Medical Employment Agency New Zealand & United Kingdom, Medical Staffing International

NZAOT Medical Staffing International Achievement Award 2004

Lynette Eaton, Professional Supervisor of Occupational Therapy at Starship Children’s Hospital, was awarded the Medical Staffing / NZAOT Occupational Therapy Achievement Award this year, for her involvement in the planning and implementation of a neurodevelopmental service to National Women’s Hospital.

The Hospital had been without this service for some years, and Lynette’s work represents an important advance in the promotion of OT within National Women’s.

Lynette tells us more about her project, her career, and why she is so passionate about her role as an OT:

This is a particularly complex and important project. How did you get started on it?
The neurodevelopmental therapy role at National Women’s Hospital was re-established mid 2001. The role is shared and interdisciplinary (occupational therapy and physiotherapy). This was an explicit decision based on the teaming and service provision philosophy of the Children’s Therapy department, Starship Children’s Health. This shared role also reflects current practice standards for neonatal care as outlined in the international therapy literature. In this literature, the role of occupational therapy, as well as physiotherapy and speech-language therapy with pre-term and high-risk neonates is clearly outlined. I was keen to take the opportunity to be involved in this project when we were approached as I have a particular passion and interest in working with infants in the acute environment and this was a fantastic extension to the clinical areas I had been involved in at Starship.

What kind of research and planning did you implement to ensure the project was built on a solid foundation?
The initial research phase involved the establishment of guidelines around the scope of the role, specifically in relation to which infants would be routinely referred. This was done in conjunction with Senior Neonatal staff at National Women’s, Clinical Nurse Educators and the service manager of the unit. The process was guided by literature based evidence indicating the particular groups of high risk infants that may benefit from specific therapeutic assessment and the implementation of early intervention programs.

The planning phase took several months and involved meetings with staff at National Women’s, including the speech-language therapist who was already working there, literature review and service planning, training and supervision with a senior therapist who had previously been in the role and a graduated implementation of the service with initial direct supervision of assessment and intervention. We have also had ongoing supervision and peer review. The physiotherapist and I work together at National Women’s one morning a week. I believe there is potential for more involvement ih this area, but currently like in many areas, there are limits to resourcing.

Tell us more about the focus of this project.
The primary focus of the role is a consultative assessment service for high-risk neonates. The criteria for referral is:

Infants born <1000g
Infants with neurological complications/diagnoses
Infants with musculoskeletal abnormalities
Infants enrolled in certain research projects/parental concern

The role extends to providing monitoring and intervention when infants are in the unit for an extended period, and liaison with community services with regards to their ongoing neurodevelopmental needs. The service has been reviewed and presented at an audit/quality meeting.

Another important aspect of the role has been to provide regular education opportunities for families of infants in the unit outlining the concepts of Developmentally Supportive Care. This is provided in the context of coffee mornings that are organised by Parent Care at National Women’s – a volunteer run parent support and information service.

We understand you have a particular interest in ongoing education for your profession. Can you tell us more about how you believe nurses and therapists can be further educated?
We have had the opportunity to provide input into teaching forums for the nursing staff. This has been done in the context of their post-graduate nursing training package, and we have also recently been involved in the development of a new developmental care protocol for the new unit at Auckland City Hospital. Part of the implementation of this has been involvement in teaching/orientation for all nurses coming to work in the new unit. One of the great pleasures of the job has been the opportunity to work with such a wonderful and experienced staff in the neonatal unit. The multi/interdisciplinary philosophy of the unit and the therapy role is an effective, family-centered model for us to work within.

Children’s Therapy has also run two conferences over the last four years aimed at therapists working in acute paediatrics and related services and this has also been a great opportunity to share some of our learning and experiences working in a neonatal environment.

You are very proactive and ambitious. How did you come to be here?
I decided to apply for Occupational Therapy after returning from a year overseas with my family, where we had spent four months working in a missionary orphanage in Venezuela. It was a fairly life-changing experience and a series of events and interactions with people found me on the doorstep of AUT in 1992. After graduating I spent a few months overseas with my husband, on his medical elective, and did some volunteer work in Egypt and Israel before coming back to a job in the general medical wards at Middlemore Hospital. I took the opportunity to move to Starship when a job came up later that year and have been there for nine years.

Last year I completed a masters, taking the opportunity to focus some of this study on the physiological development and neurodevelopmental issues of infants born prematurely. Studying was a great opportunity to re-focus on some fundamental issues that underpin our practice, explore issues around clinical reasoning (especially in the acute environment I am in), do some specific learning in areas of neurophysiology, upper limb rehabilitation, biomechanics and neurological therapy, and undertake the process of research.

I love paediatrics and I love the acute environment. It is an exciting clinical area and for me, working here sits very well with the philosophy of early intervention (either early in an infants life, or early following illness or injury), that I subscribe to.

What are the opportunities other OTs wanting to advance themselves and their profession?
There are many (sometimes hidden!) opportunities for people in our profession to develop their practice in areas where service has been previously limited or have not been conventional in the New Zealand context. Research, planning, organisation and developing credibility over time with a high standard of practice and ongoing learning and development are, I believe, vital components of role development under these circumstances. Our involvement in the re-development of the therapy role at National Women’s has been one example of this kind of professional development and it has been a wonderful opportunity to be involved in it.

How do you feel about winning this Medical Staffing / NZAOT Award?
It is a real honour because it recognises what OT can offer in diverse areas of practice, and I am proud to be involved in this. I do feel that I accept it on behalf of some of the wonderful colleagues I work with. There is a strong interdisciplinary focus in the neonatal unit and I acknowledge the role of the physio, SLT, nurses and medical staff I work with.

After 12 years in the field, how do you feel about being an OT today?
I love being an OT. It is a daily learning experience, a challenge to find out how best to enable infants, children and their families, a struggle at times to deal with the trauma of what they go through, but amazing to be a part of healing, recovery and compensation. Starship and National Women’s are stimulating environments to work in with plenty of inspiring people to encourage ongoing learning and development.

Last year’s Medical Staffing / NZAOT Occupational Therapy Achievement Award was won by Heleen Blijlevens, who has noticed increased awareness of her work that has led to her involvement in both workshops and conferences. Medical Staffing director Kirsten Thomforde says, “Both Heleen and Lynette have demonstrated the high caliber of work carried out by Occupational Therapists. We are very happy to be able to support such talented and committed professionals.” Medical Staffing contributes $1000 to winners of each Award. For more information please visit www.nzaot.com

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