"Growing up, Allison Smith thought she wanted to follow in her mother’s footsteps and become a nurse. That was, until she had blood drawn for the first time, and she realized that a career in nursing was no longer in her cards. But her passion for caregiving persisted, and a love of children eventually inspired her to volunteer at a local hospital, where she shadowed in the pediatric rehabilitation unit. It was this experience that sparked the remainder of Allison’s professional pursuits.
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As an occupational therapist at St. Jude Children’s Research Hospital in Memphis, Tenn., Allison works with oncology and hematology patients to encourage rehabilitation through the performance daily living skills. Here, she discusses what it’s like working with children on a daily basis, how she balances the emotional demands of her job, and why it’s okay to abandon your original vision for plan b.
Name: Allison Smith
Age: 28
Location: Memphis, Tenn.
Current title: Pediatric Occupational Therapist
Education: Master’s in Occupational Therapy, Washington University in St. Louis; BASc in Psychology, Indiana University
How did you first become interested in occupational therapy? What drew you to that career?
Growing up I always knew that wanted to work in a profession with children—as a teacher, a pediatrician, a nurse…As I got older, I did a lot of volunteer work at hospitals and schools. My mother is a nurse and I kind of thought I would follow in her footsteps—until the first time I got my blood drawn and realized that path was NOT for me. This may sound crazy and slightly ridiculous, but I was watching “The Bachelorette” (I know, right?) in high school and one of the contestants, Trista, was giving an interview about her job as a pediatric physical therapist at a hospital in my hometown of St. Louis, Mo. The job sounded amazing! At the time, I was volunteering at a hospital and asked to shadow in the rehabilitation unit. As I started to learn more about career opportunities in rehab, I realized my true passion was occupational therapy, so I could help children get back to living their lives to the fullest extent possible. I think what drew me to this career was my passion for working and helping people—and I guess I have reality TV to thank for showing me the way!
Right out of graduate school you worked at both an elderly care nursing facility as well as a children’s hospital. Was it difficult to decide which path you wanted to ultimately pursue?
I knew the moment I started graduate school my passion was to work with children. It was a little difficult finding a full-time pediatric position after graduation, so I worked part-time at St. Louis Children’s Hospital, and at a skilled nursing facility PRN (“pro re nata,” or as needed) to supplement my time off. While I did fall in love with working with the elderly population and hearing all of their incredible stories, I knew that I wanted to work with children and kept looking to find the perfect job.
I realized my true passion was occupational therapy, so I could help children get back to living their lives to the fullest extent possible.
As a pediatric occupational therapist, what are some of the things that you work on with the children?
Many people ask this question. They often think “occupational therapy” is a service that assists you with getting jobs. Makes sense when you think about the terminology! So you may ask, “Why would you have to help a child get a job?” The term occupational therapy is defined as assisting patients and clients to enhance everyday functioning and performance in daily living skills (occupations). When we think of the occupations of children we think of playing, learning, dressing, eating, bathing, toileting, grooming, etc. We work on developmental skills (cutting, coloring, stacking blocks, handwriting, etc.), neurological skills (coordination, hemiplegia, etc.), musculoskeletal skills (decreased range of motion, strengthening, etc.), and visual skills (loss of vision from eye tumor, decreased vision from surgery, etc.)
What drew you to St. Jude? Does working at a research hospital provide a different experience?
I came to St. Jude as a clinical student per my curriculum through graduate school. After three months at St. Jude, I fell in love with my patients and their families, and realized that I have a passion for working with oncology and hematology populations. Everyone who works at St. Jude is driven by its mission—finding cures and saving children. The doctors, nurses, and therapists work collaboratively each day to provide children and their families with the best treatment and care.
Working at a research institution is a great benefit to my job. I’ve had the opportunity to participate in research protocols and studies that will eventually help me provide better care to my patients and future patients. In addition, St. Jude encourages employees to participate in activities outside of our job responsibilities, including conferences, grand rounds, continuing education courses, and more.
You’ve been working with St. Jude as a pediatric occupational therapist for the last two years. Tell us about what your day-to-day responsibilities look like?
The first thing I do in the mornings is look at my schedule for the day. On a typical day I can see anywhere from 8-12 patients, and each treatment session and evaluation is about 30 minutes. On an average day I see about 2-3 evaluations/re-evaluations with the remainder being treatment sessions. In our initial evaluation and re-evaluation for children 5 years or younger, we look at developmental milestones. These activities may include cutting, stacking blocks, stringing beads, throwing/catching a ball, drawing shapes, and more. We also develop parent rapport by asking questions about how they are functioning at home and in school/daycare, if applicable. We check visual skills and motor skills—tracking an object, rolling, sitting up, crawling, etc. If the child is 6 years old or older, we evaluate grip and pinch strength, fine motor coordination, daily living skills (dressing, bathing, toileting), and more.
Treatment sessions are where we get to have fun because we utilize play in every aspect. If we need to strengthen a patient, we play volleyball with weights or use a weighted bar to hit a beach ball back and forth. If we are working on fine motor skills, we play Connect 4, Jenga, and other board games. To work on endurance and cognitive tasks, we make brownies or cook the child’s favorite meals. Most of my day is very active and fun. We are both outpatient and inpatient so we definitely get our steps in running around the hospital!
After I’ve seen all of my patients, I document what we did with each child throughout the day, update goals, and plan for next sessions. We also assist with transition services once a child’s medical treatment is completed at St. Jude. To accomplish this, we speak with schools, other therapists from a home community, doctors, and other providers throughout the day.
In addition, St. Jude encourages us to participate in activities outside of patient care, so I’m involved in various committees, psychosocial rounds/acute neurological injury rounds, teach our Handwriting Camp, and more.
