Preparing for Rotation: Before and After

Image copyright TheOTprocess

Hi readers, I wrote a post about preparing for rotation in early April. I decided to keep it private so I could show the journey and reflect on the different feelings I was experiencing.

BEFORE ROTATING:

After spending 9 months in my current rotation, the time has come to rotate to my next post in cardiology. On discussion with more experienced colleagues they felt more blasé about rotations, however they could recall feeling apprehensive the first time they had to move to another area. I feel apprehensive too and I’d be interested how others feel when a new rotation is on the horizon. Anyway, I’m one of life’s planners. There’s always a list somewhere in my house with ‘things to do’ on it. So I thought I would start a plan.

Get the OT text books out

I located my trusty copy of Turner, Foster and Johnson (5th ed.- I love this book) and found a chapter on cardiac and respiratory disease and gave it a quick read. I did a mind map of the chapter which gave an overview of the main clinical problems, the role of the OT and OT interventions. I realised I need to do more swotting up of energy conservation and pacing, so I’ve stuck a post-it note in there to come back to but also felt comforted that there were things in there that I knew how to do.

Look up key terms

During my current rotation, I come across cardiology terms written in medical notes or hear staff discussing them. So I wrote a list of the ones I’ve come across (e.g. AF. NSTEMI, STEMI, tachycardia, bradycardia, and aortic stenosis) and looked them up and wrote the definitions in my little OT notebook. This then led to finding other words I didn’t know and looking them up too (argh!).

Pre-rotation visit

I was advised by other OT’s and physiotherapists in my department that a visit to the new department is also a good idea. I arranged a visit and had a chat to the OT who I was taking over and she gave me a tour round the department. Questions I asked were:

• Usual structure of the day: times of handovers, meetings, MDT’s etc.
• How patients are referred: verbal, written or both.
• How to get equipment: is there equipment on the ward or do I need to take equipment to the ward?
• Where the assessments sheets and referral forms are kept
• If I had any problems or needed advice who I could contact for support.
• The hours-some services are shifts and weekends whereas others are just Mon-Fri 8-4

This made me feel that I least I could get up and running on my first day without asking too many annoying questions. Luckily I’d been up to the ward on a few occasions so I knew the layout and where the patient files are kept etc. If you didn’t know, a quick trip up and introducing yourself to the staff wouldn’t go amiss.

Bookmark certain conditions

The OT gave me some really good advice to bookmark on my computer certain conditions that I may come across to regularly refer to. She pointed me in the direction of the British Heart Foundation who produce handy guides for patients (and curious OTs). I’m off to read this now. I’ve got my traditional placement jitters (I thought they would go away once qualified) but now I’m looking forward to the opportunity of learning a different area of OT and building up my professional knowledge. I will be sad to leave where I am but as a recently qualified OT I think I need to rotate to create a sound base of knowledge.

AFTER ROTATING:

Well the first few days of rotating, I felt like saying “ignore all the advice I gave you, NOTHING prepares you for your first rotation!”. It all felt so overwhelming.

Feeling the differences/noticing the similarities

Initially all I noticed was the differences to what I had done previously.  I really missed having senior OT’s close by to ask for advice. As the days went on and I felt more comfortable and realised that I could get on with it. I started to work closely with the physio and it was really helpful to talk through my clinical reasoning and bounce ideas off them. The other big difference was the systems and the different ways of working. However, by the end of the first week, I felt lots better and started to see all the similarities and working just became more natural. I was surprised at the speed I acclimatised: in my first job it seemed to take me ages to get to grips with the work. I think the natural first reponse is to panic and then the mind goes blank (and I kind of momentarily forget how to be an OT). Not the best response to the situation but it’s important to be honest with how you feel, recognise that you are having a ‘moment’ (and it’s just a moment), take a few deep breaths and give youself a few internal words of encouragement.

Learning new skills

I initially felt that I had to do everything and see everyone as soon as possible, like on my last rotation. However,  after a couple of days, I started to learn how to prioritise patients. My supervisor was really helpful and would spend time with me going through my caseload to help me prioritise.I find writing down at the end of the day a jobs to do list and priorities helpful so I am prepared for the next day and the morning meeting.

The research pays off

The research I had done, had helped. Initially I couldn’t see it, but on reflection things could have been a lot worse if I hadn’t put the effort in. I already had pre-prepared, pre-packaged nuggets of information that I could pass onto patients about breathlessness, energy conservation and pacing. I learned to go home at night and look up things that I wasn’t sure how to do and come back prepared the next day. For example; I came across patients following sternal or pacemaker precautions. I remembered, from my last rotation, a patient telling me that OT’s taught him how to get off the bed whilst following the precautions. A quick Google, and I was back in the game-and ready to tell patients. Also, now I know for next time! Win.

You can’t plan for everything

As much as I like to plan, I’ve realised that I learn the best from dealing with the situation in front of me and using the people and resources around me to learn new information. It doesn’t feel like starting a new job but just learning new things and adapting to a different environment. I’m learning lots and know I’ve got more to learn but I’m enjoying it.

So a month into my new rotation I’ve still got plenty of development points. My next step is to get some feedback on how I’m doing so I can improve my practise further and to revisit that chapter in Turner, Foster, Johnson as things will make a lot more sense now.

So considering my ‘before’ and ‘after’ my learning points for a new rotation are:

• do some research
• go on a pre-rotation visit
• expect differences, don’t let it phase you, and look for similarities
• tap into your team around you, ask questions and get advice
• you’ll settle in sooner than you think, let it pass.

I don’t think next time I rotate I will be as apprehensive. I’d be interested to learn other people’s tips for getting to grips with a new rotation.