Occupational therapists are considered an integral part of the interdisciplinary healthcare team, especially in the acute care setting, where therapists evaluate and treat patients during their hospital admission. Therapists working in this setting face numerous challenges, including medically complex patients, high productivity standards, and the rapid pace of service delivery. Despite a widespread understanding of the complexity of acute care, level II fieldwork students are expected to face these challenges at the beginning of their clinical rotation. This qualitative pilot study aimed to gain insight into the lived experiences of level II fieldwork students in the acute care setting, including their perceptions of preparedness. Participants were recruited from acute care hospitals using a flyer and snowball sampling; they were included if they were enrolled in an accredited occupational therapy program and had completed at least four weeks of a level II fieldwork placement in acute care. Semi-structured interviews were audio and visually recorded, transcribed verbatim, coded, and thematically analyzed. A total of four participants completed the interview process. Information power was achieved, and four themes emerged from the data: intricacies of patients in acute care, unpredictability of the acute care setting, learning through lived experience, and the importance of mentorship. This study is significant to the occupational therapy profession in that it has explored the lived experiences of students completing their fieldwork in the acute care setting, which had not previously been published in the literature. This research will allow fieldwork educators, fieldwork coordinators, and academic faculty to better understand the complexities of student preparedness in the acute care setting.