day in the life of an occupational therapist

A Day In The Life of an Inpatient Rehab Occupational Therapist

Pretty frequently I’m asked by new occupational therapists and students what a typical day is like working as an occupational therapist in the inpatient rehab setting. While there’s not one simple way to answer this question, I think it will be valuable to at least lay out what happens in a “normal” day for me.

This basic outline of my work day starts when I walk into the hospital and ends when I clock out for the day.

In the inpatient rehab setting, I can have a super smooth day where everything goes according to schedule, or the day can go in a much crazier direction. The latter happens much less often, though, thankfully.

My Morning Routine

I clock in at my unit at 7:00 AM. After clocking in, I check my schedule for the day and write it down.

Review Patients’ Notes

occupational therapy day in the life

Even if I know the patients, I look up their chart and review the therapy notes from the past few days. Since I’m part time, I may not see the same patients each shift like a full time therapist does.

I also check the nursing report from the day and night shift before to see if they have any new orders, critical lab values, or recent falls (I hope not!).

Thoroughly reviewing new patient/evaluation notes is crucial, so I try to give myself an extra five minutes just for that patient if I have an eval.

Start Treating at 7:30 on the Dot

If I have a new patient evaluation, it will almost always be the first or second session scheduled. The session is almost always an hour to assess their overall function while incorporating an ADL treatment.

If I’m not completing an eval, I almost always have ADL retraining sessions with existing patients the first several hours of the morning. I try to include as much as I can with bathing, dressing, and toileting while educating and incorporating neuro re-ed if I have a neuro patient.

Back to Back Treatments

The morning is back to back scheduled treatments until 12:00 pm.

It can (and does) feel like a complete whirlwind.

I see patients for usually one hour at a time with some half hour sessions sprinkled in. They’re always scheduled back to back without any time for breaks until lunch.

While that may seem crazy and hectic, I very much prefer this set-up as opposed to running all over SNF’s and ALF’s looking for patients and crossing my fingers that they’re available and agreeable to do therapy.

With inpatient rehab, the patient knows they’re there for rehab and they’re ready and willing to work with you (most of the time!)

Depending on how long my sessions are, I’ll have 4-7 treatment sessions. It depends on whether the scheduled sessions are 1 hour or 30 minute sessions.

This makes the morning fly by, which I absolutely love. I’m always being challenged and working to get my creative juices flowing for each patient since I work with varied patients on different teams throughout the week.

Lunch “Break” Time!

At every inpatient rehab facility I’ve worked, 12:00-1:00 is the time that therapy stops so patients and therapists can eat lunch.

This one hour time slot gives me time to eat and work on documentation. If I don’t get a head start on documenting, it can cut into my evening after work.

I usually spend about 25 of those minutes scarfing something down and taking a quick breather chatting with my coworkers before I get to the paperwork.

Working Lunch

From 12:25ish-1:00 I buckle down with a “natural” energy drink that I shouldn’t be drinking and crack open my notes from my morning session.

There are four different types of notes I might work on:

  1. Daily notes
  2. Weekly notes
  3. Discharges
  4. Evaluations

If I don’t have any weekly notes, discharges, or evaluations, I aim to get three daily notes done from the morning sessions to help make my afternoon a little lighter.

I sometimes have to wrack my brain to remember all of the different sessions and documentation needed for each patient’s treatment.

Before I know it, it’s 1:00 and time to wrap up the paperwork.

occupational therapy day in the life

Back to Work for the Afternoon

The afternoons are definitely my favorite since I start treatments right at 1:00 and finish at 2:30. I only have 1.5 hours of treatments in the afternoon. I usually have one 30 minute treatment and one 60 minute treatment.

The afternoons also fly by, but I am usually pretty fatigued right after lunch, even with my caffeine problem.

For my afternoon treatments, I’ll do similar self-care treatments as the morning if the patient hasn’t gotten any OT yet. The only difference is that I usually leave out the bathing and dressing since my patients are up and dressed by this time.

I really like doing I-ADL activities like kitchen or laundry tasks to work on dynamic balance, reaching, standing tolerance, and gross/fine motor coordination. I’m super fortunate that we have a full kitchen equipped with a stove, sink, refrigerator, dishwasher and dishes, and as well a laundry room with a working washer and dryer so our patients can practice all of this before going home.

I also find myself doing a lot of tub/shower and toilet transfers in the afternoon in our training bathroom. The reason is because it’s hard to get to these ADLs when you have dressing and bathing in the patient rooms in the morning.

