Not to scare anyone with the image above. Unfortunately, this picture has some legitimacy. It is not an uncommon site these days on an acute care floor. This image is NOT 100% accurate with the level of PPE being worn by this student, however. Most hospitals, that I know of, will not allow student clinicians to work with patients who have been positively diagnosed with the coronavirus. All patients are being tested for coronavirus with patients room being properly identified using with a green (negative), yellow (pending), or red (positive) tag. Moreover at my own hospital clinicians and student clinicians are wearing eye protection and surgical masks with the increased cases that we are witnessing in November 2020 going into December 2020.
I am the Site Coordinator of Clinical Education (SCCE) at my my hospital for the Rehabilitation Therapy department including Occupational Therapists, Physical Therapists, Recreational Therapy, and Speech Language Pathologists. It is an extra role that I started in April 2020 in addition to my normal clinical job duties.
I’ve started to get the emails very frequently over the past 2-3 weeks with people asking me about quarantining, Personal Protective Equipment (PPE), what to wear, where to park. You name it. And I can’t blame anyone – we are in a stressful situation already, now you have go into another setting and learn a whole new set of norms.
Quarantine – “Do I have to?”
Some of you will be traveling out of state to your clinical sites. This is definitely a specific question for your clinical site because there’s a confluence of factors from state guidelines, CDC guidelines, and even your city or county guidelines can contribute to the answer. In my state it depends on the out of state visitor and the current infection rate of the state they left. Every state, county, and city and even each hospital/clinic/site might have its own policy. It definitely needs to be determined prior to starting and it may change in the weeks, months ahead. One thing is for sure – if you have symptoms prior to starting or during your clinical, report to your clinical instructor (CI) immediately. No one wants you to jeopardize your health or the health of your patients.
Personal Protective Equipment (PPE) – “Do I need to bring my own PPE?”
I’ve had students ask me if we will provide equipment or if they have to provide their own equipment. At one point I know that hospitals sent home students as they ran out of PPE and we were in dire conservation mode. Luckily, the landscape for PPE procurement has changed for the most part. It may be a good question to ask for the smaller clinics regarding their equipment however with a hospital and places with resources – a surgical masks, gloves and a gown (depending on your setting) should not be hard to get.
There may be other nuances with each site. Most people ask about lunch, what to wear, and other general questisons that each site will have to answer separately. Rule of thumb: polo shirt (I’m not sure why the polo has been such a fixture in inpatient rehabilitation settings, even in some acute care hospitals) and solid color pants. You may be lucky and your setting allows scrub pants – much more comfortable than business casual slacks!
Get your head in the game
You are wrapping up your finals after a chaotic first semester of hybrid courses, social distancing, and unconventional guidelines. Everything you have worked hard for has culminated to this point where you venture out into your fieldwork placement site! Take a deep breath! This will be an exciting time to take all of the things you read about in your textbooks, all those research articles, all that research projects, all the case studies you read and wrote your treatment plans – it is showtime!
You aren’t expected to be an expert
I think that some students come in afraid to ask questions. Maybe you don’t think this is you; and I hope that all students feel that they can ask their clinical instructor (CI) questions. Maybe there’s a personality conflict, or maybe your CI will not feel approachable. If that’s the case, I am sorry to hear that! Hopefully you will be in a clinic or setting where you can receive some feedback from other therapists if you feel it’s difficult to interact with your instructor. As a student, you may be observing more so your first week. Be thinking about why and how the leading therapist approaches problems.
None of us are born experts – it took years for us to get here and achieve our level of expertise. One area that I notice with students are the soft skills, the speaking to patients, introducing yourself, the confidence when speaking with patients, and the general customer service type of skills that goes with any job. You will make mistakes, your interventions may not execute the way you wanted it to – it’s okay! Everything you say and do may not be perfect, however you will learn and remember the end goal of this clinical rotation…
Remember the goal: Entry-level Occupational Therapist
Your clinical will be scored using the Fieldwork Performance Evaluation by AOTA, and the criteria is for you to be an entry level occupational therapist. You guys have all the potential – you know all the latest, greatest reserach in addition to your own research projects in school. You’ve learned all fundamental, basic skills from your respective Occupational Therapy programs and you will be taking those skills to the clinic. The hard thing is implementing those broad array of skills, learning how to work with people, knowing when to use and when not to use certain skills and techniques. Your clinical instructor will guide you through those things, the time management, working with multiple patients/clients in an 8 hour day will be the skills you probably did not learn.
I was at a workshop where an OT clinician named Dan Eisner presented and he described his book, Clinical Success Formula. It provides amazing content for you to gain perspective and implement strategies for you to get through your clinical site. There is affiliate linking however you can purchase the book used, new (https://amzn.to/3nMRTGj), Kindle format (https://amzn.to/336jCd2) or even get the book free through Kindle Unlimited (included with your Kindle Unlimited membership). I read the book a few years after completing my fieldwork and it’s a fun, quick read!