Struggling to finish....any suggestions???

Let me start by saying, before I took this assignment I was completely mislead and basically lied to regarding the details of the position in order to "reel me in" to get me to take the job. Which I did. Now, on an assignment which I absolutely hate....I am struggling to finish the 13 weeks. Basically, it is like my worst nightmare come to life. It is a dementia care facility. As a COTA, I struggle with long term care....I know that seems weird....being that most travel jobs for COTA's are in long term care/SNF's. It is all I can do to get up and go to work in the morning......I drive 50 minutes to work everyday...dreading each passing mile because that puts me closer and closer to the facility....and BURNING RUBBER to get the heck outta there when it is time to go. So my question to the community is......

Have you ever been on assignment that you absolutely hated and had a difficult time with?? How did you deal with it?? Any tips or tricks?? At this point I am willing to try anything.

Thanks Travelbookers!!!!

Counting down the days til Feb 3rd. 6 more weeks. Im not sure if I can tough it out.

I have been in a couple, unfortunately both SNFs.  I simply focused on giving the best care I could under the circumstances.  I forced a smile  when I felt like crying.  I did treatments that were incredibly creative with people who did not really benefit in the long term, but enjoyed the company, so I was able to justify it as a skilled intervention reinforcing some aspect of function.  Some days I simply took every patient to the toilet. (ugh)  I did a lot of cooking, stirring is exercise! and sensory stim, and adl self feeding.  Singing is self expression, that was fun, I learned some great old songs.  
So how bad is it?  How did they mislead you?  And How did you end up living so far from work, the commute would kill me.
hang in there
Diane

Diane,
I am trying to stick it out at this point. I have racked my brain of every single functional and semi-functional activities that I can think of. We have cooked, we have cleaned, we have done laundry and dishes. We have done christmas crafts and made jewelry....oh yeah....all of the above....and then some....and its really not that part that I have the struggle with. I was told during the first interview for the position that it was a facility that specialized in dementia care...I was on the phone with the DOR for over 45 minutes, her explaining how I would really benefit from working there and be able to learn alot....I called the recrutier back and said....I can barely tolerate SNF's for 13 wks ...I absolutely cannot work in a dementia unit for 13 weeks. No way. Not for me....meanwhile the next day, I got another call from the DOR again that stated, "Gosh, I think you are confused about the position.....this is just a regular SNF...we have 21 part A's and 17 of those are rehab to home.." OH....ok....well gosh, I figured I obviously misunderstood her from the first interview....So, I took it. My husband, also a COTA had already accepted a position in the surrounding area....about an hour from my facility. SO, show up to work and guess what?? Yes, 21 pts on part A caseload....1 or 2 were rehab to home, all the rest, long term AND the qualification for admission is a dx of dementia. WHOA. That is what I was told initially, but then told something different....which lured me into taking the job. Grrrr. We found housing about 35 miles away....which I figured would work out great....until I realized it was gonna take me 45-50 minutes one way to get there.....Sheesh. So needless to say, I have been more than disappointed with this assignment. Just trying to make it through...BUT the great things are....the rehab staff are great....really like them....the brand new rehab director is seeming to be rather pushy about minutes and RUGS which is the biggest struggle these days.....well coupled with the lack of progress and lack of a caseload with rehab potential....yeah...other than that....its not so bad. Hahahaha. Large rehab gym, clean facility, clean residents. BUT hopefully the last 6 weeks will go by super fast. Fingers Crossed. Tomorrow I will try not to cry on my way home from work. Maybe I will take my sewing machine to work and get some of my folks to help me make new scrub tops. :)

Jen, I'm so sorry you're struggling so bad! Just think, it's ONLY 6 more weeks? :-) I have no promising words of wisdom for you, you know that! But let me tell you something you may not hear enough: THANK YOU! You know my mom is terminal, yet I'm extremely grateful for all the workers in her facility. They love her as if she is their own mother or sister. She may not always be able to tell people thank you and how much it means to have a smiling face near, so I try to thank them too. Even if you never see a family member or people don't have family members close, just remember that it is appreciated. The littlest thing my mom can "help" me with, she loves. Feeling useful is inate in our beings. Career-wise, you may not be able to help rehab someone towards their home life, but maybe it helps emotionally more than you will ever know! Hang in there & have a Merry Christmas!

