STARTING MY CAREER AS A DYSPRAXIC OCCUPATIONAL THERAPIST: MY FIRST STEPS & STUMBLES
To celebrate Dyspraxia Awareness Week I thought it was would be good idea to write about what it is like to be me, a Dyspraxic adult transitioning from training in a new profession into actual practice out there in the workplace, all with the added hurdles of a neurological difference. I come across lots of occupational therapists (OTs) with Dyspraxia so I’m sure it’ll be relatable for some of you, and if not it’s useful stuff to know when you work with dyspraxic service users or colleagues.
Managing dyspraxia at work is not without it’s challenges. I have lots of funny stories to be fair. A few weeks ago, for example, I tripped walking through a crowded meeting room and sat on my (unimpressed) consultant’s lap in front of the whole team! In the next week’s clinic MDT I leaned on a table and it collapsed, taking a coffee and ten transition papers with it (all were ruined of course, and none were mine!). Very recently I sat on a squishy kid’s stool to chat to someone in the waiting room, and it was softer than expected so I rolled off it backwards, landing flat on the floor with my legs in the air. I sat up and carried on talking as if nothing had happened, and on the way back to the office the work experience student complimented how smooth it was.
Luckily, my current team are fab, and I think they find it kinda endearing and we get by fine, but not everybody is this fortunate. Some teams are have less of a sense of humour about their transition papers, for example, and some dyspraxic people don’t fancy the banter, and don’t want to be giggled at, and things like this can really affect your sense of professional confidence.
Sadly, when I first qualified, things were much more difficult. I think it’s a good time to point out that dyspraxia isn’t all about co-ordination, and the aspects of neurodiversity that are more associated with autism can apply to us, so for me coping with change is difficult, learning new skills is difficult, and emotional regulation can be really hard (so if I’m really excited, say, I struggle to rein it in, and if I’m really really sad I wouldn’t be able to mask it well). Learning multi-step tasks was tough, which made every day things that my colleagues did without thinking (and that most of you could do without thinking) REALLY hard. For example, that before you mobilise someone you need to read notes, check obs, check the environment and make sure they’re wearing appropriate footwear- That was difficult! Hoisting was a NIGHTMARE, and learning new medical jargon was a real challenge too. And on top of that, I really struggled with my written notes, because structuring them was hard work (my god SOAP notes can do one), and just the physical work of handwriting…well that’s one dyspraxic trait that actually is well known isn’t it.
Quite reasonably, my seniors didn’t understand it at all. They were all new grads once, and they picked these things up easily enough, why wasn’t I? Having to train a new graduate was already a big task to balance with caseloads, and on top of that they had a ‘complicated’ new starter who couldn’t grasp the basics.
So I picked up on their frustration and it made me even more anxious than I already was. An incredulous physio would be lecturing me in a room full of people and I wouldn’t be following and I’d get overwhelmed and burst into tears. A couple of incidents like that and in my mind I’d lost all hope of being respected as a professional- I felt that they saw me as a child, they felt that I was petulant and couldn’t take initiative and the situation spiralled. I struggled HARD with anxiety (very over represented in the dyspraxic community) and I’d be waking up every morning feeling sick with fear, having panic attacks in the store cupboard most days and lying awake every night. From the stress, and from the extra aches from standing up all day and trying to hand write quickly, I’d be too tired to socialise or climb or cook, and so had no occupational balance. I was too stressed to have an appetite and lost a lot of weight. The first few months of independence post-uni are probably hard for anyone, but it was a dark time.
In the end I went to my manager who referred me to occupational health who referred me to counselling, and with a combination of that and the fact that I just got better at stuff with practice meant that the situation did improve. I learnt how to hoist, me and my supervisor learnt to get on, and I grew to love elderly care, but it took nearly 8 months, I wasn’t prepared for the challenges of working with a disability, they weren’t particularly dyspraxia aware, it was nobody’s fault but the whole thing was unpleasant for everyone.
And I’m telling this story not just out of self pity ( 😛 ) or to put you poor bleeders off graduating, but because more or less the whole thing was avoidable. With better neurodiversity education (which you haven’t got much control over), and having the strategies to manage my condition and advocate for myself (which you have!) it could’ve gone a lot differently.
So on that note, I will tell you about my new(ish) workplace. Although I came in with a year or so’s experience, this was totally different work and all new skills to learn. I was nervous about this, but I went in expecting it to be a difficult transition. I was open from the start about having dyspraxia, and when I met the OT manager on the first day, she asked what I might need an assured me I could always come if I had a problem.
