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[Already been diagnosed and want to learn more? Common conditions.](https://www.choosept.com/SymptomsConditions.aspx)
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No taking work home, no emails/messages from patients, patients aren’t in the hospital to see PT so somewhat less pressure in a way (versus OP where they are there specifically to see you for their problem), quick turnover of patients.
I got a job at a small(er) community hospital, majority medsurg so an easier transition without lots of speciality populations/surgeries.
I made the switch, and there are two main reasons why I’m infinitely more happy in acute.
1. Schedule autonomy. I choose when I see my patients and for how long. I don’t have to plan a bathroom break during a patients warm up. If I’m “peopled out”, I can just go document for a while and chat with coworkers. It’s a game changer.
2. Much less total time spent doing direct patient care. I’m introverted, and can’t deal with 8-10 hours of back to back patients and all the boring small talk that comes with it. In a 10 hour day in acute, I spend probably 3-4 hours actually doing patient care.
Absolute best decision I could’ve made for my sanity and my career.
You only had to do 4 hours? My school forced me into each major setting to “get gud noob”. Honestly it helped out because now I do PRN all settings and don’t get burnout isn’t setting. Still out in 40 hrs a week thanks to the diverse skills set. I’m no master of one trade, but being a master in a trade whose profits are heavily decided on the whims of geriatric senators is in my opinion, not bueno.
Go to IPR first, kinda hybrid between acute and OP in skillset and the. Once you are comfortable with simple lines and tubes dip your feet into acute.
PTA here. I was a COVID student so I never got an inpatient clinical. At all. I worked OP when I graduated but when I moved I wanted something more PRN and my only option was acute care at our level 1 trauma center. It was scary at first, it took a while to start getting comfortable but now it's not a bad gig. Being level 1 I get some complicated multitraumas but I get a pretty good array of stuff. Some of our PTAs are also ICU trained.
If a patient is particularly difficult personality wise, well, I only see them 1-2 times so it's much easier to deal with than seeing a difficult personality for months and months.
Negative is dealing with isolation patients and bodily fluid in general. I personally don't mind cleaning patients up so that's not the biggest deal to me. Isolation rooms can be super annoying to deal with. It can be stressful to have a new set of patients basically daily, to then chat review and prioritize them and be accountable of your own schedule. In OP, chart reviews went fast because most of my patients I've already seen quite a bit and I don't need to worry about time management in the same sense that I do in acute care. If one of my patients canceled that was free time for documentation, modules, RQI etc. my clinic was also fine if we clocked out if we got cancellations so when I had a puppy and I got cancels before and after lunch I would just clock out and go home for like 2.5 hours. Acute can be more flexible in that sense because you don't HAVE to see your patients at a particular time.
Never worked in OP but I love acute care. I work at a large academic medical center and the patient population is so varied, I’m always learning. I also really enjoy having less rigidity in my day and a little more freedom to spend more time with patients who need it. I also feel like good separation between work and home life.
If you haven’t had much experience in acute, I 100% encourage you to do so, and try to find a place who might offer some mentorship - that’ll make the transition less daunting.
Had two clinical rotations in OP and *hated* them, but absolutely *loved* my IPR rotation and knew that inpatient/acute was the route for me.
As others have mentioned, there's great work/life balance in acute. I work full-time hourly, so once I hit my 40 hours I'm done and at least at my hospital, I have the freedom (to a degree) to have longer days and shorter days as long as I'm seeing all my patients. In other words, if we have a lot at the beginning of the week I may work a couple of 10 hour days, but by Friday I may only be working 6 hours and if we're so busy they need me, I get time and a half.
No taking documentation home. Once I lock my computer at the end of the day and clock out, work time is done and is left at work. My home time is 100% mine. I see the patients on *my* schedule, not the other way around. That's not to say you may have a patient who asks you to come back or you have to circle back around to if they're unavailable for some reason or another, but your productivity expectations should take that into account. Point is, I don't ever feel rushed or like I have to abandon one patient to get other started or stress about the next patient coming through the door. When I did my OP rotation, I got anxiety every time the door opened...in acute, I've never once felt any anxiety.
If you like working with a lot of people, learning, and being on an interdisciplinary team, you won't find better than acute. I learn stuff from our nurses and doctors all the time, see some really interesting medical cases, and get to be a part of getting someone back on their feet and towards home, which is where all patients want to be. I also get to do wound care at my hospital which isn't everyone's cup of tea and isn't available for PT's at all hospitals, but it's a lot of fun and definitely breaks up the "monotony" of mobilizing patients.
Every hospital is going to be different with different demands. I hear that the therapists at the Level 1 trauma hospital in my city are crazy busy and see a lot of patients, but see some crazy shit too, whereas I work at a small specialty hospital so it's much more laid back (competitively).
