Productivity Issues & Working Off The Clock as a Travel Therapist

hey everyone hey guys welcome to another

travel therapy mentor

live video tonight we're going to be

talking about some productivity issues

and working off the clock as a travel

therapist

over the last few weeks we've seen the

market picking back up and

some travelers have reached out to us

recently a few different travelers

reached out to us with issues about

their contract

they were wondering about how they

should handle a situation where

they're either being given too too big

of a caseload

such that they can't get it done in a

40-hour period

how they should deal with that how if

they should approach the manager if they

should approach the travel company if

they should just work off the clock what

should they do

so we want to go through some of that

and hopefully give you guys some insight

so whitney's going to introduce us and

i'm going to get this video shared in a

few different groups

hey everybody my name is whitney aiken

and i'm jared kuzaza

and we are both traveling doctors of

physical therapy thank you so much for

joining us tonight i know many of you

guys may have tuned in in the past

every week we bring you a new video

about a different travel therapy topic

each week we upload our facebook live

videos to our youtube channel and

our podcast so thank you for those of

you guys that are listening or watching

on other platforms

we hope tonight's topic will bring you

some value and bring you some insight

from our experience

this productivity thing is probably the

worst part about being a health care

professional

and i hope that many of you guys

watching this will get value out of

tonight's video

and i'm sure that many of you agree

whether you're a permanent therapist

or you're a student who's gotten into

some of your internships or if you're a

traveling therapist

many of you guys may have experienced

this in the past these productivity

issues

it's definitely not unique to being a

traveler but we want to talk a little

bit about

some ways that you might encounter these

productivity problems

as a traveler and some ways that you can

approach the situation

to try to avoid having to work off the

clock

and then try to avoid you know having a

confrontation with the facility or

worst case scenario avoid having to have

your contract ended if there are

problems

so this is definitely something we've

had personal experience with in the past

so we're going to talk a little bit

about how you might encounter these

situations

in different settings we'll talk about

some of our experiences

um you know where we ran into problems

and then how we handled it and we'll

give you guys some suggestions as well

so if you are tuning in with us live or

you're watching later on the replay we

would love if you'd leave a comment

below

and just say hi i see that quite a few

of you guys are tuning in with us live

hi ben hi jonathan hey ally

thank you guys for tuning in we just

love if you'd say hi

in the comments let us know who you are

are you a current traveling therapist

are you someone who's thinking about

doing travel

hey jessica thanks for joining and if

you wouldn't mind just giving this video

a thumbs up

hopefully you'll gain some value and

some insight from it tonight we really

hope it will be helpful

so you guys can move forward and stand

up for yourselves

as a clinician and not just be a

workhorse for some of these facilities

where they

unfortunately will push you if you let

them

hey jonathan jonathan says hi guys i'm

all about this conversation i know

jonathan had commented on our post

earlier about being a

crusader as he said for this issue so i

thank you for joining

jonathan hi lynn thank you for joining

as well

so as we mentioned sometimes jobs in

general

not just travel jobs but a lot of

healthcare jobs will have pretty

unrealistic

expectations for productivity for

example your skilled nursing facilities

that want 90 plus

percent especially for evaluating

therapists

your outpatient clinics that are wanting

to see you to see 18

20 plus patients on an eight-hour day

and you know we'll go over some of the

other settings so this is not uncommon

to see

unfortunately and there's a big

difference here when we're talking about

being a travel therapist

versus a salaried employee and and why

it might be different for you with this

whole working off the clock thing

yeah i think the first thing to cover

here is that a lot of facilities that

you go to

as a traveler they might not have ever

had travelers there before and they

don't understand how the process works

they have just talked to the travel

company and

they look at you sometimes as like a

salary person coming in just to do the

job

and it doesn't matter how long it takes

you because a lot of times they just

work with salaried employees that

they if they work more than 40 hours it

doesn't really matter to the company

they're not billing for more than 40

hours they're getting paid the same

whether they work 36 or 46

and so sometimes it's just a situation

where

the facility has unrealistic

expectations for a 40-hour work week and

they don't even understand that you're

just an hourly employee

and how the process works so sometimes

it's as simple as just explaining to

them the situation

how being a travel therapist works how

as an hourly employee you can't legally

work off the clock you can't work

you can't clock out and do documentation

like sometimes uh

permanent employees or salaried

employees are willing to do

so sometimes it is a very simple

conversation but sometimes it can be

more difficult and it's tricky um you

know for you guys out there right now

that are salaried employees listening to

this we feel for you too

we hate that there are such things as

salaried positions

where you're kind of expected just to do

the job i know you guys end up working

way more than 40 hours a week you end up

working 45

plus sometimes um and it's unfortunate

there are pros and cons to that too i

mean it

is nice to have a guaranteed paycheck

and uh and that

that kind of thing so there are pros to

being a salary person but

definitely a downside is being expected

to just work as many hours as it takes

to get the job done yeah unfortunately

in healthcare as healthcare employees

you know what we do has to be tied to

some type of productivity

expectations some kind of metrics and

that's challenging because the facility

has to get paid

but as travelers as it is we are hourly

employees so we can use that to our

benefit as long as you stand up for

yourself and let it be known that

you're expected to work only 40 hours

you need to be able to get

the work done that's required in a 40

hour period and

for us as healthcare workers i hope you

guys agree that part of our work is our

documentation time that is part of our

40-hour work

week we shouldn't be having to take this

documentation home

and do it on our own time or do it off

the clock even though there are hourly

employees that are permanent that will

clock out to do their notes to try to

meet their productivity

we really hope that you guys will stand

up for yourself and not do that we'll

talk through some strategies about how

to

make sure that's the case yeah we've had

managers and we've heard from a lot of

travelers that they've had managers as

well

that that think of documentation as

almost like an extracurricular thing

like

it doesn't actually it's not part of the

job but that doesn't make any sense

documentation is

definitely part of the job and if you

don't do it the company doesn't get

reimbursed for the treatment so it's a

vital part of the job

and that should never be something that

you're expected to do after hours or off

the clock

yeah so we'll talk about some different

settings here some issues that you guys

might encounter and we'll tell you about

what we've encountered as well

so i'll cover skilled nursing facilities

first because i feel like these are the

ones that really push for these

unrealistic productivity expectations

now with the recent medicare changes

that happened in the fall was it fall of

last year has it been that long

it's been almost a year now um since

pdpm

came out the these new medicare rules

tried to change some of the billing

tactics

in the therapy world in skill nursing

facilities

and we have not worked in any skilled

nursing facilities since those changes

have come about but i do know that

they're all you know facilities and

management are always going to find some

way to try to

up the ante and work around these rules

to try to get more out of their

employees

so even though some of the rules have

changed i know there's still going to be

problems with productivity expectations

so

prior to pdpm a common thing was to see

an expectation of 90 percent

plus and with the ability to use

group and concurrent treatments more

which i know

with cova that's probably not as doable

right now but i know that when

the facilities allow you to use the

group and the concurrent more they might

even want more than 90 percent they

might even want like 100 plus percent

productivity which is just insane if

you're treating more than one patient at

one time

yeah the beginning of the year we heard

of some travelers ptas

that had assignments that expected like

110 productivity which is

it's wild yeah it's crazy so back before

the the rules and it might be kind of

the same right now let me know if you

guys are working in skill nursing um i

know they

they were trying to push more group and

then with cova they had to take

group back so it's probably still a lot

of them are probably still expecting

that like 90

mark that meant you i had almost zero

time in the day for anything so much as

a bathroom break

a conversation with your co-worker or

those inevitable things that happen

where you have to go and

talk to a nurse or the patient you go

and try to get

isn't available maybe they're in the

bathroom maybe they're at

an appointment you know all those little

tiny things that add up in your day it

left

almost no time for any of that much less

your documentation time so it was just

completely unrealistic

um so yeah that's what we would run into

and we would never take a contract as a

as an evaluating therapist a pt and ot

or slp

where they asked for a strict 90 plus

because in our experience and working in

skilled nursing that just wasn't

possible yeah we whitney's taken a

couple sniff contracts i've only taken

one

and we never took one that wanted more

than 85 percent which still

can be really difficult depending on the

situation but

yeah i mean there there's basically what

happens in a lot of situations

is either the the traveler or the

permanent therapist there will

start working off the clock or they will

start sacrificing patient care

to try to get improved productivity and

we're not willing to do either of those

things and i don't think that you guys

should

be doing that either and we ran into a

lot too and i'm sure you guys watching

this have seen the exact same thing

we ran into a lot of the permanent staff

there would just find ways to cut

corners to meet these numbers even

though they weren't realistic

so they kind of would lump a bunch of

time into their evaluation codes

or if it was a discharge or some other

note that required a lot of time because

i know if i was working with a patient

who

say they were max assist you know the

entire time that i'm in the room with

the patient my hands are on them and i'm

doing things so then i have to then walk

back to the computer and sit there for

30 minutes and type the note

and that time is actually not billable

if you're not with the patient but what

we would find is that a lot of the

therapists would just lump that

time that they're sitting at the

computer typing in the therapy room

lump that into their eval charge and

they would also lump other things in

there like running around looking for

equipment

like wheelchairs and wheelchair legs

they would lump in the time that they

were talking to the nurse or trying to

find

other equipment um chart reviewing and

