OT

New-ish grad OT in the U.S. Formerly my journey through grad school, now my journey through life and employment

[soontobeot]

I am no longer an OT

And it is truly the best thing I've ever done. My new job is absolutely amazing and I could go on and on about how the opportunities this job and this career path have to offer far surpass anything I would ever get in the rehab world. In every single way and in every single aspect of my professional and personal life. I hate that I feel this way though. I hate that I spent thousands and thousands of dollars that I will have to continue to pay back for years to come on a career that was nothing like what it was made out to be as a student. I have been and will continue to be in therapy for a long time working on forgiving myself for that. I know SO many people who feel the same way and are early in their career and are feeling so burnt out. My mission is now encouraging others to take the same leap of faith I did and leave the clinical world. And to help employers see what valuable employees former therapists are. I have already started and am having success.

It took me over a year, over 100 applications, more rejection and tears than I have ever experienced and I was in such a terrible place mentally and hoped to either get out of OT or no longer be alive.

It is truly remarkable just how much having a job you like at a place of employment that values employees and work life balance and promoting from within, can change everything.

[soontobeot]

Everyone around me who didn't choose to go into healthcare is blowing past me in terms of career development, career satisfaction, being treated so well by employers. I feel like everyone around me is succeeding in that area of life and I worked just as hard as them and it hurts. I had nothing but the right intentions and its a slap in the face.

Everyone I work with feels the same way so I know I am not alone and I am in therapy weekly for trying to cope with the anger and sadness but it's getting harder and harder the longer I go unable to get out of this field.

[soontobeot]

I don't know how I will ever forgive myself for spending years and years getting straight As and working tirelessly to ensure a stable and enjoyable career and putting myself up to my eyeballs in debt for this. A career that used to be great but honestly just sucks now. Go to the Facebook page "alternative careers for rehabilitation professions" and read the pots about what everyone is experiencing particularly in any kind of long term care setting. From the time I was a little kid I was always at the top of the class and could've done anything with my life and I hate myself for choosing this. I don't have the option to go back to school because of the insane amount of money I already owe and getting out of this field even with the help of a successful well known career coach is proving to be so difficult. I can't put into words how broken, gutted, shattered I am by this. I am not okay.

[soontobeot]

There will never be words to adequately describe how I feel about the experience I've had in the OT field. Yesterday marked 3 years since my first day of work as an OT. I read through this blog and cried because I was so full of hope and excitement about the career ahead of me. I chose OT so carefully. I was lucky that I had the grades and test scores to pretty much do anything in grad school and I chose OT because of the many settings you can work in, good work life balance, fulfilling, patient care, decent pay. I told myself that no matter what else life threw at me, I would set myself up to have a great career and that was something no one could ever take from me, and that career would never get up and walk away from me.

If only I knew then what I know now.

In the last 3 years I have witnessed absolutely horrific and inhumane things as well as a disturbing amount of Medicare fraud in multiple nursing homes. And nothing done about it at all when you report clear abuse and neglect and refuse to play into the insurance fraud game and stand up for our clinical judgement and our profession. And the vast majority of people I talk to who have experience in nursing homes have eerily similar stories. I spoke to a professor about my experiences in nursing homes and she minimalized my experience and said that was absolutely not the norm. I don't believe her. I believe my coworkers and friends who have actually lived these experiences.

I don't work in a nursing home now, I work in acute care. I dont love it. I don't even really like it most days and I have a lot of coworkers at a large hospital system and so many of them few the same. I go around all day and have people refuse to get out of bed and be unkind to me when I go out of my way to try to be kind and helpful to them. I don't know what it is.

I've interviewed and applied to so many positions and been met with an attitude that is really offputting at a lot of them. Oh, you don't have the exact experience we are looking for and therefore you would require more training than we would prefer to provide.

I have been applying to other jobs in other fields. I have a plan and am actively working with a career coach to leave the field and the attitude in other fields is just so different and a welcome change. Like, ok you are smart and have some good skills that we are looking for and we can teach you the rest and you have a lot of potential.

I don't even know what the point of this post is. I can't put into words how all consuming and devastating it has been for me to not only have lost myself in a career that turned out to be the complete opposite of what I hoped, but to owe a large sum of money in loans for a career that is honestly nothing like what it was made out to be in school. This has negatively impacted every relationship in my life and caused me so much stress that I wasn't able to keep food inside of me or sleep for a period of time.

I don't know what to tell anyone who asks for wisdom or advice because I honestly don't have any. This experience has honestly been devastating for me and I am in therapy weekly to try to work through the trauma I experienced in the SNF setting and to work through the grief and loss of this career for me.

[soontobeot]

Today at work (in acute care)

I had a patient in his 90s, totally with it, retired physician and professor of medicine. He told me about how much the field has changed since he retired and it made me so sad.

Also today, had another patient who is in and out of the hospital a fair amount. He more or less said thanks but no thanks to home health OT because he's had it numerous times before and said they just give him some arm exercises and while he does the exercises they're doing paperwork on the computer.

[soontobeot]

This career has sucked the life out of me in ways I can't even begin to explain.