There were difficulties transitioning to a totally different routine, and after a couple of months of learning what worked and what didn’t, and trawling dyspraxia foundation and access to work websites for case studies about adjustments, I wrote an essay like email to my poor supervisor explaining what all the difficult bits were, but also (crucially), what extra strengths I think my dyspraxia brings to the team. I explained certain things that I had work arounds for- like the fact that I can’t remember complex processes after them just being verbally explained, so that I might need people to rephrase things, and then I would make my own written prompts (which I did) to do them more independently in future. I like this approach because I come bringing solutions as well as just problems, and I take some responsibility for adapting as well as I can, on top of suggesting what I need from them. I explained that some things don’t have a solution and will just require them to be patient and adjust expectations, for example that I would need more practice to learn new things and would need longer to hand write notes. I also explained that I was worried about what other team members who didn’t know about my dyspraxia might think, when I forgot something or knocked over coffee or forgot my trousers (yes, really. Twice.), and that I was scared I’d have a bad reputation.
To my immense relief, she read the whole thing, thanked me for explaining, and reassured me that nobody was saying anything and that if there were ever problems with the wider team she’d have my back. It was like an enormous weight was lifted and I wished I’d done similar in my first week as a new graduate.
I LIKE TO BE OPEN ABOUT MY DYSPRAXIA
I’d also said that if anybody brought anything up or wanted to know why I behaved a certain way I had no issue with the information being shared, but to my knowledge it’s never come up. For my part, I’ve just dropped it into conversation at various relevant points, such as on the day when I lost my phone twice in the toilets and once in the mailbag in one morning, or on the day when my ribs ached from having got stuck in a window the day before. Some people might not be comfortable sharing this, and that’s fine, but for me it’s how I like it. I’ve also adjusted my attitude so frankly, I’ll take no crap. If somebody were to start complaining that things take me a long time or that I might ask the same question twice, I’ve no hesitation in telling them I’ve got a disability thank you very much and an extra five minutes on my notes is a reasonable adjustment. I like to hope that if there was any whiff of bitching behind my back I’d be willing to shut it down myself but it’s nice to know the support is there. Also, having been around just about long enough to stop being paranoid, I don’t think any of the people I work with are like that.
I’ve also learnt to prempt when something will be really hard for me to learn, like splinting for example, or hand writing assessments, and plan time out to learn and practice on myself and my long suffering friends. I’m allowed to use work time for this, but if work’s really busy it’s well worth using my evenings and weekends to reduce the anxiety that surrounds it. To be fair though, it’s much easier to do with these things than it was with hoisting or fettling oxygen canisters!
FINDING COPING STRATEGIES THAT WORK
I also try and make sure I’ve got copies of all the paper work I could possible need in my bag so nothing can catch me out in clinic (and hey, if I’m bored I’ve got a whole list of fun, school friendly hand activities to keep me busy wherever I am!), and I try and keep things like putty, pen grips and stress balls as that’s the type of thing I’d forget (that’s also why my bag is so bloody heavy). I HAVE to write notes on the day I see the patient, even if that regrettably means staying late, so I don’t forget information, or worse forget to finish paperwork for a patient. I got really behind last week and remembering what I was doing with every patient stressed me out so much, don’t do it! I also keep a diary with a tick list of the patients I’ve seen OR done admin tasks for, with room for 2 ticks- one for when I’ve written their notes and the other for when I’ve logged the appointment outcome, that way nothing gets missed. I realised that often my stats were illegible or I’d copied patient numbers wrong, which caused loads of extra headache for admin and for me, so I asked them nicely if I could submit them typed, and they said yes. That tiny bit of proactive problem solving has probably saved me hours by now!
If I’m honest there are still things that get me overwhelmed. When it’s been too busy for me to have much senior support I question my decisions a lot. Recently a physio showed me the 20 minutes fit mask testing procedure and concluded with “so as you can see, it’s not rocket science”. I wandered off looking confused and am still trying to figure it out! But all these little hurdles are overcomable. The more experiences you have of struggling and then figuring it out, the more evidence you have to support the fact that you can do it, and the less the anxiety sets in. My main piece of advice in situations like the above would be not to be scared to say “actually I don’t understand and I need to go over that again”- usually people are kinder than I expect them to be, but even if they weren’t it’s better than constantly thinking I’m doing it wrong.
My last piece of wisdom is about the attitude that’s helped me feel less self conscious about dyspraxia at work. It’s more or less what I concluded my email with when I started the new job: “It’s fine to laugh when I fall over something or drop something or look confused about a simple instruction because hey, those things are funny! It’s only if if affects how you regard me as a professional that we have a problem”. To me, having a sense of humour about things, but also respecting myself and drawing the line when needed, has been the ultimate saviour.
Oh, and also, while it might make me the slowest at paperwork, with the empathy, problem solving and resilience it gives me, dyspraxia undoubtedly makes me a better therapist.