A Day In The Life of an Inpatient Rehab Occupational Therapist
Frequently, I’m asked by new occupational therapists and OT students what a typical day is like working as an occupational therapist in the inpatient rehab setting. While there’s not a quick way to answer this question, I figured it will be helpful to at least lay out what happens in a “normal” day for me.
I first want to describe what inpatient rehab, also known as acute rehab, is for those who are less familiar with the setting. Briefly, inpatient rehab is an inpatient setting (usually in a hospital) that provides three hours a day of therapy for people who have experienced a major injury or illness impacting their function. Occupational therapists work alongside physical therapists (and sometimes speech therapists) to help that person increase their independence with their necessary life skills.
Going back to my day: This basic outline of my work day starts when I walk into the hospital and ends when I clock out for the day.
I can have a super smooth day where everything goes according to schedule, or the day can go in a more hectic 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
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 day 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 any recent falls or incidents.
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 them for an evaluation.
I Start Treating at 7:30
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-education if I have a patient with a new neurological impairment impacting their function.
Treatments are Back to Back
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. Treatments can also be 90 minute sessions, but this is rare since they’re usually broken up into separate sessions.
These back to back sessions makes the morning fly by, which I absolutely love. I’m always being challenged and working to get my creative OT juices flowing for each patient since I work with varied patients on different teams throughout the week.
Lunch “Break” Time!
At most inpatient rehab facilities I’ve worked at, 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 eating something fairly quickly as well as taking a quick breather chatting with my coworkers before I get to the paperwork.
From 12:25ish-1:00 I buckle down and crack open my notes from my morning sessions.
There are four different types of notes I might work on:
- Daily notes
- Weekly notes
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.
Before I know it, it’s already 1:00 and time to wrap up the paperwork.
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.
For my afternoon treatments, I might 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 higher level I-ADL activities like kitchen or laundry tasks to work on dynamic balance, functional reaching, standing tolerance, and gross motor and/or fine motor coordination. I’m very 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 retraining if they did not have any 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 and interesting for the patient.
Wrapping Up After Treatments (AKA the Paperwork Fun!)
From 2:30 to about 3:30, I sit down to work on notes, sometimes with the help of some extra 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 Evaluation Paperwork for the End of the Day
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 took me some time when I was a new grad, but I’ve found that I’ve now become much more efficient and faster at completing notes. It can be a real challenge when you’re new to the setting, but it becomes much easier with practice.
It really helps me to create lists to check off what notes and documentation 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 and maybe even some Trader Joe’s popcorn 🙂
So that’s my “average” day in the life as an inpatient rehab occupational therapist!
Acute inpatient rehab is a fast, challenging, and physically demanding setting. Even with the challenges, I absolutely love working in this setting and wholeheartedly recommend it to any new grad interested in working with adults.
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.
Are you an acute rehab OT? If so, does your day differ from this or does it sound pretty similar? I’d love to hear about it in the comments!
This post was originally published on August 14, 2016 and updated on May 18, 2021.