I've been working as an OT for 3 years now and I am not even close to being the same person. I feel like a shell of who I once was.

The number of people I've talked to both at my places of employment and from grad school who don't like this field at all is mind blowing/terrifying/disturbing/saddening.

[soontobeot]

It's officially been 3 months of trying to find a job with no luck. I applied to 11 jobs last week alone. When is my lucky break going to come 😔

[soontobeot]

I can't help but feel like skilled nursing ruined my career before it even started

What I am learning in my many rejections from various work opportunities is that they want people who have experience in the specific area that you will be working in. If you want to work in acute care, they are looking for people who specifically have prior experience in acute care. If you want to work at a therapeutic school, same thing they are really looking for someone who already has experience in that specific setting. The full time work experience I have as an OT is all skilled nursing because that's all I was able to get. I know I never want to do that again but it feels like I will never get past this hump. I feel like I have wasted the first 2.5 years of my career. I am such a type A person who has such a desire to advance and grow in my career and this has genuinely been so hard for me. I have gone above and beyond to try to get a job in any other setting that is not long term care and have yet to be successful. Next up is to just buy insurance on the exchange and hope I can get some PRN work in the settings I hope to work in. I should have done that from the start. If you have a goal to work in acute care, I don't think taking a job at a SNF is the way to go. I wish I knew that before. I just hope I can get a PRN position somewhere. I know I keep saying this, but never in a million years did I think any of this would be the experience I would get after finishing OT school.

[soontobeot]

Is the job market just terrible everywhere right now for therapists??? I feel like I've spent every single day for most of my career looking at job postings and applying to try to get out of skilled nursing. It's been 2.5 years and I have yet to be able to find a position that is full time that is not at a SNF. I don't live in a rural area at all either. I am in the process of moving to one of the largest cities in the U.S. I truly am excited to live in the same city as my boyfriend again and not 1,000 miles away, and very much looking forward to the network of friends that I will have there because that is not something I was able to find in my current city. I have been applying to full time jobs in my new city since May and I am now applying to anything that is not skilled nursing. I have had interviews with 6 places to far but they offered the positions to someone else. I have gotten a lot of straight rejections, and a lot of no responses out of at least 50 applications I've sent out so far. I have even searched the website for every pediatric place in that city I could find and emailed my resume to a handful of them too. It's just very frustrating. I'm actually moving in a couple weeks, and I'm going to have bills to pay and I need insurance and I am very stressed and getting tired of rejection. Even knowing someone and having them put a referral in for me didn't get me a job and that was the hardest rejection for me. I was beyond excited for all the opportunities that this big city has to offer but now I'm terrified I am not going to be able to find a job. I have basically been looking for a non SNF job for 2.5 years why is this so hard??? Like I have a 4.0 GPA and worked 2 OT related jobs in grad school, one in peds and one with adults to make sure I was a well rounded applicant for jobs and still all this time later I feel like all my hard work has gotten me nowhere. I even had a breakdown and applied to ortho related medical device sales jobs because I just don't know what to do and am so frustrated and defeated.

[soontobeot]

I am currently unemployed. I finished my time at the SNF and truly could not be happier to say that I will never set foot in a nursing home as an employee ever again. Not how I ever dreamed my career would be going, but here I am. My time to myself has been much needed though, I have a lot of healing I need to do and have been to my doctor and have been referred for therapy to help process and cope with what I had to experience while working in SNFs. I honestly feel like the doctor didn't believe me and thought I was exaggerating when I told her about the things I had to witness and just deal with on a daily basis. If only she knew.

[soontobeot]

I put in my 30 day notice at my job. No more nursing homes ever again. I just need to find another job and I am absolutely terrified that I will not be able to get a job in acute care which is what I want so badly. I had 3 interviews with the same place and really thought I had it and I got the rejection today. All of these places want people with acute care experience but how am I supposed to get any experience if no one wants to hire anyone who doesn't have experience?! I'm trying not to spiral into a pit of despair but that's what's happening.

[soontobeot]

I feel like my clinical decision making as an OT totally disregarded. When I put for someone to receive therapy 3 times per week due to low activity tolerance, I do not mean 6 days in a row for 60 minutes per day and then have several days off. But that doesn't matter. The facility only cares about receiving a certain amount of money from the patients insurance and they will only get that if they get a particular number of therapy minutes over a particular number of days. And if you are the only discipline seeing the patient they put even more pressure on you to do this. If I ask the manager about this and state that I was thinking that the patient would be 3 times per week as in M/W/F for the 30-40 min that I have recommended based on clinical judgement, I am told "that patient is in assessment so we need to do X". They are for profit. Money will always come first. The manager gets in trouble if she does not schedule them for this number of minutes. I am just so burnt out from all this crap. I am not a pawn in a scheme to suck as much money as you can out of a patients insurance. This is not why I spent thousands and thousands of dollars to go to OT school. I am not going to make a blanket statement and say that every single SNF is like this, but it is extremely common. And I want to raise awareness.