all that sort of thing but technically

you're not supposed to bill for all that

unless you're actually working with the

patient

so i unfortunately see a lot of

therapists cutting corners just to meet

these unrealistic numbers

so that's a big problem in my opinion

for skilled nursing and one of the major

reasons why we won't work there again

yeah um so unfortunately that's a big

thing with skilled nursing the other

thing is just

like i mentioned a lot of those

unaccounted for times like you have to

just do so much in an acute care

or an inpatient setting whether it's a

skilled nursing it's a hospital

all those times where you're just

running around trying to you know get

patients and you can't quite get them or

talk to the nurse or talk to another

staff member and it's really hard to

account for your time there and these

are reasons why productivity might be a

little lower

and why we feel something like 75

percent is a little more reasonable

yeah um but in the medicare world and

the billing

impossible to find that yeah it's just

so hard so those are some of the issues

you'll run into

in an inpatient or skilled nursing

facility for home health

some issues you could run into there

would be that

the facility or the management of the

home health company would

assign you too many patients so what

would be a typical number of patients

for i think between four and six is

pretty normal and it depends on how many

evals starter cares things like that

but i think an average is about five

patients per day for home health

so you would want to watch out for

contracts that would be asking you to

see

way too many patients in one day you

would also want to watch out for

contracts that were asking you

just to do too big of a driving radius

because if you were just in one small

county it might be more realistic to do

the

six plus patients a day whereas if

you're covering multiple counties you

might only be able to see like three

yeah so you need to look out for that

because those are some ways that they

might push you

to do too much that's unrealistic for

you to be able to meet

in your 40-hour work week yeah we had

somebody last year actually

reach out and ask us about a potential

contract they were going to be taking

and they interviewed

for a home health position and they were

being they were told that they would be

seeing eight people per day so 40 people

in a week

which is impossible unless they're all

in the same building or something

there's no way that you're going to be

able to do that in a 40 hour work week

yeah and the other thing would be

looking at the point system and how many

points they're assigning a certain

type of visit so if you're being

assigned something like a start of care

you have to expect that it's going to

take you quite a lot more time to do the

documentation for assertive care than it

would just a standard visit an

evaluation or a discharge

so that should be accounted for in your

productivity if you're getting a lot of

starter cares in a week

then you might end up working way more

than 40 hours

because the documentation time so you

have to fill out that situation and see

am i reasonably able to complete all

this work including the documentation

within the

40 hours that i'm expected

so let's talk about outpatient next so

outpatient there's a variety of things

that can cause it to be

cause you to be in a situation where you

have too many patients you can't get

everything done

during your normal hours and those

include things like overlapping patients

double books evals at the end of the day

that's something we ran into we worked

at a facility one time

where they put all their evals right

before lunch and right at the end of the

day

so you never had time to document the

evals unless you were staying after and

doing it then

and for their normal staff they were

used to doing that but us as travelers

were getting paid overtime to do that

and that was a point of contention and

we're going to talk about

um here after we go throughout the

settings some ways that you can approach

these situations to try to solve the

problem solve a little bit and we'll

tell you how we problem solved with that

one but

yeah outpatient um you know as we know

especially in the pt world

we have some of those what we call pt

mills that will just try to pump

more patients through the door and if

you're finding that you're having to

stay

over to get your documentation done

that's not okay you should be able to

complete all your visits

for the day and all your documentation

during your 40 hours and not stay after

not take your notes home

so there's a lot of outpatient clinics

that will try to put way too many

patients on your schedule

for the day yeah we've taken the

majority of our contracts on outpatient

and we've run into situations like that

and sometimes you have to have difficult

conversations

if you have way too many patients you're

not able to get everything done

and usually managers are willing to work

with you but it really just depends on

the situation

um the next setting i kind of mentioned

a little earlier was acute care in our

experience acute care is

the least um bad i guess

about this we never really had any

issues with any of our acute care and

even

in my acute care rotations as a student

i didn't feel like productivity was an

issue

i felt like i usually got out of there

in under 40 hours most of the time

and a lot of times with the patients

when they just are just admitted to the

hospital sometimes

they can wait until the next day to be

assessed or seen by a therapist

so i felt like acute care was the least

bad of all the settings in terms of

giving you unrealistic

productivity but you know depending on

how big of a hospital it is and how well

it's managed you could always be given

too many patients you could always be

given too many

floors or units to have to float to

which could make it difficult to

complete the required patient load in

the 40 hours we pretty much never hear

from travelers that have issues with

productivity and

acute care i don't know why that is but

it seems like reimbursement is set up so

that it's not so much

pushed to see as many patients as

possible yeah if you're

typically an acute care therapist please

leave us a comment and let us know if

you agree with that or if you've run

into problems with your productivity in

acute care but

as far as we understand we don't feel

like it's too bad in acute care

and then the last one i want to mention

were schools now we have no experience

working with pediatrics or working in

schools but i have heard insights from

therapists who do work in schools

that sometimes you'll be assigned too

large of a caseload so too many kids on

your caseload

sometimes you'll be assigned too many

schools to have to float to so sometimes

you'll be within one district and have

to float to more than one school which

could be

problematic and then i think a big thing

with schools are the iep

requirements so sometimes you might be

assigned

too many ieps which results in just too

many meetings and phone calls

and it's a matter of how do you account

for all that time and still get paid

for your hours and i know that um

schools are typically like a 36

hour contract not a 40-hour contract so

you want to be aware of that

you know talk to some other therapists

who are experienced in working in

schools

find out what's a reasonable amount of

kids to have on your caseload with a

reasonable amount of schools to be

floating between

and what would be a reasonable amount of

ieps and different meetings that you

would be involved in so that you're not

spreading yourself too thin and working

way more than your 36 to 40 hours

in that setting all right so let's talk

about how we handle a situation

now that we've talked about all

different settings and how this can

happen how do you handle

a situation where you get to an

assignment and

you have way too much work you know that

it's going to take you

say 45 hours a week i had a new traveler

he's actually a new grad that called me

last week to talk about a situation

where he started a contract

was told he was going to see eight to 12

patients per day in outpatient

and he got there and he had like 22

evals his first week which was

insane and then when he didn't have eval

scheduled he was being double or triple

booked

each hour triple triple booked so he was

asking me like how do you handle that

situation

um first first thing to to mention here

is the best thing to do is not ever have

to deal with this type of situation so

in your interview try to ask very

detailed questions

to understand what you're walking into

so don't just

go into your interview very prepared so

a lot of travelers we've talked about

this in the past

they think of an interview as them being

interviewed for the position which is

obviously normally how it is and travel

contracts are that way to an extent

but with a travel contract you're really

interviewing the facility as well to

make sure it's a good fit for you

so you have to go into it prepared and

ask very specific questions about

caseload and evals per day and all this

all this stuff so you know if this is an

assignment that will work for you

and if it sounds you know it sounds like

there's too many red flags like

22 evals in your first week that's

something that you need to ask about

so hopefully you can avoid this

situation but with that being said

they're not always up front about

this and this traveler said that he did

ask and he was told 8 to 12 patients per

day

and then walked into to this situation

yeah it's

tough we can't stress enough being

prepared for your interview so

we have some suggested interview

questions we have an article on that on

our website at traveltherapymentor.com

but i always recommend writing out a

list of questions specific to the

setting in which you're interviewing

so my question list would look different

for an inpatient setting than it would

look for an outpatient setting

or vice versa so you want to ask if it's

an outpatient setting how many

patients per day typically you know if

it was a skilled nursing facility find

out what's the productivity expectation

if it's a home health setting um ask how

many patients per week or how many

points per week how are the points

weighted between the different types of

visits

you want to find out some really

detailed questions about about

productivity

if it comes to outpatient and really all

the settings you might ask what's the

typical number of evaluations that i

might see in a day

or in a week now typically for example

with outpatient they might

front load your case load where you have

a lot of evaluations to start just so

you can build your caseload up a little

bit

but you know hopefully that wouldn't be

for example this traveler having so many

the first week

hopefully that wouldn't be the case

throughout the contract

so you want to find out you know what's

my first week going to look like am i

going to have some ramp up time that

sort of thing

um so and to add to this situation with

this traveler

um his first day he had six evaluations

scheduled

and two triple book treatment hours so

that's 12 patients which

is actually what they said he would have

but obviously that is a situation

if you have six evals and and on top of

that you do not know the documentation

system at all

that is an extremely hard situation i

mean that's going to take a lot of time

to document all that get

get used to the documentation system

enough to even be able to document six

evals it's going to take some time

so his question was what do i do here

and um

basically i was trying to give him some

advice it's a tough situation but

the first thing is talk to the hiring

manager and say like hey

i'm not familiar with the system it's

going to take me a really long time to

do this are you guys willing to

pay for all the hours it's going to take

me to do this and by you asking that

question

it's letting them know that hey i'm not

just gonna

have 12 hours of work this first day and

only bill you guys for eight i'm billing

you for 12.

