Today, I’m going to let you in on some of the real and unfiltered experiences that go along with Level II Fieldwork that not everyone talks about and how to navigate some of them. For those that don’t know, these are the two full-time clinical internships that OT students have to complete prior to graduation.
Before I begin, I want to say that I absolutely LOVE my fieldwork placement. It’s unique, challenging, motivating, rewarding, and I have the best clinical instructors (CIs) who have taught me so much already! I’m also not done! I just passed my midterms, so I’ll follow-up with another article after I finish.
That being said, everyone has different experiences. I compiled a few of the themes that I’ve discussed with new grads who went through this last year, my own experience, and those of some of my classmates and others on social media. In this post, I’ll touch on: energy level, Imposter Syndrome, documentation, work/life balance, and knowledge and growth.
Level II Fieldwork Themes
Energy Level
The first and probably biggest thing that I noticed right away after starting fieldwork is that I was constantly EXHAUSTED. I would say, for the first 4 to 5 weeks I felt this way. Now, I’ve had professors and other graduate students say that to prepare us, but I never really understood until I experienced it myself.
Let me tell you this. This is the most tired I have *ever* been in my life. Granted, I’ve never been a new parent or had constant sleepless nights. However, this is a whole other level of energy drain that most, if not all, experience during fieldwork. I’m talking your whole body feeling like it’s being pulled by a force other than you to move, falling asleep at 5p (or right when you get home), tripping over words and not realizing what even came out of your mouth. My classmate said she even fell asleep WHILE drinking a glass of wine on the evening after her full week. While hilarious, it’s also a reality for most.
It kept me up at night as to why I felt SO tired. Maybe my late night thoughts had something to do with it? It also could be the fact that my body wasn’t adjusted to this lifestyle anymore. Think about it! School schedules are a lot more flexible than fieldwork. Most schools don’t have 8-12 hour days, 4-5 days a week of constant work with hardly even a lunch break. Of course, in school, you have a lot of extra work outside of class and it can be stressful. In fieldwork, the above is our normal and you have to get everything done within a tight time frame. Every setting is different, but it’s not uncommon to be documenting through lunch or staying late until everything is finished.
Another contributing factor to this exhaustion is that you are always “on.” Not only are you physically at fieldwork for long hours, but during that time (especially in the beginning) you are constantly taking in information, assessing yourself and the environment (safety first!), trying to build rapport, trying to look and feel competent, paying close attention to your skills, receiving feedback, adjusting based on that feedback, reading how people are responding to you and adjusting accordingly. The list could go on and on. There are many, many times where your plan A or B isn’t working how you’d hoped and you have to adapt in the moment. All of that requires a lot of mental, emotional, and often physical energy. And let me tell you, you feeeeel it!
It can be hard to prepare yourself ahead of time, but remember that what people are saying about exhaustion is no joke. And to my CIs and other practitioners, it can be helpful to remember that the fieldwork students may be not entirely themselves due to being overwhelmed or just plain exhausted. That’s, of course, no excuse for a poor work ethic or not meeting criteria, but it can help you empathize a little bit. Think of strategies you used or feel may be helpful and really encourage them to implement them to stay at their best. (We’ll talk about some I recommend in my next post!) J
Silver lining, it does get better as your time in your rotations progresses!
Impostor Syndrome
Holy canoli!! I felt this so hard (and sometimes still do!)
What is Impostor Syndrome? Well, it’s the feeling of not thinking you’re good enough or worthy enough to be where you are. Every single person I’ve talked to about their fieldwork experience has said that they felt that they had little to no idea what they were doing and were just hoping that they didn’t screw up big time. Most of us don’t give ourselves enough credit!
Here’s what I’ve learned:
- It’s really easy to feel like you don’t belong or aren’t good enough when you’re around other professionals with much more experience than you.
- When this happens, remind yourself that they were in your shoes at one point and all had a starting point. Use this as a motivator that you could one day be as awesome as them!