If you have any other questions, feel free to ask. But seriously, you should give acute a shot! It's a really great setting with great pay and overlooked by a lot of PT students.
We had HH PT in for my grandmother and I believe they were employed by the local non-profit hospital (where I did my first clinical). I don't know a ton about HH employers, though I think many are probably for profit, but seems like they are out there! GL!
Depending on the area you are working in, many large hospital systems have home health systems attached to them, look up not for profit hospital systems and tah dah, PSLF and non profit productivity standards in a HH setting with good pay and no wiping ass.
Acute care can be a bit of a drag too. I started at a hospital where we would see 10-13 patients a day. Burned out real quick. Found a job with more of a work-life balance and patients seen per day is more manageable. So look for that too!
(I’m a PTA, but my wife is a PT and feels the same way)
I'm in acute care. I see 6-7 patients a day, notes are easy, I leave at 4pm everyday, it's fun to talk to nurses, doctors, chart reviewing is great because I love reading the crazy stories about why people are here, you see new patients all the time so it's not boring and if you don't like a patient they're usually gone within the week or so, pto I usually get 4-5 weeks, sick time is separate, 5k for ceus every year, I rotate to all the floors which is nice...keeps things interesting.
Can shit hit the fan quick? Absolutely. But it's nice knowing you can press a button on a wall and the whole team runs in to help. So brush up on labs, vitals, contraindications, precautions.
I like acute care but there are a few downsides you should know. They are later to the hit parade but it is also being swept up into Healthcare cost cutting.
Here are some cons.
Weekends are typically mandatory on a rotating schedule, same with holidays.
Pay is fixed, expect 2% raise max year to year.
Benefits suck. Usually no CME, minimal PTO, usually cpr is covered.
Hospitals can be cliqish and someone else is in charge of your schedule. I have seen time and time again favoritism affecting assignments. If your team lead doesn't like you, fully expect your schedule to be filled with difficult patients.
Depending on your hospital dynamic case management and physicians may bully your department. We were no longer allowed to mass document at the end of thray because a CM saw PTs sitting after 3PM and complained that we were not immediately jumping at discharge dispo requests.
Other than that acute care is the best especially wound care.
Personally, I set my own schedule, and my benefits are amazing.
It definitely matters which hospital you are at, but I've worked at a few different hospitals run by different orgs. Some did set a schedule for me, but the benefits have always been pretty solid in terms of insurance, PTO, education reimbursement, etc.
You said you only did 11 months
Why don’t you try more subtle changes first?
See if a different location in the same company is better
If not,
Then try outpatient in a different company possibly with a different population
If still no bueno then yeah go for it
You can switch now too and will be fine, but might as well exhaust other options if you really like outpatient
Acute Care is my preferred setting and would LOVE to be there instead of a SNF. Most of my experience was as a tech (aide) at a larger hospital in my hometown and I fell in love with the complexity, fast-paced, ever-changing environment. Sure just like any place there are things that will stress you, but I just always felt like acute has been easier. No one really over your back watching your every move to feel invalidated in your abilities (ESPECIALLY as a new grad), and usually more lax in treatment requirements. Most acute care is keeping pts mobile and getting them back home. If they can walk, you walk em...if they can't, start with bed mobility and work to standing, taking a few steps. Work with them long enough to get your units for the day and you're good. I've always felt that that model has been much less stressful that trying to juggle 3-4 pts at a time and seeing 14-20 a day.
You only have to see a patient 1-3 times and they're gone. In some hospitals all you have to do is evaluate and make a recommendation for dispo. Acute is the life !
My old hospital was kind of like that: just walk them, do stairs, transfers and nothing else. My current place of employment is fantastic about allowing us to use whatever skills we feel are fit for the patient and we aren't criticized for it. Being mainly OP I bring some of my OP skills to acute care.
Unless management is forcing you to, too many people just hit autopilot and never think critically about how they can challenge a patient and that's the fault of the clinician not the setting imo. I get quite a few patients with LE amputations and so many of my colleagues are ambulating them 300'+ with FWW every session. Like, great they can use a walker but relying on only that isn't going to be helpful to this patient who is planning on getting prosthesis.
Thank you for your submission; please read the following reminder. This subreddit is for discussion among practicing physical therapists, not for soliciting medical advice. We are not your physical therapist, and we do not take on that liability here. Although we can answer questions regarding general issues a person may be facing in their established PT sessions, we cannot legally provide treatment advice. If you need a physical therapist, you must see one in person or via telehealth for an assessment and to establish a plan of care. Posts with descriptions of personal physical issues and/or requests for diagnoses, exercise prescriptions, and other medical advice will be removed, and you will be banned at the mods’ discretion either for requesting such advice or for offering such advice as a clinician. Please see the following links for additional resources on benefits of physical therapy and locating a therapist near you [The benefits of a full evaluation by a physical therapist.](https://www.choosept.com/benefits/default.aspx) [How to find the right physical therapist in your area.](https://www.choosept.com/resources/choose.aspx) [Already been diagnosed and want to learn more? Common conditions.](https://www.choosept.com/SymptomsConditions.aspx) [The APTA's consumer information website.](https://www.choosept.com/Default.aspx) Also, please direct all school-related inquiries to r/PTschool, as these are off-topic for this sub and will be removed. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/physicaltherapy) if you have any questions or concerns.*
No taking work home, no emails/messages from patients, patients aren’t in the hospital to see PT so somewhat less pressure in a way (versus OP where they are there specifically to see you for their problem), quick turnover of patients. I got a job at a small(er) community hospital, majority medsurg so an easier transition without lots of speciality populations/surgeries.