is that okay and then that's opens the

door for the conversation for them

either to change the caseload and and

try to

adjust things and make it more

manageable or to say

um you know this first week is going to

be rough we're willing to pay you

overtime

and that may or may not be okay with you

you know that's still a very difficult

first week

but in that situation then you can you

can ask the question of

can we adjust some things uh this is

probably too much for me

for this first week can we like while

i'm getting used to the documentation

system can we have less evals or

something along those lines

yeah so we're getting into a little bit

of talking about um

kind of what to do if you get in that

situation there's only so much you can

screen for on the

um the interview and sometimes you know

they'll tell you they'll make you all

these promises and then it might be a

little bit different than when you get

there

um just before we jump into that too

much i did want to say a couple other

things

to ask about during the interview

because something else that can make a

big difference would be

asking what other staff members are

available so

if you were interviewing for an

outpatient contract and they said we

need you to see 15 patients a day

that would be quite different if you had

a tech available versus if you didn't

so it's really important to ask what

kind of support staff is available

i would also ask what how many other

therapists of your same discipline

work there because settings like skill

nursing for example if you are the only

pt or ot or slp doing the evaluations

that's going to spread you a lot thinner

and make 90 productivity a lot more

difficult whereas if there are

two pt's or two ot's to spread out the

evals that discharges the progress notes

that might make your case load a little

more manageable yeah and asking how many

assistants you're managing if you're an

evaluating therapist

that's a big factor as well if you are

in a skilled nursing facility where

you're the only pt and there's no ptas

obviously that's going to be a lot

easier than if you're the only pt and

there's three ptas that you're doing

supervisory visits and

progress notes for all their patients

you might also ask if there's any other

type of support staff for example like a

front office person

so this is something we never really

thought to ask about for outpatient but

we've had some outpatient contracts

where they might have a front desk

person but that person may or may not

do the scheduling yeah we had no idea

that this was a thing until

my first assignment ever was an

outpatient assignment where i had to

schedule all the patients

and that can be very time consuming

especially in an evaluation

when you have you know you might think

60 minutes to do an evaluation is a ton

of time

but if you have to spend 20 minutes of

that trying to schedule out their next

10 visits

you know it gets pretty pretty tight on

time and it makes documenting difficult

we mostly ran into that in

hospital based outpatient clinics where

they might have the support staff doing

a couple different roles in the hospital

so they might not necessarily have like

a

front desk that does the the scheduling

so yeah we would find that that would

actually take up quite a bit of time

we'd have to allow time at the end of

the evaluation which that time usually

when you pass it off to the front desk

to do the scheduling you have like five

or ten minutes

to finish typing your eval but if that's

not the case that takes a lot of time so

ask if there's any other tasks and

duties that you're responsible for

outside of patient care

would be a good question also during the

interview

here's a red flag we want you to look

out for and you're if you're asking

about productivity

and you're you're finding out a little

bit about what's expected of you

it's always a red flag if they say oh

yeah but if you

if you need to you can take your laptop

home and do

your documentation at home you know

after work that's fine

yeah that is a big red flag and actually

uh we've been to several outpatient

clinics that

that say that kind of thing and what i

used to love to say back then

when we lived in the fifth wheel is oh

we don't have internet access at home

i can't do that anyway uh that was my

favorite thing to say but obviously that

is uh

that's kind of a funny thing to say that

was jared's way of like skirting around

the issue without actually having to

like confront the issue

yeah um what i would say you know for

you guys is to say

you know um i won't be doing any

documentation at home

i am an hourly employee so i'll only be

working on the clock

say that sort of thing yeah and you

really honestly you know i think you go

into an interview and you want to have

all these pleasantries and you want to

make a good impression and you want to

be nice

and you you know you want to make it you

want to make a good impression but

if it really means the difference

between you having an awful experience

versus like finding out the true

nitty-gritty details

and maybe having to pass on the

interview you need to ask the hard

questions

and not just do the niceties on the

phone because it's so much easier to

just

be a little bit straightforward on the

phone and then end up saying you know

what i'm sorry this isn't the job for me

i appreciate your time

rather than just say oh yeah yeah that

sounds okay and then you get there and

it's a nightmare yeah

because it's not just it's not just a

job you will have maybe

moved your whole life to go to another

state to this job

and then if it's awful and you're stuck

there now and now you're having to

backpedal and deal with the issues that

we're going to talk about here in a

minute once you're there

it's a problem so ask as many questions

as you can on the phone

be kind and nice but be professional you

know be professional but also be a

little bit firm

on on your phone interview don't be

afraid to ask some of those difficult

questions and put the interviewer on the

spot

um something else i have done with like

the skilled nursing ones

if the interviewer says it's 90 or

whatever i would say something like

okay how have your travelers in the past

or how did your permanent staff how did

they manage their caseload

um such as that they could get this done

in 40 hours something like or you could

just ask something like how do you

handle non-visit discharges because

that's a non-billable thing

that's obviously going to take time how

do i do that if i'm supposed to be at 90

or we would say something like okay if

i'm going to be the only evaluating

therapist there and you'd like for me to

have 90

productivity um you know what if i have

a lot of

a ton of admissions a ton of evals one

week or what if i have a ton of

discharges one week and my productivity

drops below 90 what then and if you get

a nice response where they say well

we'll work with you and it's okay

you know as long as you average you know

85 to 90

that's okay if they say that they're

going to work with you if they seem

kind talk through some of these

scenarios and find out what feedback you

get

but if you just hit a brick wall and

they just say no it's 90 percent

yeah it's probably not the kind of place

you want it's probably not the kind of

place you want to be so those are the

situations where you really need to kind

of push the interviewer a little bit to

see what it's going to be like

try to in your head walk through your

day of what it might look like

what if i run into this issue and what

if i run into this just you and that

sort of thing because you really want to

find out as much as you can before you

agree to take this job

yeah one other thing we should cover

here is

some travelers in the past i've talked

to they feel bad

um trying to get like basically counting

extra hours or getting overtime because

they feel like okay i'm already making

more money than the permanent staff

i should just do what i need to do to

get the job done they work off the clock

i can do it too

i understand this way of thinking but

what you have to remember and sometimes

managers will make you feel that way too

as a traveler they'll say

things like well you know you're getting

paid a lot to be here