Jennifer,
I can't speak as a COTA  but I will recall my days as an inpatient addictions counselor, so take it for what it's worth.  There were several days that I wanted to not return and crying seem to be the only emotion that I could count on.  Reality is, it was just plain tough.  But I got through it by recognizing the daily wins and focusing on that.  It seemed that when I picked what my favorite part of the day was with a patient and then focused on what my goals were for tomorrow, it shifted my thought process. It was still tough at times but I will tell you this, that experience has made me extremely resilient and I ended up staying in the setting for 5 years.  Jobs since then seem easier to handle and I end up using what I learned to everything afterwards.  Count your wins each day, one day at a time, and you will get through it. 

Have a great holiday season.

Sunny

Why not just put in your notice?  I say get out of there asap!  Travel assignments always run the risk of being pretty bad but you never want to completely stress yourself out to the point where you just feel burnt out.         

Jennifer , 
Dementia dx is an admission criteria!???!!!     I would be so mad, I hope you let them know, too , if you havent already.  
I know how frustrating the minutes and catagories are, in fact, I will no longer work for a contract rehab department (genesis, rehabcare, premier, functional pathyways, etc) because of  the emphasis on productivity at the expense of good treatment.   That type of situation invites fraud.    ( I was asked at one if I could  "credit minutes today and get the work tomorrow?"  !   )
Good thing the facility and your coworkers are nice.  How does the OTR handle it, is he /she crying , too?  
Be glad you get to leave in less than 6 weeks!  With some new scrub tops.  
So, where are you headed next?
Diane

Jeremy,

The travel company she is with is going to try and push her to stay and probably won't let her get out of her contract with putting a 30 day in. Trust me, I was with them and they tried to push me to stay in a clinic that was comitting medicare fraud after the clinical liaison agreed with me that my clinic was in the wrong. Then it was like holding a grudge against me because I did leave early. Bad idea if she is not wanting to burn bridges with that travel company. Not saying that travel company is bad or anything because they are not in any way but a 30 day is almost impossible with them.  

Jennifer, 

I really don't have any advise for you because I haven't been put into a situation like that but would like to offer you some encouragement to keep going. You are almost there and if you get some really cute scrub tops out of it hey that is a good deal. Just remeber that you are doing the best you can for those patients and that you are making them better in some way or another. Even with dementia their best times are when they are conversing with others. Keep going and you will come out stronger from the experience. GO JENNIFER!!!! 

I absolutely appreciate all of the responses and words of encouragement. Just another great thing about Travelbook. Yesterday at the end of the day while a few of the girls were wrapping up thier day, I opened up the conversation about the pressure for minutes and RUGS, etc....and found out that I wasn't the only one crying on the way home....there are others that share in my frustration and it was great to be able to talk that out with them. Really helps when you are working with great people.
In response, Jeremy, cancelling the contract at this point is just not an option for me.....there are alot of circumstances behind that decision. BUT, in any other situation....I probably would have already cancelled it. Trust me, I have contemplated it MANY times already.
My OTR is also a traveler and she is great....but I think she also feels the pressure as she has been there a long time....but she understands how I feel and is totally willing to help me make it through these 6 weeks. So that is good.
I love some of my patients....and I do really feel like I bring some light to thier day. I am gonna keep on keeping on and do my very best for these people....and maybe I can impact some of the other staff in a positive way....I told them yesterday that I will always stand up for what is right, even if I am standing alone. And that is just what I am going to do. Thanks to everyone (Cathy, Diane, Jana, and Jeremy) for all of the words of encouragement and tips for getting through the next few weeks. I am off tomorrow so today is my "friday" which means......another week bites the dust. :)

:-)

