OT Across America: Austin, TX with Steve Broes, COTA/L

For our “OT Across America: Austin, TX” edition, we had the pleasure of interviewing Steve Broes, COTA/L, who is a really neat guy. His interview provides some really great insight about working in occupational therapy in Austin as well as the perks of working as a full-time PRN clinician.

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Tell us a bit about your background. What drew you to occupational therapy?

I think probably the oldest influence I had that drew me into occupational therapy was that my mom was a therapy tech in a SNF. She had always talked about OT, PT and Speech and what that was like and how much she loved her job, so I think that played an influence. But ultimately OT was the perfect job for me, just helping people get back to their life and heal and recover.

What setting are you in and what school did you attend?

I’m exclusively PRN, and I work in skilled nursing facilities and inpatient rehab hospitals. I’m also considering moving into home health a little bit. I’ve been practicing as a COTA for about two years and I love it! I attended Austin Community College.

What does your typical day look like?

What I like about being PRN is that I don’t have a typical day. There’s a lot of variety and to me, variety is the spice of life. It always depends, so sometimes I wake up and I’ll go over to a SNF or to inpatient rehab which is probably more of a typical day for me.

I try to work Monday-Friday PRN and will pick up the occasional weekend here and there, but I typically do 5 days a week.

I try and stay away from working 6 days a week because it gets to be too much. Quality of life, you know? And that’s why I like being PRN. I have probably 12 bosses but no one’s really the boss of me, like if I want to work I work, but if I don’t want to work, I tell them I’m not available.

What is your productivity like?

Each of my employers is different. Inpatient rehab, if I’ve had a productivity, I’m pretty sure I’ve probably never met it, haha. Skilled nursing is 85%, sometimes 90%.  I used to have an employer that was 95% but I no longer go there. So 85%, sometimes 90%, which for me is doable. I feel okay with that. I stay organized, that’s all.

How many patients do you see in a day?

I’d say if I’m at an inpatient rehab hospital, I’d see something like 6 patients in a day. If I’m at a skilled nursing facility, I’ll probably see 8 patients in a day, just because in inpatient facilities an hour is how long I’ll see a patient, but in the SNF I sometimes just need to see the patient for half an hour, so I’ll have a little more patients.

What are the most common diagnoses you see?

Some of the most common diagnoses are strokes, joint replacements, or somebody fell and has comorbidities and they got weak in the hospital so they need rehab and safety training before going home so they don’t fall again. Those are the most common ones we see.

What do you like most about your job?

What I love most about my job is the flexibility, I feel free like a contract worker. It’s really nice. Even though I’m striving to get Monday through Friday, the variety is what really does it for me. I don’t have to deal with the same problems every day. I get to deal with different problems. Some of them are low quality problems and some of them are high quality problems but they’re different problems. If I was just drilled with the same problems over and over again, I’d pull my hair out.

That and I absolutely love 99.999% of the people I’ve worked with. They’re all the coolest people in the world. I love them, I absolutely love and adore them. That’s my other favorite part about the job especially in the Austin area, everybody’s so cool. They’re all just regular people with really good hearts that want to help people get back to their lives.

All of my bosses are also really nice.

What are the biggest challenges in your work-life?

The biggest challenge for me, as a PRN, is that I never know anybody. Everybody is brand new and fresh with the exception of when I covered a maternity leave, that was really cool. I had that continuation of getting to know the patients and then at the end of her leave I went back to going all over.

So constantly having a new patient and having to learn somebody new all day every day can be difficult. And then also travel time can be difficult. I have about 12 facilities that I go to and sometimes my commute can be up to an hour each way so when I go out to those places with 2 hours of commute. I can often get cancelled but that’s the joy of multiple employers, I can always go somewhere else, it’s no big deal.

One other obstacle is that as a PRN COTA, my hours aren’t guaranteed, and I have to buy my own health insurance independently. But it ends up evening out with the increased pay rate.