- You are not going to be perfect.
- You know what? That’s OKAY. People know that internships are a place to learn and prepare you for your career. It’s also a good place to make mistakes. In fieldwork, you have a certified OT or OTA to be responsible for you and their clients. They can intervene if something isn’t going well or give you advice and show you how to correct those mistakes in the future.
- Pretty much everyone feels the same way when starting out.
- Yes, I’m serious. Even current OTs remember how helpless they felt starting out. The good news is you have some excellent opportunities for training to get you to the level of a competent entry-level professional. The other thing is OT is a profession of lifelong learning, so you will regularly be starting over, expanding your toolkit, and feeling a little uncomfortable. Get used it! But also, learn how you best can manage those situations. We can’t grow unless we step outside of our comfort zones, remember that!
Documentation
Alright, let’s talk documentation. Again, every site does it differently and there is no right or wrong answer for what to use. What I can tell you is that you will likely be learning a slightly different system than what you learned in OT school. OT school provides a nice foundation about how to write clinically and can help you get used to observing a session, documenting, and receiving feedback. Most of the time, you weren’t under a tight deadline for that documentation. I currently take about 7-10 minutes to write a SOAP note for the day. Often, I’m doing this when a client is running behind schedule, during my lunch time, at the end of the day, or really whenever I have a free second.
The most important thing I can tell you about managing documentation is DO NOT GET BEHIND. I cannot stress this enough. When you first start out, most places have you just observing and assisting your CI and then gradually starting to take over the caseload. By the time you have the full caseload, documentation can be a good chunk of your day. In FW, you see so many clients and it can be hard to remember little important details about the sessions if you wait too long to write your notes! Seriously. Write your notes as soon as you get the chance!
The other thing that’s important about documentation is to obtain a good training on whatever documentation system your site uses PRIOR to you taking over. Why? It’s difficult to be stumbling around a documentation system trying to find certain things when you have deadlines to meet. It’s a waste of time. Yes, regardless of an extensive training, there may be times that you need to click around (for electronic documentation) to find what you are looking for. However, it shouldn’t be a norm. If the site doesn’t offer an orientation on the documentation system, be proactive and ask for one. Even if you have to stay after hours to fit it in, let me tell you, it’s worth it down the road!
Last but not least, for every electronic documentation system SAVE OFTEN. I’ve learned the hard way a couple of times. It’s so, so, sooooo important!
Work/Life Balance
Fieldwork will take up many hours of your week and it’s important to take advantage of the time that you aren’t prepping or at your rotations in order to stay at your best. What down this come down to? Scheduling your time and self-care.
Let’s start with self-care. This is something that every single one of my OT professors stressed as extremely important during fieldwork and as a clinician. I’m not going to lie, I wasn’t super concerned with including more time for self-care, because I had been getting through grad school just fine with just meeting deadlines and occasionally seeing friends and meditating. (That’s what self-care meant, right?) Well, fieldwork is demanding. You will come into contact with many clients and their stories. Like I said before, you’ll constantly be “on,” and there will be much more that you are required to do as a fieldwork student than there ever was a grad student. You will be handling a lot of extra stress that you may never have encountered before. Don’t let this scare you. There are ways to manage it!
Have you ever heard that saying about hobbies? They say you should have one that makes you money, one that keeps you in shape, and one that allows you to be creative. We can use the OT internship as the one that (will) make you money. For the others, I have noticed an extreme difference in my overall health and well-being since I’ve started kickboxing regularly (in shape) and working on this blog (creativity). Yes, finding the time can be difficult, but it’s about prioritizing the time you do have free for refreshing and being the best you can be for your clients.
In addition to that saying, I also think it’s important that you have something in your routine that relaxes you. I really enjoy mindfulness or guided meditation. To implement this, I recommend the app, Calm, which allows you to customize your meditation based on how long you have and what you feel that day. It’s quick, easy, and helpful to include!
