The rest of the story...really!

Part I

The thing about small towns is that every nursing home in the vicinity wants an OT.  While it is nice to be wanted, well, that is not my favorite gig.  Don't get me wrong, I do adore the geriatric population but working as a therapist in that setting is not my passion.  I also could add more home health patients, but not enough to make it economically feasable for me since driving between patient homes takes a huge chunk of the day.  I had sent out about 20 resumes to various educational settings to see if anyone needed help mid-year.  No luck.

I ended up keeping my home health patients, which I had 4 originally.  I also ended up back at the hospital 2 days a week to help them out.  Sometime in Decemeber, I received a flyer in the mail about a new outpatient pediatric therapy clinic opening soon in a town about 30 minutes away.  It peaked my interest so I checked out their website then called the administrator to get some details.  The flyer made the place seem very similar to ones I was familiar to in Dallas.  One of "those" places where they say they can meet many various needs under one roof.  My experience had been that too often "those" places were staffed by newer therapists (either new grads or new to pediatrics) and/or staffed in such a way that cookie-cutter therapy was applied to almost everyone.  My other concern was all the rules that would be involved since it would be/is a certified CORF (Comprehensive Outpatient Rehabilitation Facility).  When you start dealing with Medicaid and Medicare, it just feels too complicated to me.  So, I approached this situation with some hesitation.

After interviewing, negotiating, investigating, and praying, I took a position there 3 weeks ago and started working there 2 weeks ago.  I am working there on Tuesdays and Thursdays, 9-5.  At first, I hated the thought of not picking my kids up those two days and just being gone longer in general.  However, things seemed to fall into place which made it a bit easier.  I still take the kids in the morning since I don't have to be there until 9 AM.  B stays 2 extra hours with Aunt J while A and L both get to enjoy their respective "after school care" activities.  They were thrilled, so that made me feel less guilty.  I mean who wouldn't be thrilled with games, snacks, etc!  Daddy picks them all up and I arrive home shortly after they do.

I think I will like working there for the most part.  Like I said, all the rules that go with the type of facility it is will take some getting used to, but I feel like that will work itself out soon enough.  If I had to break it down into postives and not-so-positives, it might look like this:

Positive:

•  Brand NEW 10,000 square foot facility.  An extra bonus is that they are utilizing that square footage inside of the town's small outlet mall.  A boost for the mall, the community, and any of us that might need to shop at the kitchen store across the "hall" when we have a break!  :)
• All new stuff~ equipment, supplies, you name it!  The administrator has great taste and has done a nice job of making it very welcoming and engaging for the kids, while at the same time very useful for the staff and families.
• The opportunity to be part of the start-up.  It has been exciting to have my opinion valued and get to make decisions regarding what the needs of the facility are in order to best serve the clients.  I mean who doesn't love spending other people's money...with their permission!!
• The opportunity to set the standard of care for this facility.  That means a LOT to me!  So far, the staff is small until our client base grows.  We have the administrator, office manager, social worker/assistant administrator, speech therapist, occupational therapy assistant, and occupational therapist (me!).  There are a few others that have already signed on to work as needed, but basically, if they can get a physical therapist and a dietician hired, that would make a great start-up staff.  Again, setting the standard of care is so important to me.  In spending time with the other current staff, I believe that they are mindful of that as well.  I have been told that despite what and how similar types of facilities are doing things, that our goal is to provide the best that each individual client and their familiy needs. 
• Finally, a place once again to house all my STUFF!  :)  I have been a therapist for a long time so I have lots of stuff; papers, articles, books, stuff!  I am so proud of myself too!  Because we didn't have clients the first two weeks (getting the clinic ready), I had time to actually organize my stuff.  I love nice, clean labels on nice, new folders!  :)

Not-so-Positive:

• Not having control, or not having full-confidence of those in control, of hiring.  Don't get me wrong, I truly like the administrator and I think she will listen to my opinion regarding some best practice towards hiring, but it is still an uneasy feeling when you have not known those in charge for long.  My two biggest fears are that too many new graduates or therapists that just want a "change" and decide to switch over to pediatrics will get hired and/or others will be hired eventually that I don't share like-minded philosophy with.  I certainly don't mind some balance, but I have to have confidence in those that I entrust these kids to or work along side.  I don't mean that in a know-it-all way.  I certainly do NOT know it all and I am always wanting to learn more, but there just needs to be good fit among the staff.  Puzzles pieces~ each different but creating the whole picture once fitted together.
• The fear of being told how to treat or what can and can't be done for a child.  I don't know really.  I don't think that will happen, but I can't say for sure it won't.  Just a fear of the unknown, I guess.  For example, when we were learning the computer system and how to input the information for reports, I wanted to be able to utilize a style of reports that I felt was most beneficial for the families.  The IT person was very willing to take my suggestions and try to create something that would work, but I could tell this would be new for them.  I mentioned that I like the written reports I give my families to read a certain way and I learned that the other facilities don't usually give reports to the families.  Uh, what?!  Again, I am hopeful that this is my chance to set the standard.
• The fact that this is a "business" into which a couple of people have invested a lot (a lot) of money.  I am not used to that.  I hope the "business" doesn't interfere with the task at hand!

I will leave the not-so-positive's at a minimum because I want to believe that this is a good thing and not keep second guessing.  And although when my opinion is requested I feel free to give it, I want to try not to always say, "well, where I used to work...".  (However, I loved so much of how we did things there, it is truly hard not to start my sentences that way!)

I am grateful to have this opportunity again.  I believe this can be a much-needed resource for the community the facility resides in as well as many of the smaller surrounding communities.

Fingers crossed!

Stacey