Tea Time with PTA in a SNF (Anonymous)

Updated: Dec 12, 2020

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: I am a PTA and mom of three. PTA grad of 2015 after a long stint of stay at home momming, preceded by teaching. I enjoy gardening, watching real housewives, hiking, spending time with my family, and video games.

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: Associates Applied Science, PTA. I also hold a bachelor’s in government/history, which is what I used to teach in my prior career. I was interested in therapy because I wanted to do something in healthcare, but did not want to deal with needles.

Q: What practice setting are you sharing about today?

A: I am a PRN in a SNF, was full time until PDPM, but PRN work is working out really well.

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

A: I have been working in inpatient since I graduated, so 5 years.

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

A: 9am for 4-5 treatment hours on my schedule. I take a break regardless because I’m not eating lunch at 3.

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

A: I clock in and out on the same iPad I use for my notes, via the KRONOS app.

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

A: I get my schedule hard copy already printed by the DOR, but I also can see it on the iPad. For most places they write in start times for the session, but leave no time in between. So as it is written, I see patient A for thirty minutes starting at 9, next patient B I have scheduled at 9:30. So that’s fun. I don’t stress when I’m late because teleportation has not been an invention yet.

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

A: I typically see 8-12 patients these days, since group is not an option with COVID, and most treats after PDPM are not 90 minutes long. Ha. Average treat times are anywhere from 25-45 minutes at this point.

Q: What is the productivity expectation at your job? How do you find meeting it?

A: The productivity prior to COVID was over 100% due to group usage. We cannot regularly check our own productivity, and I have never been talked to concerning productivity. A very candid OT once told me years ago, “ They haven't been giving out raises since 10 years ago, so what is my incentive to save them even more money?” That comment was made pre PDPM, but she has a point. I know within my heart I am not milking the clock, but I am not a robot, and neither are the nursing staff or patients, so I would have no problem justifying my productivity. Things happen.

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: I mainly see patients with SCI, CVA, general weakness, or subacute after a surgery. Standard treatments, I usually do some gait activity, transfer activity, and strengthening activity.

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: As a PRN, no meetings but when I was full time we used to have one with the entire rehab staff to touch base with clients and their progress thus far.

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

A: I am encouraged to perform point of service documentation, which I do for the most part depending on how much I can have the patient do while I am typing. With COVID I may do less POS documentation because of bringing an iPad into a room. I am expected to get my notes done by the end of my shift. My notes usually take me 5-10 mins to complete, depending/

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

A: I’m a PTA, but I find the wording and favorite goals depend on the therapist. I have had tests such as the Ashworth, 30 second chair rise, Berg, FRT, 2 minute walk test.

Q: What is a ball-park range of what a therapist 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: PTA in New Hampshire can expected 28-32 full time, PRN being higher

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

A: really.

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

A: I enjoy working with geriatric patients and I also appreciate the better initial pay SNF setting provides. My favorite patient was one that was very engaged in her rehabilitation and came to us having to use the hoyer to transfer out of bed, to walking with a walker with supervision. I was so proud of her!

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

A: Don’t expect any mentorship program, even if they say it. It is probably a canned questionnaire you and your “mentor” have to fill out every three months. This bummed me out as a new grad. The best mentoring I received is through cotreats with OT’s and SLP’s. I get to watch them and learn from them, which has always been helpful.

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: OMG. TBI SCI patient who I asked to roll their wheelchair to the omnicycle. They impulsively did a wheelie, fell back, and the omnicycle landed on them. Shockingly NO INJURIES and she did not hit her head, but I cried for weeks every day in the shower. I still feel great shame and humiliation over what happened. She had placed her antitippers upside down specifically so she could do tip the wheelchair back more on her own, but in this case she overshot. I literally asked her to move his w/c forward 5 inches. And this was the result. It was in my first month on the job and the staff at the time were so incredibly mean. Now I check everyone’s antitippers before we leave their room. It sounds so common sense but I was brand new. I felt awful and still feel nauseous thinking about it.

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

A: I’m PRN during COVID, which has been nice because I can choose where I go. This has been a great change from full time which was difficult.

Q: If you’re comfortable sharing, approximately how much money did your OT program cost (including tuition, fees, books, housing if applicable) Did you take out loans to help you pay for school? What was that process like?

A: When doing the math, PTA as opposed to PT made sense to me. I took out a student loan totalling about 18k. Taking out the loan was easy. Since COVID it has been furloughed and has not been accruing interest. I just got word payment schedule restarts in January 2021

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

A: Hopefully in home health PRN or part time.

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

A: I would like to see a union. They are a necessary evil. We got absolutely sold down the river in PDPM and the productivity requirements, no raises, poor retirement plans and insurance plans dictate it.

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

A: I don’t know if I would have done it. 3 years in and I’ve been laid off. It is not all that they say it is.

Q: What life motto do you live by?

A: Be consistent in kindness. I think burning bridges is not the way to go. I’m kind to all my coworkers because I feel that even the “bad” ones or the burnt out cynical ones have something I can learn.

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

A: No.


Hi everyone, it's Robyn here! I want to thank this therapist for sharing their story. My aim is to share "real" stories with both the highs and the lows. I fully empathize with this therapist as I have experienced that feeling of being "low" in the therapy world and questioning whether or not OT/therapy life was the right choice for me. I still question it, TBH. But I appreciate all of this person's insights and I wish them well on their journey. Wherever you are on your path, whether you're in school, a new grad, a veteran therapist, or even just thinking about applying to OT/PT/SLP programs, please give yourself grace and honor wherever you are along that journey. Follow your heart on what is right for YOU. What is best for you will be completely different for each and every one of us. Follow your bliss and keep moving - YOU. ARE. AMAZING! Have a great week

xoxoxo, Robyn

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