Level 2 Fieldwork Blues

Hey friends! It's been a long time since I posted something about anything. I moved back to NYC for the summer to be with family and began my level 2 fieldwork at the Brooklyn VA.

For all my non-OT friends, fieldwork is like an internship. It's an immersive 12 week program (USC students complete it in the summers) for students to learn through a hands-on experience within a specific setting of work (pediatric clinic, school based, acute inpatient, outpatient, NICU, geriatric care, skilled nursing facility, employment services, etc.).

The goal?

By the end of 12 weeks, students are expected to have refined their clinical skills to match that of an entry level practitioner. Students learn and practice under a licensed OT supervisor which in the OT world are called clinical instructors (CI) not what I initially believed to be... criminal informants (all my White Collar fans?)

I wanted to put off blogging for a long time because I found myself struggling with occupational therapy outside of the school context. I've been hesitant about speaking to this issue because of the already confusing enigma of what OT is. By questioning the profession, I felt like I was undermining the legitimacy of the profession. I started asking myself Will I ever be taken seriously as a clinician? Can I make a difference in an individual's life?

My time at the VA consists of both inpatient and outpatient care. This is my first exposure to an inpatient setting with patients whose medical status can fluctuate by the minute. In the first few days, I observed treatment sessions that consisted of functional mobility, bed mobility, and some grooming. Evaluations that were most commonly used were range of motion (ROM), manual muscle testing (MMT), and functional independence measure (FIM) scores. It was all so overwhelming... almost impersonal and routine, NOT holistic or person-centered as I was taught in school. Where was the occupation? When should I ask patients what they want to work on? After all, isn't that what OT is all about?

PLUS- I've been struggling to complete chart reviews of 5+ patients, to remember all that information, and to create treatment plans on the spot. I found my drive to succeed, to impress my CI, to help people diminishing. Second week of fieldwork and I found myself in front of my computer, reading charts with tears down my face.

School is easy. It's black and white. There are parameters and guidelines to get that A. In the real world... everything is so gray. I experienced patients refusing initial evaluations and transferring patients 3x my size. There was no way school could have prepared me for this. But BOY- engaging with patients, seeing them grow in both inpatient and outpatient settings have been rewarding and fulfilling. Some specific lessons I picked up for fieldwork is for a later post but I wanted to encourage all my peers and future OT students that level 2 FW can be extremely overwhelming and that you are not alone in thinking conflicting thoughts about a "perfect" profession! It's okay to doubt, to question, to wrestle with such thoughts and feelings, you are not alone!