OT Settings Series: Academia, Community-Based Practice, and Occupational Therapy with Erin Jeffords

Did you think that OT practitioners can only work at hospitals? Think again!

Next up on our #OTSettingsSeries is Erin Jeffords, MS, OTR/L, CBIS. She is a rockstar! She has a breadth of experience in a variety of areas including in neurorehab, community-based practice, and academics. Erin has over 10 years of practice behind her belt and we can all learn a little from her.

MEET ERIN

• Graduated: 2009
• Current settings: Academia and Community-based practice
• Previous settings: Neuro rehab/brain injury, Assisted living, Skilled nursing facility

Shannen: Hi there Erin. It is so great to hear from you. Can you tell us a little about your journey. What are you doing with your occupational therapy background?

Erin: Hi there Shannen, happy to be here. A little bit about my journey. I became a licensed occupational therapist after graduating from the Medical University of South Carolina in 2009. I initially began my career working in inpatient settings on a neuro rehabilitation unit in acute care and then transitioning into brain injury rehab at Medstar National Rehabilitation Hospital in Washington, DC.

After my first child’s birth, I decided to take a step back from my full-time role and worked part-time in the community in assisted living facilities while working PRN in skilled nursing. During this transition, I began to more clearly see the value of OT in the natural setting. For the past five years, I have been teaching as an adjunct professor in an occupational therapy assistant and Masters of OT program teaching labs related to physical dysfunction, geriatrics, and assistive technology. I am currently enrolled in a post-professional doctorate program through Thomas Jefferson University.

Shannen: Wow, I love that. You are so, so amazing. I look forward to having a little one in the somewhat near future and I also hope to be able to find the balance of working in the clinical roles with a mix of adjunct teaching. I also enjoy teaching!

Shannen: Can you share a little more detail in regard to what the settings of Academia and Community-based practice means to you?

Erin: Sure thing!

Academia: I practice as an adjunct professor in a Master of Occupational Therapy program at Lenoir-Rhyne University. As an adjunct, I work less closely with faculty than a full-time professor. In South Carolina, we are the only MSOT program with the other program at the Medical University of South Carolina, transitioning to an entry-level doctoral program. Currently, I am teaching an Assistive Technology course with 80 students between two campuses. The course works this semester is all online. I have missed the face to face classes, and my students have risen to the challenge. Personally, all virtual graduate schools would not have been a good fit for me as a student, and they are handling it all well. The plan is to return face to face in the spring, so I hope that things in our area are safe to follow that plan.

Community-based: I practice in a combination of rural and urban settings depending on the types of referrals I receive. I also speak to groups and complete educational series related to groups to fall risk prevention.

As an OT, I feel like it is our role to be interdisciplinary focused. Even if I do not work closely with other professions daily, I always include them in the conversation to promote best practice.

Shannen: Can you share what your clients/patients look like? What types of diagnoses, age, etc?

Erin: My typical clients are community-dwelling seniors over the age of 65 who want to safely age in place. In the past, I have received funding through the university that I teach as an adjunct to treat clients and groups in an assessment and treatment course. I recently accepted a new role as a home health provider and will be treating Medicare (A) clients in their homes. Referrals in my area consist of various diagnoses, including Diabetes, Parkinson’s, Alzheimer’s, history of stroke, CHF, COPD, MS, and other neurological conditions. In South Carolina, we have a high incidence of diabetes and heart disease as comorbidities related to our lifestyle (a diet consisting of high sugar, fat, and sodium).

Shannen: Oh I definitely hear you in regard to heart disease and diabetes. I also live in the South as you know… the dreaded Stroke Belt. Okay, next question. What value does OT bring to a community-based setting and how do you incorporate salient interventions into practice?

Erin: It is relatively easy to incorporate meaningful and functional occupations into interventions in the community setting because everything is real life versus scenarios. Our value as OTs in the community can be overlooked if we are unwilling to advocate for our services. More older adults who want to age in place services that provide education on home modification and fall risk prevention can be a tremendous proactive versus reactive model.

Shannen: What does OT look like in your setting? What types of assessments do you use? Do you use specific theories and frames of reference?

Erin: I typically use the P-E-O model and assessments vary. When evaluating for fall risks I typically use assessments such as the BERG and Timed up and Go. I also have been currently using the FES-I and have an upcoming poster presentation for my state organization related to this measurement tool which looks at fear in relation to fall risk.

Community-based: In the community I have done 1 day speakings for local organizations and church groups as well as an 8-week fall risk prevention series. For Assisted Living and Home Health OT it varies per client and the sessions are typically an hour in length. I find that anything more than an hour in those settings are not productive.

Academia: In my Geriatric lab my students must create a binder with all different types of assessments related to ADLs, balance, cognition, and other assessment tools. I like for them to create a hard and electronic copy, so they have easy access depending on the setting they are in. I also have a mild obsession with the Dollar Tree, and I recommend students and practitioners create all treatment sessions that are functional and it can be done at relatively low cost with resources at these types of stores.

Over the summer I was able to crowd source and create baskets for seniors in my area that stimulated their heart, mind, and body in order to decrease fall risks. Most of the supplies came from Amazon and places such as this.

Shannen: Okay be still my actual heart. Literally you are a person after my own heart. I am a fall rpThat is so brilliant, caring, wonderful that you facilitated a crowd sourcing campaign and carried out your purpose to serve local elders. I. LOVE. THAT.

Shannen: What certifications or specialties do you have? Do you have any others that are on your bucket list?

Erin: Physical Agent Modalities, Traumatic Brain Injury Specialist, Level 2 Fieldwork Educator Certification, Car Fit. My bucket list for certifications are LSVT and Tai Chi for Arthritis.

