day in the life of an occupational therapist

A Day In The Life of an Inpatient Rehab Occupational Therapist

I’m often asked by new grad 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 as an inpatient rehab OT. 

I first want to describe what inpatient rehab, also known as acute rehab, is for those who are less familiar with this OT setting. Briefly, inpatient rehab is an inpatient setting (usually in a hospital, sometimes in a standalone facility) that provides three hours a day of therapy for people who have experienced a new major injury or illness impacting their function and independence.

Occupational therapists work alongside physical therapists (and sometimes speech therapists) to help that person increase their independence with their necessary life skills. To learn more about inpatient rehab and OT, be sure to also check out our comprehensive article, Occupational Therapy’s Role in Inpatient Settings.

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’ Prior 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 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 my prior experience of running all over SNF’s and ALF’s looking for my 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.

Working Lunch

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:

  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.

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 occupational therapy 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 depending on what they need. 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 primary 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 my treatment 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

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 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 this setting (or any OT setting for that matter), 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 evaluation 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 movie theater popcorn πŸ™‚


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 I 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 truly making a difference in your patients’ lives every day.

Are you an acute rehab occupational therapist? 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 last updated on July 12, 2023.

You may also like


  • 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! πŸ™‚

  • 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. πŸ™‚

    • 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 →

    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! πŸ™‚
    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 πŸ™‚ 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!

  • Marissa Fast February 13, 2020   Reply →

    Just passed my NBCOT and am looking for jobs in the Rocky Mountains. I love school-based OT, and am most comfortable that, but I’ve also worked in an ALF as a medication administration professional for many years, and love that as well. There are not many jobs available in the mountains, but there are a few inpatient positions open. I’m considering applying but am super nervous about it! I did my Level II in a SNF, and it sounds pretty similar. It was a lot of ortho. I’m just nervous to be a new grad and I’m not sure that they have other OTs at the site.

    • Sarah Stromsdorfer, OTR/L February 16, 2020   Reply →

      It would be really unlikely that you wouldn’t have other OTs in an inpatient rehab setting, but you can certainly find out about the staffing and mentorship opportunities before you take the job. Since you’ve had a SNF fieldwork I think you’d be just fine! Inpatient rehab is such a great learning experience for new grads πŸ™‚ But definitely ask the managers about the other OTs/staffing so you can be sure you won’t be the only one.

  • Christine Oak April 15, 2020   Reply →

    Thank you so much for this article, it’s so nice to have a site like this to pull the curtain down and provide insider insight on practice settings for those who don’t have any prior experience but want to learn more. I would love to know more about how to get a job in Inpt rehab, definitely an area I really think OT shines because it’s so highly ADL and occupation-driven which is what OT is all about! I currently have been working for 8 months in a SNF in Southern California and am looking for opportunities to work in inpatient rehab but really struggling to get any leads. Any advice or tips for someone looking to break into inpt rehab with no previous experience in this setting?? Thanks so much!

    • Sarah Stromsdorfer, OTR/L April 15, 2020   Reply →

      Hi Christine, with your SNF experience you should have no trouble getting into an inpatient rehab position. The patients, diagnoses and treatments are actually very similar, with the main difference being the increased amount of therapy per day for the patients with a shorter length of stay. If you have any trouble getting a position now, once you have a full year of experience you should definitely get something, even if it’s a PRN position initially. Starting off as a PRN, as long as they’ll provide you with enough hours per week, is a great way to get your foot in the door and snag a full-time position once one opens up. Best of luck to you!

  • Erica K September 9, 2020   Reply →

    Thanks so much for this, Sarah! I’m currently in a FW II in IPR and I was wondering if you could give any more detail on the “self care” treatments you do in the afternoon with patients that didn’t receive any OT in the morning if not working on bathing/dressing. Evidence shows working on ADLs is best way to improve underlying deficits for performance, so I am struggling with how to do this for patients in the afternoon if they are already dressed/bathed!

