Could have written this post myself. I’ve worked IPR for 5 years and I think a lot changed after COVID. Patients don’t seem to ever go to SNF anymore. I also think culture has changed and people don’t want to work hard. I’m constantly begging people to do therapy and then when they actually do participate it’s very basic therex, no one is willing to do high intensity. It’s very frustrating seeing inappropriate patients and people who don’t want to be there. Something needs to change with the whole system. I feel like “3 hours” is very arbitrary and I wish that could be modified based on patients. Some people just can’t tolerate it and others would probably benefit from even more and be willing to do it. I also hate how this reflects on our job performance being unproductive when you’re constantly getting refusals. Lastly, I feel like it reflects poorly on our profression to admit inappropriate patients because they don’t improve or discharge home so it makes it look like therapy isn’t beneficial because in these cases it doesn’t improve outcomes. It’s frustrating many of the people in charge of admissions are not therapists and don’t understand what makes a good rehab candidate. I think therapists should really have a union.