Another factor that is really important with your work/life balance is time management. We all know that life doesn’t stop no matter how busy you are in your fieldwork placements. Relationships shouldn’t stop either. In order to schedule in my social time, I give my friends my schedule and at least a week ahead of time schedule a 2-3 hour block with them. I may not have time to spend a whole day with them on a regular basis, but even a nice lunch is helpful to maintaining that contact and having that support system. (It’s also helpful to have someone to vent to or who knows you well enough to walk you through a challenging time).
In addition to social time, I schedule time to do paperwork or prep each night/week, time to participate in my hobbies, time to meal prep, etc. If you somehow got away with not using a planner throughout school, I highly suggest you start now. Heck, I even schedule time blocks for self-care! It has helped me manage my priorities and still play an active part in the lives of my loved ones.
Sometimes it seems like there just aren’t enough hours in the day. Making time for self-care and scheduling out my life to the best of your ability really helps me take full advantage of all of the time I have.
Knowledge and Growth
To best describe this experience, I’ll take you back to my very first semester in OT school. I had moved 3,000 miles away from home, by myself, to attend my dream school and pursue my degree in occupational therapy. I remember breaking down around my second week and feeling like I had made a terrible mistake. Anatomy wasn’t sticking, everyone was smarter than me, and I really felt like I hadn’t retained anything. I spoke to one of my new friends about it and told her how jealous I was because she appeared to know everything. She told me that she also felt like she had no idea what she was doing. As it turned out, most of my classmates felt that way! That moment of uncertainty was simply an obstacle I had to overcome before I really applied myself and did everything I possibly could to learn all I could.
At the end of my semester, even seeing that “A,” I felt like I just memorized for the tests and forgot everything. Well, after finals, I went home to visit my family. I remember I was talking to my mom and she stopped me and said she had no idea what I was talking about. That’s when I realized, I was using OT language and was naturally just implementing what I had learned. And I HAD learned! A LOT!
That’s about like fieldwork. It’s a roller coaster and the days start to run together because you are there so much. It can be hard to feel like you’ve actually progressed, but when you come out of it, there’s no doubt that you have. Even though it is challenging at times, it does get easier as you learn and grow. A unique growth feature in clinical fieldwork is it’s multi-dimensional. Not only do you change professionally (to be expected), but who you are as a person is different as well. Your clients touch you, your viewpoints and beliefs are challenged, and a new perspective and experience can really impact you. And that’s amazing!!!
Summary
So, some of what I’ve talked about may seem intimidating, but don’t let it scare you entirely. It doesn’t end badly if you really want to make it. You determine your fate.
However, you have to be uncomfortable, you have to be tired, you have to be challenged to know how and when to push yourself and how and when to reset. With all of that challenge, you can choose to adapt, grow, and make yourself into the best entry-level practitioner you can possibly be. Nothing worth having comes easy and that definitely applies to becoming an occupational therapy practitioner.
From day to day, you may not feel that you’ve changed, but there will be a point when you notice. And that feeling, that breakthrough…. it’s like nothing I could ever adequately put into words. It’s beyond incredible and makes it all worth it. You won’t be the same person or professional who walked into day one and that’s what it’s all about.
So, be prepared, but don’t be discouraged. Fieldwork is a magical, wonderful, emotional, challenging, cathartic, refreshing, rewarding experience. And, man, does it seem to fly by! Everyone went through it, everyone has their strengths and areas they need to improve on, and everyone’s experience will be a little different, but what is absolutely certain is that you will be changed at the end. In the process, you just might change a few lives yourself. And that’s why we do what we do. <3
Do you have any other themes you’ve noticed with level II fieldwork personal experiences or those of students? Do you have any questions? Let me know in the comments below. 🙂
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Later, I’ll talk about some more strategies that you can use to stay at your best in fieldwork and in practice. Keep a lookout for that!