Sorry your assignment is not going so great. Just keep in mind that you can do anything for 13 weeks and that there’s an end at the tunnel. Can you imagine working there permanent? 6 weeks will go by fast, your half way done. I’ve been in an assignment that I was lied to and you just make the best of it. I would count my days, hours, and even minutes. I would start my day by “ 9 days, 7 hours, 45 mins”. LOL.. I went in and did my job and got out, it took a lot out of me but at least you have an end date.. I really have no idea what your profession entails but hang in there and maybe think of this as being an added bonus to your resume I normally don’t have patient contact so I can easily lay low if needed…. As for the advice from Jeremy, WTH…. Ending an assignment early doesn’t look good down the road, 1. It makes you appear that you’re not able to complete a 13 week assignment under stress or not so good conditions ( I have heard this from recruiters), 2. It might make it hard to get a next assignment because there’s someone else that can finish a really bad assignment, and 3. It may make an interviewer question why you only worked a 6 week assignment when normally it should be 13 weeks. Of course this is just my assessment, I know of a travel who is always quitting an assignment, doesn’t finishing an assignment and now she’s having a hard time getting any one to give her a job. As for my experience with recruiters, most really don’t know what we do in the field and some only care about filling a position. The interviewer may have known that was a crapping job and had to lie to get you there. It happens. I would say if something is not sounding right, try to see if you talk with someone that has worked there before. Hang in there Jennifer, 6 weeks, 6 weeks, and your outta there!!!!

Hi, there,

I'm new to the healthcare travel book, and I'm an OT with a lot of experience in SNF (16 years) - the last 2 of them travel. Jennifer, I would tell you to look at this assignment as a blessing and a challenge to really learn something new. It's about going deeper with your patients and their families. For example, doing "regular" tasks with dementia patients causes nothing but frustration. However, if you shift your focus just a bit, you might find out that this turns out to be one of the most satisfying experiences you could have. It's about learning who each of your patients was before dementia, then modifying activities they once loved to their current cognitive level. Let me give you a few examples. Betty sundowned every day around 4. I called her family to find out what she was like years ago and found out she loved to quilt. Since she obviously couldn't quilt now, I modified the task. I bought fabric, had another patient I was working with measure and cut 4" squares. The next day when she was sundowning, crying, and getting others hyped up, I took her to a table and started laying out the squares. By square four, she took the pile and was busy piecing a quilt together. I taught staff to set her up, and voila, that knocked out her sundowning most of the time. Jack was nonverbal for a year - I found out he went to Las Vegas at least 5 times a year with his wife when he was younger. All I had to do was hand him a deck of cards, and he began to tell me all about cards ("52 cards in a deck. Four suits. Diamonds. Hearts., etc")

You just have to find ONE thing to unlock their minds. It's a challenge.

Don't get me wrong. I just switched assignments from a SNF in which I was doing a ton of neuro (which I LOVE) and modalities for tone management to a building that hasn't had an OT for 10 years which is full of little old ladies with dementia. After two weeks, I had a big cry and decided that it was MY choice to make a difference. And I have.

It's not easy. But I encourage you to shift your thinking. Email me for ideas. I have bunches of what to do with folks with dementia. Or check out my blog about traveling OT in SNF:  http://travelingotr.blogspot.com/2011/12/lesson-of-day-never-underestimate-power.html

Best of luck!
Tre

Great input, Tre!  I am going to visit your blog.  Thanks for posting it.
Diane

Leaving early burns bridges in most cases as most facillities use rehab groups which mange many buildings in many states. Be like me ....eat bean burritos and it will keep everyone off your butt!!!!.....lol ...........as a traveling OTR I survive on my wit!!!  

Hi Jennifer!  Happy New Year to you both by the way.  Ugggh I feel for you.  I've been there in past travel assignments, counting down the days which feel more like years.  I felt like I had PTSD from SNFs and being pressured for high RUG levels (the rehab managers never asked the therapists if a pt is appropriate for high minutes or heeded input if pt was ready for d/c;  clinical judgement- what's that?!).   I refuse to play the game anymore as at times it was unethical at the patient's expense, not to mention the therapists were actually bullied if they hadn't tried every possibly angle of treatment.   If you ever feel a pt is not up for the RUG minutes, then document why and move onto the next patient.  Trust your judgement, collaborate closely with the OT and other therapists- at least you have a good team.   If your treatment is no longer skilled intervention and only a way to meet the minutes that are demanded of the therapists, then I would document and hand it back to the OT to reassess the need for tx.   Hopefully your next assignment will be back in home health!!   My thoughts are with you.  Just focus on the patients you can help and I am sure you will indeed help them.  

