In this instalment of our Student Stories series, Tessa Goldberger (MOT 2020) discussed the pressures of private practice, the importance of broadening one’s skill set, and the breadth of occupational therapy itself as a field. Read on to learn her tips for thriving in the program and making a smooth transition into clinical practice!
What have your first couple of years in clinical practice been like?
Honestly, it’s been a lot; I’ve felt a little lost at times. I went right into community OT with ICBC, which was a huge change, because I’d never had a placement in private care. Because of COVID, everyone was working remotely right from the start, so I didn’t really see anyone I was working with. It felt like I was just sitting alone in an office sometimes, but, luckily, there were lots of opportunities for mentorship, so I wasn’t totally on my owns.
After eight months, I switched jobs and started working at a school, which was also private, because I wanted to have coworkers again. There was a ton of change going from ICBC to paediatrics—it’s been a whirlwind, with lots of learning outside of OT as a profession. At ICBC, I was treating adults with concussions and chronic pain, doing gradual return to work, and stuff like that, and in the school I’m working with neurodiverse kids, kids with neurodevelopmental challenges, and autism; it’s almost like two different jobs.
I’d tell anyone entering the profession not to get stuck in one position and to try different things out to see what fits, especially early on. Work in rehab, with aging populations, with kids, in community care—get as big a variety of experience as you can to gain those skills, because I’m sure it’s harder to change once you’ve been working one job for years. I was set on spinal cord injury early on and hadn’t even been thinking of working with kids, but here I am, and I’m learning tons.
You volunteered in a variety of settings before this. How did volunteering prepare you to be an OT, and how did the MOT program complement this preparation?
My main goal was to get as wide a range of experiences, both as a volunteer and at different jobs, as I could; I wanted to be as well-rounded as possible. I worked as a spin instructor, worked in retail at lululemon, and volunteered at a cancer centre, ICORD, and a seniors’ centre. I think the variety of experiences I had helped prepare me for the variety of situations I’d find myself in as an OT—it teaches you to communicate well and see things from different perspectives.
The program gave us diverse placements and did a really good job of giving us opportunities to work with different people—you get a range of ages and occupations, which teaches you to relate to the person and put the person first. OT is different in each of these environments, which teaches you to problem-solve, try different things, and not get too comfortable. What works for one person or environment might not work for another, but there’s always another solution you can come up with.
Recent graduates often highlight the difficulty of engaging in self-care and managing their work-life balance. How has this been for you?
I struggled with the balance in the beginning: there’s always more that you can do in private care, so the day’s only over when you decide it is. It’s hard, too, because not everything falls within billable hours, and cancellations aren’t reimbursed, so you end up working a ton of hours—in private care, your output is your income. My schedule was kind of unstable, especially because of COVID-19, and some days, I’d look up and be like: ‘Whoa. It’s seven-thirty, and I haven’t taken a break.’
The keys to maintaining work-life balance all sound pretty obvious in OT, but it’s not always easy to implement them: manage your schedule, stay on top of your sleep, take movement breaks, eat well, exercise, and talk to people outside of work. You also need to set boundaries around your work and remind yourself that the weight of the issue you’re working on doesn’t fall on your shoulders alone. I think a lot of us are drawn to OT because we’re empaths, and that can be a good thing, but it can also lead to us taking on way more than we can handle. Remember that there’s a team around you, and, if the client’s needs are outside of your scope, then you’re not necessarily helping in that case anyway.
One of the main things that helped me was using the resources available to me at work. I definitely had imposter syndrome at first, and it took some time for me to gain confidence. Once I’d stopped being afraid of asking questions, I was reminded that there’s no formula for evidence-based solutions in clinical practice, and talking to coworkers can help you take advantage of each other’s strengths.
Another thing is that my job has lots of opportunities for professional development, which is part of what drew me to it in the beginning. That’s something I think everyone should look for and take advantage of, because it keeps you constantly learning. All told, it took me about six months to get up to speed and feel more efficient in my work. If you’re new to the field, give it time.
What sorts of challenges have you encountered that are more specific to your role?
Working in private practice is complicated. You’re always walking a tightrope in terms of helping your client advance but not going too fast, there are setbacks, and there’s often pressure from ICBC to speed things up; you have clients’ own personalities and making sure they’re in the right environment to make progress. It can also be hard to get funding to keep doing your work, your clients might not want to work that day, and you have to navigate all these different systems.
In schools, you’re trying to meet both the parents’ and child’s needs and to balance their requests. What they want can be different, and you need to respect both of their points of view, because they’re all valid. It takes time to learn, so you don’t get complacent in what you already know. On the one hand, you never stop learning, but that also means you never get settled, which is kind of stressful.
OT is so broad that you’ll never learn everything you need to know in the classroom, and I knew I’d do most of my learning in the workplace, but it was still a bit of a shock just how much I didn’t know when I started both of these jobs. I wish there were a student manual about the entrance to work to sort of orient us and point us in the right direction. If you’ve just done a week in paediatrics on a placement, you’re still so uneducated upon graduation. A little handbook covering the pitfalls and challenges of entering practice could make that process easier.
What advice would you give current students about starting their careers?
For graduating students, I’d say: don’t put too much pressure on yourself, and don’t be afraid to switch jobs. If you try a job out and it’s not a good fit, take as much as you can away from it, and look for something new. Try as many different areas as you can for your first few years, because you never know for sure what’s going to click for you, and OT is so broad that you can always find a way to transfer your skills to a new position.
What I’d tell first-years is that you’ll be overwhelmed with information while you’re in the program, and you’ll keep learning in the field, so just enjoy the process. I know a lot of us are perfectionists and want to get high marks, but the more fun you have, the more you engage with the material. Don’t take yourself too seriously, because in the end, it’s your learning and the relationships that matter.
Finally, we’ve covered many of the difficulties of becoming an OT. What are some things that you love about your job?
I love getting to work with people, seeing them make progress, and knowing that I’m making a difference, even if it’s just a little bit. Being an OT lets me hear about the experiences of people’s lives, and it’s really interactive: you get to know people’s stories, and you work together, with both the team and the client, to help them engage in their occupations. It’s the collaborative nature of the profession that makes me grateful to be an OT.