Bill,
My experience is a mirror reflection of yours. I was so fed up with working
my tail off in nursing homes, doing absolutely terrific therapy and spending
tons of time thinking out of the box while chasing my tail in circles to
meet my quotas that I burned out too. When I finally returned I insisted on
working only PRN as a contract therapist (with my OWN contract). I explained
that I don't waste a single minute but that I would be billing for all of my
time so don't waste it with extra paperwork or cleaning the therapy room
unless you want to pay a therapist's wage to have the work done.
(Fortunately, my husband has the benefits so I could do this.) We just
decided that we were going to do therapy our way (my husband was an OT at
the time) and that was the way it was. I talked to administration-types and
was very up front with my focus and if my way of doing therapy didn't jive
with their ideas, I didn't take the job. I have had to bounce around from
time to time as administration changed but in the end, I felt great about
sticking to my morals. I often ended up working in high need areas where an
OT was hard to find. Once they got me in their facilities, they were
thrilled with the patient's progress and the family's satisfaction (as
compared with the contract companies who had breezed in and out and left the
patients with a sense of "what did I just spend the last hour doing that
would help me get better?" I now work in a different field within OT and
have only self-induced pressure. I make sure I'm making a profit or breaking
even for my employer each month and everyone is happy. The high pressure,
money chasing life just wasn't for me. 
Jenny

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