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Every semester of college, I have made myself a nice color-coded schedule of my classes. This semester I have 2 online classes, no Wednesday or Friday classes, and none of my classes start before noon (yay for sleeping in)!

This is my final semester of school before I graduate with my OT degree and I am taking:

Issues & Trends in OT

Management & Entrepreneurship

Board Prep

I also chose Dementia & Early Intervention as my electives

And this semester I will finish my group Research Project

I am excited to have so much free time this semester to use sleeping in, going to the gym, visiting family, and maybe getting a head start on studying for the boards!?

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. 

Guest post by Brynne Terry, OTR/L

My first Level II Fieldwork placement was far from what one might expect, but an experience I will cherish forever. I had the opportunity to work in a brand-new OT fieldwork setting, live in another state for 3 months, work with individuals throughout the community of all ages and of many different diagnoses, and the best part of it all?  There were dogs. That’s right – I got to use (wo)man’s best friend during treatment using what we called Canine Facilitated Interventions ™.

If you are as unfamiliar as I was with Canine Facilitated Interventions ™, it is in short, a treatment approach utilizing highly trained assistance dogs to increase a client’s participation and meaningful engagement in treatment sessions. Think: dressing dogs in their collars and vests, brushing their teeth, brushing their coats, and doing other activities that incorporate unique performance skills that can be translated from canine to self. It’s essentially incorporating all the activities you’d normally be addressing in treatment,just with some added fun of a furry friend!

I am a dog person, so as you can imagine, I was extremely excited going into this fieldwork placement. However, I was also feeling a bit apprehensive. As a first-time fieldwork student, I had no idea what to expect, and on top of that, Canine Facilitated Interventions ™ are not typical treatment approaches taught in OT school, so I knew I had an extra layer of learning to tackle.

My second Level II Fieldwork was also rather non-traditional outpatient setting, addressing habit and routine modification to help clients better manage chronic conditions such as headaches, pain, and fatigue. The primary focus was changing various lifestyle factors – sleep, eating, and exercise routines, stress and time management, etc. – in order to facilitate health-promoting habits and routines,thus decreasing the negative impact of a chronic condition on a client’s day-to-day occupations and roles.

Again,it was another big learning curve to adjust to, and with both experiences came many learning lessons – many of which I had to learn the hard way.

Here are a few tips I’d like to share so you can maximize your success in any setting (and learn from my mistakes, so you don’t make the same ones), whether it is non-traditional, new, or out of area:

• Identify your goals

Before going into any fieldwork placement, no matter the setting, it is important to identify your personal goals for professional development. Having a clear idea of what you want to get out of the experience will help direct you throughout the experience. Of course there’s competency goals you must achieve by the end of the rotation, but choosing a few areas to focus on outside of the OT-specific skills can help you go above and beyond to develop even further as a professional. I found setting personal goals prior to beginning fieldwork extremely valuable given my non-traditional settings.

• Go in with an openmind and be flexible

While going in with specific goals is always a good idea, I also want to highlight the importance of flexibility. As my placement was a new setting, there was a lot of program development and planning involved on the go. In my outpatient setting, there were late cancellations, no-shows, and last-minute appointments being scheduled. Not every treatment session, activity, or day went as intended,and that was okay. Keep an open mind to different opportunities and remember that each experience is a learning experience, even if it doesn’t end up being the initial plan.

• Take initiative and be creative

If you are in a new OT setting where the structure of the fieldwork experience is still being developed, use that as an opportunity to grow your leadership skills and use your creative OT mind. Offer suggestions that will help shape your experience into one that is unique and designed to improve your personal goals.

• Get comfortable with the uncomfortable

As a student, you may often feel like you have no idea what you’re doing. You may also feel this way if you are in an unfamiliar practice setting. Embrace it.Growth comes from stepping outside of your comfort zone, so take on new challenges and responsibilities even if you’re feeling unsure. Know that feelings of uncertainty are completely normal! This brings me to the next point…

• Communicate with supervisors and coworkers

Take the opportunities you are given, but do not be afraid to ask questions, set boundaries, and communicate often. If you’re feeling overwhelmed with responsibilities, questioning a treatment approach, or have any other concern related to your fieldwork experience, talk to someone who can help.  Your supervisors and coworkers are there to support you, so communicate with them early and often, be friendly, maintain professional relationships, and thank them whenever they assist you.

