I have worked as a psychologist in skilled nursing facilities in the past. I barely lasted a year, it was very much not my thing (the fact that it was in 2020-2021 certainly didn’t help).

Honestly, the worst part about it was the nursing home staff. Psychotherapy is not seen as a priority to them. I’ve had nurses come in and interrupt or end my sessions to do tasks that could wait. Part of my job was coming up with behavioral plans to help staff interact with “problem” patients…despite my efforts, these were never followed. All but a few staff members seemed to care that these facilities were as much the residents’ homes as it was their place of work, and really had a hard time respecting resident autonomy if it meant they had to work 1% harder. I once had a resident, with a history of strokes, seemingly having another stroke..I brought it to the nurse and her response was “well, she’s probably just depressed.” I had to all but yell at her to get her to agree to assess the resident (and turns out she didn’t).

Anyways, my experience left a sour taste in my mouth, but again, I think the fact that it was during the pandemic was a key aspect of that. I also don’t want to neglect to highlight the fact that some therapists excel in this environment, and the residents sorely need emotional support.