Tea Time in Acute Care (Anonymous OT)

Q: Please tell us a little bit about yourself! What’s your favorite food? Favorite season? Do you have pets? Best place you’ve ever visited? Tell us what makes you sparkle!

A: My favorite food is Pizza. Favorite season is Spring, because that’s when things are renewing and the Kentucky Derby is coming up. I have 2 dogs (great dane and lab) and a one-year-old. The best place I’ve ever visited was Scotland or Ireland. Both amazingly beautiful with welcoming people.

Q: What degree(s) do you have (any specialties you hold if applicable) what made you interested in pursuing OT, what have you been up to since graduation?

A: I have a Bachelor's in Exercise Science and Masters in Occupational Science/Therapy. I am orthotic/burn trained. DPAM certified. I have been working at a level 1 acute care/trauma hospital in Nashville, TN. I chose OT because I spent a lot of time doing PT growing up with athletic injuries (and I was considering PT), but the OT seemed like I could use my creativity more with practice.

Q: What practice setting are you sharing about today?

A: I remain in an acute care hospital. ICU.

Q: How long have you worked in this practice setting?

A: 9 years and counting

Q: Please describe a typical day/work week? What time do you typically arrive/take a break/leave work?

A: I arrive at work between 7:30-8:00. 30 min break for lunch and obviously bathroom breaks as needed. Leave usually between 4:00-4:30

Q: Do you formally clock in and clock out, if so, how is on the computer or via sheet, etc.?

A: We do clock out using a badge reader or on the computer using our employee ID number.

Q: Who provides you with your schedule? Do you typically stay on this schedule or does it fluctuate depending on patients’ availability?

A: I changed from full time to part-time last September after my son was born. But now I am PRN. When I did FT and PT, schedules were based on 40 hour work weeks and weekend coverages. We usually had a comp day in the middle of the workweek when working weekends to offset overtime.

Q: How many patients do you typically see? How long do you work with them for?

A: I would usually see b/w 8-9 patients a day (evals/treats). My time with them was dependent on the type of work I was doing with them (evaluation, treatment, or splinting). Evals: 30 min or less. Treatments: 15-30 min. Splints: 30-120 minutes.

Q: What is the productivity expectation at your job? How do you find meeting it? A: Our standard was 95%. I met it often. But I was in an ICU that had high turnover rates with more evals than most.

Q: What type of diagnoses do your clients typically have? Can you please provide 1-2 activities you would do in a standard treatment session with one of these clients/families?

A: My patient’s diagnoses were all over the spectrum being at a trauma hospital. But here were my most common:

- SCI (spinal cord injuries): Usually working on therapeutic trust initially, especially when sitting on the side of the bed. Then we would do basic ADLs with weight shifting of the UEs if they were intact. Higher injuries tended to be more focused on P/AAROM/AROM to BUEs, splinting, family education and patient autonomy for positioning to prevent bedsores.

- GSW (gunshot wounds): These are common in a trauma hospital. We will pick an UE GSW. Typically we work on edema management because of the trauma, swelling will occur. Then splinting for function if a nerve was damaged and hemi dressing to the affected UE.

Q: Do you have meetings to attend throughout the day/week? If so, what do they typically entail and who attends these meetings with you?

A: Yes, we have monthly rehab meetings (all rehab disciplines), monthly OT meetings (OTs), monthly rehab educations (all rehab disciplines).

Q: What type of documentation do you complete? (i.e. how long does it take, how frequent are your notes due, etc.)

A: I’ve personally used Medilinks, Cerner and Epic, so electronic documentation to answer your question. Usually takes b/w 10-25 min depending on the detail in regards to diagnostic specifications. Notes are due daily.

Q: What does a typical evaluation look like? How long does it take? What assessment tools do you use?

A: Typical eval is a standard, reviewing the following: home environment, PLOF, assistance at home, DME at home, occupation, hand dominance, sensation, vision, ROM, strength, balance, pain. I leave pain for last because people will tell you they are in pain. If i can redirect them to focus on something else I do to facilitate greater activity tolerance and participation.

Assessment tools: figure 8 measurement for edema, finger to nose test, MMT, visual assessment of ROM, KELS, MOCA

Q: What is a ball-park range of what an OT can expect to earn in your practice area (please also include approximate geographical location - rural South Carolina, suburb in Connecticut, etc.) Please also include if this rate is for per diem, with benefits, per visit, etc.

A: Urban city in TN (full time): $60,000-$70,000; (part time): $30-40,000. PRN rate: $43-45/hour. PT/FT included benefits.

Q: How did you get your “foot in the door” to work in this setting?

A: I got a job at the same hospital as a tech to get medical experience while I went to school.

Q: What is your favorite part of this practice setting? Can you provide a favorite memory of a patient/client that you know OT positively impacted their life?

