What do Occupational Therapists do in skilled nursing facilities…

I work within skilled nursing. Skilled nursing facilities (SNFs) provide medical care for variable periods of time, from relatively short to permanent. In SNFs, Occupational Therapists address a patient’s self-care skills, training in the use of adaptive equipment, compensatory techniques, and environmental modifications, as well as behavioral and mental health issues.

I typically begin my day at 5:30am. From there until about 6:30am, I follow a “no phone rule” in order to bring greater focus and attention to my day. I make sure during this time that I avoid looking at my phone and attempt not to respond to any emails; this is my time mentally prepare and get ready for my day. 

I arrive at work around 6:45am, giving myself enough time to get settled in, look at my patient list, and complete any chart reviews if needed. This allows me to prepare for my day.

What I love about skilled nursing is that you really get to know your patient’s routines and occupations, which allows me to decide in which order I want to see my patients. 

I have a good line of communication among our multidisciplinary team, so should there be a change in the schedule, I am able to shift things around in my day. Flexibility is key working in this setting. Sometimes I may have a little gap in the morning between my first couple patients due to breakfast, where you can catch me enjoying a little cup of coffee with my patients. Sometimes, I may be enjoying my cup of coffee with my patient while they enjoy their breakfast and coffee. I feel these times are key therapeutic moments, which can reveal a lot about a patient. I’m working with patients through lunch as I have other patients with feeding goals. Once they have their lunch, then I go have mine and complete all of my documentation for the day. 

Due to COVID-19, many of my patients are not getting to see their families, and I find my role has taken on a whole new meaning – offering comfort and companionship. 

What is challenging about my role?

What can be challenging about this field is the productivity requirements. It is dependent on the facility you work in, but across the board you are required to be productive in your treatments, which leaves little space for reflection and moments of quiet. Here is where you have to plan which patients to prioritise.. It can be hard when you find several patients are not ready to be seen. That is when you, as an OT, have to find those therapeutic moments. As I mentioned before, a cup of coffee with a patient is also therapy. 

This blog is part of our ‘What do Occupational Therapists do…’ series to celebrate OT month.

Author: Shama Mukhles

Twitter handle: @yayy_shama

Bio: Shama Mukhles, COTA. Second year OTR student at the University of Texas- Tyler.

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