A Day in the Life of a Clinical Specialist Occupational Therapist in Critical Care: helping patients regain their independence
Working as a Clinical Specialist Occupational Therapist in Critical Care at Queen Elizabeth Hospital Birmingham is a varied and rewarding role. As one of the UK's largest tertiary referral centres, the hospital's four specialist critical care units care for patients across neuroscience, major trauma and burns, spinal cord injury, cardiothoracic surgery, heart and lung transplantation, and liver failure services. Occupational therapists play a key role in supporting patients' physical, cognitive, psychological and functional recovery from the earliest stages of critical illness.
My day begins with reviewing new and current patients and prioritising my caseload. I then attend goal-planning meetings to establish meaningful short and medium-term goals that support rehabilitation and independence.
The first patient I see is recovering from a cervical spinal cord injury. I assess their upper limb function, provide specialist splinting, and educate the patient, family and nursing staff on positioning, joint protection and exercise programmes. Having recently regained his voice after prolonged mechanical ventilation, I also support him to use voice-controlled technology, environmental controls and over-bed equipment to improve communication, independence and access to meaningful activities such as calling and texting family.
The second patient I see has had a traumatic brain injury experiencing post-traumatic amnesia. Through cognitive assessment I identify areas of impairment and provide education and reassurance to both the patient and family. Interventions focus on graded cognitive and sensory stimulation, orientation strategies and early rehabilitation to support recovery and future rehabilitation planning.
Later, I work with a heart transplant patient experiencing ICU acquired weakness and significant anxiety. Treatment includes oedema management, upper limb rehabilitation, adaptive equipment provision and functional activities that promote independence in their ability to eat and drink, a key goal in their rehabilitation programme. Alongside physical rehabilitation, I use anxiety management strategies including relaxation techniques, guided imagery and CBT-informed approaches to help the patient build confidence, manage distress and engage effectively in therapy.
In the afternoon, I complete a complex seating assessment for a patient recovering from an emergency liver transplant who is experiencing delirium. Working alongside physiotherapy and nursing colleagues, I assess posture, pressure care, cognition and fatigue to optimise positioning, comfort, respiratory function and participation in rehabilitation.
All therapy sessions throughout the day are completed with junior occupational therapists, supporting clinical reasoning, complex decision-making and professional development while ensuring high-quality, evidence-based care is provided.
Education remains a key component of my role, whether supporting patients and families, training nursing staff, providing specialist advice, or mentoring junior therapists.
At the end of my day, I attend the ICU quality care group, to feedback relevant initiatives and areas of concern relevant to the Occupational Therapy ICU service.
Working as a Clinical Specialist Occupational Therapist in Critical Care allows me to combine advanced clinical practice, leadership, education with compassionate care. Each day presents opportunities to support patients through life-changing illness and help them regain independence, rebuild confidence and progress towards recovery.
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