How To Avoid Burnout As A New Physical Therapist In The Home

By Alex Germano, PT, DPT

Physical therapist

You have probably heard that working in the home can be too difficult for your first job after school. The stress associated with scheduling your own patients, driving around busy areas, and constantly accommodating the needs of older adults can be a risk when entering this field. This stress over a longer period of time can lead to this tricky feeling called burnout. In a field where you are constantly giving your energy to your patients and their families, it is important to keep your head on a swivel for the signs of overdoing it. As scary as burnout can be, working in the home setting has been the most rewarding job in my life. The flexibility, autonomy, and ability to impact my patients’ lives on a day-to-day basis continue to energize me during those long days.

As I finish my first year at FOX, I reflect on times when burnout started to creep up. In addition to my full-time position treating older adults in their home, I took on a role as a lead therapist in a local assisted living facility, started coaching five CrossFit classes a week, became a new dog mom, and got married.

Burnout was definitely calling my name as I started to spread myself too thin in many different areas of my life. Below are a few tricks that I used to alleviate stress and manage the home visit setting like a pro, and I think you’ll find them useful.

ASSESS YOUR STRENGTHS AND WEAKNESSES

First, coming to terms with where you excel as a clinician and where you have room to grow is a great start in avoiding the new grad burnout.

When I started, I realized I was a strong communicator, very organized and punctual – all great things for home visits. On the other hand, I also understood that my ability to be flexible and think on the fly left a lot to be desired, such as when patients had to suddenly cancel or were having a bad day… yikes, not so great.

During my initial months with FOX, I always looked for opportunities that would help me showcase my strengths but continue to challenge my weaknesses.

I became more forgiving to myself if I wasn’t able to come up with a quick answer for rescheduling patients when they needed to change times. If I couldn’t come up with an answer to their questions, I’d also forgive myself.

Imagine if every time a patient needed to cancel, you became flustered and upset. Being that hard on yourself over longer periods of time can lead to burnout fast.

Instead, look at your “weaknesses” as growth opportunities. That way, you can give yourself the space and self-respect to work on them at your own pace or find other strategies to help.

FIND YOUR PEOPLE

I am a social person. Are you? Working in the home-visit setting can be a lonely grind. I rarely see co-workers, and I sometimes encounter a challenge during the day that has me reeling with questions.

I always reach out to my mentor first. With FOX, the Emerging Professionals Mentor Program offers a six-month mentorship for new grads that includes a ramp-up of caseload and one-on-one time with an experienced clinician. It was a great way to get a hang of being a home visit clinician and not feel overwhelmed at the start. My mentor is an invaluable resource that I continue to use past the six-month new grad period and we continue to talk just about every day!

And when it comes to talking to my co-workers, don’t discount the impact of today’s technology. I have a pretty great chat going on with my occupational therapy and speech-language pathology counterparts. We are constantly bouncing ideas off each other, reaching out for support for those tough patients, and coordinating our efforts. We usually have a pretty good laugh or two about what the day-to-day experience can sometimes entail! I can recall a few weeks ago when I arrived to a patient’s house, he was snacking on chocolate and sipping a small glass of red wine (thankfully he hadn’t made it far through the glass). When I told the occupational and speech therapists about this they were (*jokingly*) bummed they weren’t offered any!

I also recommend seeing your coworkers in person and attending journal clubs or meetings to get more face-to-face time. I usually feel the best after actually sitting and talking with the people who are also hustling around the state of Virginia working to provide this type of care.

Help is really never that far away, and we even have team members whose dedicated role is to support clinicians in the field. Once I established these forms of support, I realized that the 10-minute car rides alone between patients was actually a great time to decompress and prepare for the next one!

SETTING BOUNDARIES

Being a physical therapist in the-home is stressful, no doubt about it, and managing the delicate balance between work and the rest of your life can be difficult. If you let work take the spotlight after the hours of patient care, you will never really get the rest and recovery you need after a long week.

I recommend setting strict limits on checking email, calling patients, and discussing work after a set hour at night.

Documentation can be a bit tricky. Some days, you really can’t get it all done at point of service, which can mean a lot of work after the hours of patient care. It has worked for me to do the remaining notes at the end of the same day to avoid building up too much work on the weekends. I usually arrive home at 5 p.m. and spend some time with my pup. After making dinner and cleaning up around the house, I will give myself no more than an hour to haul through some notes. My husband is aware of the time I need outside of normal patient care hours and is very helpful in giving me the space do these things!

I enjoy keeping my weekends work-free and it truly helps in preventing work from overflowing into my life outside of being a physical therapist.

SCHEDULE A DAY FOR YOURSELF

The best part of working in the home is the ability to control your schedule. Every few weeks, I try to schedule a Friday free of work. This way I can decompress by sleeping in, enjoying a workout, and getting some things done around the house.

In the home-care environment, you can even follow my lead and schedule your days to start a little later or end early in order to accommodate appointments, coaching, or other special events.

TRY SOME CONTINUING EDUCATION

Though you’d think the opposite would be the case, funny enough, investing time in continuing education can help alleviate feelings of burnout. It can be monotonous to perform interventions over and over.

I feel the most engaged and excited to go to work every week after my virtual continuing education course meets. It helps me look at each patient in a new light and determine new strategies to progress them.

Burnout is commonly confused with doing too much work when really it can come down to feelings of ineffectiveness. Fighting these feelings with new knowledge is truly powerful and will empower you.