Are you a new occupational therapy grad or current OT student wondering which adult setting will be the best fit once you graduate?
There are many settings for you to choose from, and it can be tempting to jump into the first place that calls you back for an interview.
But trust me, this is not the best strategy. While there are options galore for new occupational therapists, certain settings may not provide you the same growth and experience as others.
If you’re interested in working with adults, I’m here to tell you why you should consider acute inpatient rehab for your first job.
After working in a variety of adult and geriatric settings, I firmly believe that if you want the most experience and growth as a beginning Occupational Therapist, acute inpatient rehab is the way to go.
Here are 8 reasons to consider inpatient rehab as a new grad.
1. You’ll Treat a Solid Variety of Diagnoses
In acute inpatient rehab, you will see and treat more conditions than you thought existed.
And it’s awesome.
Not only will you get orthopedic patients, but you will also see plenty of neurological diagnoses and a slew of other cases that will guarantee invaluable learning experiences.
When I was a new grad, I started in the geriatric outpatient setting for my first six months and saw the same few diagnoses over and over. It was still rewarding, but I didn’t feel like I was challenging myself. Once I started my job in inpatient rehab, I really felt like the brand-new grad that I was.
I spent another six months constantly reading up on interventions like I was back in fieldwork, but it was of course totally worth it now that I feel like I “get it.”
2. Reasonable Productivity Standards
Of the multiple inpatient rehab settings I’ve worked in either fieldwork or professionally, productivity standards have always been 75%. Compared to the SNF’s and ALF’s productivity standards of 85-90% for OTR’s, this is a big difference.
When you’re a new grad, you will need quite a bit of extra time to get acclimated to documentation, protocols, intervention planning, chart reviews, and the list goes on.
When you’re faced with the high productivity demands of geriatric settings, this can be extremely overwhelming and it’s almost impossible not to have to work off the clock.
3. Great Team Environment
Another downside of some settings like home health and certain geriatric facilities is that you might be the only occupational therapist working in that facility.
This was the case for me quite a bit of the time as a floating OT. Granted, I did have physical therapists to work with at times, but about 60-70% of the time I was on my own.
It’s really tough to learn the ropes when you’re on your own. This is a huge reason why inpatient rehab is GREAT.
You’ll always be surrounded by other OTs, PTs, and SLPs. If I ever have a question now, there’s always someone with more experience to give me tips and advice for anything I’m puzzled or curious about.
4. Consistent Schedule
This one was huge for me. In geriatric settings, you might go into work, be scheduled for five patients, and get refusals for half of them.
With your productivity standards, you might only be able to charge the company for two hours. (I can’t tell you how many times this has happened to me.)
Thank goodness for the wonderful 7:00 AM-3:30 PM schedule of inpatient rehab, where I know I’m almost always going to get paid for a full day.
Sure, some days I may only have a half day since I’m PRN, but at least I know it’s going to be worth my time to go.
If you get hired on for a full time position in an inpatient rehab hospital or unit, you can be sure you’ll get full days five days a week. If you get a full time position in home health or geriatric outpatient, it can be much less consistent than that due to fluctuating caseloads.
5. Seeing Patients’ Progress
This one is huge for me, since it’s what drove me to become an OT in the first place.
I loved working with my inpatient rehab patients as a patient care tech and seeing how well they were doing with therapy. In acute care or geriatric outpatient, I’ve found that you either see a patient only a few times and then discharge or the progress can be very slow.
Along with seeing your patients progress quickly, you also really get to know them, since you’re working with them every day for at least an hour over a two week (or more) average length of stay.
6. The Day Always Flies By
In inpatient rehab, your patients are scheduled back to back. It can seem pretty crazy at first, but I do really love how fast the day goes. (For a rundown about my day in particular goes, check out my blog post on my average day as an inpatient rehab OT).
You won’t be driving around for hours from home to home (which is usually unpaid time) like you would do in home health. For more home health as a new grad, check out why I say to steer away from it as a new OT.
You also have so much to work on with patients that are in this setting that you won’t be lost coming up with treatment ideas.
7. Fewer Ethical Dilemmas
In general, non-profit hospital systems are going to present you with less “situations” that may have you concerned about practicing unethically in comparison to many for-profit Skilled Nursing Facility therapy providers. To be clear, it’s usually not the actual SNF’s that have issues, but rather the agencies they contract with.
You might notice seeing articles like this one from APTA citing “Top SNF Therapy Provider Settles DOJ Lawsuit for $125 Million” on a fairly regular basis. This is scary when the license you worked so hard for is on the line.
This is of course not to say that there aren’t any good SNF companies out there, because there are! It’s just become hard to find these companies as many focus increasingly on profits and productivity.
When you’re a new graduate, it can be much harder to say no to doing things that you feel may cross the ethical boundaries. For example, treating patients that are inappropriate for therapy.
This is also not to say that some hospital settings may have some issues as well. As a whole, though, I have felt that hospitals are much less “corrupt-feeling.”
8. The Job Itself is Extremely Rewarding
This might tie in a little bit with the “seeing patients” progress” part. However, I have to say that even with how tired I can sometimes be, I love feeling like I made a difference every day.
I can’t imagine working in another setting at this point and am really glad I got into it when I first started out. Your patients and their families will be so appreciative of you, which is a wonderful feeling.
It might take some time applying to multiple inpatient rehab facilities before you get a “bite,” but keep at it. It will definitely be worth it.
These are the reasons why I personally recommend acute inpatient rehab for new Occupational Therapists.
Do you agree? Disagree? I’d love to hear in the comments what your recommendations are for new OTs seeking to work with the adult population.