When plans change: Thriving in an unexpected fieldwork setting

As occupational therapy students, we prepare mentally and academically for our fieldwork experiences several months in advance. But what happens when your carefully laid plans take an unexpected turn? I found myself in this situation when my Level IIA fieldwork assignment shifted from a skilled nursing facility (SNF) to a long-term acute care (LTAC) facility specializing in spinal cord injuries—with only 2 weeks’ notice due to unforeseen staffing changes.

Embracing the Unexpected

The transition from my expected SNF placement to an LTAC setting was jarring. Instead of working with a general geriatric population, I was suddenly immersed in a highly specialized environment treating adults with spinal cord injuries, which was a topic I had little experience and confidence in. This dramatic shift taught me valuable lessons about adaptability and professional growth that I want to share.

Key Recommendations for Success in an Unexpected Fieldwork Placement:

1. Embrace Intensive Self-Study: Take ownership of your learning journey and fieldwork opportunity. I spent evenings studying relevant materials and practicing clinical skills by staying late at the facility or at my apartment, as the LTAC facility utilized a plethora of new technology and methods of treatment that I was not used to, such as power wheelchair adaptations, 3-dimensional printed adaptations to clothing items, and different types of catheterization equipment (e.g., indwelling, intermittent, suprapubic catheters). I spent early mornings working with other occupational therapy practitioners on transfers, as transfers with a general geriatric population are a lot different than transfers with a patient living with a spinal cord injury. This extra effort helped bridge knowledge gaps and built confidence.
2. Maintain a Growth Mindset: As NVIDIA CEO Jensen Huang wisely noted, improvement requires "pain and suffering." View challenges as opportunities for growth rather than obstacles. This mindset helped change my satisfaction with my skill levels during my fieldwork. The discomfort you feel is a sign you're expanding your clinical capabilities and skills.
3. Practice Gratitude and Positivity: I learned that with every task that I was given, easy or difficult, responding with a smile and “thank you” will go a long way. Despite feeling overwhelmed by to-do lists or expectations, maintaining a positive attitude helped me build strong relationships with the patients, my clinical supervisor, and the occupational therapy and interdisciplinary health care teams.
4. Take it Day by Day: When working with a complex patient population, avoid getting overwhelmed by looking too far ahead. Yes, there are a lot of objectives that the sites want their students to accomplish by the end of their experience; however, focus on one day at a time. Focus on your daily improvements and celebrate small wins along the way. Failures will happen, and they should, and your response to them will help you grow into an amazing occupational therapy practitioner.
5. Step Into and Enjoy the Uncomfortable Zone: Whether we like it or not, real professional growth happens outside our comfort zone for an entry-level occupational therapy practitioner. Embrace the uncertainty and challenges—they're preparing you for real-world practice and patients. Not every patient enjoyed my presence or interventions, especially during the beginning weeks. I believe these moments are what helped me improve my professionalism and intervention skills.

Reflecting on the Experience: The Golden Lining

While this placement wasn't what I initially expected, it provided invaluable experience with a specialized patient population and helped me develop crucial adaptability skills for real-world practice. The intense learning curve pushed me to become a more skillful and confident future practitioner. Additionally, this placement was one of the most valuable experiences in my educational journey, and I am deeply grateful for my clinical supervisor and the occupational therapy team who helped me throughout the 12-week fieldwork experience.

Conclusion

Sometimes the most unexpected experiences become our greatest teachers. For students facing similar situations in their fieldwork or capstone journeys, remember that adapting to change is a crucial skill in occupational therapy, health care, and life in general. Embrace the challenge, maintain a positive attitude, always smile and breathe, and take advantage of every learning opportunity—even if it wasn't part of your original plan.

Tyler Hood is a third-year student at Washington University in St. Louis School of Medicine’s Program in Occupational Therapy. He is service-driven and passionate about teaching, learning, and making a positive change in occupational therapy practice. He hopes to work in an outpatient setting while continuing to promote positive change in occupational therapy to improve the profession’s prominence.