Be an advocate for change!
Eva LETOURNEAU [1]
Recently, I realized that I have been an occupational therapist for more than fifteen years, and a certified somatosensory therapist of pain for ten years now. Passing those steps questioned me about the accomplishment, but also about what is to come.
During those years, I had the chance to work as a therapist in three different countries in public and private settings and with a lot of wonderful colleagues. I was also lucky enough to teach the method of somatosensory pain rehabilitation to more than one hundred people coming from all over the world. I also learned on my own, through these fantastic experiences. And there is one thing that resonates most with me, it is the notion of being an advocate for change!
I would like to explain what this means for me and how I think we all could, as health professionals, try to become advocates for change.
When I think about which change, I mostly think about the way neuropathic pain is perceived and more specifically how neuropathic pain patients are perceived and taken care of. Still after all these years, I too often hear a medical doctor, another health care professional or even the patients themselves, minimizing neuropathic pain, associating them with imagination – a construction of the mind – or even relating them to maximized pain in order to obtain something in return.
I will always try to educate and explain to everyone around me what neuropathic pain is, and more importantly, how to recognize it and treat it. I hope that through my passion about improving the quality of care and the services provided to patients, I will continue being an advocate for change. To be more specific, I can think of five paths to make a difference in health facilities in driving improvements that benefit patients and colleagues.
The first thing that I would recommend doing, is championing patient-centered care. It goes with a very important thing: as a caregiver, never doubt the lack of authenticity of your patient’s expression of pain. This is the postulate of the patient’s sincerity in the method of somatosensory pain rehabilitation. When healthcare professionals prioritize patient needs and preferences and work to ensure that healthcare services are adapted to the patients needs, it is an effective way to promote change. This can involve advocating for improvements in communication, care, coordination and access to information and resources. Discussions with other professinals about the patient suffering from neuropathic pain, in order to work as a team has been very useful for me, sometimes just to have the same language regarding the origin of the pain and its authenticity. Listening to the patient’s experience and discuss the goals of the therapeutic plan is crucial and should be systematically done.
Second, a good way to encourage staff development in terms of knowledge and practical skills is, in my experience, to just be available to discuss scientific findings about neuropathic pain and any related topic. It can also mean to discreetly do my job as an occupational therapist and let the improvements in the patient’s condition speak for themselves. It can also be the fact of proposing to teach my colleagues about the method of somatosensory pain rehabilitation and coach them with their patients. Being an advocate for change implies the importance of staff training and development in delivering high-quality care with the latest best practices and healthcare progresses. Discussing policies of continuing education and professional development with people in charge of human resources in your facility can be the first step to ensure change.
Third, I try to promote innovation in facilities where I am and with collaborators such as doctors. A good portion of that is to endlessly explain what scientific research says about neuropathic pain by sharing scientific articles on the subject in my communications with other healthcare professionals. I had good results with some doctors, who now refer patients with allodynia as a diagnostic, asking for rehabilitation. I think it is important to encourage the exploration of new ways to deliver care that can improve patient outcomes. The method of somatosensory pain rehabilitation is one of them.
The fourth thing that I learned to do, is fostering collaboration. Being an advocate for change is recognizing that improving healthcare requires a collaborative effort with different professionals and organizations. I think we can work to facilitate communication and collaboration between different groups and promote shared goals and values. A simple way to do this is to take the habit of always contact other professionals working with your patient, especially if they work in a different facility. For myself, as an occupational therapist, a lot of my patients have treatments with a physiotherapist as those two professions work in physical rehabilitation. Since physiotherapy can involve manual therapy and physical contact that can influence neuropathic pain, especially when mechanical allodynia is present, I try to talk to my colleague as early as possible to discuss a common goal in terms of therapeutic plan. A lot of times, I explain what allodynia is and how to avoid eliciting that touch-evoked pain in order to get rid of it and prevent pain exacerbation for the patient. Sometimes I acknowledge that we voluntarily leave the neuropathic pain aside, for now, to focus on other urgent objectives with the patient. Another key collaborator for me is the doctor in charge of the patient. I think it is mandatory to give clear information to the doctor about the evolution of my patient, the modalities that I propose to use and the therapeutic goals that have been set. Within those communications, I try to put a lot of my objective observations and standardize testing to give credit to what I want to do and even refer to specific scientific articles if needed. I think that it helps open the discussion and facilitates collaboration.
The fifth way is something that I hope I can get better at in the years to come. That is advocating for policy changes on a larger level. Being an advocate for change could mean playing a key role in advocating for policy changes that can improve the healthcare system. This can involve working with policymakers and other stakeholders to identify areas where policy changes can have the greatest impact. Regarding neuropathic pain, the fact of participating more actively in groups that can have power like association of professionals, could be a path.
Overall, I think that being an advocate for change requires a commitment to a continuous improvement and a willingness to work collaboratively with others. By focusing on patient-centered care, staff development, innovation, collaboration and policy changes, advocates can help create a healthcare system that delivers better outcomes for neuropathic pain patients. I hope to be able to continue doing this for many years.
[1] BSc OT, M Rehab, CSTP©
