My Top Barrier to OT in Postpartum Care
The difficulty with an emerging practice area among a highly protected population in the hospital setting is that: 1.) Nursing staff are extremely protective of their patients (as well they should be), 2.) Nursing staff in maternal care tend to be senior nursing staff that went to school before a focus on interdisciplinary care was in place, 3.) They rarely work with occupational therapists and have a limited understanding of the general role, training, and education that occupational therapists have in general, 4.) They don't quite understand the hands-off approach occupational therapy has when addressing mental health--meaning, we speak to and consult patients rather than engage in physical rehabilitation therapy, and 5.) They have never had a women's health OT model an interdisciplinary working relationship in postpartum care before.
When I decided to push maternal care forward in the world of occupational therapy emerging practice areas, I knew that I would meet many typical challenges therapists encounter (no one knowing what occupation is, not understanding what occupational therapists do, a lack of knowledge of our role in mental health, etc.), but I also knew that postpartum nurses were very protective of their patients. As a recovering mom in postpartum care 4 times, I appreciated this protection to the nth degree.
Based on this knowledge, I understood that educating nursing staff was going to be paramount to true program success. However, the constraints of my time and duties in this setting required that my attention be divided... which made nursing education difficult.
Going forward, I would recommend 2 things to occupational therapists interested in furthering this emerging practice area:
1.) Team up--If you are doing capstone work, try to go to one setting with at least 2 students. One student can focus on the education piece, while the other can focus on building a website/patient follow-up. Patient care duties can be split, or a third therapist could take charge of that aspect. The more therapists, the more efficient interdisciplinary interactions will be.
2.) Do not enter maternal care if you are not comfortable being an occupational therapist in a nurse's world. Big OT personalities are wonderful on so many fronts, but I'm of the opinion that in nurse-dominated settings, it serves the patient more to be flexible and accommodating... winning the trust of nursing staff, and then gently educating them on our training, education, and focus with time. In my estimation, this is why personality is the most important factor when considering an occupational therapist for roles in the NICU and other similar settings.
At the end of the day, we need to practice what we preach and learn about the other professions, their roles, training, and education. Then we must create an environment where we respect their contribution and expertise. Occupational therapist trailblazers who are leaders who must primarily lead by example, the rest will follow.