you should be able to get the job done

or something like that they'll make

these comments

that kind of kind of put you on a

position where you feel like you should

work off the clock to get everything

done what you have to remember is

you're doing them a service just as much

as they're doing a service to you uh for

you by paying you money

um you're helping them with the patience

like they needed someone there and

you're filling that role

you should not feel like you're taking

advantage of them and

you deserve to be treated worse than the

permanent staff or you deserve to be

taken advantage of because you're making

more money

you have to remember that the reason we

make more money as travelers is we have

duplicate expenses we're paying for two

households

and that comes with additional costs

obviously

so just because you're making a higher

hourly rate doesn't mean that you really

come out that much further ahead

when you account for all the additional

costs and all the additional hassle and

the

risk of like cancelled contracts and

things like that so never look at it as

oh i'm a traveler i make

more money than i should just suck it up

it's extraordinary

extremely important yeah ezra had said

not only are we paying duplicate

expenses but you have moved your life to

get there probably in like a two-week

period you know these jobs are listed as

asap starts

they need somebody right now they're in

a tough situation you have moved maybe

across the country

across a couple states at least a few

hours away

and you have come there and you have

come to do a job for them because they

had no one else

if they had someone else they would be

there if they had a local employee to

hire

they would be there you are there to

provide a service and we

earn a certain wage to be able to do

that so you should not feel bad

about making the money that you make and

you should not be made to feel bad

i was made to feel bad at my first job

my very first travel job

we had an interim manager who was a

physical therapist assistant and i was a

pt a grand new

new grad pt so he probably knew how much

i was making

he probably knew that i was making more

than him because he was a pta

in a interim uh role as the director

and one day i made a comment that i said

i was going to step outside because it

was a nice day at my lunch break and i

was gonna eat my lunch outside

and he said to me you ate your lunch

outside and i said

yes i did and he said you should've been

working on your notes at lunch

most of us do our notes at lunch and i

said

well i clocked out for lunch because you

know that's what i'm supposed to do

i don't work during lunch and he said oh

well you know we're paying you a lot of

money to be here

um something like that and i just i

don't remember exactly what i said but

this is like the exact situation where

you need to say stand up for yourself

and not just be made to feel bad

and be made to feel like you need to

work off something yeah don't get taken

advantage of like that it happens to

a lot of people we personally

me specifically i have never worked one

minute off the clock i've

built for every minute i've ever been

working on anything patient related

and i refuse to to do that i just i set

the precedent early on i will never do

that

and and i think that you guys should do

the same and i think that there's a way

that you can go about it very

professionally i think you just need to

remind the person who's addressing you

the director the manager say i'm sorry

i'm an hourly employee

um i'm not a salaried employee i clock

in when i'm working and i clock out when

i'm not working

if i'm required to complete this

documentation if i'm required to

complete these duties i'm going to be

working on the clock it is illegal

for me to work off the clock um so let's

get into talking about some ways that

if you run into the situation where

you're going to

be either going into overtime to do the

work required

or you just realize the case load is is

too heavy for what you can complete in

40 hours

so yeah jared kind of had mentioned this

a little earlier with the outpatient

scenario

yeah there's a few different ways you

can handle it if you run into

depending on if they say something to

you or not about those kind of things if

if the situation is just that you have

such a large caseload that you're

documenting

and you have to work after hours to get

the documentation done

usually the way i'll handle that in the

beginning especially if i'm new to the

documentation system it's taking me

longer anyway

they should understand that so they

shouldn't just expect someone to be able

to come into a new facility

new documentation system work a full

case load like someone that's been there

for years

and be able to get it done in 40 hours

like that first week

especially so there's been a lot of

situations in the past where i'll start

an assignment and i'll walk into a full

caseload no orientation or anything like

that which is just

you know that's not an ideal situation

but sometimes it happens

and in order to get oriented with the

documentation system and get everything

done

it might take me 43 or 44 hours the

first week so what i'll do is i will

account for every hour that i worked

every minute that i worked

write it on my timesheet turn it in at

the end of the week

that is the uh the situation where

they'll look at the timesheet they'll

see that you have overtime on there

and either they will sign it not say

anything and then that just

sets the precedent okay i'll work as

long as i need to to get this done i'll

get paid over time for it

i make a very good overtime rate i'm

fine doing that or they'll say

hey you have overtime on here we can't

really pay you overtime

and then that's when you you start the

conversation of okay

it took me a long time to do all this

documentation working

i stayed afterwards i was doing doing um

you know say i had

additional evals some days or whatever

double books things like that and just

lay out

what the situation was and say okay in

the future it probably won't take me as

long because i'll get more familiar with

the documentation system but

still if i'm working over then i'm going

to put that on my timesheet

and that i'll tell them i'm an hourly

employee i clock in when i get here i

clock out when i leave

and then whatever the time is is what i

write on here and

they can either change the schedule to

account for the extra time that i need

to get things done

or they can pay overtime and that's

really the situation that they're faced

with

obviously a lot of managers don't like

that but there's nothing they can really

do about it like

you're an hourly employee that's the way

it works yeah so in the situation of a

skilled nursing facility i had this a

couple times

where i would realize that they would

put you know

seven hours and 45 minutes of patient

care on my schedule for the day

and i had an eight hour day and so if

that monday

they put seven hours and 45 minutes of

patient care on my schedule and it took

me

eight and a half hours or nine hours and

then you know by tuesday it's the same

thing

i would usually um go to the director

and say um

hey you know i know it's only tuesday or

wednesday and i'm already at this many

hours for the week

what would you like me to do and that

will usually open the door for a

conversation where they'll say why are

you not able to complete

um the the required you know amount of

patient care in these required

number of hours so i usually will go

through a detailed um you know list well

this patient you know i had to do a a

discharge in this patient i had to do an

evaluation and

you know these other duties that i'm

required to do i'm not able to complete

it in that amount of time

so there might be a discussion there

about trying to

improve your productivity they might

want you to try to do more point of

service and you'll have a conversation a

point of service documentation meaning

that you're typing while you're with the

patient

so you might carry on a conversation

about how you could improve that

but what they might say is okay i'll

adjust your schedule for the later in

the week so i'll give you a little bit

less hours

on thursday and friday to keep you under

40.

