Q: What practice setting are you sharing about today?
A: Today I am sharing about the role of occupational therapy within the Neonatal Intensive Care Unit (NICU) setting. However, it is important to note that prior experience in a pediatric setting is beneficial and preferred in order to prepare for working in the NICU.
Q: What is your educational background? What degree(s) and/or specialties do you hold?
A: I received my Master’s degree from Touro University Nevada.
Q: How long have you worked in this practice setting?
A: I have been with this current hospital for almost one year. I also completed my clinical rotation with them.
Q: Please describe a typical day in your practice setting? What time do you arrive/take break(s)/leave work?
A: Our shifts are normally 8am-5pm with a one hour lunch.
Q: Do you formally clock in and clock out, if so, how is on the computer or via sheet, etc.?
A: Each employee has a badge, which we use to clock in and out via badge scanner. There is also an option to manually clock in on the computer.
Q: Who provides you with your schedule? Do you typically stay on this schedule or does it fluctuate depending on patients’ availability?
A: Management sets the schedule each quarter, and it is pretty consistent in terms of staying on schedule. Depending on the caseload for that day, you might cross over to help on the adult side, if you have been cross-trained.
Q: How many patients do you typically see? How long do you work with them for?
A: The day’s caseload is typically 7-8 patients, about 30 minutes for each treatment.
Q: What type of diagnoses do your patients typically have? Can you please provide 1-2 activities you would do in a standard treatment session with one of these patients?
A: Most of the babies who are born prematurely come forth with respiratory or cardiac issues. Due to these underlying factors and premature birth, their development and feeding are affected. Therefore, our treatment sessions vary depending on what the infant is ready for. For example, in order to be ready for PO feeds, the sensory system needs to be somewhat intact so that the infant can be alert and well-regulated to feed safely. Rooting reflex and readiness cues should also be present.
Q: Do you have meetings to attend throughout the day? If so, how long and who attends these meetings with you?
A: We have monthly staff meetings for the rehab department. Depending on if you’re cross trained in other areas (outpatient, inpatient, pediatrics), then you also have those monthly meetings.
Q: What type of documentation do you complete? (i.e. how long does it take, how frequent are your notes due, etc.)
A: All of our documentation is done electronically and must be completed by the end of the shift. Daily notes take from about 5-10 minutes to complete. Evaluations can take up to 15-20 minutes to complete. As more experience is gained, documentation goes faster!
Q: What does a typical evaluation look like? How long does it take? What assessment tools do you use?
A: A typical evaluation usually takes about 30-45 minutes. It includes assessing the infant’s overall movements, if they have the appropriate developmental reflexes according to their age, if their sensory system is intact, and if they are ready for PO feeds.
Q: What is a ball-park range of what an OT can expect to earn in your practice area (please also include approximate geographical location - rural South Carolina, suburb in Connecticut, etc.) Please also include if this rate is for per diem, with benefits, per visit, etc.
A: An entry-level OT in Southern California can expect to make between $40-45 hourly. Depending on the company, some employers will pay you per treatment hour or they will pay you for a full shift (i.e. you still get paid even if a patient cancels). At my hospital, benefits are included for full-time or regular part-time associates.
Q: How did you get your “foot in the door” to work in this setting?
A: The best course of action is to get experience working with the pediatric population and to gain a mentor that works in the NICU. At the hospital where I completed my clinical rotation, the OT’s work in inpatient, outpatient rehabilitation (for adults and pediatrics), hand therapy, and the NICU. Although my rotation was focused on neuro-rehabilitation and adult inpatient, I expressed my interest in seeing the other settings. I was lucky enough to have the opportunity to shadow the pediatric and NICU therapists for a couple of days. I definitely took advantage of that time, asking a lot of questions and seeking their knowledge. Around that time, the hospital was also looking to hire a new OT so I was offered the position when I became licensed. Both of my mentors are OT’s that work in the NICU as well as outpatient pediatrics, and they have both been a huge part of my growth as a therapist.
Q: What is your favorite part of this practice setting? Can you provide a favorite memory of a patient/client that you know OT positively impacted their life?
A: My favorite part is definitely cuddling and playing with the babies! One of my favorite memories occurred while I was working in the outpatient clinic. One of my patients is a 3 year old girl who is diagnosed with Autism and has tactile processing difficulties. We were finger-painting but she became overwhelmed and wiped her hands all over my pants. Her mom gasped and said “Sofia! What do you say?” The little girl looked up at me, smiled and said “I love you Jessica!” That just melted my heart – and it was the first time she said my name. Although she had a hyper-responsive reaction in that session, she had really come a long way. Three months ago, she would not have let anything get on her hands!
Q: What is the biggest mistake you’ve made in this setting? How did you correct this mistake (if possible) or what did you learn from it?
A: The biggest mistake I have made is not talking to the parents or caregivers enough. A lot of times, I would be so focused on treating the patient and the parents would have to ask what I was looking for or working on. I then learned to start talking out loud so that the parents could hear my thought process. Many parents do not know what the therapists are looking for, which is why they bring their child to us in the first place. I have also learned that by keeping an open dialogue with the parents, I can see what they need more education on and if they understand how to implement the home program activities.
Q: How do you personally prioritize self-care and prevent/manage burnout?
A: Luckily I don’t have to take any work home, so once I clock out, I am done with work. To prevent burnout, I like to have a three-day weekend or small vacation every couple of months.
Q: If you could go back in time, what advice would you give yourself (or to a new grad) who wants to enter this practice setting as an OT?
A: My advice to a new grad would include: get a mentor, read about sensory integration, NDT, and feeding, and become familiar with normal versus abnormal movement patterns in infants and children.
You can follow Jessica's journey on instagram @jessicamogi
and she also designed an OT jersey t-shirt that can be purchase here: https://jcmogi1.wixsite.com/jessicamogi-ot
Thank you, Jessica!