Greetings, Again, and Here's to Grandma Layton

Back to my blog home page: http://travelingotr.blogspot.com

I apologize for not writing. It's not that I haven't thought of writing; in fact, I must have said at least once a day, "Now that would be a good blog topic!"

My "break" between assignments was not quite a break. I'm not complaining; I enjoyed every minute, even the 2,000+ mile drive with my very caring brother. I enjoyed visiting most of my immediate family.  I spent almost a week with mom (thank you!) stripping paint off 83 year old window trim in "the Nest" I am renovating (with twinnie). For those of you who like to renovate, I find a heat gun does a nice, quick job over chemical stripper.

Best way to strip paint off trim!

I've had quite a few people say to me, "Why would you leave California for Kansas?"

1) My family is within driving distance, and I love them!! If they have asked me to stay closer for a bit, I have the ability to do that.
2) There are little gifts to being somewhere new and (yes) interesting; after all,
3) Every place can  be interesting! It's all in your mindset.

Speaking of little gifts, I have to share this bit of something interesting.

(raise your hand if you know of this amazing lady)

Grandma Layton!

She lived near where I am assigned.  I learned about her during my 12- week psychosocial clinical in OT school. If you haven't encountered her, she is someone new and admirable from which to learn. Check her out:  http://www.elizabethlayton.com/

Elizabeth "Grandma" Layton was a lady who battled an adulthood of depression until she took a contour drawing class at her local college (at the age of 68!) Contour drawing literally means "drawing the outline."

She learned to draw herself using a "blind" technique by looking in a mirror and drawing the outline of herself without looking at the paper much. She branched out to express her opinions about social issues as she did her self-portraits.

For example:

Old Age Advocates

or

Tender Loving Care (for the dying)

...and she healed herself through her art.   What an amazing and inspiring woman. Her works are found in over 200 museums.

One of my favorite Grandma Layton pieces is a drawing of her representation of someone who has had a stroke. This picture is worth a thousand words.

Stroke

She drew many pieces, and you can check them out on her website. I encourage you to read about her. She is a great example of someone who found a way of coping with her illness and inspiring people along her path.



Grand!

Back to my blog home page: http://travelingotr.blogspot.com

My assignment should have ended tomorrow. 18 weeks. I can't believe I have been here 18 weeks. (I've extended until the end of March!)

I remember my first week here.

The noise from the residents with dementia was overstimulating. The well-meaning staff had not been trained how to deal effectively with behaviors.

Remember this little chicklet at the Royal Wedding?  This was how I felt, too, for the first few weeks of this assignment!

Poor thing!

I'm happy to report that it's gotten much better.

In fact, if you review the blog I linked to above, you'll remember the tiny  lady, Lizzie, who cruises her wheelchair down the hall singing, "Dum dum dum dum dum" and "By by by by byyyyy."

Nonstop!

The most curious thing happened with her. I sat at her table the other evening when I was working with her tablemate on another ADL (activity of daily living), feeding. I started talking with her, and she could hold quite a conversation.

I realized something...I had not given her the benefit of the doubt!

I had simply resented her for making noise.  I had not made the attempt to figure out what made her tick. I had made no connection with her until now.

After that dinner, she recognized me when I passed in the hall. I stopped and greeted her, held her hand for a moment several times this week. I realized yesterday that her behaviors have curbed quite a bit over the last month or so.

Until tonight.

I was trying to get the heck out out of the building in 8 hours! (Isn't every SNF like a black hole?!) I was banging out my billing and daily docs on Casamba when I heard her singing down the hall. The sound was getting closer and closer. I knew she was headed to the exit door, and I prayed to God she wasn't going to set off the alarm!

 

By by by by byyyyyyy

Instead of heading straight toward the alarmed door, she wheeled right into the rehab department toward me.

"Well, Lizzie! How are you?"

I gave up all hope of leaving quickly. She had the sweetest smile on her face. I asked her about dinner. She told me she had a lovely dinner with her family even though I know she had been in the dining room with all the other residents. She talked about her son and the rest of her family.

Finally, I told her I needed to get the paperwork done so I could leave. "It's been so nice to see you!"

I really meant it.

She took my hand and stroked it. (I just love those tactile little old ladies.)

"You're a grand person..." and she lifted my hand and kissed it.

I've had people compliment me, but I've never had anyone tell me that I am grand.

She melted my heart.  Really.

She made my day.

What to Consider: IF YOU'RE A WANNABE TRAVELING THERAPIST

Back to my blog home page: http://travelingotr.blogspot.com

No life lessons today.  Just some recommendations in case some of you are considering a medical, nursing or rehabilitation travel assignment.

Experience

I'm not yelling, but I need to put this part in caps:  YOU SHOULDN'T EVEN THINK OF BEING A TRAVELER IF YOU ARE FRESH OUT OF SCHOOL.

