From 2016 until 2023 I was working at Counties Manukau District Health Board in the acute stroke unit as a Senior Occupational Therapist. I waa provided with opportunities to connect and consult with people from various populations, this is evident as Counties Manukau catchment area serves a population whom come from diverse cultures and backgrounds. I was actively involved in service initiatives to improve the stroke care pathway across our clinical services. I was participated in the Stroke Integration Meetings to spearhead initiatives to improve the stroke pathway across our inpatient and community services. In 2019, I completed a Leading Quality Care programme and worked on various ward projects. I mentor university students where I instilled knowledge and skills in stroke care and management. I supervised therapists and therapy assistants of the Occupational Therapy Team who are situated in the acute medical wards and lead a team of therapists in the stroke unit.

Learning and extending my skills and knowledge is a value I hold highly. In 2022 completed my research thesis in stroke rehabilitation for my Masters of Health Science with Auckland University. My thesis helped to increase our understanding of the perceptions and experiences of therapists and stroke patients with dyspraxia when using mental imagery in acute and rehabilitation settings.

Most recently I have relocated to the United Kingdom where I have been in two locum positions thus far. In August to September 2023 I worked in the Neurosurgery Team at the National Hospital for Neurology and Neurosurgery. Following this placement I am working with the Royal Free Trust in Barnet Hospital in the Intensive Care Unit. I am developing the role of an Occupational Therapist in this specialised area and supporting and teaching Occupational Therapists and Therapy Support Workers of the rehabilitation approaches and processes in the ICU unit.

No

I was recommended this recruitment company from my sister, J.Noble and her friend, L.Vaccari, who are both audiologists.

When in New Zealand in my past role I was required to help manage the acute Occupational Therapy Team when my line manager was absent. On one particular day earlier this year we have many absentees in our team for a few days while our manager was not present. Within the team I had to attend meetings for my own ward, hold a case load and help support other members of the team on other wards. This day can be quote typical.
To manage my day and meet my roles and responsibilities it was important to prioritise. I firstly meet with the team to check in and made sure therapists could bgin their day and be informed of the essential information required. I liaised and informed the necessary people whom needed to be updated on our current staffing levels for that given day. I prioritised attending the meeting and kindly asked the therapy support worker to help continue the rehabilitation programs with my patients to ensure their therapy time was not compromised.
The outcome was positive, I was able to manage both the clinical and non-clinical work/ meetings appropriately, whilst still managing the team. It meant that we worked smarter and prioritised the tasks that were essential for the day.

It is identifying what potential hazards exist, or may occur or appear in a workplace and how they could cause hard and then take the necessary steps to minimise that risk. This is our responsibilities as employers in the work place to be aware and highlight risks, to ensure that we and our patients can all remain a safe at possible.

- have a second person present to assist if the patient is likely to fall.
if a second person is not able to be present, then for the therapist to be aware of the building.ward and know where the emergency bells/alerts are situated incase an emergency situation arrises.
- reduced all hazards in the area - remove mats, plugs, cords, ensure the environment is clean, sorted and you have sufficient space to complete the assessment safely.
- to ensure all the equipment available or which will be used is in working order
- to use equipment/hoists walkers where possible, but not compromising on health outcomes, rather increasing their safety.
- ensure all the essential and necessary medications have been provided as charter.
- check/ensure all vitals signs are checks and appropriate for the assessment to be complete and their current medical status.
- to ask patient to inform you if they become symptomatic as for the therapists to check in with their patient regularly throughout the assessment
- ensure the patient has appropriate footwear/non-slip socks on to reduce their risk.
- allow the patient to have rest periods - arrange for some chairs to be positioned within the room and hallway to allow the patient to have a rest period if required.
- ensure that all hallways and rooms have sufficient lighting.
- inform their nurse caring for them that you will be completing a therapy session with then.

Listen to the person giving the complaint. Explain you will go away and inform your team or ward manager, depending on the location or whom the issues involves. Ask if they would like to be updated in the future of this outcomes of this issue.
Then immediately contact the ward manager or your line manager, to inform them of the issue raised.
If applicable, complete a DATIX of the issue.
Potentially brainstorm the potential solutions available to mitigate this issue if applicable.
If necessary to increase the safety of others, inform or educate other staff members who may be in contact or impacted by this issue as soon as possible to reduce the risk.

Clinical governance within the NHS is a framework through which healthcare organisations are accountable for continuously improving the quality of their services and safeguarding high quality of care.

There are 7 pillars of clinical governance:
Education and Training
Clinical Audit
Clinical Effectiveness
Staff Management
Risk Management
Information Management
Patient and Public Involvement

This helps to provide optimal quality of care to our patients and community. When an issue has been identified, or occurred, it is recommended that there needs to be an open, transparent and blame free reporting system. This provides an opportunity for a lesson to be learnt, shared and acted upon in a constructive and ordered manner, to reduce the likelihood of re-occurance.

I was caring for a stroke patient and as a MDT we had recommended that she was transferred down to our inpatient rehabilitation ward where she could receive intense neurology therapy to help her achieve her goals and improve her functioning. She agreed to be transferred, however within 48 hours we had returned back to our acute stroke unit as she had medical complications. Once she was medically safe she was to return back to the rehabilitation ward to continue her rehabilitation as we had planned. However, she and her family informed our team she and her family had refused for her to go back to the rehabilitation unit.
I then sat down with her and her family. I listened to their concerns, issues and experiences. After this I apologised for issues and concerns raised. I informed them of the process as to how they could provide formal feedback or a complaint if they wished. Furthermore, I discussed their concerns with the registrar in the rehabilitation ward with the patient and families consent. He then came to visit the patient and family to acknowledge their concerns, listen, and explained how her time in the rehabilitation ward could help her to achieve her goals.
The outcome was that the patient was agreeable to return back to the rehabilitation ward and her family not only consented for this but reported they felt listened to and acknowledged our work with their family member.