TJ1: Managing Stressful Work Environments in the Health Sector 040

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About Managing A Stressful Work Environment

This is the first solo episode of the Transition Journey (TJ) series. Workplace stress has a profound influence on our lives, extending to our physical and mental health, personal relationships, and daily habits. In this episode, Tanner shares his first-hand experiences with a stressful work environment. He further uncovers the unpredictability and unsanitary conditions of some of his home health visits, and the frustrating lack of support from management.

In this episode, Tanner will share with us his journey, what he would do differently, and what he learned from the stressful work environment he was part of. He emphasizes the importance of finding a job that aligns with one’s values and expectations, the significance of transparency in decision-making processes at work, and the need for companies to be open to feedback and suggestions from employees.

Tanner also offers handy tips on navigating a stressful work environment, finding personalized stress relief methods, and how he realized that he shouldn’t be solely dependent on one company for income and livelihood.

This episode serves as a reminder that while stress is an inevitable part of life, staying in an unhealthy and stressful work environment isn’t. It calls for listeners to be proactive in managing their workplace stress and, if necessary, make the difficult decision of choosing a healthier work environment over a stressful one. Tanner hopes that you can learn from his experience and that this can help you with your career choices.




Welcome to the Rehab Rebels podcast. Are you a rehab professional ready to transition to an alternative career? Hear inspiring stories from others just like you and learn the best ways to bridge your career gap. This podcast has you covered. Now here’s your host, doctor of physical therapy and podcaster, Tanner Welsch. 



Hello Rehab Rebels, welcome back to another episode. In this solo episode, I’m going to share my experience with working in a stressful environment. So this episode is about stress. It is for those who are in stressful work environments, are heading towards one, want to know how to address the stressful environment they’re in and ways to manage stress. So I’m going to share a story about the stressful work environment that I was in. Towards the end, we are going to break down what I learned from the stressful work environment, what I would do differently, how the experience changed me, ways to address a stressful work environment and ways to manage stress. 


To give a little preface to the story, this was my first physical therapy job Two years after graduating PT school. I was living in my parents’ basement and driving one hour one way to get to work. In another episode a couple of episodes from this one I will give more backstory and explain what I was doing, living in my parents’ basement and not having practiced PT for two years. So stay tuned. That will be in a couple episodes talking about what is your why that’s a little preface to the story and how this all started was I really had nothing to base it on, I had no prior experience, I had no other colleagues or really anybody to bounce any ideas off of. So I was going into this without really knowing what to expect and just rolling with it. I was working for a contract company. They contracted with two or three school nursing facilities in town and I later found out they also contracted with a home health company, a couple that covered the area. I was the only physical therapy staff. I had two PTAs covering a couple of facilities and also doing home health. There was a OT who I was grateful for. She was Greek for bouncing ideas off of, and a Coda. What ended up happening was the rehab director, who lived three hours away, would come to the area about once a week to once every two weeks, and what I slowly discovered was there were systems in place and expectations in place that I had not run into before, and the expectations in place were pretty much just all about the bottom line and rick and his and as much billables and income as possible. So an example that we often ran into or forced to do is on Fridays, when the patients would get out of the hospital and come into these school nursing facilities. The way the Medicare reimbursement system was set up is when we would evaluate these patients on day one when they come back from the hospital and are admitted into the school nursing facility. The facilities get more money if we evaluate them right away versus waiting two or three days to see them. Because I was working for a big corporate company, their priorities were the bottom line and to rake in as much income as possible, so that was something I figured out. 


There was also times when we were slower because there was some ebb and flow up and down. We were either slammed or slow. And when it was slower, a lot of times there would be these systems in place where the PTAs would go out and supposedly screen people that needed PT services to help with their functional mobility. It was a cycle is really what it was A cycle really to keep things going and keep doing physical therapy and keep the money raking in. And what happened was the systems that they had in place to manage all this weren’t great. They did not have like a calendar for us to use to track the patients that we were seeing between the different systems that they had. They had a system for doing home health and a separate system for the nursing homes. I had to use an agenda and write down the times I was seeing patients, when and where, which location, which house I was going to. It was kind of all over the place. And three months in is when I discovered they had home health services and got dropped the ball like, okay, here’s the new EMR system that we’ve never used before. Figure it out. 


