Jenny and Bill, thank you so much for writing this rant. I am a COTA who has 
worked in pediatrics for 7 years and I just recently moved to?a state where I 
have found there is not much opportunity for COTA's with pediatric exp. unless 
it is in the school system and I can not afford to be out of work for three 
months of the year. So, I went to the contract companies and I am now working 
in an SNF and I love the clients. And, hate all this paper work and 
productivity, stuff. Last week I found myself speaking to the regional manager 
who came in to do an audit on the SNF, and I remember thinking to myself what 
does any of this have to do with OT or the welfare of my patients. Infact, her 
visit has managed?to upset my boss who is now a real monster to be around. So 
now I am pondering the whole field of OT. I moved here to go back to school to 
be an OTR, but ouch! I have had to do a lot soul searching, still am. I have 
not written to this list yet so please do not think I am always this bitter, it 
is just that working with children I could match an activity with the child's 
personality, there was room for creativity and I just dont see this happening 
in an SNF (at least not where I am at). It is all?transfer belts and machines, 
wee haaaa!!! With all this said, I still have to earn a living, and while I am 
hunting down that just right job, can anyone give me?some?examples of SOAP 
notes or where I might find some online. Seems mine are not?relaying skilled 
OT. I wish I had longer to write. You all seem like very nice people so thank 
you for?letting me share with you.
Debbie?



Tnow.com
Sent: Sun, 19 Aug 2007 7:31 pm
Subject: Re: [OTlist] SNFs



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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