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From OT to Mom to Back Again

Written by: Christine Sedam Schwer, MS, OTR/L

Virtual Hand to Shoulder Fellow '22/'23

Before getting married, I had been an OT for almost 7 years. I was lucky enough to spend the first 5 of those years in a fast paced, level I trauma, regional spinal cord center. It was intense and exciting. We got to rotate throughout all of the acute care services of the hospital. There was always something new to learn. We also got to work in the hospital’s inpatient acute rehab unit, which was really interesting as well. It was very challenging, but very rewarding work, and I was intensely career focused.

Being young and single at the time, my life was mostly about my job and my friends. I decided to stretch my wings and take a travel position across the county in Colorado. My job was to fill a position that would cover acute care, home care, and outpatient hand therapy in that region. The understanding was that the majority of the work would be with hand patients. It was my first truly outpatient experience in hands, and it was fun. It was a melding of some things that I already knew, and a lot of what I wanted to learn. I had always had an interest in hand therapy, but took my Level II Fieldworks in adult acute rehab and in pediatric outpatient/homecare rehabilitation. With this new position, I was finally getting an opportunity to practice hand therapy, studying a lot, and learning on the job.

When the assignment was over, I moved back to Pennsylvania, and eventually got married. I went back into a university hospital setting for work, but this time, there was a hand therapy rotation, and I got a little more hand experience. About then is when we had our first two children. I left the hospital (and its weekends and holiday hours) for a more family friendly lifestyle change to part-time in home care. It was a big adjustment to have to divide my time between my career and my family responsibilities, but I wanted to do both. I think it made me a better mom, and I got to maintain some of my professional responsibilities.

Frankly, I enjoyed going to work. There, I had one thing to focus on, and I felt like I was making a difference and doing well. Also, it was a nice change of pace from the exhausting routines of 24/7 child care and the uncertainties and insecurities of being a mom with young children.

When we had our third child, and moved to a new home, it was just too expensive to have 3 kids in childcare, and earn any additional income. It was at that point that I took a step back from my clinical career, and was lucky enough to be able to stay home, full time, and raise my children. In reality, there really wasn’t too much of a choice. My husband works shift work, and is the primary bread winner in our family. I was the one who could be consistently available at all times, even if it meant “not working”. (And, I HATE that phrase. As a mom, you are always doing something- even if it’s being preoccupied by the things you need to be doing or haven’t done. A mom is ALWAYS working, but I digress).

Despite my career ambitions, I was excited to be a Mommy. For me, it did not make sense to pay more for childcare than I brought home in a paycheck. I understand that other people make other choices, have better support, or more resources, and I respect that. This is just how my situation was for me.

Being a stay-at-mom was a blessing, and I was lucky to have that opportunity. I got to experience a lot of joy, and snuggles, and carpools, and school committees. The kids and I played together, and I was a part of a Mom’s group. I was able to take my kids places during the day, and meet up for play dates. But with all the positives, there were also negatives.

I missed my life as an OT. I missed having that piece of myself, and my career, and setting career goals. Being a stay at home Mom can be lonely sometimes, and I missed my friends and my work. My husband works shift work, and has a very inconsistent schedule. That made it hard for me to even see my friends outside of work. It was like planning a space launch to even schedule the time alone to make a hair appointment, much less some free time for myself! I also missed contributing financially to the household. Some of this I put on myself, because I wasn’t comfortable with “being supported” by my husband’s paycheck, and I wanted to have more of a stake in our financial decisions. On top of all of that, I was afraid to lose my OT skills and edge as an experienced clinician.

As luck would have it, shortly after our move, my prior employer in homecare was looking for someone who was willing to do some chart audits for insurance, as well as review charts for quality improvement. It was NOT a lot of hours, but it was something career related, that kept my mind in the game, and helped me to avoid any extensive gaps on my resume. It wasn’t exciting, but it was consistent, and I could complete it on my own time (which often meant in the middle of the night or super early in the morning). Additionally, I maintained my OT license by completing all of my continuing education requirements. And I will be honest- it was often last minute. Sometimes, it was over holiday breaks when I could plow through online courses while family was available to entertain my kids. It wasn’t glamorous, but it worked.

My kids got older, and by the time my youngest was entering kindergarten, I wanted to start thinking about how to get back, part-time, into the workforce. The company I was doing chart audits for changed hands, and they no longer needed me. I didn’t want to go back into homecare. I hopefully wanted to figure something out by the time my daughter was in school, full time, in first grade.

That is when Covid hit, and life had other plans. For the next one and a half years, we were bouncing in and out of the classroom between “in-school” and “on-line” learning. I had to be available for when the kids were at home, and that was too unpredictable to balance with a new job. Then, I had to provide transportation for one of my children, both ways, to and from school. This transportation time constraint, alone, did not leave me with the available time needed to go back to work. I was feeling antsy and restless. I really wanted to find something for myself, professionally, that would fit into our lives at that time. And what would that even look like? Some time had passed since I was in a clinical setting. Would I even be good at being an OT anymore? Had I lost my edge or my skills? How would I balance work with family again? What if, what if, what if?

I had always had an interest in hands, but did not have a lot of experience. Being able to work in a purely outpatient orthopedic, hand setting seemed like a dream that was out of reach. I did not have a level II in hand therapy, and having experience is often a pre-requisite for getting your foot in the door. It’s a “Catch 22”. Employers want experience, but without a Level II clinical fieldwork in hand therapy, it’s hard to get the experience that they want. That and I had been a stay at home mom for awhile. Would I even be considered? Maybe I should go back to acute care? I wondered how much of what I knew was still relevant.

I had known about the Virtual Hand and Shoulder Fellowship for a little while, but, even though I liked hand therapy, I didn’t seriously consider the program to be an option for me. I still didn’t foresee myself being able to get a job in a hand clinic. I didn’t feel that I knew enough to jump back into working at a place like that, even though I had some prior experience.

Then, one day, something started to click. With everything else going on around me at that time, I may not have been able to return to work as soon as I wanted to, but I could certainly use that time productively. I decided that I would put myself in the best possible position that I could be in, in order to have the best options, for when it became time to return to work. And that is when I enrolled in the Virtual Hand and Shoulder Fellowship.

It was a great decision, and at just the right time for me. The Virtual Hand and Shoulder Fellowship gave me the knowledge and clinical reasoning skills that I needed to build a strong foundation. This, in turn, gave me the confidence to pursue my desire to work in hand therapy. As a fellow, I gained a much better understanding of hand anatomy, biomechanics, pathology, and the rationale behind therapy protocols. This gave me the base of knowledge and confidence that I needed to contact a hand center near me. I spoke to the clinic about my background and involvement in the fellowship, and asked if there was an opportunity to come and observe. They allowed me to come (yay!), and that experience, in turn, brought a different perspective and level of practicality to what I was learning. Furthermore, it strengthened my resolve to pursue this line of work.

The education gained throughout this fellowship was invaluable in that it provided a structured approach to learning the intricacies of the upper extremity. It not only opened my mind to the possibilities ahead, but it also opened doors for me that might not otherwise have been opened. My CV and references are in order, and I am ready to embark on the next chapter of my career. Better yet, I feel like I am prepared to embark on the next chapter of my career. Now, who can I schedule to be at home in time to get my daughter off the bus?



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