PS Did you ever find the card of health care recruiters in Australia?

I wanted to be sure and post a follow up to this forum topic I started a week or so ago....I am so thankful for this website. Thankful that it allows up to support one another and offer friendly helpful advice when needed. Love that. I think it is a chance also for share experiences whether they are good or bad.....and get feedback.....I took a much needed Monday off from work and that seems to have helped a little to give me a break. BUT MOST IMPORTANTLY....
Last week....I recieved a package in the mail from a patient of mine that I used to see for Home Health in Washington while we were there on assignment. She and I became really close over the time that I was there.....She is a young mother of 4 teenagers and had suffered from several debiliating seizures and a cerebellar stroke resulting in various medical complexities including her being no longer ambulatory. While I was seeing her in her home, before we left the area headed east for a new assignment I fabricated a small splint for her to use for her leisure activites. She had some weakness that kept her from holding onto things for a long period of time.....the splint allowed her to hold onto a pencil, pen, knitting hook, marker, etc. Inside the box was a package, wrapped, and a card. I quickly opened the card and read it......I want to share the words with you....

"Before I became ill and then had the stroke I loved to knit. I had started a blanket that I was never able to finish because I wasn't able to hold the hook. Before you left, you made me this little saddle type brace that I wear and I have been knitting ever since. This blanket was started over 2 years ago and finished, FINALLY, with that brace. I want you to have it, as your simple creation gave me back my hobby and brings me many hours of joy. Thank You. We miss you."

Wrapped inside was a beautifully knitted purple blanket. And I burst into tears. She had no idea how much I needed to hear those words....That what I did made a difference in her life, and I am so humbled. That was just the inspiration that I needed for these last 5 weeks at the dementia care facility. But it also proved to me that home health is where my heart is. I feel like that is the place I make the biggest impact in peoples life. Just felt like this was worth sharing. I took the card to work and read it to everyone there too......

Happy New Year Travelbookers!!

Wish  there was a "like" button. That is great Jennifer!

Awesome Jen! You & all home health do make a difference. Never forget it!

I am so glad you posted this happy ending, thanks for sharing.
diane

That is such a great story-  she had perfect timing sending that to you!   Am sure there are other patients out there who were just as touched and you never knew it.   Sometimes we have to try out different settings before we know where we really thrive.   Happy ending for sure!

Happy New Year and congratulations on making it this far! I feel for you and your situation, at least you have a great team and a husband to vent with! Get a calendar and X off the days..it will be here before you know it...I am a nurse who has done a couple of travel assignments...that's a great story about your home care patient; see you are making a huge difference to those who can express it...and maybe that's just it; you are making a difference to the dementia patients, they just aren't able to say thank you...hang in there and just view this assignment as a way to learn more about yourself and your preferences...I agree with the other posters-as tempting as it is to just quit; it's probably better to hang in there...

Just an FYI, I journal on assignment. You know pretty much when you walk throught he door that you've been lied to, so I soon as I get that feeling I startl. Being an OR nurse, the rules are pretty much the same everywhere you go, so if I see things that are outside of AORN standards I know I need to start a jpurnal. I have had 2 assignments that I had to remove myself from dangerous practices. I went to the CON with my findings and requested to withdraw from the contract. Both times it worked out well, mostly because they already knew they had a problem. I give 2-weeks notice to get someone else in to finish my contract or negotiate to move to another facility inside their system. (The problems at one facilty was pretty seroius infractions like no surgical consents for scheduled procedures, lack of MAR, etc.)
I have also found that sometimes the staff are the best comfort on a bad assignment. They are usually just as stressed as you are with no way to get out. I can handle a tough assignment most of the time by just being there for the other staff. I have made some wonderful friends this way.
Hang in there.