You work with children for an extended period of time. Once they are finished with therapy, do you ever get updates from them?
Yes, we love receiving updates from families! One thing that makes St. Jude unique is that our patients are here for an extended period of time, which gives us a lot of time to build relationships with them and their families. Our patients can be here for a couple of weeks to potentially a couple of years. And even once patients have completed treatment, they are technically always patients at St. Jude, and will come to campus for check-ups and evaluations for the rest of their lives. It’s always great to have the chance to see them and keep up with their progress at home.
What advice do you have for someone who is considering a career in occupational therapy?
My biggest advice is to get involved. Occupational therapy is a career more and more people are learning about and pursuing. I think it is important to volunteer with different populations and in various settings before applying to graduate school. Being knowledgeable and having good observational experience is key to success in this field. Even when I was in graduate school, I formed connections with other therapists at nearby hospitals that specialized in oncology to start growing my knowledge base. Getting involved in outside organizations is also beneficial. I volunteered with the Special Olympics and in hippotherapy (therapy involving horseback riding) prior to attending graduate school. I would also say it’s important to work hard and take advantage of all the resources schools have to offer for both research and learning. In this field, you can work with people of many ages in so many different settings. You can do anything from pediatric traumatic brain injury, hand therapy, or adult mental health to school-based therapy, spinal cord injury therapy, or nursing home therapy. The list only goes on. This career is so rewarding, and you make a difference in people’s lives every day. I am so thankful to have a job that I am proud of and that I look forward to going to every day.
This career is so rewarding, and you make a difference in people’s lives every day. I am so thankful to have a job that I am proud of and that I look forward to going to every day.
I imagine your role is both incredibly rewarding and very emotional. How do you take time for yourself to disconnect and recharge?
Absolutely! This job is extremely rewarding, but it does require a lot of emotional strength. St. Jude provides wonderful benefits for employees to take breaks if needed. That being said, this year I am extremely occupied outside of work with planning my wedding. When I need to disconnect, it’s nice to think about flowers and fonts for invitations. You can ask my fiancé this as well, but he will tell you I travel (A LOT). I have friends and family all over the country and I make sure to get away and spend time with people that I love. I also love international travel and make sure to take a longer trip somewhere new every year.
Do you have a favorite success story?
There are so many! I have to go back to one of my first patients at St. Jude. She was an adorable little girl. She was 2 years old and had a smile that made you want to give her a big hug. She had the sweetest, softest voice as well. Her parents were wonderful. She had fine and gross motor coordination issues that required occupational therapy from the beginning. She loved to play during our sessions and was a fantastic patient; she would do almost anything I asked. The only thing that she would not work on was imitating vertical lines. No matter how hard I tried she hated it. I put Minnie stickers at the top and Mickey at the bottom and had her draw lines between them. Even that didn’t work—and she LOVED Minnie. She would outsmart me and my tactics every time to avoid working on her lines. After medical treatment she went back to her hometown, and I received a letter from her mother to let me know about her progress. The letter stated that one night they were in the bath and she picked up the bath paint marker and said, “Lines, lines, like Ms. Allison.” And finally drew the vertical lines. I knew in that moment that I helped this girl in some small way, but she changed me in a big way—not only my outlook on what I do every day, but my life as a whole. I realized that our work does make a difference—even if it’s something as simple as drawing lines.
Our work does make a difference—even if it’s something as simple as drawing lines.
What advice would you give to your 23-year-old self?
Have fun, work hard, keep family and friends close, and don’t take life too seriously. I had a lot of fun when I was younger, but I always knew that I would be going on to more schooling and I needed to take school seriously. I also know now that the “stress” I have felt cannot bat an eye to what other people, especially people I am around on a daily basis, feel. If you work hard and pursue your dreams, things will work out. Also, I would tell myself to have a good work/life balance. Travel when you’re young because life will get in the way. Never forget the people that molded you and thank them every day by telling or showing them how much you love and appreciate them. Call your family and friends or make trips to see them because relationships can be tough in the future if you don’t make the effort. Never take a moment for granted.
Allison Smith is The Everygirl…
The best advice you’ve ever received?
Everything happens for a reason. I know it seems cliché, but this motto has truly been the case for me. When I was in college I applied to a graduate school, and it turned out I had applied too late to be considered. I was DEVASTATED. This school was in a city where all my friends were going and I wanted to be closer to them. It turned out for the best because I ended up going to Washington University in St. Louis, which has one of the best programs in the country. After school, I was upset that I couldn’t find a full-time pediatric job, but I kept at it, and eight months later my dream job opened up. Now I am a Memphian…Something I never considered! I should also mention that I met my future husband here, so I am a firm believer in everything happens for a reason!
If you could have lunch with any woman who would it be and why?
I would LOVE to have lunch with Kate Middleton. She seems down to earth and someone I’d love to be friends with. I admire her for both her family values and her philanthropic endeavors. I would also love some of her fashion advice!
Morning routine?
I wish mine was glamorous but it is not! If I am being honest, I wake up at about 6:48am (after hitting snooze twice) shower, throw on scrubs and a St. Jude T-shirt, “fix” my hair (not always the cutest), put on makeup (basically just mascara), grab a breakfast bar and my water bottle, hop in the car for my six-minute commute, and get to my desk by 7:30 a.m. Like I said, my routine is not glamorous. My fiancé and are going to try to get up and work out in the mornings when we start the wedding diet, but stay tuned for how that goes!
Perfect day off?
My perfect day off would involve relaxing. Sleeping in and watching good Lifetime Original Movies would be a perfect day!
I wish I knew how to…
Draw. Every day I teach children how to draw, but when I draw a picture for them to color in or cut out, I am always told: “Ms. Allison, that does not look like a person (or whatever I am trying to draw).” I have always envied artistic people!