4 things you should know before becoming an OT

4 things you should know before becoming an OT

Before OT school, I had a poor understanding of what OTs did. Even during OT school, the presentations and exams don’t really prepare you for what you actually do as an OT. Here are 4 things I wish I knew before becoming an Occupational Therapist and tips to avoid burnout.

Also check out 7 things you should know before becoming an OT by OTspot.

OTs help with showers

When I was shadowing an OT I saw patients exercising in the gym, working on fine motor activities, cooking food, stacking cones, and other activities. No one told me OTs helped people shower.

I didn’t even realize this until late into OT school when my professor told us about the first time he had to help a patient with a shower. As a fieldwork student, he too was surprised that showering was part of OT.

Helping a patient bathe can be uncomfortable to you and the person you are helping. Here are a few things that helped me get over it and actually prefer it in some of my therapy sessions.

First of all, OT is about empowering others. As OTs we are really just facilitating patients as they take a shower.

Every time I have a patient take a shower, I try to have them do everything on their own. I get them in the shower and have them undress with the shower curtain closed. Next, they hand me their clothes, and I have them shower on their own as much as possible.

There are definitely circumstances where you will need to assist the patient more, but the hardest part for most of the patients is just getting in the shower.

Once they are in there, you really don’t have much to do unless they have limited range of motion, difficulty reaching, or confusion. You’re mostly just making sure they are safe.

OTs help with Toileting

OTs do toileting

Not all OTs have to help with toileting, but some OTs do, especially if they work at a hospital, skilled nursing facility, or rehab.

I guess you could say this goes along with bathing. Toileting is still my least favorite activity as an OT, and there are times when you can ask a CNA or someone else to do it, but sometimes there’s no one around to help.

Plus the CNAs help toilet their patients all day long, and when you ask them to do it, you assume job superiority. I get it! Toileting is not fun for anyone, but people still need your help.

I would suggest that you get creative in finding ways that the patient can help, so you’re not doing all the work.

There are some facilities where you don’t have to help with toileting, and if you really don’t want to do it, I’m sure you can find a way out of it. Some patients don’t even want you to do it and will ask for their nurse.

It’s not just CNAs and OTs who assist with toileting. It’s also nurses, PTs and wound care specialists. Even doctors have to deal with crap from time to time. Some even specialize in it.

The best OT Setting isn’t a rehab or SNF

When you think of OT you usually think of rehab and pediatrics, but OT’s also work in the ICU, Surgical ICU, NICU, Emergency Department, Med Surg, and IMC/step down floors.

I actually prefer working in the acute care side of the hospital rather than rehab. In acute, you see all the exciting things happen. You also learn a lot more medical terminology and procedures.

The best part about working in the hospital is the flexibility. Often in a hospital setting you don’t have a scheduled time to see patients, so it’s not a big deal if you show up to work a little late or leave a little early.

Some hospitals are definitely more lenient than others, but it’s generally not as strict because you don’t typically have a schedule.

One other thing I like more than rehab is the time spent with patients. In rehab, you sometimes are required to see a patient for 90 minutes. This can be frustrating for the patients especially if you don’t have an activity that is meaningful to them.

In the hospital, you see your patient and quickly move onto the next patient after 30-45 minutes. You can spend more time if needed, but the hospital pace is usually much more upbeat.

OTs can get hurt on the job

If you look up work related injuries for Nurses or CNAs you will see that the statistics are high. If you work in a hospital, skilled nursing home, or rehab you are expected to help patients with bed mobility. This may include helping patients don back braces in bed, scooting up in bed, rolling, getting out of bed, or standing.

Therapy and nursing staff are taught proper lifting techniques, but most staff poorly implement these techniques. For example, there are many situations when it’s difficulty to avoid awkward positions such as bending or twisting.

Most facilities will have a policy that staff should not lift more than 50 lbs, but this is poorly understood by employees.

Some of us may have an idea of what it feels like to lift a 50 pound box, but it’s difficulty to guess those restrictions when we are pulling someone up in bed or lifting someone’s legs from sit to supine.

It’s not just rehab that can cause work related injuries. Hand therapists may develop cumulative trauma or tendonitis from massaging scar tissue or performing other manual therapy.

Any job can have work related risks. You can get injured on the job sitting at a desk. It’s just important to understand these risks before going into the field.

OT burnout is real

OT burnout

After working as an OT full time, your job can feel the same day-to-day, especially if you’re doing the same thing everyday.

You may feel like your constantly giving your patients the same advice, tips, exercises, and methods to help them achieve independence. This can make life a little less exciting at work and your patients will notice.

Tip #1: Do something differrent

My advice is to change things up. I personally have always worked at more than one job, so I have a different experience every day when I go to work. When I lived in Las Vegas I worked at 3 hospitals and a hand therapy clinic. Everyday I was somewhere different.

I know that might be stressful for some, but it helped me get out of the everyday rut.

Tip #2: Do Occupational Therapy

As a student, you truly learn about OT. It’s all about making therapy helpful and purposeful for your patients. Students come out of OT school with such vigor, because they have been challenged by their professors to change the medical landscape.

Unfortunately, the medical field is resistive and encourages complacency. Some settings, such as hospitals, are especially difficulty to perform meaningful therapy. For example, it may be difficult to make therapy purposeful if your patient is confined to a bed in the ICU.

There are strategies to overcome these hurdles and finding small ways to make therapy more meaningful to your patients can make all the difference.

So next time when you’re bored with your day-to-day treatments, do OT stuff. Listen to your patients and find an activity that will be fun. It may require some creativity or a field trip, but thinking outside the box can make your patient interaction much more enjoyable.

Tip #3: Ask different questions

Another helpful tip is to develop relationships with your patients. Don’t just ask them the questions for your evaluation but dive into their life. Try to find out what makes them tick and what they enjoy doing. Become curious about them and really listen.

When you develop a relationship with your patients and understand them better they notice, and your day becomes a little more memorable.


Occupational Therapy can be a rewarding career, but it also has its challenges. You may have to assist with CNA duties or work with patients who don’t want therapy. At times, you can feel burned out.

I’ve found that it gets easier with time and changing things up. Stay positive and keep a creative mindset and OT will become more meaningful to you.

I hope this article was helpful.

Do you have any experiences that surprised you after working as an OT? How have you overcome OT burnout? Let me know in the comments.

Curious about OT salary? Check out my guide here.

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