so it's good it's a good way to open up

the dialogue and you'll find out what

the manager is willing to do or not

we have had managers where they didn't

have any other physical therapists in

the region say if it was a rural area

where they would say it's okay i don't

care if you go into overtime because i

just need to get these patients seen

but i did have other managers that would

say i'm just going to adjust your

schedule

so you only have you know five hours of

patient care on thursday and friday to

keep you under 40 hours but they'll also

probably try to give you

you know can you please try to just be

as productive as possible and then you

just say

yes i'm trying to be as productive as

possible i'm doing my very best

i'm you know doing the best that i can

but you know there are a lot of

discharges and there are a lot of

progress reports and i am the only

evaluating therapist

and i am having to supervise my

assistants and that sort of thing and so

if you have this open dialogue and stand

up for yourself

you know it's going to go one way or the

other if they're being if they're really

pushing back and they're not giving you

any leeway

after you tried to have these

conversations with the manager this is

when we'd say it's a good time to go and

talk to your recruiter about it

yeah and what whitney laid out there is

probably the best way to handle it so

about midway through the week go to the

manager say hey

this first couple days i've gotten more

hours than eight each day

um how can i adjust the schedule or is

there is it okay if i go into overtime

it's probably better to

address that before you get to the end

of the week and you already have over

time

to give them a chance to adjust things

or just to give them a heads up that

it's going to happen

that's probably the best way to handle

it if you guys have any suggestions how

you handled this in the past

let us know in the comments yeah

absolutely and if you guys are watching

this if you're learning anything if

you're getting any value out of

tonight's video we'd love if you press

the thumbs up

button give us a heart comment

anything like that just to show us a

little bit of love on the video

um so i think that's the best swing

thing to do for any kind of inpatient

uh facility because they can usually

adjust the number of patients on your

caseload

for an inpatient facility for a home

health visit you know they might say

okay i'm not going to give you as many

visits

towards the end of the week maybe i can

give some of the visits to a different

therapist

you know let's see how we can adjust

this now i have

had some issues where it went beyond

that we had a couple times especially

at one skilled nursing um where we

worked together in one school nursing

where i was by myself

where it didn't work out i mean not to

say it didn't work out but there was

something that had to happen beyond

just talking to the manager because they

were not pleased with our productivity

because again we were not willing to

bulk up our eval minutes and lie and

commit medicare fraud we were not

willing to work off the clock so our

productivity was a lot lower than 90

percent

and keep in mind this is a facility

where everyone else there did those

things

they clocked out um to do documentation

they added extra minutes for patients so

the manager thought that there was just

something wrong with us

i literally would unfortunately watch my

assistants my physical therapist

assistants

stand in the hallway of a patient with

their ipad

um in front of a patient's door and

clock out for 10 minutes until the

patient was ready to be seen

and then clock back in so that their

productivity would not reflect poorly

because they didn't want to lose their

jobs and it was the saddest thing

that is a terrible situation because you

know they live there

and they need that job and there might

not be another facility around that they

can go and work at and they don't want

to lose their job to another

um pta or coda or someone who who's

waiting to have that job

and it's really sad and i hope that if

you're watching this that you don't do

that and that you stand up for yourself

but it was it was just the way it was

and we weren't willing to do it so we

had to have a talking to a couple times

and one of the times we had to have

at the travel company they have

something called a clinical liaison

who's usually a therapist that works for

the travel agency that can talk to you

through

some clinical situations because your

recruiter may not be able to

you know really talk to you about clinic

type of stuff they're not therapists

so we had to talk to the clinical

liaison um

once or twice i think and they would

just say hey you know what's going on i

heard you had a little trouble with your

productivity

and we just explained the situation to

them and um

we had at that specific job we we knew

what the situation was

and we both had taken notes about

everything that we had to do

that was not productive time and so we

had all of that laid out we were

very um confident and in our own

abilities and

we knew that we were doing the best we

could and uh so yeah

that conversation with the clinical

liaison they're just giving us some

suggestions about how to improve

productivity all those things obviously

we have already

talked about thought about taking into

account and it just came down to the

fact that

you can't hit 90 productivity or even 85

productivity in a facility that is not

well managed and that you can't do point

of service documentation you just

you can't do it yeah so you know it was

a good conversation they just said okay

you know i understand just try to do the

best you can and we'll go back and talk

to them and let them know we talked to

you

um the other time i had to have it

happen with my very first job and i was

a

new grad and i spoke to them and i said

you know what they knew i was a new grad

they

they wanted me anyway i'm doing the best

i can i'm the

only pt i have five ptas and multiple

buildings

and um you know i just talked him

through the situation and so

the regional manager even said okay i'll

try to see if i can have the tech

help a little bit more with you know

this this or this like transporting

patients and like that time that it

takes you to go and find a patient and

bring them back to the gym and all that

kind of stuff

so every time we've ever had it come up

they were willing to work with us

because as jared said it's a lot easier

if they can work things out with you and

just

try their best to get you to be a little

more productive

and not have to work off the clock

rather than fire you and

take the time to find another trap you

have to remember it's in everyone's best

interest to work things out and that's

why

in a situation like that always go to

the manager first try to talk to them

try to come up with some

uh solution that will work for both

parties because you don't want to find

another contract it's a pain

it can especially when times are

difficult like right now it might take a

while to find another contract you have

to move

and the facility doesn't want to hire

another traveler because it takes time

to get them in there and they

also have to train them and you know

account for that time when they're less

productive in the beginning just like

you were

so they do not want to have someone new

and you don't want to move so it's

always best to try to work it out

yeah and then the other situation we've

mentioned before with outpatient

sometimes outpatient can be

ruthless too where they really want you

to double book and all this stuff so i

would really

during your interview try to screen for

that try to screen for this whole double

booking

situation even overlapping sometimes can

be difficult

try to figure out if it's going to be a

scenario where you're going to be

successful before you ever get there

especially if you're a new grad and you

know that you don't have any experience

or not comfortable yet

with trying to overlap patients that

that sort of thing

before you ever get there try to screen

for that because once you're there it's

tough because

there are certain therapists who are

quicker than others

there are certain therapists who are

better at documenting while they're with

the patient than

others so a lot of times there will be

some pushback from these outpatient

facilities where they'll say

you need to get your notes done while

you're with the patient most of us do it

we're all doing it why aren't you doing

it and

and we get that because some of them are

fast-paced so you have to know yourself

and know if you're going to be somebody

who can get your

documentation done while you're with the

patients if you're somebody who's

comfortable with the overlapping of the

patients

because sometimes if you say that you

are during the interview and then you

