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Toni Talks about PT Today

Finding Time to Take Time Off

Published July 19, 2011 6:03 PM by Toni Patt

Physical Therapy is a very time-dependent occupation. No matter what setting we practice in, we are always watching the clock. In outpatient, appointments should start on time. In SNF and inpatient rehab settings, reimbursement is based on duration of treatment. Every patient must receive a specific number of minutes. In acute care, productivity is time-based. I don't know about others but I'm constantly looking at my watch.

My days are very busy. I have to see stroke patients before rounds start, see rehab patients as scheduled and carry an acute caseload to supplement my productivity. By the end of the day, I'm exhausted. This week it caught up with me. After working Saturday, I had to rest to have enough energy to walk to my car. I knew I needed a break so I had to request time off this week.

Sometimes I can't find the time to be down. I know I should. I know I can't go indefinitely but never seem to know when to say enough is enough. I have two days off this week. I can relax or at least slow down. Nothing that I'll do during that time has a scheduled start or stop. Even as I write this, my mind is composing lists of what I need to accomplish.

Taking time off is against my nature. I think about taking off, and then think of the things that won't happen if I'm not there. I decide I'll manage. I don't need time off. Finally I run out of energy and need a break. I always feel bad when it happens. I usually sleep 12 hours, feel much better and lose a day in the process. I know better. I've done it enough times.

I'm not the only one who does this. Everyone is under the same pressure to cram more into less time. Everyone needs a break. I have to tell myself it's OK to slow down.


So agree with the last 2 posts. I've been a PT for 31  years and was not able stay in this field thinking that I couldn't take a vacation. We all need to recharge and yes... I have worked while raising 3 children and being a GS leader and volunteer in my kids' things and community, etc.. Learning when to say "yes" or "no" is not easy but you need to take care of yourself in order to be able to take care of others. The world will not collapse if we take a breather. Perspective is a lesson in progress no matter what stage or age!

Sue July 24, 2011 4:55 PM

I can totally relate.  Saying no is a difficult practice to cultivate.  Prioritizing "down time" is even more difficult.  While I was at my parents last week for my father's surgery, my mom looked at me and said, "Do you ever just relax?"  No, not really.  Like you said, it's not in my nature.

Hope you enjoyed your two days off!  

Janey Goude July 22, 2011 9:55 PM


      Thank you for sharing your thoughts, and feelings. I think you are on to something we all know to be true but rarely address it,especially to our bosses. I like to to achieve much in my job, but I am one of those people who has only taken one vacation in 20+ years that I can remember. So, overdoing It has not helped. Fortunately I am healthy.

 Maybe more of us can start making this an issue to be dealt with amongst our peers & employers. But ofcourse with tact.

 I hope you find balance soon in your rest and work.

                                   God bless, Billy

billy, Licensed Physical Therapist Assistant July 22, 2011 3:25 PM
annapolis MD

You are certainly not alone.  The worst part is trying to get approval for time off (even though you've earned it!).   I am the ONLY P.T. in an acute care hospital with an outpatient department.  It is very stressful having to go back and forth all day between hospital patients and scheduled outpatients.  Have you ever had to tell an inpatient who had to use the bathroom that you must go see an outpatient and leave the mess for nursing to finish up?  Talk about stress!  There are many days I'd love to throw my beeper out the window (if only it opened).  Productivity standards are getting more difficult to meet than ever.  We have two PTA's in addition to myself.  The standards are the same for the PT and the PTA's.  That alone does not compute.  Evaluation preparation and documentation, rounds, and screenings that cannot be billed for should be built into productivity standards.  I, for one, am ready to throw in the towel and work on my own.  There has to be a better way....and I'm ready to find it!

Carol, Acute Care/Outpatient - Physical Therapist, Hospital July 21, 2011 11:06 PM
Bluffton SC

I've done the same, many times. Unfortunately my body seems to be able to hold it together until vacation time. It is almost as if it is given permission to fall apart at that point and I waste 1-2 days with migraines/viruses/whatever ailment has been lurking and put on hold.

Be really extravagant! Take a day off and go be with your horses while you're well enough to enjoy it. It might become an occasional habit.

Now go and enjoy!

Dean Metz July 21, 2011 11:54 AM

Ha.  Keep thinking like that and you'll be burnt out in a year.  Good luck.  Don't sweat the small stuff.  Relax.  It's not a life and death occupation.  If you can't, time to look for a new job, maybe in a different facility or location.

Paul, physical therapy - PT, DPT, CGFI, outpatient clinic July 20, 2011 2:22 PM
New York NY

This is so true!  It is funny how excited and over-eager you are coming out of school.  My first year working I learned by trial and error that if you never say "no" you will forever be exhausted with patients who need super early or late times.

I am all about treating and helping people, but you have to at some point put your own self-preservation first...or you'll crash and burn.

This post hits home with many of us I am sure.

I hope you did get that time off by the way.


Jennifer July 19, 2011 8:54 PM

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