Other Afternoon Treatments

If I’m working with a patient that is extremely limited by weakness, I might run their treatment a little bit differently. I might skip the I-ADLs and focus on beneficial therapeutic exercise or neuro re-education. I’ll try to get at least one unit of self-care if they did not have OT in the morning, though.

My facility also does a lot of family education sessions in the afternoon, in which I’ll educate primary caregivers on post-discharge recommendations and work on hands-on training with the patient and their caregivers.

Community re-entry going to the gift shop, public restrooms, or outside is also one of my favorite afternoon activities if it’s therapeutic for the patient.

Wrapping Up After Treatments (AKA Paperwork Fun!)

From 2:30 to about 3:30, I sit down to work on notes, sometimes with the help of a little more caffeine if I had an especially physical day.

If all I have are daily notes without any discharges or evaluations, then it’s the easiest part of the day. But as we all know, we don’t always get easy days. More often than not I have an evaluation (or two), weekly progress notes, and/or discharge summaries to complete.

Saving Evaluations for the End of the Day

occupational therapy day in the life

Evaluations definitely take the most time as far as paperwork goes.

If I have an evaluation to document, I try to reserve the majority of it for this time of day after all of my treatments are complete. I don’t like getting started at lunch just to have to quit 15 minutes later to start treating.

It’s taken time but I’ve found that I’ve become much more efficient and faster at competing notes. It can be a real battle at first, but becomes much easier with practice.

It really helps me to create lists to check off what components I need to complete.

After the eval paperwork is done, I’ll get to my daily, weekly, or discharge notes. Being part time makes the weekly and discharges a little tougher since I don’t know the patients as well as their full-time therapist.

In these cases, I spend extra time reading through all of the patients’ notes and talking with their physical therapist and speech therapist. It ends up taking me longer to complete discharges than a normal full-time OT, but I’m okay with it since I want their records to be thorough and accurate.

Last But Certainly Not Least: The Billing Sheet

Once I’m finished with all of my necessary paperwork, I fill out a billing sheet with each patient’s individual treatment times with the units billed for the treatment.

After I fill that out, I clock out and head home to unwind with some Netflix :).

_______________

So that’s my “average” day in a nutshell!

Acute inpatient rehab is a fast, challenging, and physically demanding setting. And I wouldn’t have it any other way.

While I may be biased, I absolutely love working in this setting and wholeheartedly recommend it to any new grad.

It’s a fantastic learning experience to see any and every condition, learn from other great therapists, and feel like you’re making a difference in your patients’ lives every day.

Does your day differ from this or does it sound pretty similar? I’d love to hear about it in the comments!

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19 comments

  • Sarah January 6, 2017   Reply →

    This was such a great post! I am about to start a level II fieldwork rotation in inpatient rehab and this was a great refresher of what my daily schedule may be similar to. Do you have any recommendations for a new student when it comes to organizing out your day with patients? Remembering what happened with who, etc.?

    • Sarah Stromsdorfer, OTR/L January 6, 2017   Reply →

      Thanks, Sarah! My biggest recommendation is to bring a clipboard and a medium-sized notebook to write notes on each treatment. It’s a lot of extra work to do this but I found that as a student and new grad in inpatient rehab I couldn’t remember really anything I did in treatments! It does get much easier to remember as time goes on though.

  • Crystal January 30, 2017   Reply →

    I work in inpatient rehab and my days are similar (but I don’t have as much documentation time). My first patient is at 7am. I only get 30 min for lunch. In the afternoons, I’m treating from 12:30-3pm. I LOVE inpatient rehab and would highly recommend it to any OT! 🙂

  • Jim Cummings July 23, 2017   Reply →

    Thank you for this. I am in my first MOT semester and I am working on presentation on acute rehab. I am glad to see a narrative like this.

    • Sarah Stromsdorfer, OTR/L July 23, 2017   Reply →

      Thanks, Jim! I’m glad it was helpful for you.

  • Jenny October 7, 2017   Reply →

    Thanks for your great website! I also work in inpatient rehab and am struggling to get my documentation done on time. I’m curious– do you find yourself working unpaid overtime to finish your notes? Or do you really just clock out when you’re done for the day, even if iteans some overtime? Increases productivity demands and burn-out are serious concerns of mine for our proefession (and myself!) as we keep needing to do more within the same number of hours!

  • Faith James, OTS November 5, 2017   Reply →

    Such a great description and overview, thank you, Sarah!

    I’m in my second year of OT school in a combined bachelors and masters program, so having this insight into a typical day for a inpatient rehab setting is super helpful!