You could be put in ethical dilemmas you never dreamed of due to your lack of experience. Get some experience in the field, then travel in the setting in which you've become experienced. 2 years is good. You're a baby therapist until then.

These buildings benefit from experienced therapists who have the experience to make a positive impact.

This is to OT's, since we have a crazy shortage: It is likely in many locations that you will be the only OT.

Newbies need mentorship! The buildings need a confident expert!

Skilled nursing facilities (SNFs) need you to have knowledge of contracture management and wheelchair positioning. You shouldn't consider skilled nursing unless you can take a wheelchair apart and put it back together, eye a resident and tell your co-workers what size wheelchair width (s)he needs without pulling out a measuring tape.

I've heard of OT's who say,  "I don't do wheelchairs!"

I say, "Shame on you."

Research

Do your homework!

Go onto the state website for any state in which you wish to travel. If you want to go to a state that takes months to get a license (like California), start the process on your own before you contact the recruiter. You can negotiate their reimbursement of the license.

In my case, I took a fun trip to California in December 2009 to get the required Live Scan fingerprints completed. I pulled everything together by March 2010 (not in a hurry, since I was not at that point mentally ready for the change), and I received the license in early July 2010. By the end of July, I was feeling an itch  that had to be scratched (though I loved the therapy team at the building in which I was working). I was certain of my assignment in California by mid August 2010.

For me, it was all about the recruiter. I was working for a different travel company two years ago when I received a call from Med Travelers. The recruiter presented me with an opportunity to work with them in Fall 2009, but I chose another option and ended up in Kansas City.

It was while working in Kansas City in Spring 2010 that he called me again, and this time, I knew I wanted to work with him. He had been so professional, so patient. I want to highlight this recruiter sometime, so I won't say any more, but to keep it simple, working with Med Travelers has been a very positive experience!

Gut Feeling

Test your gut feeling when you talk to each recruiter. Trust your intuition! The one with whom you feel most comfortable and trust the most is your future recruiter.

It doesn't matter if they aren't paying quite as much as the other guys, believe me!!

My first recruiter from another company was a guy who always seemed to be on the beach or rescuing puppies. He didn't return calls. He didn't do squat to provide options for my next assignment, even though the pay was stellar. In the end, it wasn't worth it.

Most travel companies, in fact, offer very similar packages. So, beware the ones who offer you the moon, the sun and the stars!

Details

Ask recruiters for names of therapists on current assignments so you can interview them. Make a list of things you need explicitly written into your contract. For instance, make sure you write any planned vacation time, reimbursed travel or guaranteed hours per week into your contract.

Make sure you clear all tax questions about living and working in different states with the company with whom you wish to work before you start, especially if you own a house and will not occupy it.

...and FYI, your assignment needs to be greater than 50 miles from your home of record, or your per diem benefits (lodging/food) are taxable.

If you stay in the same assignment for over a year, your per diem benefits become taxable, which is why I am leaving my current beloved assignment after September 7.

If you wish to get relocation reimbursement, keep in mind that it will come out of the same pot of funds from which your weekly salary is paid.

For example, if you want full reimbursement for driving cross country and staying in hotels for 3 days, you'll end up with a slightly smaller salary on a weekly basis over the course of a 13-week contract than if you took a smaller sum. It depends on what you want, just be aware.

The Interview

When you interview with your particular assignment, ask:

• Why they have an opening
• How long it has been since they had a permanent OT
• How long their current traveler has been in place
• The size of the building For example, if you are asked to be the only OT in a 150-bed building, you should know you are going to be absolutely swamped, doing documentation after hours and probably crying when you drive home on Friday nights. Just ask!
• Don't be afraid to ask about the building's issues (every SNF has some issues)...

I can tell you that if you have solid experience promoting joint integrity and postural stability through contracture management and positioning programs, they will want to snatch you up.

Granted, that is not all that you will be doing. It's likely you'll have a variable caseload of Medicare A, HMO and Medicare B patients. If you have questions about this, send me a comment, and I will outline it for you.

Due Diligence

If you want to be a real star, go onto the Medicare website and check out the skilled nursing facility for which you are interviewing.

From this tab, type in the name of the building and check out the number and type of deficiencies (aka "tags") the building had from the last posted state survey.

This will fulfill your due diligence, as you may be able to discuss clinical issues and determine what programs you may be able to initiate or assist with to improve quality of care.

Again, trust your gut.

When I interviewed for my current post, I was rock solid after an hour talk with the regional director of ops that I would love this building. In addition, I found she was the only other OT in 15 years of practice that clinically problem-solved the same way I did with long-term care patients.

Wow! She has turned out to be an incredible ally and peer.

If you're hesitant to be alone, travel to a location where you have friends or family. Don't be afraid to explore! That is the great advantage of going various places...it's a big, wide, wonderful world.

Tre

P.S. If you're thinking of traveling and have questions, write me!  I'd be glad to help you through the process.