Two-and-a-half years ago, when Natalie Zachwieja, OTR/L, MS, occupational therapist at Kessler Institute for Rehabilitation in West Orange, N.J., began treating tetraplegic patients, she could have been overwhelmed by the extensive therapeutic ground she needed to cover in a relatively short period of rehab. But she wasn’t. Instead, she relied on guidance from mentors.

Her regular mentor, Michael Bunuan, OTR/L, MS, made sure Zachwieja knew when to introduce new goals, the right stretches to do and the right positioning devices. She also was able to tap into the expertise of Gabriella Stiefbold, OT, ATP, to address the patients’ electronic aids for daily living and assistive technology needs. “Knowing that there was a good mentoring program and that I wouldn’t just be thrown into the fire was a huge factor in accepting the job at Kessler,” Zachwieja says. “I knew that when that patient left here, I had done everything that I could have to prepare him to go home and into the community.”

That gentle guidance has helped her feel supported and confident in treating patients from day one. “There’s an awesome staff here who’s always there to answer questions if I ever need [them]. If there are specific things that I need mentoring on, it’s really easy to touch base with our clinic manager and ask for time,” she says. “Time is given to work one-on-one with somebody who specializes in whatever you’re interested in, just to make sure that everybody’s on the same page and competent in everything.”

A Program for Learning

The mentoring program was established at Kessler around the same time the East Orange traumatic brain injury program and West Orange spinal cord injury program merged about five years ago, says Stiefbold, clinical manager of the spinal cord unit. With an influx of staff new to either SCI or TBI units, the program was designed to help them quickly achieve core competencies needed to treat patients effectively, she says.

The mentoring program combines formal and informal learning opportunities. New staff attend lectures tailored to the patient population on their assigned units. On the SCI unit, lectures include transfers and positioning, mat mobility and a hands-on series leading to ventilator certification that enables therapists to treat ventilator-dependent patients with SCI in the gym without nursing supervision.

Lectures are updated at least annually to keep up-to-date with the latest techniques, topics and trends. Presentations are augmented with handouts, an SCI textbook (“Spinal Cord Injuries Management and Rehabilitation” by Sue Ann Sisto, PT, MA, PhD, et. al.) and other reference materials and videos.

Lectures also introduce staff to SCI specialty programs, including shoulder evaluation and treatment; the bowel, bladder and shower program; wheelchair skills; EADLs; the RT300 FES bike; locomotor training with body weight supported therapy; and fitness class. Another component of the program systematically introduces the interdisciplinary team and their roles.

“We want to make sure that the mentoring process is the same and very aggressive,” Stiefbold says. “A lot of the education takes place before they come to the floor but is ongoing when they get to the floor.”

Perhaps the most helpful component of the Kessler mentoring program is the buddy system, in which staff who are new to either the facility or a particular unit are paired with an experienced therapist. That more senior therapist guides the newcomer in documentation and goal setting, handling skills and whatever techniques or tasks the novice requires or requests.

That helping hand eases the transition into the unit. “The mentor is their go-to person,” Stiefbold says. “So if they’re ordering equipment, if they’re developing their treatment plans, that is what the mentor is there for.”

When Kessler therapists presented the mentoring program at a model spinal cord injury leadership meeting, it was well received. While they do not know whether other facilities adopted the program, they do know from discussions with their counterparts at other organizations that the Kessler method stood out because it was “individualized, structured, well meaning, organized and consistent,” Stiefbold says. Other mentoring programs did not have the combination of formal lectures that keep the program structured, organized and consistent, and the informal meetings with a personal mentor that make it helpful and individualized.

Spirit of Collegiality

They measure the efficacy of the program through staff and patient satisfaction surveys, which consistently rank the facility high in areas such as “someone at work addresses my educational needs” and how happy patients are with their rehab experiences.

And they have found the mentoring does more than help new staff — it fosters a spirit of lifelong learning and support and contributes to staff retention. Even experienced staff sign up to learn new techniques from other therapists on a regular basis. “Everybody wants to help everyone else succeed because we’re all here for the patients. So it’s a really nice working environment. There’s no competition. There’s no feeling like you’re asking a silly question,” Zachwieja says.

As Zachwieja develops her own skills as an OT, she has started moving into the mentor role herself. “It’s nice to be able to give back and feel comfortable in my skill set now,” she says. “It’s really nice to come full circle and feel like I can give back.” •

Anne Federwisch is a freelance writer.