get there and

you're really not doing a good job with

it it's a tough situation

some suggestions i would have for you

there especially if you're a new grad

i was like this when i was a new grad i

was really obsessive about making my

documentation very thorough

very good i've learned from some older

and more experienced clinicians that at

some point you have to kind of choose

like am i going to have a life outside

of work

or am i going to sit here for hours

making sure every note is perfect

so you you might want to consider

cutting corners a little bit on your

documentation of course you'll document

well within legal balance but don't be

too wordy try to

get as much done as you can also i think

when you're a newer therapist

and you know those of us who just love

to talk to our patients you really feel

bad about not talking to your patient

instead having your nose in a computer

but

sadly it is part of being a therapist

sometimes we have to you know

sacrifice a little bit of our time

talking to our patient to make sure we

can get our notes done on time

yep we're getting a bunch of questions

and comments we're going to go through

those in a few minutes

one thing i want to mention before we

wrap this video up is

some recruiters and

i guess some facilities will tell you

that travelers don't usually get

overtime

and that is the case the majority

facilities do not want travelers to get

overtime so

almost always in a situation like that

they'll try to work it out so that

you're not getting over time either

adjusting the schedule

or changing things around where you have

more help or or whatever

they're trying to make it so that you're

able to get everything done in 40 hours

but there are some facilities where you

do get a significant amount over time i

worked at a facility where i worked 62

hours in one week

i got like 200 hours of overtime and one

assignment so there are some

facilities where you that you can work a

ton of overtime if you're willing to

do it so just keep that in mind it's not

always that

if you're going to get over time it's

the end of the world and they're going

to be really mad at you sometimes they

almost expect it and

they're fine with it so have the

conversation

stand up for yourself ask them you know

what's the expectation

tell them the situation and uh you know

obviously do the best you can to be as

productive and efficient as possible

but if you feel like you're doing all

you can and you're still working more

hours than your that you have allotted

every day then don't feel

bad at all about putting those hours

down and and charging facility over time

yeah you just have to fill out every

single contract is going to be different

every single manager is going to be

different so

as we mentioned always try to work it

out with your manager um

you know be professional and

be stand up for yourself and say you

know i'm trying the best that i can

these are the things that i'm doing

maybe see if they have some suggestions

maybe see if there's any way they can

adjust the schedule whether that's

reducing your caseload or like one

clinic that we worked out jared

mentioned

we had evaluations that were always

scheduled at the end of the day

and she our manager kept saying you know

you're putting down overtime

i can't pay you overtime and we would

say okay well you're putting evaluations

at the end of the day when am i supposed

to type that note i can't leave it till

the next day because then i have a full

caseload the next day

so they adjusted our schedule to where

we would always have

a 30-minute block at the end of the day

to do our notes

we actually didn't ask for that we just

asked if she could not put

evaluations at the last patient of the

day so maybe something like that like

say could i put my evaluations earlier

in the day that way i might have some

more time

to type my evaluation throughout the day

with my with my treatments

you know have my text help me for a few

minutes at the start of each patient so

i have a little more time to get my

notes done

so talk through some of those strategies

if you're really finding that you're not

able to work out some kind of solution

they're being way too hard on you the

caseload is just

way too unmanageable this is when you

need to go and talk to your recruiter

probably prior to that i would have

mentioned something to my recruiter i

would have just said hey

just so you know we're having some

problems but we're trying to work it out

clinically

then you know the following week if it's

not working out then you might have to

say

to the recruiter okay i might need some

help here and then the recruiter or the

staffing company might have to have an

intervention

with the management um so they can talk

it out and then

ultimately sometimes if you're not able

to work it out

sometimes you might need to end the

contract if it's really awful

and on the other side of it is sometimes

if they're not pleased with your

productivity or

the way that you're doing the job they

might request to cancel your contract

early

again it's usually pretty rare most of

the time you can work something out most

of the time they'd rather work it out

with you

and keep you there than have to fire you

and get a whole new person but every now

and then it does happen

yeah it's always a last resort but

for the amount of time the times that

that could happen it is always worth it

to stand up for yourself

and um try to work things out with the

manager don't feel like you're a bad

therapist just because you're not able

to get things done

um in an eight-hour day when especially

in a situation where you see the

permanent staff working off the clock

and and doing

sketchy ethical things in order to get

their their uh

caseload done or their workload done

absolutely

so let's go through some of the

questions and comments that you guys

have

if you guys that are watching or whether

you're watching later if you have more

comments or questions please leave them

below and we will read them all and go

through them

again we really appreciate those of you

guys that are watching live again if

you've gotten any value out of this

video we'd love if you'd hit the thumbs

up button or the heart

button if you are watching or listening

later on the podcast or the youtube

channel please

don't forget to subscribe click the

subscribe button so you can reach our

videos and our podcasts

in future weeks larry says i have a good

manager right now it feels like such a

breath of fresh air compared to the

other sounds like you guys have had some

good ones

yeah we've had some awesome managers i

would say we've had way more good

contracts than bad contracts

and we've learned a lot over the years

as to

what to ask in the interview to try to

avoid as many bad contract

contracts as possible and we are way

more picky now than when we started we

are willing to pass on on jobs pretty

quickly if if there's any red flags in

the interview

whereas it used to be when we were

younger we were more desperate and we

didn't know what to ask and we would get

put

in worse situations so our more recent

contracts have been much better

let's see

okay holly says this summer i had a

five-week

slp contract in a primarily covered

positive skilled nursing facility i'm

sure that was hard holly

we had to go we had to gown up wear

gloves

n95s face shields etc for all the

patients

ipads were not allowed in the room i had

not thought about this

ipads are not allowed in the room i got

a call from the building buildings

corporate officer asking why i was not

able to reach the 85 and 95

productivity yeah that's crazy i i can't

imagine what it's been like lately but

yeah just more barriers to trying to

have a an efficient day

with so much ppe and things like that so

i'm sure it's even harder than ever in

skilled nursing facilities to have high

productivity and i'm sure they are still

expecting it

so yeah i mean you have to stand up for

yourself in that situation and let them

know

all the issues you have to work through

in order to be able to see a patient in

the first place and

you can't do point of service and all

those things so so sad because sometimes

with these skilled nursing

facilities the person who is your

manager or your regional manager they

might be so far

removed like they might be a clinician

by trade but they might be so

far removed from the day-to-day that's

what happened at my very first contract

when i had to have a talking shoe

multiple times we had multiple buildings

i had to i had to get in my car and

physically drive to other buildings at

the

assisted living and independent living

homes and all that and i'm like there is

no way for me to account for my time

between literally driving to another

building and i spent time on the phone

like scheduling my patients

at the other buildings and i don't think

