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A Day in the Life of an Outpatient Occupational Therapist

Adult Neurological Rehabilitation

What are the main ‘takeaways’ of an outpatient neurological occupational therapy setting and for what should you be prepared if you are considering becoming an outpatient occupational therapist?

  1. Outpatient occupational therapy is the hardest, most time-consuming setting in the occupational therapy profession because of the broad case mix, length of POC, and demands of bringing someone to maximum potential.
  2. Outpatient OT is not a 9-5! You will and should go home at the end of the night and read research, study, and treatment plan! Your patients are trusting you to restore their function! This is important.
  3. Outpatient occupational therapy is never boring. The case mix is highly variable and the outpatient therapist is able to use their entire scope of practice
  4. The OT is able to see patients for 45 minutes to 1 hour of undivided time for 6 weeks to 10-12+ months! If your patient has a progressive neurological condition, you will remain their overseeing therapist throughout the condition.
  5. The outpatient OT is able to build rapport, a relationship with their patient and their loved ones, and is able to help them through challenges that arise throughout their lifespan.
  6. To be prepared for this setting, you should have an arsenal of assessments and research databases at your disposal. Look into memberships and subscriptions for research databases like JSTOR. (My subscription is through my alma mater).
  7. From day one, begin building a book of protocols, treatment rationales, and anecdotal cases studies – this will make your life easier in the future!!
  8. Outpatient occupational therapy is not popular and many outpatient clinics only employ 1-2 OTs for ever 10-15 PTs due to ignorance on our scope of practice. We are going to turn this around!
  9. If you are overwhelmed by these truths, consider a mentor/tutor prior to transitioning to outpatient occupational therapy.

I want to provide a realistic depiction of what an outpatient occupational therapy practitioner faces throughout the day. While it is true that my circumstances are slightly different because I am the owner of these practices, the information you take from this article will be generalized. This is a typical day for an occupational therapist working in outpatient occupational therapy – it is the same type of day experienced by the other occupational therapists / occupational therapy assistants working in the outpatient setting.

I work in the full scope of practice of occupational therapy. My caseload requires me to understand both orthopedic conditions and neurological-based ailments. In one day, I could see someone with executive function deficits like Alzheimer’s Disease, carpal tunnel, a knee replacement, sciatica, Parkinson’s Disease, and cerebral vascular accident. Other days could look exactly the same or completely different. This requires a lot of preparation. Even after practicing for many years and holding employment in the medical rehab unit, skilled nursing facilities, director of rehab, and consultation for teletherapy services — I still require research and studying an additional 10-12 hour weekly in unpaid research and continuing education. Why? Because medical evolutions are always happening and I need to ensure that each patient is getting the most appropriate and research-supported treatments. 

 

 8:30am – 9:00am 

I arrive 30 minutes or more before my first patient of the day. Although I have treatment planned the Sunday prior to the week, there are last minute changes and evaluations that may have been scheduled and I want to ensure I remain ahead of my day and in as much control as one can be in outpatient occupational therapy. 

If there are no ‘surprises’, I will use this time to create home exercise programs for my patients or complete documentation that was not completed prior to that morning. I believe no matter what place setting I find myself, I always find myself ‘catching up’ on documentation! 

Although I love my work in occupational therapy, I am also an introvert! ‘New’ experiences fill me with anticipation and anxiety. Oftentimes, no matter how many years I work, I am filled with the same feelings before I start my day (especially if there is a new evaluation). I use this time to pray and ‘center’ my feelings for the day ahead. Compartmentalization is key to adapt, pivot, stay flexible, and still remain in control for those who are depending on me!

 

9:00am – 4:00pm 

In our clinics, we do not have ‘official’ lunch hours. In outpatient occupational therapy, people cancel all of the time. Schedules are the opposite of ‘set in stone’. Therefore, it is up to the therapist to determine when the 30 minute lunch break will be. Otherwise, our patients are scheduled at the beginning of the week and we are able to prepare accordingly. Each practitioner will see up to 7 patients for 45 minutes to 60 minutes depending on clinical needs. I may see some patients once weekly and others I will see 3 times weekly – it all depends! Even still, there are times when I expect to be treating 7 patients and 4 people cancel! This is not uncommon! 

As I stated, outpatient occupational therapy requires use of the entire scope of practice. Because of this, I have spent years training, researching, and developing my competence in the various lanes of occupational therapy. I utilize the following approaches and practices throughout each day: Behavioral health management, neurocognitive remedial principles for the treatment of executive dysfunction, visual perceptual dysfunction, physical restorative medicine working on motor return, gait assessments and functional ambulation, decreased chronic pain in upper body, back, and lower body, improving range of motion, using modalities, wheelchair assessments, and the list continues. 

Because my facility does not support point-of-service documentation, I take notes on my Ipad using GoodNotes (This APP is a HUGE lifesaver for all of the practitioners at Buffalo Occupational Therapy). Because we are holistic and work with progressive neurological conditions 85% of the time, it is important for us to be undivided in our attention so we can observe and analyze little changes from week to week or session to session. 

Common Pathologies: Carpal Tunnel, Cubital Tunnel, CVA, MS, PD, Myositis, Chronic Pain – Sciatica, Arthritis (RA), Alzheimer’s or other related dementias, gait dysfunction, fine motor deficits from a variety of conditions

Half Hour Lunch [ Unspecified]

We are required to take a 30-minute break for lunch, though I will be honest – I always work through lunch on my own accord. Either completing documentation or working on a project. On days when the weather is nice, I will try to get out of the clinic and get some fresh air. I will get the mail for the clinic or have a social conversation with whomever is available. Otherwise, I keep to myself and try to be as productive as possible throughout the day. 

4pm – 5:30+pm

At the end of the day or during a break in the day, I am able to transfer my information to the electronic medical records program. We use WebPT. I always go to our quick treatment note database for inspiration as we have already done the work to include all of the research-supported rationale! If you are a member of the BOT PORTAL – you can access our database through the Documentation Database.

As the administrator, I will review notes and co-sign documents for billing purposes, plan for the week, set-up the patient records for new patients that were scheduled, and work on BOT Portal content!