So I was driving two hours a day to get to and from work and then when I got home, I was doing a couple hours at least documenting and trying to figure out this documentation system, and there were times I would leave and then come back home and there was like I’d go right to bed. I mean, there was no time for me to do anything else. How does this is going on? We tried to talk to the rehab director and staff Can we improve some things? How do we make this better? And what we either got was what we were just thought they wanted us to hear and told just to be quiet, and or this is how it is, this is what corporate says, this is what we got to do. There really was no discussion, there was no back and forth, or you know, let’s come together and see if we can make some changes and get things better. It was just like this is how it is that really showed the writing on the wall that, okay, there really is no other options to go here. This is just the reality of this particular job and this particular role in this particular position. So I was getting stressed out because we were running into different things that I felt could be solved. You know, maybe done something differently, but it was out of my control and it was just up to what the corporation said and that was it. 


Along this time we were going into people’s homes. Some of them weren’t the cleanest and there was one in particular that was pretty gross. They had laid out I think it was like tinfoil just out in the living room for their cats to go to the bathroom on. It was just a bad living environment. But we were expected to do therapy there and some that ended up happening was I ended up getting ring-wormed. I assumed that’s where I got it from, but there’s no way to prove it. So it was on me to figure out and take care of myself and what this environment kept building and building, and building, and what it ended up making me feel was very trapped, like there was no place to go, and so when I started looking at how do I get out of here, something that I came across was they gave me a tuition reimbursement program to stay with them and they spread it out over three years as additional payment to go towards my tuition, which initially was great. But what I found out was in the fine print they give it to you a year in advance, which means if you want to leave, you either have to pay them back a year of what they paid you in tuition or you have to not accept the tuition for a whole year, so you don’t have to owe them back a year’s worth of tuition. What I ended up doing was just not accepting the tuition because I knew I was on my way out. 


After all this and it got so bad the stress and my health and everything that was going on I ended up developing what was called alopecia ariata or alopecia ariata, and what this is is an autoimmune disease where the immune system attacks the hair follicles on often the scalp, but sometimes the beard and other parts of the body. For me it was on my facial hair there were circular patches the size of a dime to a quarter where the hair just was white, patches of white hair. And this was from the amount of prolonged stress that I was in, that my body was just not having it. Around all this time, within, I’d say, eight months of starting this job is when all this happened and coded and uphitting as well, and I just had this realization. I was like man, what, what am I doing? Like why didn’t I go to school? Spend all this time going to school, get into all this debt to kill myself? Like what I felt. Like literally for a company and corporation that doesn’t really care and they don’t even actually see what we’re doing here on the ground floor of the services we’re providing and caring for the patients, the investors and the corporations. There’s a huge disconnect there and it just felt a I lose, lose situation and a losing battle, and I really just felt trapped and helpless. 


So in the next episode I’m going to talk about how I got out of this situation and other options for those that are in situations like this, but for this particular episode, we’re going to break down what I’ve learned from this experience and what I realized was there is an appropriate amount of stress, I think, even a healthy amount of stress that the body can manage, but for prolonged periods of time, this is just detrimental to our physical, mental and social well-being, and for me, knowing where my limitations are is really important, I think, in any of the health field, because we are pushed to the limits. There’s just no doubt about it, and so for me, that was a big eye-opener. This, being my first job, was I really went too far here and gave too much, and I should have stopped way before it got to. Another thing I realized was who am I working for? What’s the company like? Are they always putting out fires? Are they willing to listen to me, work with me or not? Do they have systems in place to streamline workflows? 


And stress is inevitable. It’s part of life, but choosing to stay in an unhealthy work environment isn’t At some point maybe not right now, but at some point we do have a choice and can plan for choosing to a better career, a better job, some other options that we’ll talk about in the next episode. What I also realized was, if I can’t reduce stress, there is no room for myself, there is no room for me to think or care for me, my future, big picture things, you know, living a rich life, creative life, a lifestyle by design. These are things I want to do, and that’s not possible when you’re stressed out every day and always on, and these problems, the stress that goes uncontrolled, will bleed over into other things: personal relationships and maybe even bad habits. I ended up eating more and was really not choosing the best health habits for me and eating habits. So that was something that I learned also from this particular experience. 


What would I do differently? That is a bit of a difficult question to answer, because this is my first job. I really didn’t know anything before and they provided tuition incentive and everything on the surface looked great, but later I found out hey, you know, we’re paying you this a year in advance. So really my only option out of that was to say okay, thank you, but from now on I’m no longer going to accept this, because I knew I had to get out of the situation and was going to eventually leave. So what I would have done differently, you know, not let the stress get that bad and be able to express my limits and that I can’t do anymore and just hope that something different would have come up. And that is definitely a difficult question to ask how the experiences changed me. I’d say it definitely a shift in mindset. 