• Don’t neglect self-care and be kind to yourself

Of all my strategies for success, this is the one I want to emphasize most. Being in anew work environment or living environment is exciting, but can also be overwhelming. You are trying to learn so many new things about OT while also trying to be an OT. You are not going to be perfect and you will probably make mistakes. It’s all a part of the learning process, so DO NOT be too hard on yourself! Perfection got the best of me, so this is something I wish I had ingrained in my own mind prior to fieldwork. Practice positive self-talk and know what stress management strategies are effective for you (e.g. exercise, meditation, journaling, etc.).Build these into your daily routine beforeyou get too overwhelmed.

• Maintain your support system

A huge component of getting through fieldwork, especially if you are away from home or your school, is maintaining your support system. If you are placed in a new city, keep in contact with your friends and loved ones, or create new connections in your temporary “home.”

• Stay eager and reflect on the bigger picture

Not every fieldwork placement will be the best fit for you, but you will still learn and grow an incredible amount. If you don’t love your fieldwork setting,remember it is short-term and that it is still contributing to your goal of becoming an OT. I guarantee that you will learn valuable information or skill sets from all placements that will be beneficial to your future career.

• Listen to and learn from your clients

Of all the things you learn about the process of OT during fieldwork, perhaps the biggest takeaways will be from your clients. Listen to them, understand them, and adapt to them. This is what will make you a better OT, and able to treat any patient from a holistic perspective. Additionally, if you’re working with older adults, they often have words of wisdom and really great advice – take it! One of my clients, who was robbed of so many of his meaningful occupations by his multiple chronic conditions, told me “Don’t take your health for granted, because when you lose your health you lose everything.”

About the Author:

Brynne Terry, MA, OTR/L, is an occupational therapist in California. She completed her B.A. in Human Performance and M.A. of Occupational Therapy at the University of Southern California. She is pursuing her OTD at Boston University, where her focus is promoting health and wellness among the college student population through an occupational therapy lens.

Follow Brynne on instagram @bewellbalance to learn more about her & the focus of her OTD

I’ve never been very good at keeping resolutions so this year I decided to do something different. Each month this year, I am going to choose a quote and have it as my “quote of the month.”

My quote for January is “you are exactly where you need to be!”

I go back to college this month and haven’t sat in a classroom since May. It’s been a long time. And I’ll admit that I have mixed emotions about going back. I am so ready to graduate and move on to the next chapter. But this month, I will remind myself, you are exactly where you need to be.

When I am moving stuff into my apartment and feeling nervous about living away from home again, I will tell myself, you are exactly where you need to be.

When I’m sitting in a classroom, feeling antsy, I will tell myself, you are exactly where you need to be.

And when I desperately want to be done school and start my career as an OT, I will tell myself, you are exactly where you need to be.

I always knew that I wanted to go into a health profession. When I was little, I preferred to watch “doctor shows” over usual kid shows. My mom is also a pharmacist and encouraged me to consider a health career.

When I was in high school, I started to look into different health careers and consider my possibilities. I didn’t want to go into a career involving needles and I didn’t want to spend the rest of my life in school. I eventually came across OT and started to read more about it. I liked that it looked at the whole person, helped them do what was important to them, and only required a Master’s degree. My mom helped me set up some days to shadow with OTs she knew and I attended an OT exploration camp for a few days one summer, at a college. These experiences helped me realize that OT was the perfect career for me.

My senior year of college, I chose to apply to combined 5 year BS/MS programs. I chose this route because it would save time and money, as well as the stress of having to apply to graduate programs later. I applied to 5 programs and was accepted to all 5. (When I got my first acceptance, I could not believe it was true and emailed the school asking if it was correct, it was!)

At the end of my 4th year, I graduated with my BS in Health Science, with a minor in psychology, and then completed my Level II Fieldwork rotations in a SNF and outpatient pediatrics.

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I am now about to start my final semester of OT school and will graduate in May with my Master’s Degree in Occupational Therapy. After that, I will study and sit for the boards and then can begin working as an OT!