the regional manager had any concept of

that and it sounds like your corporate

office had no concept of the fact that

you're

you cannot do point of service in a

coveted positive room you have to spend

an additional

amount of time gowning up gowning down

cleaning disinfecting everything and

they probably just don't have an

awareness of that because all they're

doing is looking at a computer screen

with numbers on it and they're like why

are you not productive sometimes they

don't have an awareness but sometimes

they're just used to bullying people

into

just doing it and if they just say it

enough and they say you should be able

to get this done

people will do it and they're not used

to people saying

you know sorry these are the reasons why

i can't do this and it's not realistic

yeah

you have to stand up for yourself you

have to be confident um i know it's

harder when you're a new grad because

you already feel like you're at a

disadvantage you already have that

impostor syndrome

but you know stand up for yourself as

best you can when you're a new grad and

when you're especially an

experienced clinician you need to say

look i have experience i've done this

before i've worked at buildings like

this before

i'm a good clinician this just cannot be

physically done

you know i've done well before i have

great references all these things it's

just what you're asking me to do cannot

be

done and in your circumstance holly with

the covet thing

it's just absurd it cannot be done yeah

kimberly says this has given me anxiety

just hearing about the experiences

of sniff life and remembering mine i

always had to make lists of unproductive

time and reasons why i was lower

last time i was questioned is when i

finally said this isn't a good fit for

me

i hope to never feel that stressed again

yeah that is exactly true we

uh the la my only sniff contract i

decided that sniffs were not for me

i think we had a pretty bad experience

there same kind of thing

keeping lists of unproductive time and

meetings that that didn't account for

productivity

and all these these issues and um yeah

i i don't think sniffs are worth it for

the most part yeah i know there's a lot

of people that do like working in sniffs

and to be honest we didn't mind working

with patients and we didn't mind working

with our coworkers and everything it was

just the productivity we just thought

was so unrealistic

um i just hope it'll get better but i

don't know if it will yeah

um all right elisa says i'm so glad

that you covered this topic i'm on my

first travel assignment

um i was kept for nine to ten hours on

my first two weeks

being new to this i wasn't sure how to

handle this and handle this

this conversation was so helpful thank

you yeah it's hard

but if you let them allow that to happen

they'll continue to do it so say

something about it

and get something adjusted or let them

approve overtime

and that's that's really the best way to

handle it just let them decide do we

want to adjust the case load so that

they can get it done in eight hours or

do we want to pay them over time

and uh and take whatever they decide or

do worst case scenario do they want to

fire you but in most cases they're not

going to after they've already spent

time training you on boarding you

they're not going to want to

fire you they're going to want to work

it out all right cassie says

how often have you two had to confront

the manager supervisor about

productivity expectations throughout

your travel contract is it a fairly

common thing across the board or is it

just based on the setting

um i would i wouldn't say it's that

common

um maybe we've had issues like this on

25 of our contracts maybe like a fourth

of them um

where we've just struggled with

productivity or

they didn't want us to get over time and

we were

documenting after hours and things like

that but it's not real common but it

does happen

and a lot of times it's just a situation

where

they're not used to working with

travelers and if you just explain the

situation sometimes that just changes

everything

i've worked at three different skilled

nursing facilities and it happened at

all three skilled nursing facilities so

i don't know if there are good skilled

nursing facilities out there i assume

there are

i know i was a student at one that was

probably the best one i've ever seen

i've heard the rare gem of a skill

nursing facility that was good but all

three i ever worked at as a traveler i

had to have

talks with management about productivity

and have

schedules adjusted and all that good

stuff a handful of times there's been

minor discussion at our outpatient

contracts yeah it does seem to be more

common in skilled nursing

yeah but outpatient we usually had a

better experience because we did the

appropriate screening during

our um during our interviews to avoid

those issues

all right nick says a home health

company in a fort myers asked me to take

hours

off my time sheet in order to avoid

overtime he says oh

i don't think so they also told me every

patient should be documented as

at least men assist

that's interesting nick yeah i would

never take hours off if i worked them i

worked them

um they just have to deal with it for

that week and then yeah they can always

adjust

in the future yep uh

all right a few more questions here

again if you guys have any questions or

comments please leave them below

jordan says bill for every minute you're

on the clock appreciate you guys and any

client should appreciate you just as

much or more

thanks jordan and jordan is one as a

recruiter so we appreciate that jordan

jonathan says yes don't let them make

you feel like you should just suck it up

you are also doing them a service very

true absolutely jonathan

nick says it doesn't matter the location

for me if the job sucks everything sucks

about the assignment for me

very true yeah it could be a really

awesome location

and and going into a job with crazy

productivity expectations or

double booking and having to document

after hours and things like that can

ruin the whole

the whole experience so i don't know if

everybody feels that way though i bet a

lot of people would be like i'm in san

diego i'll work off the clock i don't

care

i would i would much rather be in a

terrible location

and have a good job than be in a

wonderful location and have a bad job

yeah it does definitely affect the mood

for the whole week so

all right see if we have a few more

questions here

larry says i've always asked about

productivity and when i expressed this

appointment i predicted

productivity expectations the interview

usually ends quickly and i don't get

that assignment

i was sacrificing employment for

principles and i needed that money

yeah i i definitely hear you there it's

difficult when there's limited job

options

but i think it's always better to go

with principals than

just take an assignment just for the

money yeah i mean it's tricky larry i

think in times like this

with a poor job market you have to pick

your battles to an extent

um you know i wouldn't encourage anybody

to take a job that's going to be so

awful that you're having to work off the

clock all the time

but you know if you can find a way to

make it work maybe it's not

easy but maybe if you sacrifice having

to have your nose in the computer a

little bit more

and shorten your notes and maybe you're

15 minutes over here or there

that you choose not to write down you

know if it's worth it to you to get that

job

just pick your battles but i would

encourage you to try to do everything

you can to avoid working off the clock

yeah that's a good point too i mean

if it's five or ten minutes a day that's

not a huge deal but if you're staying an

hour

after every day doing documentation

that's obviously a big deal and

something i forgot to mention earlier is

you know it kind of depends too

you know i would have kind of a rule

with myself like if i knew that it was

my fault i wasn't productive that day

maybe i

you know was chit chatting too much with

my co-worker and i

jared don't give me that look wouldn't

he have known the chit chat for sure

if you know if me and a coworker are

sitting there at the end of the day and

we know we're not getting our nudes done

because we're just talking or like we're

just tired i'm not gonna write down over

time for that you know that's my fault

that i stayed there a half an hour late

i could have gotten those notes done

earlier

so if you know it's your fault then

don't you know take advantage of the

situation and write down over time but

if you were busting your butt doing

everything you can

to get it all done in 40 hours and you

just couldn't that's when you need to

really stand up for yourself very true

nick says if they don't pay mileage run

away he made that mistake in florida on

assignment