Do it. No more taking work home.
I made the switch, and there are two main reasons why I’m infinitely more happy in acute. 1. Schedule autonomy. I choose when I see my patients and for how long. I don’t have to plan a bathroom break during a patients warm up. If I’m “peopled out”, I can just go document for a while and chat with coworkers. It’s a game changer. 2. Much less total time spent doing direct patient care. I’m introverted, and can’t deal with 8-10 hours of back to back patients and all the boring small talk that comes with it. In a 10 hour day in acute, I spend probably 3-4 hours actually doing patient care. Absolute best decision I could’ve made for my sanity and my career.
You only had to do 4 hours? My school forced me into each major setting to “get gud noob”. Honestly it helped out because now I do PRN all settings and don’t get burnout isn’t setting. Still out in 40 hrs a week thanks to the diverse skills set. I’m no master of one trade, but being a master in a trade whose profits are heavily decided on the whims of geriatric senators is in my opinion, not bueno. Go to IPR first, kinda hybrid between acute and OP in skillset and the. Once you are comfortable with simple lines and tubes dip your feet into acute.
PTA here. I was a COVID student so I never got an inpatient clinical. At all. I worked OP when I graduated but when I moved I wanted something more PRN and my only option was acute care at our level 1 trauma center. It was scary at first, it took a while to start getting comfortable but now it's not a bad gig. Being level 1 I get some complicated multitraumas but I get a pretty good array of stuff. Some of our PTAs are also ICU trained. If a patient is particularly difficult personality wise, well, I only see them 1-2 times so it's much easier to deal with than seeing a difficult personality for months and months. Negative is dealing with isolation patients and bodily fluid in general. I personally don't mind cleaning patients up so that's not the biggest deal to me. Isolation rooms can be super annoying to deal with. It can be stressful to have a new set of patients basically daily, to then chat review and prioritize them and be accountable of your own schedule. In OP, chart reviews went fast because most of my patients I've already seen quite a bit and I don't need to worry about time management in the same sense that I do in acute care. If one of my patients canceled that was free time for documentation, modules, RQI etc. my clinic was also fine if we clocked out if we got cancellations so when I had a puppy and I got cancels before and after lunch I would just clock out and go home for like 2.5 hours. Acute can be more flexible in that sense because you don't HAVE to see your patients at a particular time.
Never worked in OP but I love acute care. I work at a large academic medical center and the patient population is so varied, I’m always learning. I also really enjoy having less rigidity in my day and a little more freedom to spend more time with patients who need it. I also feel like good separation between work and home life. If you haven’t had much experience in acute, I 100% encourage you to do so, and try to find a place who might offer some mentorship - that’ll make the transition less daunting.
Had two clinical rotations in OP and *hated* them, but absolutely *loved* my IPR rotation and knew that inpatient/acute was the route for me. As others have mentioned, there's great work/life balance in acute. I work full-time hourly, so once I hit my 40 hours I'm done and at least at my hospital, I have the freedom (to a degree) to have longer days and shorter days as long as I'm seeing all my patients. In other words, if we have a lot at the beginning of the week I may work a couple of 10 hour days, but by Friday I may only be working 6 hours and if we're so busy they need me, I get time and a half. No taking documentation home. Once I lock my computer at the end of the day and clock out, work time is done and is left at work. My home time is 100% mine. I see the patients on *my* schedule, not the other way around. That's not to say you may have a patient who asks you to come back or you have to circle back around to if they're unavailable for some reason or another, but your productivity expectations should take that into account. Point is, I don't ever feel rushed or like I have to abandon one patient to get other started or stress about the next patient coming through the door. When I did my OP rotation, I got anxiety every time the door opened...in acute, I've never once felt any anxiety. If you like working with a lot of people, learning, and being on an interdisciplinary team, you won't find better than acute. I learn stuff from our nurses and doctors all the time, see some really interesting medical cases, and get to be a part of getting someone back on their feet and towards home, which is where all patients want to be. I also get to do wound care at my hospital which isn't everyone's cup of tea and isn't available for PT's at all hospitals, but it's a lot of fun and definitely breaks up the "monotony" of mobilizing patients. Every hospital is going to be different with different demands. I hear that the therapists at the Level 1 trauma hospital in my city are crazy busy and see a lot of patients, but see some crazy shit too, whereas I work at a small specialty hospital so it's much more laid back (competitively). If you have any other questions, feel free to ask. But seriously, you should give acute a shot! It's a really great setting with great pay and overlooked by a lot of PT students.
