Occupational Therapy Burnout—What It Is and How to Fix It

Occupational Therapy Burnout—What It Is and How to Fix It

In this OT burnout article we’ll start with what, exactly, burnout is, and then quickly get into strategies to help you prevent and fight burnout in the occupational therapy profession.

It’s approaching midnight on Sunday night.

You’re lying in bed and attempting to sleep, but your heart is pounding.

As you toss and turn, you keep thinking about how tired you’ll be at work tomorrow. And just thinking about going to work makes your heart start pounding harder, and you start obsessing: in just six hours, you need to be at work.

And then it’s five hours, then four.

There’s a fine line between a bit of insomnia and the type of sleepless, existential dread that accompanies professional burnout.

If those nights spent tossing and turning are coupled with other signs of burnout, that’s when it’s time to worry.

We’ll start with what, exactly, burnout is, but the main point of this article is to help you prevent and fight burnout in the occupational therapy profession—so read on to learn more!

What is burnout?

According to Psychology Today, burnout is

“A state of chronic stress that leads to physical and emotional exhaustion, cynicism and detachment, and feelings of ineffectiveness and lack of accomplishment.”

Yikes!

That sounds terrible, but it also probably sounds pretty familiar to some of you. After all, it’s easy to get caught up in the day-to-day grind of those three ”P”s that can really ruin your day in the healthcare setting: productivity, paperwork, and…poutiness.

When the bulk of your day consists of running around, trying to figure out how to get your units, adding on the burden of increasing documentation requirements, then dealing with negativity and (for lack of a better term) poutiness all around you, it’s no surprise that burnout can take hold.

Let’s talk a bit about the signs of OT burnout, and then explore what we can do about it.

Here are some of the signs and symptoms of occupational therapy burnout

Before we get too deep in the weeds, I’d like to point out that occupational therapy burnout isn’t exactly a clinical diagnosis; instead, it’s something insidious that starts to affect your day-to-day well being.

And while there’s no quick fix or pill you can pop to cure burnout, there are certainly methods to prevent and fight it.

Some of the signs and symptoms that you’re dealing with OT burnout include:

A feeling of detachment from your patients

You help your patient to the edge of the bed. He screams in pain, and you instinctively think, “Suck it up, buttercup.” Or, you simply feel nothing at all, and robotically continue your treatment session—which, frankly, is even more troublesome.

Loss of interest in growing your career

Maybe you were the superstar of your OT class—tutoring all the younger students and winning all the awards. But these days, you can’t even fathom sitting through an online con-ed course, much less attending an in-person course.

Loss of motivation

Speaking of courses, you’ve long since resigned yourself to the cheapest, most passive methods possible to get your CEUs. The thought of taking a Neuro-Ifrah or NDT course makes you feel physically ill. And even though you know that changing jobs or settings might help, you simply don’t think there’s a point to trying.

Chronic fatigue

You’ve started to notice that every day feels like you’re slogging through wet cement. You can’t imagine exercising after work, and your family has gently remarked that you never seem to have the energy to engage.

Anxiety or depression

You might feel a sense of impending doom, or it might seem like getting out of bed is an insurmountable challenge some days. Crying and/or and perseverating on every little thing are becoming your norm. Your free days are frequently spent ruminating on the fact that you have to go back to work soon.

Feelings of bitterness and resentment—especially toward those still invested in their careers

That new OT who wants to pick up all the challenging patients, take all the courses, and join every committee? You roll your eyes every time you see him bounding down the hall. Why is he so dang excited about OT?

Why do we burn out?

It’s fascinating to consider how quickly some people burn out, while others can practice for 20 or more years in the field without ever feeling burned out.

As much attention as the medical field has gotten for burnout issues, many claim the issue is endemic among all millennial professionals, and isn’t always related to a specific workplace issue. Instead, some journalists assert that younger professionals feel they should be working all the time—which, in turn, stems from the student debt crisis.

Others point to more insidious workplace factors that lead to burnout in any profession. Gallup surveys have repeatedly revealed the same factors leading to burnout:

  • Inability to do what you do best

  • Not having a voice in the workplace

  • Not having anyone at work who encourages your development

And, if you think about it in terms of the Gallup findings, it makes perfect sense that medical professionals would burn out in this day and age.

