Nicola Crossey on the power of occupational therapy in emergency care
As a clinical lead therapist for occupational therapy and physiotherapy in acute and emergency medicine, Nicola Crossey plays a crucial role in supporting patient care across two major hospitals. In celebration of occupational therapy week (4-11 November), Nicola highlights the impactful work of occupational therapists within multidisciplinary teams and how rewarding a career in occupational therapy can be.
Do you have a typical working day?
No two days are the same. I work across St Mary’s and Charing Cross hospitals – part of Imperial College Healthcare. I manage a large team of occupational therapists (OTs) and physiotherapists (PTs) who cover our accident and emergency (A&E) departments and acute medical and assessment units. Our service cover includes our same day emergency care (SDEC) clinics, older person’s assessment and liaison (OPAL) team, and older person’s rapid access clinic (OPRAC).
I typically split my time 50/50 between each site but I am flexible, depending on what is happening on the ground. My day may involve assessing and treating patients, providing clinical support for staff, overseeing quality improvement projects or conducting meetings, supervisions and training sessions.
I love the problem-solving involved in complex cases and the dynamic, fast-paced environment of the acute hospital environment. Our front-door therapists work in an interdisciplinary way, with OTs and PTs using a shared skill set to provide comprehensive assessments that inform patient pathways. My team are fantastic — they are hard-working, dedicated, and focused on improving patient outcomes. It’s truly a pleasure to work with and lead such a talented group of therapists.
Nicola Crossey
"I have found occupational therapy to be a constantly evolving and rewarding career with a healthy amount of challenges to keep me engaged."
What attracted you to a career in occupational therapy?
Before starting my occupational therapy degree in Australia, I worked in the disability sector as a support worker, building daily routines and community participation for the service users. This job was foundational in shaping my passion for a career in helping others, and I found it deeply rewarding when therapeutic goals were achieved. I still carry this ethos when working with my patients and team members.
I have worked in this role for two years, and I love that I get to connect with so many people – both patients and colleagues. I am pleased that I get to work across multiple front door and acute medicine teams, which allows me to collaborate with many inspirational people inside and outside of the Trust. I especially enjoy working with elderly patients and those who are living with complex conditions such as frailty. I am grateful we have such fantastic frailty services and experts within our Trust which provide continued excellence in care.
What kind of impact can occupational therapists have on patients and staff alike?
There can be a misconception that ‘occupational therapy’ is related to a person’s employment, but it is much broader. Our goal is to build or rebuild a person’s abilities to maximise functional independence across all stages of life.
It is incredibly rewarding to apply our skills in ways that improve patients’ lives. Whether we are arranging support so that patients can return home or offering practical recommendations to increase their independence, the difference we make is tangible and aligned with each patient’s goals.
OTs act as an important link between hospitals and community services, crucial for ensuring seamless patient transitions and contributing to hospital flow.
I recently completed an improvement project – which contributed toward my final project in my master’s degree – which focused on increasing the speed of senior decision making for elderly patients that require therapy in our emergency department. The project was based across St Mary’s and Charing Cross emergency departments and was a way for multidisciplinary team members to collaborate in goal setting and work together toward shared departmental targets. These included increasing the identification of frailty in our emergency departments, accelerating senior decision making in consideration of four-hour performance standards, and most importantly, the aspiration to improve the patient hospital journey by avoiding delays to clinical assessment.
The year-long project reinforced the power of collaborative working and highlighted the dynamic role that front-door therapists can play in emergency care.
Nicola Crossey
"Our goal is to build or rebuild a person’s abilities to maximise functional independence across all stages of life."
Why would you encourage aspiring occupational therapists to pursue a career in occupational therapy?
I have found occupational therapy to be a constantly evolving and rewarding career with a healthy amount of challenges to keep me engaged. OTs can develop diverse skills that are applicable in many settings, as well as opportunities to specialise clinically. Learning and growth are key to job satisfaction, and occupational therapy offers many pathways for ongoing professional development.
OTs are essential members of multidisciplinary teams and positively impact hospital systems and the surrounding communities. I'm immensely proud to be an OT, supporting patients and colleagues in my role.
During occupational therapy week, I want to thank all my incredible colleagues for their dedication to providing the highest quality of care. OTs truly are a powerful force in global health and social care.