[soontobeot]

They laid off all of the "hospitality aides" at my facility several days ago. They were extremely helpful and did things like pass out meal trays/collect meal trays/set residents up to start eating by opening containers etc, they passed out ice and water, and snacks twice a day. There was one hospitality aide who was quite problematic. There was a noted uptick in smoking at the facility since she started and I was told by multiple other staff members that she was buying residents cigarettes and charging them commission. And she would get into a lot of verbal arguments with staff, just very problematic in general. But all of the others were awesome and the work they did was very helpful and allowed the CNAs to get more done in terms of patient care. And literally nobody even has water, I have gotten all my patients water because they can't even have that very basic need met anymore.

In a way, I want to document these kinds of things before I'm too far removed from skilled nursing to remember how horrific my particular experience in these facilities was. I want to be able to have particular situations to use as an example for others when I share my experience and warn them of what could happen if you work at one.

[soontobeot]

When it seems like things couldn't possibly get any worse at my current job, they do. I am struggling so much to get through the last of the time I have to be at this job and make it out in one piece. As someone who has never had sleep issues at age 27, I am taking melatonin every night so that I am able to sleep. I am having really significant GI issues to the point where I am getting concerned that it could be IBD due to the severity of the symptoms and the correlation with stress and my strong family history of autoimmune disorders. I can't afford to go to a doctor and have a million tests done though because I barely make enough money at this job to cover my rent and my insurance has a huge deductible because that's the plan this job offers. I'm still waiting on my license to come in for the state I'm moving to. I'm actively looking every day at jobs in the city I'm moving to, and it's a major city with tons of opportunities so I know something will come my way in the next couple months. I have the most wonderful boyfriend who has an equally wonderful family who are all in my corner and I am so lucky to have all of that waiting for me in my new city. It'll be around 2 months until I am able to get myself out of this job though. I know it's not THAT long. But when your job is as much of a horror show as mine every day and it really just needs to be shut down, it's HARD and I feel so alone and unsupported by my workplace.

Today was an especially hard day and the only thing I've done since I got home from work is cry. Everyone I know from school and who has moved on from working in SNFs has told me the same thing, that it's a different world and I'm going to love it and to hold onto hope that my experience is far from normal and better days are coming. On days like today that's the only thing keeping me going.

[soontobeot]

Let me tell you a little bit about my first day as an OT

And when I say first day, I really do mean fresh out of school and very first day as an employed adult with a graduate degree. The only job I could find was at a SNF, but I was still excited to get a real paycheck and to use the skills I learned in school as a full fledged OT and I had no plans for staying longer than a year.

So I arrive at work, and the very nice rehab manager who I had been corresponding with for about 2 months prior was nowhere to be found and she hadn't answered any of my messages. I was then informed that she was fired. I later found out that she was fired because she refused to falsify documents and commit fraud like the director of nursing demanded that she do.

So instead there was a corporate manager who showed up and couldn't have cared less that I had never used that particular documentation system before and just in general was a new grad and was told I would be receiving training. I was handed a laptop and told that I need to evaluate an admission who was Med A as soon as possible. So I went in there and figured it out and did the evaluation and then the manager told me that I absolutely cannot take that long to do an evaluation and that it it killing productivity. At this point I was ready to walk out. The only reason I stayed was the COTA who had been there for 10 years convinced me to stay and that this corporate woman would be gone soon and that she and the other assistants would stand up for me.

I'm still friends with the COTA 2 years later and I call her "work mom" even though I don't work there anymore, and I've celebrated thanksgiving with her and her family when I couldn't go home to see mine. So I am grateful for her, but working in that building didn't ever get much better and PDPM killed the job market so I literally had nowhere else to go for months even though I applied to every single job that was posted for about 8 months. I left without securing another job because it got so bad. My family was willing to cover my expenses until I found something else because they saw that place absolutely suck the life out of me and that I was near needing to be admitted to a medical facility for the stress I was under.

But yeah, if that doesn't say run the other way I don't know what does.

[soontobeot]

There are a number of accounts in instagram and groups on Facebook where therapists are discussing the really serious problems that are becoming more and more commonplace in nursing homes in particular. I encourage anyone who is interested, particularly students, to check them out. There's @acutecarerehab on instagram who has a post from 3 days ago about this, and there's @spill_the_ot who at times posts things in stories where followers can contribute to conversation about heavy topics such as burnout when you've only been a therapist for a few years and all the horror stories like mine start coming out about skilled nursing. I don't have an active Facebook account, I deactivated mine and it's been a really good decision for me but I have coworkers who are part of groups with people discussing all of these types of things on there.

Schools don't do enough to inform you of the very high likelihood of inappropriate and quite frankly, illegal and fraudulent practices that run rampant in nursing homes. I wish I knew before I got myself into this mess. I want you to know and be informed the best you can. I also have no problem answering any questions that anyone on here has about it. I was going to make a post about questions to ask when interviewing for a job geared towards SNF. I know the job market in a lot of places is really challenging right now, and I know there are bills that need to be paid and sometimes you just need a job and the only option available may be a SNF, but I want to help others be as informed as possible before going in if you must.

[soontobeot]

Myself and the other therapists were talking today about how it is literally our worst fear that someone we love will ever have no choice but to go into a nursing home.