  • Ollie December 29, 2017   Reply →

    I am going to be starting an Occupational Therapy Masters course in September, and i have to say that sounds exhausting. Is this the busiest setting in Occupational Therapy and are there other setting in which I will be able to focus more on the patients without such a whirlwind of a rush mainly focusing on efficiency?

    • Sarah Stromsdorfer, OTR/L January 2, 2018   Reply →

      I won’t lie, adult inpatient rehab is a very busy setting, as is most other adult-based settings, including subacute rehab, acute care, and outpatient therapy. You may find that working in a private pediatric clinic is a bit less busy if you can schedule your own caseload (although I can’t say for sure since I haven’t personally worked in a pediatric setting). If you’re set on working with adults, getting a PRN position and working 3-4 days a week (versus 5) is a lot more manageable.

  • Andrea January 7, 2018   Reply →

    Thank you so much for this detailed post! I start my first level 2 fieldwork in acute inpatient rehab tomorrow (!!!) and coming back to this blog has eased my nerves a bit. It sounds like my kind of fast-paced setting and I am looking forward to the experience. 🙂

    • Sarah Stromsdorfer, OTR/L January 7, 2018   Reply →

      You’re so welcome! Best of luck to you on your inpatient rehab rotation! It will be such a tremendous learning experience with the different diagnoses and interventions you can utilize. Enjoy the journey and have fun!

  • Beth July 9, 2018   Reply →

    Sarah-
    Thank you so much for this post!
    I am a new OT graduate and still am unsure of which setting and/or population to work with-they all seem great! 🙂
    What are the specific reasons you would recommend inpatient rehab for a new grad?
    Would you recommend this setting for a new grad over other settings (outpatient, subacute, acute)?
    Do you believe this setting would be good for a first OT job?
    I appreciate any and all feedback! Thank you!

    • Sarah Stromsdorfer, OTR/L July 10, 2018   Reply →

      Hi Beth, I’m so glad the post was helpful for you! I personally think inpatient rehab is a great first setting for new grads. You’ll learn SO much about true occupation-based interventions while also seeing a variety of diagnoses. I actually wrote a blog post all about this, covering all of the reasons why new grads should consider inpatient rehab for their first job. You can check it out here: 8 Reasons Why New OT Grads Should Consider Inpatient Rehab Hope this helps!

  • Kandrews February 28, 2019   Reply →

    Thank you for this post! I start my second level II rotation next week after being in a school system for my first rotation! (which is waaaaay different from inpatient rehab!!) Thank you for the refersher and easing my stress!! So thankful for the amazing OT’s and COTA’s out there taking in students and changing lives!

    • Sarah Stromsdorfer, OTR/L February 28, 2019   Reply →

      I’m so glad it was helpful for you! Your inpatient rehab FW rotation will be such a great learning experience to add to your school system FW and will really help round-out your education 🙂 Best of luck to you!!

  • Lisa March 4, 2019   Reply →

    Hi Sarah! Thank you so much for this post, it was so helpful! I am starting my level 2 fieldwork in an inpatient rehab setting soon and was wondering if you had any tips or books you’d recommend for me to get that I could use as a reference while on fieldwork?

    • Sarah Stromsdorfer, OTR/L March 5, 2019   Reply →

      Hi Lisa, congrats on starting your Level II fieldwork soon! I recommend the Occupational Therapy Toolkit if you don’t already have it, and definitely join the Occupational Therapy Treatment Ideas Facebook group for intervention ideas since there is so much information in there as well. Pinterest was also really helpful for me when I was treatment planning for the following day. I hope this helps and best of luck!

  • Jackie July 21, 2019   Reply →

    Hi Sara,
    Thank you so much for this insightful and informational post! I am a recent new grad OT and have accepted my first job in an IP rehab setting. I have absolutely no experience in IP rehab, my level IIs were in a SNF and peds OP. What advice or tips would you recommend to be successful in this setting despite having no experience? It is definitely a mixture of nervousness and excitement. Thank you!

    • Sarah Stromsdorfer, OTR/L July 21, 2019   Reply →

      Hi Jackie, that’s so great that you’re starting your first job in inpatient rehab! It’s such a great setting to grow your skillset for so many other settings down the line. Your level II FW in the SNF will definitely be helpful for when you start (it can be a lot of similar diagnoses and treatments). Just do a bit of research on FIMs beforehand (there is a lot of info on Google) and you should be fine! The great thing about inpatient rehab is that you’ll have other therapists to learn from when you start, so don’t feel like you have to know everything right away. Good luck!

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