A: My favorite part is bringing light/hope to people after the worst day of their life. Showing them we can’t stay in the bed, we have to move and get better. I have many memories of patients that I keep dear to my heart. But one I’m proud of was this: A young girl was a burn patient after a house fire. She was with us a long time (6 months) before being healthy enough to transfer to a rehab facility. We battled her depression daily, telling us often that she hadn’t accomplished anything. Of course, being an OT, I made a poster board to highlight all of her accomplishments that we reviewed daily. And left room for goals we had to have a visual reminder when we were not in the room to keep her spirits up. This was one of my best OT memories. This ended up helping and setting a tone for future treatment sessions.

Q: What advice do you have for new grads/therapists hoping to transition into this setting?

A: Don’t be embarrassed if you don’t know something, just ask. But first, attempt to find the answer on your own. But also know, there is always room for learning. No one knows everything about anything. Also, if you can’t find a FT or PT job, get a PRN job. Most FT/PT are offered to in-house staff before being posted to the public.

Q: Do you have any stories (can be funny, sad, real, neutral) or a “big mistake” you’ve made on the job? What happened? How did you correct this mistake (if possible) or what did you learn from it?

A: Patient falls are always good reminders of how unpredictable this job can be. I had a young patient with a lower extremity injury who was insistent to the point of yelling at me that he could urinate independently in standing without me close by. I gave in and let him have his privacy. He ended up falling and hitting his head (no additional injuries). Thank goodness. But I should have stood my ground for his safety. Lesson learned. Also to that point, unsafe patient’s have to be given a reality check in a safe manner. I have patients who say: I can walk on my own. I give them a little slack, but am close by for safety. When they lose their balance then I can come back and say: This is why you need to call for help. You would have fallen and ended up on the floor. Then you’d have to stay here longer. (Which no person wants to hear).

Q: How do you personally prioritize your self-care and prevent/manage burnout?

A: I honestly after 9 years am just getting better at this, and is why I work PRN now. I just wanted my boss to like me, and she only did so if you worked extra hours while maintaining productivity. I would be late to things, be tired for working extra and all for nothing but a crappy paycheck (after taxes of course). I also took a lot of my patient’s worries home with me. They didn’t have anyone and the emotional trauma I would empathize with them took a toll. I would say work your hours, but remember to leave patient’s troubles at work. Have a good winding down routine on your way home to reset your brain when you walk into your front door, otherwise, you won’t make it long in this setting.

Q: Approximately how much money did your OT program cost (including tuition, fees, books, housing if applicable)

A: Approximately $70,000

Q: Did you take out loans to help you pay for school? What was that process like?

A: Took out FASFA loans. Honestly, not a bad process, but the interest rates were out of control.

Q: Do you have any advice for pre-OT/OT students who are applying to programs from a financial standpoint?

A: Make sure this is what you want to do. Healthcare is a hard business, which is not run like a business should be at all. At the end of the day, you need money to pay bills and live. A job is not all you are.

Q: What’s next for you? Where do you see yourself in the next 5 years?

A: I’m honestly looking forward to being at home with my son and watching him grow. I’m looking to expand outside of OT for other financial opportunities.

Q: What changes would you like to see in the OT profession over the next 5-10 years?

A: Productivity standards need to change. They are reaching unethical standards. Equal pay for professions despite education level. Some entry-level PTs were starting significantly higher than I was after being there for 2-3 years.

Q: If you could go back in time, what advice would you give yourself who wants to enter this practice setting as an OT?

A: More work/life balance. Jobs will be out there. Don’t let your boss bully you.

Q: What life motto do you live by?

A: ‘We’re all fucked up. Some just hide it better than others.’ (A coach told me this in college when I was having a rough time). It reminds me that everyone is going through something. Some just can hide it better, but it doesn't mean it's not heavy.

Q: If you could do it all again would you pursue your same degree and become an OT?

A: Honestly no. I would regret the friends I’ve made, experiences I’ve had and patient’s I’ve changed. But healthcare is so behind when it comes to ethics, pay scales and business models for leadership roles/management that I would have chosen a different path.

Q: Any other questions you wish I’d asked? Add your own I am happy to include it! :-)

A: Write this situation as if documenting: You find your patient with poop and pee all over him. Go----Pt found supine with HOB elevated upon entry. Pleasant with moderate urinary/bowel incontinence episode noted, resulting in soiling of patient’s gown, sheets and skin.


Hi friends, Robyn here! I want to thank this OT for sharing her story. My mission here is to provide people a platform to share the highs and the lows in this therapy world (and Earth-life in general). I so very much appreciate her honesty and I think many of us can 100% empathize and relate. One aspect I love about OT is that you CAN step back and have a break. The options of part-time and PRN can allow us to keep our toes wet while allowing time to pursue other goals. (Although I think we should have a whole separate blog post on how sometimes PRN and part-time is SO MUCH MORE WORK than full-time in some regards). If you have any thoughts please comment down below or e-mail me at so you can be featured on the blog and share your experience! Okay, that's it for this week! Stay excellent my beautiful friends! xoxox

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