    • Sarah Stromsdorfer, OTR/L September 12, 2020   Reply →

      You’re so welcome! Thankfully in inpatient rehab you have a lot of ADL options especially if you have a kitchen or “ADL apartment.” A few things I like to do in the afternoon if I want to focus on self-care are IADL interventions like meal/beverage prep (making a coffee is a hit any time!), kitchen management (like item retrieval at high/medium heights), laundry, or working on community re-entry by visiting the gift shop, as just a few examples. And while not as exciting, you can always work on bathroom transfers any time of day πŸ™‚ These ideas are all dependent on what the patient would like to work on, so when in doubt, ask them what they did at home and what they’re struggling with now. I hope this helps!

  • Stephanie Coxwell June 1, 2021   Reply →

    Hi Sarah, I love reading your blog and I have all of your treatment guides! I’m a 2nd year COTA in a rural facility that covers many areas under one roof…SNF, hospital (swing bed), and lots of neuro on vents/traches/dialysis. Lots of contracture tx, prevention, splinting & staff education. I’ve been there 8 months and I’m still trying to figure out how to manage 10-11 patients for 30-45 minute sessions and keep up with documentation. I would love see an example of some of the checklists you use. I’ve tried making my own, but I end up frustrated with formatting. I can’t really carry a notebook or clipboard, so I have to keep lists in my pockets. I really struggle keeping up with times since my day varies so much depending on who is available & willing to participate, and some are basically PROM. Any suggestions would be appreciated!!

    • Sarah Stromsdorfer, OTR/L June 5, 2021   Reply →

      That’s quite a busy day for you! If you wear scrubs, you could get a foldable clipboard to fit in your pocket along with your patient notes. I used this checklist (which may or may not be helpful for your setting) when I was in inpatient/acute rehab to keep track of my patients, but now that I’m in acute care I just keep my patient notes on one sheet for the day in my clipboard. If anyone else has other suggestions, please also feel free to share!

  • Melissa Sofia Poelman June 12, 2021   Reply →

    Hi Sarah, this post was great and I could relate well to the structure of my day as a level II fieldwork student in acute care! The big differences are that I obviously haven’t gotten to touch on IADLs, not too much on neuro re-education, and I chase down patients like crazy lol. I love the setting, but think I want to try for IPR as a job. Do you have any recommendations as to how I can make the jump? My other placement was in a school setting so I have no other background besides doing pretty well with anatomy and neuro in school. Thanks so much! πŸ™‚

    • Sarah Stromsdorfer, OTR/L June 14, 2021   Reply →

      Hi Melissa! You can definitely try for a job in inpatient rehab even if you haven’t had a FW in the setting, since most IPR’s have at least some basic on-the-job mentorship for the first few weeks. Just start applying to positions when you’re ready! Full-time positions are the best for learning, but you may have to start with a PRN position to get your foot in the door if it ends up being difficult getting full-time. Often, once you’re working PRN, you’re more likely to be offered full-time versus an outside applicant without experience. Even if you have to start PRN, you’ll still have several weeks of mentorship and training before you’re on your own. After your training, you will always have other OTs to learn from at the facility and most are very willing to share their knowledge with you. Good luck!

  • Mariah September 2, 2021   Reply →

    Hi I have a few questions for you but first I want to thank you for all this great information I have been reading all kinds of articles on here and I have learned so much already. However, I was curious if you could help me out on these few questions
    1. What are some diagnoses you see in the inpatient rehabilitation or the most common?
    2. What are the most common interventions you do with your clients?

  • Mariah September 2, 2021   Reply →

    Also how would you describe the difference between inpatient rehab and acute care in OT?

    • Sarah Stromsdorfer, OTR/L September 12, 2021   Reply →

      Hi Mariah, we actually just published an article all about Inpatient Rehab and Acute Care with diagnoses that should answer your questions here.

  • Elena_Student OTD December 4, 2022   Reply →

    Thank you so much for sharing! This was very insightful. I’m a current student filling out my fieldwork interests, and you are the first person to give me an insider’s look at the day and life of an OT for inpatient rehab. I’m very grateful.

    • Sarah Stromsdorfer, OTR/L December 5, 2022   Reply →

      I’m so glad it was helpful for you! Best of luck with the rest of your program πŸ™‚

Leave a comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.