uh yeah for home health if if they don't

pay mileage that's usually

a red flag a few more questions here

jonathan says

what helped me was having the discussion

with the recruiting company

they explicitly told me that they do not

let their travelers take work home

this helped me so much and allowed me to

have the conversation with the clinic

we revisited this occasionally i would

say that this helped a lot so

to say no and keeping the balance always

have this conversation with the clinic

at the front end so they know the

expectations yeah i'm kind of a chicken

when it comes to those difficult

conversations so i would usually blame

it on

either say i'm hourly i just have to

write when i get here when i leave

that's you know that's the way the law

is

or you can you can always blame it on

the travel company as well like

uh the travel company said that i cannot

do anything like this

so i have to write in my in and out time

and just

so that way you don't have to you know

come up with a reason

why you know it's more difficult when

you have to

come up with an explanation on your own

instead of just saying like this is why

i have to do it this way i think that's

easier

yeah all right

anymore and again if you have any other

questions please leave them below

holly says do home health travel

assignments typically pay the same

weekly rate regardless of how many

points you see that week

yeah i think the majority of travel

contracts some

pay per point some pay per visit but the

majority um

they basically will guarantee 40 hours

and pay you the same amount whether you

see

i don't know 25 points or 30 points or

20 points or whatever

uh so usually it's the same amount but

it can vary it's usually going to be

based on your hours so

hopefully we always encourage you to try

to get contracts that have a 40 hour

guarantee

so when you agree at the beginning of

your contract that this is going to be

your pay every week based on 40 hours as

long as you complete

40 hours of work and you and or if you

have a 40-hour guarantee then you will

get paid that amount you agreed to

now if you don't have a 40-hour

guarantee and they only had a few

patients for you that week and your

caseload was really low and you only

worked

30 hours then you might only get paid

for 30 hours

unless you had the 40-hour guarantee so

that's the only difference in which your

case

i mean your paycheck would vary i don't

think your paycheck would vary if you

just had less patience

like for example at an outpatient clinic

like if i'm there from eight a.m to five

p.m

but i only had five patients show up

that day i'm not going to get paid less

for only seeing

five patients i was still clocked into

eight and clocked out at five

even if 18 showed up you know it's not

going to vary like that it'll just vary

based on your hours depending on if you

have an hourly guarantee or not

nikki ask what is productivity like for

an outpatient setting

this varies massively it can be we've

the majority of our contracts we try to

take them at

hospital-based outpatient facilities

that do one-on-one treatment and that's

more common at hospital-based or

physician-known clinics

but it can be anywhere from one-on-one

for an hour to

so eight patients in an eight-hour day

to as much as

there are some travel assignments that

might have 24 scheduled in an eight hour

day so it's a huge variation

anywhere in between i would say the

majority are between eight and twelve

that's the the majority that we've taken

um and

sometimes up to sixteen an eight hour

day but if it's any more than that

probably it's going to be a difficult

contract and unless you're

you really want that kind of stress then

then you probably shouldn't take it so i

know nikki i think nikki is an slp

so that's more for um nikki that's more

for peachy and

pt especially and it could be the same

way for ot i know ot has to usually be a

little bit more one-on-one

i know slp has to be a lot more

one-on-one so i don't think

you're gonna see that i don't think

you're gonna see that high volume of

patience at an slp outpatient

but in terms of measuring productivity

at an outpatient clinic it's usually

just the number of patients that you see

that day the number of appointments you

have not anything like this 90 percent

of the time that you're in the facility

type thing is just the number of

patients that you were able to see that

day

some um outpatient clinics will also

push for the number of

units that you bill per patient so some

of them might encourage you to try to

always get three

or four units in the hour in which the

patient is there

and sometimes that's easier to do than

others so those are the two aspects that

come into outpatient therapy

is the number of patient visits you have

in the day and the number of units that

you've built with each patient

yep um cassie says i will be at a sniff

next summer for my second clinical

rotation

was an outpatient this past summer i

didn't realize there was such a huge

issue in sniffs

so i'm a bit nervous to see how that

goes holding out hope that it won't be

too bad

yeah not all sniffs i think the majority

are pretty difficult in terms of

productivity but there are some good

ones

i think usually the ones that you see as

a traveler

are the bad ones because they're you

know they have trouble holding on to

staff and i think the good ones usually

the therapist stay there for a long time

because if you're at a sniff that's

set up really well and the patients

really enjoy it and the staff

is pretty consistent you don't have a

lot of turnover and productivity

expectations are like 70

i would stay there the rest of my life

so i think that's how a lot of the

therapists are

and so i think a lot of the travel jobs

are the facilities are not so good i

think as a student they're probably

going to send you to the good ones

um so hopefully hopefully you'll have a

good experience but cassie i would

really encourage you

as a student to talk to your ci about

these things because i think that's

something i didn't know to ask about

when i was a student

was productivity so when you get to your

skilled nursing facility rotation ask

your ci

how do you manage your productivity

what's the productivity expectation here

how do you manage

um typing while you're treating you know

skill nursing facility type patients how

do you work

in your documentation throughout the day

and you know hopefully

you might find out a little bit about

whether they clock up clock out to do

notes or anything like that so ask those

questions

and be observant in all of your clinical

rotations to

kind of learn a little bit about that

part i feel like as students we don't

learn about like

this productivity and billing side of

things and like the businessy part of it

yeah unfortunately all right i think

that's all the questions and comments

this is uh

turning into a very long video so this

is the first time watching one of our

videos we do these

every week if you guys have any

topics that you want us to cover in the

future let us know usually it's on

sunday nights but it just depends on

what's going on

but yeah feel free to join back in let

us know if you have any questions or any

future topics you want us to cover

yeah if you guys are just getting

started with uh travel therapy if you're

interested

in help getting set up with any

recruiters um if you have questions for

us

feel free to send us a message on our

website at traveltherapymentor.com

we have a place where you can ask us for

recruiter recommendations if you're just

getting started and want to get

connected with some travel therapy

companies

we also have tons of articles and videos

on just about every topic you can think

of

for travel therapy as i mentioned

earlier we do these videos every week on

facebook live if you want to be notified

when we go live on facebook i think if

you click on

i'm not exactly sure where it is on the

facebook live screen but there should be

a little bell

it's like a notification bell um where

you can get you can click on that and

get notified

when we go live which is usually like

jared said every sunday it's kind of

like the subscribe bell

on youtube and if you're watching on

youtube you can click the subscribe

button for that and then if you

want to find us on any podcast platform

um you can find us on spotify

apple podcasts and most other podcast

platforms as well but it's just the same

information that we put on facebook live

every week but we upload it to a podcast

form for those of you guys that like to

listen there yep and if you guys have

any input on anything we covered here if

you want to give your perspective

leave in the comments we always go back

to these videos later and again if you

could like this video if you got value

from it we really appreciate it alright

so we'll see you guys next week

thank you bye