After all, medical professionals are spending more and more time in front of their bloated, inefficient EMRs, rather than treating patients. This essentially removes healthcare workers from performing the roles they spent years to master––and instead forces them to spend their days fighting with technology built by engineers who have little understanding of clinicians’ daily responsibilities.

Why are OTs susceptible to burnout?

While physicians’ and nurses’ burnout have been studied extensively, less research has been performed specifically to examine occupational therapy burnout.

Yet, we are very liable to burn out and, in many cases, only after a few short years. If you look at two of the most rapidly growing non-traditional therapy Facebook groups out there (Non-Clinical Networking for Rehab Professionals and Alternative Careers for Rehab Professionals), you’ll find scores of burned out OTs and OTAs eager to be a part of this important conversation.

Here are some of the reasons why that may be:

Productivity (obviously)

In the past, therapy was much more focused on providing the right interventions for patients. Therapists were free to spend as much or as little time with patients as needed, and the days were more relaxed and mellow, with plenty of time for therapists to take a breather to recharge.

These days, even the most coveted of jobs seem to have productivity requirements, and it can be very challenging to meet those demands. This leads to therapists feeling incompetent and unsupported, not to mention unable to perform their jobs with the integrity they want.

Repetitive nature of the work

When we were in OT (or OTA) school, we thought the world was our oyster!

We were ready to make the most creative splints ever, and we wanted to become hand therapists, school-based therapists, and mental health OTs within our first five years because they all sounded so cool!  

The unfortunate reality is that OT can be rather repetitive in many settings, and those starry-eyed new grads can quickly become bored by the lack of creativity in the day-to-day grind of trying to meet productivity and slogging through mountains of paperwork.

Physical and emotional demands of rehab therapy

There is no doubt that we put our all into our work. We laugh with our patients and cry with them, and we sweat and grunt as we struggle to help them become as independent as possible while they re-learn techniques for showering and toileting.

This type of work can take its toll on our bodies and our minds.

Lack of growth and support

Many of us were attracted to the OT profession in part because of the many ways to grow and excel as a clinician. But the fact of the matter is that many of us work for supervisors who only care about the numbers.

We’re viewed as expendable and interchangeable.

That type of mentality can be painful when we’ve spent so much time, money, and energy pursuing what we hoped would be a career filled with growth potential.

Envy of more flexible careers

There is also a significant number of occupational therapy professionals who chose OT because it’s considered a flexible role.

To be fair, OT is fairly flexible, as far as jobs go.

But, as the years pass, there’s more and more focus on flexibility and work-life balance across the board. In actuality, remote work and flex time are likely a response to the fact that many office jobs require you to be unofficially working (by checking emails, answering calls, etc.) well beyond standard nine-to-five hours.

Still, when we see our non-medical friends work from home and take long lunches, it can make us pretty envious!

“Comparison is the enemy of contentment,” as they say!

How can we fix the problem with burnout in OT?

We can ruminate indefinitely on why people burn out, how the OT profession has let us down, or any other doom-and-gloom prophecies about the future of our beloved profession.

But, I’m of the mentality that we OTs are fixers.

We are the ones who can pick up the broken pieces and put Humpty Dumpty back together—building a future where we still feel confident recommending others to join us in the ranks of occupational therapy.

We are also holistic thinkers, and are uniquely equipped to fight burnout in our lives by stepping back and taking a look at our lives inside and outside of work—as well as by working to change the systems we work in.

Here are 11 ways to fight OT burnout:

1.) Conquer debt

First things first––student debt is the burden of our generation, and it has been repeatedly linked to why we feel so much pressure in our careers.

The sooner you can get out of debt, the better.

It is beyond the scope of this blog to help you untangle the web of debt, but there are many great resources out there to help you. My blog post Occupational Therapy and Student Debt is due for an update; if there is any content you think would improve it, please let me know.

There are some therapy-specific resources for debt reduction out there, such as Debt-Free PT. Or, for student loans, there are national options like Dave Ramsey. If you’re a business owner feeling crushed by debt, I highly recommend Profit First.

