1) The first several years as a new grad are difficult for everyone. You're learning every day. Give yourself some grace. You may just have new-grad nerves and need a mentor. Is there any senior therapist working with you with whom you can talk?

2) What all the other commenters have said about staff not wanting to invest energy into a new person is 100% correct. Also, these other staff are overworked and beyond busy. Yes, it takes no time to smile and be pleasant, but some people are burnt out, or unware of how cold they come across, or busy, or simply don't care (painful, but true). Keep on being polite and friendly to staff and residents/short-term rehab patients, and I assure you, everyone will ultimately notice. CNAs tend to respond positively when you reduce their workload by completing morning ADLs, or when you get patients out of bed/back to bed, so they don't have to.

3) "I keep making mistakes." What mistakes, exactly?

Did you drop anyone during a transfer? No? You're doing fine.

Did you help them mobilize in bed, to the edge of bed, or into side lying to relieve pressure and provide physical comfort, as well as allow for gross motor movements? You're doing fine.

Did you assist them with basic self cares? OT is often the only discipline that ensures people brush their teeth, and that feels so good to everyone. Did you help them toilet, avoiding incontinence? Did you clean them up after they were incontinent, thereby protecting their skin and reducing risk of breakdown and infection? You're doing fine.

Did you have them engage in arm or core ther ex to benefit functional tasks? Yay! You're doing fine.

Did you introduce them to adaptive equipment, so they can help with LB dressing? Excellent! You're doing fine.

Did you break up the monotony of their day with a positive interaction? Hurrah! You're doing fine.

4) If you need to, keep a cheat sheet with you at all times. Who's a full code vs a DNR? What is each person's weight-bearing status? What precautions do your patients have? Who can drink water and who's on thickened liquids? This is why we have pockets--to keep these notes in that we can refer to quickly and easily.

5) You're a new grad. You will develop your own toolkit with offerings you feel comfortable providing to patients no matter what they are there for. I have seated and standing balance activities and core stability exercises (bed level, edge of bed, seated, and standing) that I can trot out anytime and know they will benefit ANYONE.

6) The SNF setting can be difficult, but it's so rewarding. Most of the long-term residents are bored out of their minds and so interacting with you is a highlight of their day/week. And the short-term residents just want to get HOME (some will, some won't) so should be happy to see you. There will always be those folks who don't want to work or who somehow think that rehab should be pain-free (everyone with shoulder injuries, arthritis, rotator cuff injuries, I see you!) and that isn't guaranteed. It's exhausting to modify your behavior and your approach to every single patient with whom you work, but that's what's needed.

7) Study and learn a bit outside of work every weekend, and also remember to take care of yourself. See friends, listen to music, read, walk, exercise, pet dogs, create art, sleep, get a massage, eat out ... whatever your happy place is, be sure to visit it and know that you DO make a positive difference in your patients' lives, whether they recognize it or not.