The skilled nursing facility (SNF) life goes well. I am currently managing a full caseload, with less and less direct instruction from my supervisor, which is exciting. In the moment, things can feel chaotic and like you're on constant information overload, but at some point it magically starts to abate and things fall into place and you finally start to feel competent. I'm reaching that point. Not quite there yet, but approaching it. And it's not that the work itself is stressful and chaotic, SNF's tend to be a little chiller than, say, the hospital, but it's just the state of being a student. We're constantly learning things and the goal is to forget as few of them as possible, while still carrying out what is essentially a full-time job. I have a mental checklist of about 8 different things I need to do when I'm filling out the paperwork for a new evaluation. And I'm beginning to rely less and less on that mental checklist as it all becomes more natural.
So, as I think I mentioned before, OT's (and PT's) in SNF's often mainly focus on patient evaluations and discharges, and they have assistants that carry out the majority of the actual treatment sessions. The OT assistants are called COTA's, for Certified Occupational Therapy Assistant. COTA's are certified after attending an accredited COTA education program, completing fieldwork, and passing a certification exam, much like an OT. They can be found in as wide a range of settings as OT's, and their roles differ slightly according to setting. As assistants, they ultimately answer to the OT, and are not able to complete evaluations and discharges. They are invaluable because they carry out most of the treatments, and are masters at coming up with new and creative intervention activities for their patients. They are a wealth of knowledge when it comes to treatments, and, because they see the patients more than the OT, they can provide vital information about the patients' functioning and progression towards the goals. I am very thankful that I get to work with not one, but two awesome COTA's, and I have learned a ton from them about interventions and patient interactions.
And, I love my patients. They are completely delightful, each one in their own way. One of my patients gives us something--usually a soda or snack of some kind--after each therapy session. Another of my patients has a wonderful husband who comes and spends most of the day with her, everyday. And this same patient has quite the attitude, and it's fantastic. If we ask her to do something, like stand up and complete a functional ambulation task, or do some upper-body exercises with the free weights, she'll say, "Oh, now just wait a minute," in a protesting kind of way, followed by a lengthy explanation of why she can't do whatever it is we're asking her to do. Or, earlier this week, she informed us that both her legs were hurting. Previously she had reported pain in only one leg, so we mentioned this, and her reply was, "Oh, I've got news for you. Have the nurse bring me two pain pills. One for each leg." She is lovely.
In other news, this past weekend, I returned to Kansas City to graduate with my MOT (Master's in OT, of course). Totally makes sense, right? I graduate when I still have 7 weeks left of education. That's actually one of the things that one of my professors told us several semesters ago, "Every time you graduate, it's kind of fake. You graduate from undergrad, and then you have grad school. You graduate from grad school in mid-May, but you won't actually be finished with school until the end of June." But, as odd as it is, and, at times, slightly frustrating, it's also pretty great. I mean, I got the chance to see all my classmates again, and discuss fieldwork trials and triumphs with them, before we actually finish fieldwork. Which was incredibly refreshing and re-invigorating. And the whole graduation thing is pretty motivating too, not going to lie.
