Today is the last day for orientation for us. Well, it's been a relaxed 3 days of orientation for us, with ample lunch breaks and free time to gather in the non-airconditioned lounge to tell jokes, talk and eat (whatever we can lay our hands on - peanut cookies, my sandwiches, grapes, peaches, sweets, avacados =]) Tomorrow I'm going to a different centre :( Will miss the rest for the next 6 weeks.

Over the 3 days, I have learnt and seen the continuum of mental health services provided for patients with namely schizophrenia, bipolar, depression. There are many types of acute, inpatient services, rehabilitative and outpatient services, and OTs have such dynamic roles in all these settings. The mental health setting is really a place where OTs have to be self-motivated, constantly challenging himself/herself to find ways and means to help patients improve.

I was allowed to sit in for an MDT discuss - multi-disciplinary team discussion, where all kinds of health professionals in charge of a certain ward convene to discuss the conditions of the patients, actions taken, actions to be taken, further information gathered, etc. Interviews with patients and family/friends/helpers also take place in front of the team. (It can be quite intimidating for the patients, family/friends/helpers though, I feel) What was amazing is the ability of all the team members to organize their time, space and thoughts so well! They are able to do interviews, discussion, writing of case notes, thinking, remembering information about many different patients at once! There was practically no one sitting still in the room, always a bustle of activity with chairs moving all over the place, files being exchanged and used, stamps chopping away, etc. It was really mind-boggling to see everyone being able to cope with all the confusion inside! It is also quite humbling to see how well each person is able to organise his/her time well and to see the initiative taken by each therapist. I really have a lot to learn - how to cope with confusion as I have seen and how to organise my time well and with discipline.

This also brings me to the point about how much communication goes on between health practitioners. If there were any who wanted to find a sociable bunch, they will find it at the hospitals. LOLS. This really means that repore, relationship and trust building is very important for me to learn. I must learn how to work with others in a team, follow other's leadership and also learn to socialize (and not become isolated just like I am now.)

Other than the MDT, I attended a lantern-making group session with inpatient woman ward and also a moon-cake making group session with the child/teenage ward. I'm too tired now to talk about too many things realized. At the end of the day, we all just come to the sad realization that the mental health setting is a sad setting though it can be really interesting and occassionally funny. It is really sad to see the patients struggle against their own conditions and the stigma/barriers they face in society.

To whoever is reading this blog, anyone can have mental health problems, just that some need more help than others. Don't treat them as though they are animals or less than a human or person than we are because anyone can fall into the illness of the soul and mind at as easily as falling into an illness of the physical body.

Signing off with love,
Charmaine

Just another random thought. Saw one of my old schoolmate's recent photos.
Just wondering how all my friends have become so pretty and gorgeous? :/

It's quite a struggle to blog about my clinicals everyday. The journey that I take to and from my placement is simply awful..2 hours for each journey..and each time I am stuck in jams on a bus that goes at snail speed and keeps stopping and jerking (this makes me slide all over the seat). It doesn't really help to be stuck in a pair of ultra tight clinical pants and a pair of shoes that can hurt if it decides to that day. Lols.

So much for all these exasperated talk. I should be giving thanks for even being given an opportunity to experience such things! And that after tomorrow I will go to a different location and won't have to travel such a long distance.

Well, today's entry is about my fears for this placement - my insecurities so far. I'm quite concerned that I don't seem to be able to interact with patients very well..and don't seem to be able to communicate well with therapists..it's my perception of how I am so far..but I really wonder if I can do well at all.

Probably many people will tell me not to worry because it's new placement..but it's really difficult because others really seem so much better, mature and competant than me..hmmmm

These are some questions I have been asking myself today:
- Am I taking enough initiative in therapy sessions? Am I taking enough initiative in reading up/preparing for the therapy sessions?
- Am I able to use the knowledge I have gained over the semester just like the rest? If I'm not, then why not?
- Am I communicate well with therapists and patients? Am I asking relevant, intelligent questions? Or am I asking questions that are irrelevant and stupid?
- How do I know what questions to ask and what to look out for in a therapy session? (Sometimes I think differently from others..and others tend to be right..this really makes me worry)
- Am I able to think in a matured manner? If I'm not, then how do I learn to think maturedly?
- What should I read up on? How do I know what is important and what is not? (I tend to attempt to read up on everything because I think everything is relevant, but end up not finishing my readings - totally the obsessive compulsive personality disorder thing to do. lols)
- What are people's impressions of me? Do I come across as immatured or childish? Or my ideas too flighty? Do I come across as unlikeable right from the start?
- What am I good at then? And how can I use it appropriately?

hmmm..well these questions are important to ask but if they keep popping in my head, it isn't very productive. Oh dear. At least they are typed out now so I can lay them to rest now.