2.) Seek collaboration and community

Feelings of isolation and loneliness are definitely associated with burnout. And, again, this is paradoxically a problem of our digitally connected generation.

Maintain your relationships outside of work

It is easy when you are feeling overwhelmed to not initiate a call to your family member or old high school friend. Similarly, it’s tempting not to stop and talk to your neighbor.

But, these relationships might be exactly where you find the outside perspective that you need.

Find a work friend

My best friends at work have been a nurse, an administrative assistant, and a psychologist. Make it a point to find a friend at work. Again, Gallup links community to better workplace engagement.

Don’t forget about the wonderful, old co-treat!

One of the reasons burnout is mounting is the increased focus on billable units, coupled with increased disdain toward co-treating. Incidentally, Medicare is fine with co-treats, as long as there’s medical necessity and appropriate documentation of need.

If you’re not able to co-treat at your facility, seek other forms of collaboration. Join or start interdisciplinary committees. Sit with other professionals in the cafeteria. After all, feeling unsupported leads to burnout, but feeling supported can help fight it.

Find your tribe

Once you have all of your face-to-face support systems lined up, then be sure to seek out a community of like-minded therapists. Whether it is through a Facebook group, a speciality conference, or my new evidenced-based practice forum, there is a place for you on the internet!

(If you need a recommendation of a Facebook group or community, ask me in the comments. They are too numerous to list here :-))

3.) Find your voice

OTs are naturally gifted communicators, but we’re also not exactly the type to rock the boat in many situations.

But we owe it to our leaders to share our feelings of burnout when they strike, because they often have the power to help us make positive change.

Talk with your boss

If you’re feeling stressed out by taking paperwork home each night, your boss might have some hacks for getting through charting more quickly.

When you’re feeling overwhelmed, sometimes your boss is the last person you want to talk to, but I’ve actually done this in the past and was thankful for my boss’ compassion and documentation tips.

Here’s an article that covers how to approach your boss when you are feeling overwhelmed: OT Productivity Hacks.

Become your own boss

I’ve been super into the Enneagram lately, which is a personality test, and have been so curious to know how many of us are “Achievers.” I fall in this camp, and now can identify that in the past when I’ve felt burned out it was actually because I didn’t feel challenged enough. I am very passionate about the need for more OTs to step into leadership roles, and encourage you to read, Are You the OT Leader We Need?

4.) Identify your “north star needs”

Everyone has different needs out of life, and out of their careers. Do some introspection both alone, and with loved ones, and determine what your non-negotiables are.

Do you need to exercise daily to feel sane?

Is a healthy, homemade lunch a must-have?

Is quality time with loved ones a non-negotiable?

What about a meaningful spiritual practice?

Ensure that you meet your north star needs, and that your job (or ruminating about your job) does not cut into the things that matter most to you.

If you are feeling burned out, you may have difficulty identifying what these are. Don’t hesitate to ask a friend. Or, again, since I’m into the Enneagram right now, I’m going to recommend learning more about your personality type. Here’s the book I just picked up: The Road Back to You.

5.) Gain agency over your career

When you feel like you don’t have any real agency, or control, over where your career goes, it can start to feel like you’re prisoner on a ship bound for nowhere land. Here are a few ways to take control of your career moving forward:

Expand your skill set

While being a jack-of-all-trades can be exhilarating early in your career, I know that many of us eventually long for a niche where we can achieve mastery.

One way to establish your niche is through an additional certification. We are so lucky, as OT practitioners, that we have such a wide variety of specialities available to us. You can learn more about them here:

Focus on honing your “soft skills”

Most of us are conditioned to think that investing in our careers means being an AOTA member or taking clinically based continuing education courses, but I would say that dedicating time to developing soft skills—like listening, self-awareness, and stress management—is just as valuable an investment.

I personally love being a part of Daphne Scott’s Leadership Weekly email. Daphne is a former PT turned life coach.

If you have a podcast, book, course, etc. that has helped you develop your soft-skills, please let us know in the comments!

Take an anti-burnout course

Fellow OT Erika Del Pozo Frasso has created an online, self-paced course called Bash the Burnout for Healthcare Professionals. It’s a great way to fight burnout while earning your CEUs.