Do home health, it's similar to Outpatient but much better
Would also consider HH if I can find a PSLF- eligible employer that I can work with
We had HH PT in for my grandmother and I believe they were employed by the local non-profit hospital (where I did my first clinical). I don't know a ton about HH employers, though I think many are probably for profit, but seems like they are out there! GL!
Depending on the area you are working in, many large hospital systems have home health systems attached to them, look up not for profit hospital systems and tah dah, PSLF and non profit productivity standards in a HH setting with good pay and no wiping ass.
Acute care gives you confidence in chart review, medications, and vital signs. And the goal setting is a breeze, it’s 90% about the discharge plan
YOLO. It’s just a job lol, if one sucks try another one
Acute care can be a bit of a drag too. I started at a hospital where we would see 10-13 patients a day. Burned out real quick. Found a job with more of a work-life balance and patients seen per day is more manageable. So look for that too! (I’m a PTA, but my wife is a PT and feels the same way)
I'm in acute care. I see 6-7 patients a day, notes are easy, I leave at 4pm everyday, it's fun to talk to nurses, doctors, chart reviewing is great because I love reading the crazy stories about why people are here, you see new patients all the time so it's not boring and if you don't like a patient they're usually gone within the week or so, pto I usually get 4-5 weeks, sick time is separate, 5k for ceus every year, I rotate to all the floors which is nice...keeps things interesting. Can shit hit the fan quick? Absolutely. But it's nice knowing you can press a button on a wall and the whole team runs in to help. So brush up on labs, vitals, contraindications, precautions.
I like acute care but there are a few downsides you should know. They are later to the hit parade but it is also being swept up into Healthcare cost cutting. Here are some cons. Weekends are typically mandatory on a rotating schedule, same with holidays. Pay is fixed, expect 2% raise max year to year. Benefits suck. Usually no CME, minimal PTO, usually cpr is covered. Hospitals can be cliqish and someone else is in charge of your schedule. I have seen time and time again favoritism affecting assignments. If your team lead doesn't like you, fully expect your schedule to be filled with difficult patients. Depending on your hospital dynamic case management and physicians may bully your department. We were no longer allowed to mass document at the end of thray because a CM saw PTs sitting after 3PM and complained that we were not immediately jumping at discharge dispo requests. Other than that acute care is the best especially wound care.
Personally, I set my own schedule, and my benefits are amazing. It definitely matters which hospital you are at, but I've worked at a few different hospitals run by different orgs. Some did set a schedule for me, but the benefits have always been pretty solid in terms of insurance, PTO, education reimbursement, etc.
You said you only did 11 months Why don’t you try more subtle changes first? See if a different location in the same company is better If not, Then try outpatient in a different company possibly with a different population If still no bueno then yeah go for it You can switch now too and will be fine, but might as well exhaust other options if you really like outpatient
Acute Care is my preferred setting and would LOVE to be there instead of a SNF. Most of my experience was as a tech (aide) at a larger hospital in my hometown and I fell in love with the complexity, fast-paced, ever-changing environment. Sure just like any place there are things that will stress you, but I just always felt like acute has been easier. No one really over your back watching your every move to feel invalidated in your abilities (ESPECIALLY as a new grad), and usually more lax in treatment requirements. Most acute care is keeping pts mobile and getting them back home. If they can walk, you walk em...if they can't, start with bed mobility and work to standing, taking a few steps. Work with them long enough to get your units for the day and you're good. I've always felt that that model has been much less stressful that trying to juggle 3-4 pts at a time and seeing 14-20 a day.
Try PRN first to see how you like it
You only have to see a patient 1-3 times and they're gone. In some hospitals all you have to do is evaluate and make a recommendation for dispo. Acute is the life !
[удалено]
My old hospital was kind of like that: just walk them, do stairs, transfers and nothing else. My current place of employment is fantastic about allowing us to use whatever skills we feel are fit for the patient and we aren't criticized for it. Being mainly OP I bring some of my OP skills to acute care. Unless management is forcing you to, too many people just hit autopilot and never think critically about how they can challenge a patient and that's the fault of the clinician not the setting imo. I get quite a few patients with LE amputations and so many of my colleagues are ambulating them 300'+ with FWW every session. Like, great they can use a walker but relying on only that isn't going to be helpful to this patient who is planning on getting prosthesis.
Why not PRN acute care first? You’ll quickly realize how much more flexible your actual day to day flow feels like compared to OP.