer support on the issues that I have been assured everyone experiences. We both work on the medicine side of the team, but on very different wards, and by providing each other support and assisting with doubles etc as needed it means we are getting a broader experience and learning from each other's very different approaches.

I'm really enjoying my job, but it still feels weird that this time last year I was preparing to go on my final placement!!

xx