Shannen: Describe a moment in which you felt like you facilitated a positive change in your
client / patient’s life?

Erin: Oooh good question. Academia: When students tell me that I have positively impacted their journey to become an OT, it has given me an appreciation for their time devoted to their instruction.

Community-based: I feel like my light shines brightest when I am working with older adults. I was one of the few that knew exactly what I wanted to do, and even after fieldwork and initial jobs, I have continued to follow that same desire to work with the senior population.

Shannen: Okay once again! I am soooooo with you there. My heart is for the oldies.

Shannen: What things do you not like (or wish you could change) about this setting? Barriers?

Erin: Well for starters a pandemic… Academia: Currently, restrictions with COVID-19 have negatively impacted FW placements, as well as the option for classes to resume face to face.
Community-based: barriers would be access to care depending on if you qualify for services.

Shannen: How did you “get your foot in the door” to work in this setting?

Erin: Academia: When we relocated back to SC from the DC area, I reached out to a local OTA program and inquired about an opening for a lab and was offered a position teaching the lecture and lab. I enjoyed teaching the OTA students because the class size was small, and most of the students had life experiences with this being their second career choice. Having that experience opened the door to being a guest speaker and eventually an adjunct at the university I currently teach.

Community-based: When I went to interview for my part-time role in an assisted living, the hiring manager had positive experiences with previous employees who had worked at the hospital that I was working at full time. Thus, that experience helped pave my way to opening so many doors because it gave me the best foundation and training as OT.

As far as a transition on my own to public speaking, I have a high threshold for rejection : ), which is has been an asset because if someone says no, I keep asking or ask someone else.

Shannen: Where do you see yourself in 5 years? Ten years? How does working in these settings help you reach your personal, professional goals?

Erin: In 5 years, I would like to be finished with my post-professional OTD and would be piloting my capstone project in the community where I live. In 10 years, I would like to have my program running successfully in more than one area of my state to grow the legacy I hope to leave behind. This next year I will start my journey with my doctoral capstone project and work on it for two years.

Shannen: Congratulations, your goals are fantastic and from the work you have put in so far I can see it happening!! What are some “special skills” (like things you are not prepared from entry-level OTA/OT skills) would you recommend to succeed in your setting?

Erin: If you are interested in academia, you want to find out what most universities and colleges require. When I was teaching in the OTA program, my masters were sufficient, but in an MSOT program or higher, they typically required a doctorate or higher. Adjuncts can be hired in some instances to fill voids, and since I had plans to return to school to pursue my OTD, I was given a great opportunity. My particular interest area of research is fall risk prevention, which is the one “skill” I bring to the team for research purposes. I have been able to do hands-on research with students and older adults in the community to find supportive evidence to lower fall risk.

Shannen: How do you deal with grief, illness, sadness, loss, caregiver burden…etc. in your setting? (What psychosocial interventions…who do you refer your patients to…. how do you prevent burnout and maximize your self-care and occupational balance??)

Erin: As a parent of 2 young children (7, 4), I have learned to prioritize self-care. As a new
grad, I burned the candle at both ends. I worked overtime every week as well as PRN while trying to keep an active social life. Since having children, I have had to prioritize my needs, and my family is always first. I try to include physical exercise into my routine at least four times a week, such as boot camp, running, or Pilates. I just started taking golf lessons this past year and ran my first half marathon. I turned 40 this year, and prioritizing my own needs has a new level of importance.

When you feel burned out, it is time to step back and reflect on why. There is an extremely negative space on social media when discussing frustrations as a practitioner, and not everyone’s experience is equal. I think we must try to keep our tone as professional as possible.

Even if you have an unpleasant experience at a job going on Facebook or IG to share, it may not be the best platform. As much as you want to believe that companies will churn and burn out employees, retention is more cost-effective. If something is not working, find a way to discuss it, but try to go about it in a constructive and not destructive manner.

Shannen: Okay so you can’t see me but I am clapping at your above advice… That brings me to basically my last question. Can you share any last minute advice you would give to someone thinking about / wanting to work in your setting? What do you wish you knew about this setting x years ago (before you started)?

Erin: Academia: Remember that you have something different to offer and your experience and lens as a therapist are different than others.

Community-based: Sometimes, you are your client’s only advocate. You are their eyes and ears of their conditions. I have had to report abuse and neglect and contact family members
to advocate for my client’s wishes. It can be uncomfortable, but it is necessary.

Shannen: Simply beautiful. Anything else your heart desires to tell them to world about …?

Erin: I feel that as OTs, we must advocate for the value of our profession. When my students submit documentation, I always say ‘close your eyes and have someone read aloud’. Does that sound like OT or PT? Most students need constant reinforcement to engage in functional tasks. It is no fault of their own when they start and have fieldwork educators or other OTs in their practice utilizing interventions that are not supported by evidence. I cringe when I think of what I have witnessed, but it does not make it right just because it is done.

Also, if you are new and starting, I suggest finding mentorship. Also, if possible, take the
quality jobs over the higher paying ones in the beginning. Those jobs may not fill your pockets, but they will give you the confidence to pursue future roles as an OT and to take your career to a higher level! The experience I solidified my first five years of practice has paved the way to where I am today.

Want to connect with Erin?

• IG: @theOTadvocate
• Email: theOTadvocate@gmail.com

Questions? Comments? Feedback!! Please consider posting below!! Follow the hashtag #OTSettingsSeries on Instagram to never miss a post:)!!

Finally, a big thank you to you Erin for sharing a glimpse of your OT world and transparently discussing burnout, professionalism, family life, academia, and community-based practice through your own occupational therapy lens!

With kindness,

Shannen