What is the job market like for COTAs? Is it hard/easy to find jobs in your area?

The job market for COTAs for full time and even for part time positions is SLIM! It is rough. I don’t really see a lot of job openings for COTAs and when I do they fill quickly. A lot of times employers will just pull from their PRN pool or the postings don’t even get posted. They might just ask en employee who is already a COTA there who knows of someone looking for a job, so people might not even see the job posted.

I think that’s also a good part of being PRN is that I’m PRN with all of the companies I actually want to work for. If they do need a COTA, I think most of them have offered me a job at least twice at this point and I’ve respectfully declined from love, and so if anything does open I’m going to know about it and slip in.

But in general, it’s tough. There aren’t really any openings. You have to go outside of the city of Austin, like south or west or east.

The good thing about that is you’re going to get paid more outside of Austin, so my SNFs that have places outside of the city that I go to my pay rate is higher than people who only want to work in Austin. It makes a difference, even if it only looks like 5 or 10 dollars, it makes a huge difference at the end of the year.

Is there anything unique about OT and your region?

There’s so much variety here, I feel like I work with everybody under the sun. When I’m working in Austin, I’ll get old Austin people that are cool, creative hippies. Then I go outside of Austin and I work with a lot of old farmers and country folk. I love them all the same, you know I bond with them in different ways.

I grew up in a small mix of rural and suburban town in New Jersey (and my mom was a hippie) so I feel like everywhere I go I feel like I know them. All of my patients are usually nice, relaxed people whether they’re a nice old country-person or an old hippie.

Is OT appropriately represented in your setting? Do you feel like you really need to advocate for it or is it well known to other professions?

I feel like it’s pretty well-represented. A lot of people are so used to hearing “physical therapy” and they think they’ll just be doing exercises, so a lot of times they’ll lump OT within PT, which it’s not. But in terms of advocating for OT, everybody that works at the facility knows what OT is and they’re always trying to advocate for it. I feel like I don’t really have to do it.

But I do feel like patients don’t know what OT is, they just think therapy and exercises, but it’s like “No, no, no, you need to be able to get on and off the shower chair without falling and breaking something. That’s more important than you lifting 3 pound weights right now. Just so you know, OT is very important.”

How would you rate the compensation in your area?

I feel really great about my compensation here. I work making the PRN rate so I can relax. I feel comfortable.

What are your future plans for your career in occupational therapy?

I’m finishing a Bachelor’s degree online right now. I’ll be done really soon, so if I want to bridge across for my OTR, I feel like I can do that and that would be easy for me. So I’m considering that.

I’m also considering leaving OT and going into a different profession. Before I did OT, I was a speaker/seminar leader and life coach, and I was super successful with that. I started a very comfortable business on accident when I was 23 and it was amazing, I had so much fun. That’s when I felt most alive and lit up and like I was really expressing myself in the world in a really deep way. So that’s something that I’m probably going to bring back and do, regardless of whether I stay in OT or not.

But I want to get Neuro-IFRAH certified and I want to get my dementia specialist certification, and get into deeper CEUs. I work with so many strokes, so I feel like I could be better equipped and help them in a deeper way. I also work with so much dementia so I’d like to get more specialized training in that. And then I recently learned about ISTIM; it’s like a soft tissue mobilization technique that uses some tools to break up some soft tissue.

I’ve also considered doing some travel OT contracts. I’m already kind of doing it, traveling around the Austin area and I’ve got nothing hold me down here. I could just take a contract and take off. So if anything pops up in Hawaii, I’m gone, bye Austin! So maybe some travel is in the future for me.

But I love my city, love my coworkers, everything’s just set up so smooth here. I feel like I have the best of both worlds.

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We want to give Steve a HUGE thanks for sitting down with us and educating us about life as a COTA in Austin for our OT Across America: Austin interview. We loved getting to know his perspective in his super cool city (while also enjoying some amazing tacos!)

Do you work in as an OT or COTA in Austin? If you have any experiences to add, please share in the comments below!