So you’re just about done with your program’s curriculum and about to start preparing for your level II fieldwork.
Hooray! You’ve made it so far and are so close to the home stretch.
As you’ve likely been told, fieldwork will incorporate everything you’ve learned during your coursework in a real-life, hands-on setting.
Fieldwork really is an amazing yet challenging experience that will help shape you as an occupational therapist. You will be able to take your favorite interventions you observe or learn from the other OT’s and add them to your “bag of tricks” as you go.
It will fly by, and also feel like an eternity at times. You may have an awesome setting that you just “get” right away, or you may have the most challenging experience of your career, but both will pay off in the end (I promise!).
Important Topics to Study Ahead of Time
First things first, you’ll want to brush up on the setting you’ll be working in (obviously). You may have an out of state assignment that you are moving for, so don’t forget to pack all of your phys-dys books for adults, your mental health books, and your pediatrics books for the setting you’re going to.
If you’re going to work in any rehab setting, really brush up on muscles, nerves, innervations, dermatomes. This is all the tricky stuff from neuro and anatomy. Watch videos of Manual Muscle testing, goniometry, and transfers. This is a great one on manual muscle testing.
If you’re doing inpatient rehab, FIMs will be a doozy if you haven’t used them before, so definitely do your research on them as well as typical interventions for the setting.
I wish I could say I studied all of this for hours a day before starting fieldwork, but in reality I really only managed a couple of hours a week in the month beforehand. Try to do more than me if you can!
In pediatrics, you will want to reteach yourself all of the essentials like sensory integration, conditions and developmental milestones.
Extremely Helpful Resources
If you didn’t purchase Karen Sames’ book Documenting Occupational Therapy Practice in school, I highly, highly recommend it as it covers everything from goal writing, evals, discharges, SOAP notes, and tons of skilled terminology. I used it constantly in both of my Level II’s and during my first few months of practice on my own before I really got the hang of note writing.
One other “resource” I used on the daily was my Kwik-Clips Occupational Therapy clipboard. It has MMT/goniometry scales, goal writing phrases, dermatomes, spinal cord injury levels, CVA effects, and more of the essentials that are really helpful to glance at when you’re on the move. I still use mine today as my brain tends to push out nitty gritty details far too often.
(Quick disclosure: These two Amazon links are affiliate links, meaning I will get a small commission at no cost to you if you purchase from my link. You can also search directly in Amazon for a non-affiliate.)
Living Expenses for Field Work
Remember that your fieldwork will probably take up at least 40 hours a week, and you will be exhausted from all of the information your brain is taking in.
Work will be very difficult to try to juggle in addition to your clinicals. If you can get a small loan of some sort for living expenses, it may really help ease your stress of making ends meet… even though the thought of more loans in addition to your tuition may give you palpitations!
If you absolutely need to work, getting a weekend babysitting job where you can study and/or intervention plan while kids nap/play/whatever would be my recommendation.
Activity Analysis and Grading Up/Down
Before you start fieldwork, brush up on activity analysis and grading up/down. You will do this with every patient every day. Also read up about medication conditions, lab values, and all post surgical precautions.
A quick reminder that activity analysis and grading entails breaking down the specific patients’ deficits that make it hard for them to perform daily tasks. This could be things like left hemiplegia, decreased safety awareness, left neglect, poor standing tolerance, for example.
Then, you’ll brainstorm all of the activities that address each specific deficit and make it the “just right” challenge for the patient (not too hard, not too easy).
I struggled with this during fieldwork and thankfully had an understanding CI to teach me, but you’ll earn extra bonus points having this in your skill set before you even start 🙂
Study the Code of Ethics
It also won’t hurt at all to read your state’s and AOTA’s Code of Ethics since you will be in this brand new experience and may have some very difficult standards for productivity.
I remember being surprised after my second week at one of my fieldworks reading in one of my textbooks that under Medicare you can’t bill for non-face to face time (I had no clue!).
So along with all of the other recommended things to brush up on, try to carve out a bit of extra time on ethics since your CI might not think to educate you on this right away.
Introduce Yourself to Your CI Before Your First Day
It’s always, always a good thing to start to start off on the right foot with your CI to see what since they will devoting so much of their time for the next three months teaching you more than you thought possible.
Be sure to send your CI a formal introductory email if you can, before you start. In this you can and should ask her or him where you need to show up, what time, what you should really focus studying in preparation along with your course notes.
I know you have a million and one things to try to do before starting but here’s the thing: If you’re feeling anxious about starting, remember that you are there to learn and you will be fine.
The first couple of weeks you will mostly just be observing the patients and soaking it all in before getting hands-on, so take notes of what interventions your CI does and tweak them if you like. Your CI will also learn from you and your fresh-out-of-school, brand-spanking new evidence-based research knowledge!
Take it one day at a time and enjoy it for what it is and you will very soon look back and think, “Wow, that was fast!”
If you’ve been having any concerns prior to starting, or if I’ve missed any important factors of pre-fieldwork prepping, please feel free to shoot me an email let me know in the comments below.
And best of luck!