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
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.
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:
- 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.
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.
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
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!