6.) Improve your efficiency

Many of us look at more experienced therapists and wonder how they’re so calm, cool, and collected.

While we struggle to get out the door by 6:30, we see them calmly log off the computer at 5:00, ready to get home to their loved ones.

What we sometimes forget to consider is the fact that these experienced clinicians have often spent many hours behind the scenes, creating processes and streamlining their efforts so that they are as efficient as possible. If the source of your burnout seems to stem from always being behind on your tasks, take a look at this article: OT Productivity Hacks. You might find some really helpful techniques to improve your efficiency, decreasing that frantic feeling that colors so many days.

I am working on a documentation series right now that I am so excited to share. I’m hoping this will help you document efficiently…and maybe even enjoy the process (gasp!).

7.) Change your hours

Many therapists are attracted to the idea of working four 10-hour days, but this challenges those of us with families. Once you add in a commute, quality time with the family, and having a meal, self care can quickly fall by the wayside.

Some therapists opt to go back to five eight-hour days, and others ask their managers about cutting to four nine-hour days...or even switching to part-time! This takes us back to having an honest conversation with your manager.

8.) Change your setting

It can be easy to feel like our career offers us no flexibility. But the reality is that among our fellow healthcare providers—and even fellow rehabilitation therapists—we have a what seems to be a wider variety of opportunities.

Once I paid off my student loans, I was able to transition to working in a mental health setting. The pay was lower, but productivity was not a focus in the setting, and I felt like I was able to spend my days truly focusing on OT.

9.) Consider a non-clinical career

Luckily, even if burnout gets the best of us, we still have other options to leverage our experience and education.

If you have an injury, illness, or a disability preventing you from continuing as a clinician—or you simply don’t enjoy patient care and want to try something new—you might want to consider a different approach to OT altogether. As OTs and OTAs, our backgrounds and experience translate very well into a number of non-clinical careers.

Rather than starting completely anew with something like real estate, you can pursue quite a few roles in healthcare where your background will be valued, you can learn new skills, and you’re no longer limited by reimbursement rules when it comes to compensation.

  • Non-Clinical 101 is created by Meredith Castin, PT, DPT of The Non-Clinical PT. This self-paced online course is a lot of fun, and incredibly informative as well. It delves into all sorts of non-clinical career tracks for OT, PT, and SLP professionals, and details exactly what it takes to pursue each path. It’s extremely comprehensive, and it’s also incredibly useful in forging your plans to make the leap out of patient care. It’s structured in a four-step format and has lots of activities and downloads to keep things interactive and interesting––and to keep you on track and prevent you from getting discouraged. Non-Clinical 101 is absolutely the place to start if you’re ready to leave patient care, but have no idea what to do next—much less how to get there.

(I am an affiliate of this course. Meredith Castin serves as OT Potential’s copy editor and I absolutely support her!)

10.) Try to find “flow” in your work

“Flow” can be considered the opposite of burnout. Mihaly Csikszentmihalyi discovered that people find deeper satisfaction (and, ultimately, “optimal experiences”) when they are in a state of flow. He defines flow as “a positive feeling that occurs when there is a balance between perceived challenges and that person's skills.”

This article can help you find flow in your work as an OT: Occupational Therapy and Flow

11.) Create a side-hustle

I’m saving the best for last.

Not only do I think a side hustle, be it therapy related or not, can breathe new life into your career, I also believe that innovation is desperately needed in our healthcare systems and that OTs are well poised to help carry healthcare into the future.

Check out my blog post, Start and Grow Your OT Business or join our Facebook group, Occupational Therapy Entrepreneurs, to find inspiration on this topic.

Conclusion

Day after day, we work with patients to help them gain agency over their health.

And for many of us, there comes a time when we need to step back and regain agency over our own careers and our own health.

There is no silver bullet, but your experience as an OT has uniquely prepared you for this challenge.

No matter what situation you are in, please know that you are not trapped. You have options, and chances are someone else has already tread a similar path. Please let us know if you need any support in the comments!

How has burnout impacted your professional career and what strategies have you used to combat it? Please share with us in the comments!

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