So you’ll be completing your Level II Fieldwork Placement in a Skilled Nursing Facility? Excited? Nervous? Mixed Emotions? That’s how I felt too.
My first Level II Fieldwork Placement was in a SNF, within a large retirement community. This was a great placement because it allowed me to see patients from skilled nursing, independent living, assisted living, and long term care. I saw so many different diagnoses and conditions and got to work with some amazing people.
I went into it nervous, and had no idea if I would even like it, but ended up loving it.
I wrote a list of tips and broke them down into 5 categories: you, your patients, your treatments, your supervisors, and your co-workers.
You
- Wear comfortable shoes. You’ll be on your feet most of the day and might find yourself powerwalking after a runaway patient so you want to make sure you’re feet don’t hurt.
- Find a way to relieve stress. You are going to be stressed. You are in a whole new situation, learning a ton, and working with people all day. I was always exhausted when I came home and fell asleep in my scrubs on the couch more than once. Find something that helps you relieve stress and you’ll look forward to coming home and doing. It could be a bubble bath, exercise, reading, really anything.
- Try not to get discouraged. Sometimes you’ll find yourself in situations where you don’t know what to do. Or a patient might yell at you. Or you just feel completely overwhelmed. Take a deep breath and remind yourself that everyone was a student once and you’ll make it through.
Your patients
- Remember that they don’t want to be there. A SNF is not where most people would choose to spend their time. Be kind to them. Take the extra minute to just talk to them and get to know them, it can really make a difference.
- Be patient. When working with older adults, many of your patients may have dementia. While they might be in the SNF following a stroke or hip replacement, you are treating the entire person. Be patient and take it one step at a time.
Your treatments
- Be creative and keep the patient’s interests in mind. One of my favorite activities including hiding fake flowers in the hallway and then we went on a walk to pick flowers and stood to arrange them in a vase. It was a big hit among my ladies and addressed so many different skills.
- Realize that every session isn’t going to perfect and occupation-based. Sometimes you are lucky to find one activity to motivate a patient. Take that and use it as a starting point. Some of my older men loved the nustep (I’m not sure why) but if getting to use it got them into the gym, then I used it. And then after the nustep, used the “while you’re here, let’s do a few more things” approach and could usually get them to participate in some more occupation-based activities.
- Don’t be scared to do shower treatments. It sounds funny but my first shower treatment, I was low key terrified. But make sure you know your patient well before taking them into the shower, let the patient know where everything they need is, and remember that it won’t take that long for your shoes to dry. Patients are always so grateful after a shower treatment because it could be their first shower in weeks. (Extra tip: lay some extra towels on the floor to prevent the floor from getting slippery.)
- If possible, get your patients outside. My facility had a nice courtyard and a few patios. Patients loved when they got to go outside so if you’re doing a tabletop activity maybe try it on that patio table outside.
Your supervisor
- Get to know your supervisor. Ask them how their weekend was, ask how long they’ve been an OT, ask about their previous OT jobs, just get to know more about them. My first supervisor and I had a great relationship and I felt completely comfortable asking her questions.
Your coworkers
- You’re going to be working with these people for 12 weeks. Talk to them at lunch, get to know them. They may also know the patient you are working with and be able to offer advice. You can learn something from everyone, even therapists of other disciplines. And there’s definitely going to be a point where you pop your head out the door and have to tell the closest therapist that you need to run and grab new pants for your patient and can they keep an eye on them, so you want to be on their good sides.
Becky B OT 