October 29, 2019October 30, 2019 by Renee Leuschke, OTR/L

A Day in the Life of an Outpatient Neuro Occupational Therapist

We’re really excited to continue our Day in the Life series featuring Renee Leuschke, OTR/L. In this article, Renee shares what a day in the life is like working as an outpatient neuro occupational therapist as well as helpful information for anyone interested in working in outpatient neuro.

While I’m currently an outpatient neuro occupational therapist, I have not always worked in an outpatient setting. As a new grad, I was hired onto an orthopedic surgery floor of a hospital. I enjoyed this position, but longed to rotate to the inpatient rehab floor.

I spent several years calling inpatient rehab my home, loving every bit of the “family” rehab floors tend to have as they bring coworkers together. As new therapists shuffled in and I became one of the more experienced OTs, I was again floated to various acute floors and finally over to the outpatient clinic to cover a maternity leave.

It was there that I met my destiny. I always had a strong passion for stroke and brain injury rehab and outpatient therapy allowed me to focus solely on expanding my knowledge and ability to treat neurological diagnoses.

I have since relocated but continue to work as an outpatient neuro occupational therapist. Outpatient therapy allows me to see patients for one hour time periods and build a strong rapport with both them and their families.

Depending on clinical need, I primarily see patients one to three times a week. I provide each patient with my professional contact information and do receive questions and concerns fairly often. I want them to trust me and know that I am available to assist whatever needs they may have related to our treatment.

Outpatient therapy can be both challenging and rewarding. I see patients for much longer time periods than hospital OT’s—as short as two weeks to as long as six months! I may also see patients with chronic neurological conditions more than once as new functional needs arise.

Compared to physical therapists in outpatient, our numbers are few! This is all the more reason to show how great OT is and promote our importance, expertise, and need in the outpatient clinic setting.

How I Start My Day – 8:30 – 9:00 AM

I typically arrive to my clinic 20-30 minutes before my first patient arrives. At this time, I check email and print off my schedule for the day. I look at the chart of each patient and review my previous sessions with them to review goals and activities/exercises I have completed. I also complete more thorough chart reviews for patients who are new to me.

Generally I have a therapy trajectory in mind, and I write down a few quick treatment ideas for each patient on my schedule. During this time I also wrap up any extra documentation that I was not able to finish the previous day (new evaluations and progress notes).

And the Appointments Begin! 9:00 AM – 1:00 PM

This is where things can get confusing and flexibility is key! I may have a variety of patients scheduled. Some are coming for a regular treatment so I write a SOAP note; some patients are new to me and require a new evaluation; others require their monthly progress notes (re-evaluation).

I have seven appointment times open during the day and my schedule can vary greatly throughout the week. Some days I am completely booked, others I have openings at various times. The front desk also fields cancellation calls in the morning and I may have patients call in sick. I see four patients before my lunch break and write down quick treatment notes on my schedule to add to my formal documentation.

As a neuro OT, I cover a large territory. My domain includes upper body ROM and strengthening, fine and gross motor, functional cognition, attention, ADLs, IADLs, vision, and the list goes on. I break sessions up between working on exercise, activities, neuromuscular re-education, and self-care depending on the specific goals established.

The majority of my patients are seeking upper extremity improvements, but I do usually see one or two requiring more cognitive or visual work. I make sure not to overlap my treatment with speech therapy and formulate functional goals that are within the OT realm.

Lunchtime – 1:00 – 2:00 PM

I take advantage of my 30 minute lunch and don’t document while I eat. I usually chat with my fellow therapists or bring a book to read while I eat. I don’t always have lunch at the same time as the other OTs, so it’s a nice time to have some quiet time, regroup, and prepare for the afternoon. If it’s nice outside I may go enjoy the sunshine, but most often I eat at my desk.

I spend the 30 minutes after my lunch finishing up any documentation and completing my charges. I also use this time to finish chart reviews for afternoon patients and jot down any further treatment ideas. I make copies of cognitive worksheets or exercise programs to use in therapy or issue for home as needed.

Afternoon Wrap-Up – 2:00 – 5:30 PM

Following lunch, I see my remaining three patients. If I end up having an hour free due to a cancellation, I use that time to prepare home exercise programs in advance, make copies of general assessments and worksheets I often administer, dismantle charts for patients I have discharged, or look at my schedule for the next week.

I try to keep tabs on how far in advance my patients are scheduled so I can remind them to make more appointments. If they wait too late, it may be difficult to secure an appointment for a desirable time slot.

After my last patient, I wrap up any incomplete documentation from the afternoon and complete my charges. I double check my charges for the entire day to make sure I did not forget any and check my email one final time as well as my schedule for the following day.

And Then I’m Done!

But as with most healthcare providers, though I don’t take physical work home, I do continue to think about my day and patients during the evening. I make a mental note to try a new method or activity for a patient if something comes to me after hours.

I ponder difficult new evaluations (especially cognitive and visual!) and I think about my patients who have cancelled and hope they are feeling okay. Mentally and emotionally the job is never done! But I wouldn’t have it any other way.

I love learning about the interesting people who walk through our doors and hearing their life stories. I enjoy working for a thorough hour with them and feeling as though I can tackle many functional skills within my allotted time. I enjoy seeing them every week and rejoicing in their successes. It’s a blessing to be part of their journey.

Outpatient therapy is awesome and will challenge you to be the best therapist for your patients.

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We want to give a huge thanks to Renee Leuschke, OTR/L for sharing her experience as an outpatient neuro occupational therapist! If you’d like to share your typical day in the life as an OT, please reach out any time at Sarah@myotspot to share what your day is like!