On the more positive note, we joined a singing session today. Singing definitely wasn't perfect but it was rewarding to see then smile and laugh spontaneously! It inspires me to pick up the piano again so that I can play accompaniments for a session as such.. and same for singing! haha..I think it is still possible to sing isn't it?

Today, I also found out what a flat affect in a person with Schizophrenia looks like..some how in the afternoon, the heat made me feel like I had a flat affect too! lols..I really need to build up endurance..hahaha..

Now it is almost time to sleep. A new day tomorrow, I hope that I will find hope. (:

Signing off with love,
Char

P.S. I forgot! There is some glimmer of hope (: One of my friends is treating me to cake before I go off to the other centre! haha! But I sure will miss them :(

P.S. 2 It is amazing to see how a small group of OTs have such varied roles even in a single setting! And it is also amazing to see how OTs bring hope to patients with Schizophrenia when previously, their futures had ended when they were diagnosed with this illness. It is sad though that there is still alot of social stigma attached to Schizophrenia.

CE2 is a really new exciting milestone for me (and I think for every other yr 2 OT student too!). New experiences and new expectations, I really do hope that CE2 will go well. This time, I have been posted to a mental health setting.

At first, I thought there wouldn't be anything to reflect on because it was a rather slow-paced day, I didn't really do much and had quite a bit of free time in between. What we do in MH is so different from the never-ending running around in the acute hospitals!

However, thinking deeper, I have gained one or two important insights based on what we saw today.

1. Today, we were given an opportunity to be oriented to the skills training programme. This is a programme to assess, train and engage patients in productive activity before they go to work. Involving contract work, patients carry out crafts like pottery, candle-making, jewelry-making; do woodworking (to make beautiful stools), paper-making, gardening etc. The products made are sold comercially so that whatever is earned can go back into obtaining materials for the continuation of the programme for patients. While many of us take craft-work as simple or rather pointless, when we analyze the activities, it is amazing to realize what really goes into doing that particular craft, what makes one craft suitable for a person but not another and even how the person's skills can improve because of the craft. It really reminds me to give thanks for the abilities that God has given me, however insignificant they seem, for they truly contribute quietly alot to what makes me able to function in this world.

Another thing that was really amazing is the workmanship of the patients. Despite their conditions, either through practice or because of natural abilities (or capable OTs and OTAs =]), their products were really beautiful - sellable, if looking at it commercially. Their clay work was intricate and lovely-coloured. It is a great mistake to stigmatise MH sufferers just because of their conditions because they are able just like anyone else, it is just that they need help to fight their condition.

2. This brings me to the 2nd insight, gained while reading the book, entitled 'Even when she forgot my name'. This book is written by Wong Chai Kee, a Singaporean, about his experiences with his mother who had Alzheimer's disease. From this book, I realized that no matter what mental health condition a person is suffering from, or how severe it is, the unique person he/she is, is still there. Very often, we view MH patients as 'mad', no longer normal, and occasionally we unknowingly strip them of their rightful title of a unique individual. However, this book allowed me to see that no matter how unnatural the person's actions seem (or 'demented', is this too degratory a word?) it is the person's spiritual self/soul struggling to battle against the condition of the body. It is because of their physical condition that their unique self/soul which desires to be normal needs help to be expressed physically. So even if there were to be a person seems as though he is like a wooden-board, the innate self/soul still has the need to be treated as a person, to be treated with dignity.

3. I nearly forgot to talk about my fears. So far I have not met my supervisor, and probably won't meet him till thursday. Plus I can only find out more about the service that I am attached to on thursday too. That kind of places me slightly behind the rest. I do hope that I can catch up and that I will be able to do well..especially since my coursemates seem are so much more capable than I am..

It's time to sleep. Good night, sweet dreams, it's a new day tomorrow.

Signing off,
Charms

P.S. Now it is almost time to sleep. Just have to wait for my uniform to finish washing and then iron it.

P.S. It is bad uniform day. My pants are really tight and the top button of my new blouse fell off at lunchtime. :(

No one by your side
to just be silent and cry with you
to say no word but feel what you feel
to not expect anything from you
to not pity you but to understand you
But there's no one.
Alone. Why?

Heart like frosted glass, no light shining through.
Only cold harsh winter, hail pounding down hard.
No warmth, no light, just shiver in the endless bleak cold.