Not being dependent solely on one company for my income and livelihood was a realization. And instead of working so hard for someone else that my body literally starts attacking and killing itself, why, why? Why am I not working for myself? Are busting my butt this hard for me instead of somebody else, lining all these investors and corporate people’s pockets with my hard labor and work? So that’s something that started my realization to creating more than one stream of income and also putting myself in positions to work for myself. It also made me look at what’s the work relationship, because it really is a relationship, or it should be the place that you work and the company you work for Are they willing to listen to you? Are they willing to work with you and come together to solve problems and be honest and open with what’s going on? Or are you shut off and behind closed doors? All the decisions are being made and then you’re just being told what to do. 


That’s exactly how this particular role was and job that I was in. It was this is what corporate says, this is what you’re supposed to do. There was no really coming together or being very transparent with what was going on. There was a lot of behind the closed door stuff and I really didn’t like that. I realized that I liked being included with decisions, what’s going on, at least open to comments or thoughts, and being included. And this particular role wasn’t because of COVID. This also made me open to salary positions because there was a time I was, you know, I was working full time and then COVID it and I was only working one day a week to two days a week. So it allowed me to open up to the possibility of salary. It also prepared me for what questions to ask for the next job and you know what to look out for after working for this particular contract company. 


So what are some ways to address the stressful environment? What I would do, number one, is see if there’s something I can do to alleviate the stress or the cause of the stress, myself, ideally before it gets too stressful or too bad or inflated. So really trying to see the situation squash it if I can myself. If not, then bringing it up to management and how I’ve done this in the past in the ways that I’ve learned is setting up a time to talk to management. That’s good for them, that works in their schedule, and also bringing up the issue that you’re having, whatever it is that’s causing stress, and posing a question to them. 


Open-ended seems to be work best for me, how can we address this? And just asking them and seeing what they say, because you’re presenting it like a way that we can come together and work out a solution and you’re allowing them to provide input. So that’s one way. Another way is, if you or if I already know a way to solve the issue, what I’ll do is I’ll you know, maybe say hey, I tried this, it didn’t work. What I think would be best is if we do this, bringing them in and saying what do you think, just posing it to them and getting their feedback. And this goes back to that working relationship Are they willing to talk to you and work with you and make changes, or is it: No, this is just how it is and it’s not really a relationship, it’s more of a dictatorship. It’s our way of the highway and, from my personal experience, I don’t ever want to work for a company like that. Again, it’s just not for me and often the values that I have don’t align with the values and expectations that we’re supposed to do as re-app professionals. 


So next bullet point ways that work well for me to manage stress. This may be different for everybody, but for me, working out, going for Iran, the physical activity things and oftentimes I’ll just leave my electronics at home or phone at home and or in the car or whatever and disconnect and just try to really take a break, let the stresses and world just kind of melt away, get in the zone and do some physical activity, also being intentional with creating me time, whatever that is. So maybe it’s going to watch a movie or having a great meal or going to your favorite coffee shop and just enjoying whatever it is you’re about to eat or drink, maybe reading books also would be a way to escape. Really finding that time for yourself, at least for me, to disconnect from the world and explore myself. 


And what I have learned throughout the years is actually what I would say and what I call developing and exploring the very personal relationship with myself, and it may sound silly, but I consider having a relationship with yourself very important to what you want on a life, where you want to go, who you want in your life, some of these big questions and just kind of like a working relationship. I look at the relationship with myself, similar or any relationship. Time has to be allotted to foster healthy relationships and so if we never take time for ourselves to foster that love for ourselves and those are positive relationships within ourselves, how are we going to grow? How are we going to know what we’re doing, if it’s right or use that life compass in a positive way? There will be some more episodes coming out that I will share about that. Some you know practices and things that I’ve realized throughout the years and that I do that have, I feel, helped me on my life journey and I would like to share those with you. 


The closing remarks here I already mentioned that in the next episode I will share options with you know how to lead the situation and what I did, and in two episodes I plan on sharing that environment that I was in, you know, living in my parents basement and out of school for two years and haven’t practiced from you and on that, yeah, I invite you to click that subscribe button so you don’t miss any of these upcoming solo episodes and this new solo episode direction for Rehab Rebels. If you like this episode and want to hear about other topics, please send me a DM on Instagram telling me what you liked and what you want to hear more about. You can find us on Rehab Rebels podcast on Instagram or you can go to and click on the tab on the far right contact and it’ll have a contact form you can fill out and shoot me a message, and I would love to hear from you. So I hope there was some value to this episode. Thank you so much for listening. I will see you in the next episode, take care. 



Thank you for listening to the Rehab Rebels podcast. If this podcast was useful, make sure to hit that subscribe button and leave a review. For more information about transitioning to alternative careers, head to or follow us on Instagram at Rehab Rebels podcast. We’ll see you next time. 

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