Adventures of starting as an Occupational therapist in a large rehab company

If you have followed along with my blog since I started it in 2020, you might already know that I am an occupational therapist who graduated in November 2019 (my first blog post ever talks a bit about me).

My first clinical OT job was with a tiny private pediatric occupational therapy practice. The company was started by a woman who also graduated from my university a few years earlier than me. She had worked in the school system and realized that she wanted to do things her own way so she started a new practice. Our occupational therapy values and beliefs aligned, so when she was finally looking to expand her one woman show to have another therapist onboard, I joined the team. As we were a small practice, there we’re many outlines for documentation or how to assess and plan sessions with kids, so I had a lot of freedom. I was able to approach communication with my clients and their families however I thought was appropriate (within company guidelines of course), modify how we documented, and create all my own programming for my sessions. It was my IDEAL job.

But then the pandemic got serious, and our professional college had a pause on all non essential visits to protect therapists and their clients from COVID. As a company, we decided after the first few weeks, to pivot to virtual sessions with clients. This was a hard sell for a lot of families, as a lot of children have trouble with virtual sessions, and sometimes this seemed more work for parents. As the pandemic continued, I slowly got a few virtual clients here and there, and I enjoyed creating creative programming around my clients’ interests to capture their attention. There is no feeling better than creating activities for a session that are attention keeping enough that you shock parents with how attentive their children are.

As magical as I was finding these sessions with clients, unfortunately where I live is quite expensive for rent and the amount of clients we were getting wasn’t giving me a livable wage (and of course, as much as I hate to admit it… sometimes money rules all). So I had to slowly start looking for something to add to my week to bring in some more OT clients. Applying the traditional way to jobs is NOT my forte. I get really discouraged and depressed applying and not hearing back from places, as I am sure many people do. I got frustrated over the months, not believing I was “good enough” or experienced enough to do anything more than what I was doing now (which yes, I know is not true but anxiety is a tough debater). I also recognize that I experience a lot of imposter syndrome, which I have been working on with my therapist, and have written a blog post about (you can click to it here).

After tons and tons of applications and updating my resume and cover letter a million times, I got a phone call from a company saying they found my resume on a hiring website and wanted to offer me a job interview. People who know me closely know that I am not good at making decisions and have a very large fear of disappointing people. Which means that taking a job interview when I’m not sure if I would want the job is something I struggle with because I don’t want to be put in the position of having to decline a job offer (weird I know). So after researching and talking to people I knew who had worked in the company, I said yes to the interview and got the job shortly after.

It has been a month since starting the training process for this job, and a couple weeks of me navigating client referrals, so I thought I would write a bit about my experience so far in case any OTs-to-be, or OTs looking to change jobs end up on my blog. So far, the journey has been overwhelming but a great learning experience. We had much more orientation than I expected, and even after all of that there is still so much more to learn. I am working as a community OT (yup, in person visits to people’s homes, as well as virtual if possible). My clients are individuals with physical conditions, often with coexisting mental or cognitive challenges as well. Many of my clients are older adults, and this is quite a different population than I have ever worked with before! There are many logistical aspects to navigate when working with a large company who is getting their referrals from government funded agencies. These last past weeks have been busy days and late nights trying to learn the best practices for my clients’ needs, learning how to navigate the charting, billing and reporting systems, and all of the connections I need to advocate for my clients’ needs. With each new client referral, I feel both more at ease with the knowledge that is becoming repetitive, but also feel stressed and lost with the novel conditions and situations of each client.

Some of my biggest challenges in this new job have been:

  • navigating processes for government funding – this has been so confusing for me to navigate as someone who is new to this role, but I keep reminding myself that I have education to further help me with this process …. aka I cannot imagine some of my clients trying to navigate this on their own
  • waiting for answers. Honestly, I am the least patient individual in the world and I love crossing things off my to do lists… so I have been having trouble having to put my to do list on hold while waiting for people to call me or email me back about various company policies or further information about referrals
  • the TIME certain things take …. my first referral ever needed bathroom equipment and I didn’t realize how long an application for funding might take. At first I was so stressed that I wasn’t doing things fast enough, but now I am learning that fast isn’t really a concern in this job as funding can sometimes take months!
  • realizing that I can’t help people that don’t want help. I KNOW this already, and I know I have worked with clients in the past who haven’t wanted help. However, it’s been a struggle to go into someone’s home and see them living unsafely and have them refuse any help or recommendations. This is something that I am sure I will continue to struggle with as I need to learn that I can only do as much as I can to explain the risks and benefits of taking or not taking my recommendations.
  • WORK-LIFE BALANCE! Everyone at work keeps telling me that I need to make sure to follow all their tips to manage my time so I am not working too much, however, I haven’t been able to do this as I am constantly stressed about what I need to do next for clients. As I start getting more knowledgable about processes and better at documentation, I am hoping this will be easier to manage.

I wanted to write down my experience so that occupational therapy students, new grads, and people who are looking to change their roles within the career, can see that they are not alone in feeling lost. I have been blessed with very honest and open colleagues who have shared their stories of also feeling lost and continuously learning even years into their practice, which has helped normalize the imposter syndrome for me a bit…. however I know that some workplaces might not be the same. So if you don’t have someone to talk to about feeling lost, if you are working from home and are quite isolated from other occupational therapists in your practice, know you are not alone. Every job will bring you challenges that you don’t feel ready to attack, but from what I have learned this past month of my new job is that I can meet those challenges head on (with lots of questions being asked and research being done of course) and you can too!

I want to try to normalize the challenge of how broad yet specific our field as occupational therapists can be, and how it is ok to feel that you don’t know enough… because it just keeps us hungry to learn more and to continue to grow!

If you are feeling like you are lacking in connections with the OT community, please feel free to reach out to me via email or follow me on twitter! I follow loads of OT twitter accounts and there is so much good stuff being discussed and information being shared within the OT twitter community!

Sending all my OT love to you!


Published by maiiflowerr

Pronouns She/Her/they/them. I'm a millennial just trying to make a difference in the world, and create space for people to accept themselves and live their best lives. My fiancee, Sydney, and I are mothers to our two goofy cats, and the queens of creative adventures. I am an Occupational therapist, a dancer and a yoga instructor with a passion for supporting people and creating community.

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