How One OT Left the Field After COVID and Came Back Through Pelvic Health

Brianna became an OT in 2020 and spent her first years in post-acute rehab through the worst of COVID. Patients were struggling. Coworkers died. In 2023 she left the profession for a front-desk job, certain she was never going back.

"At that time I swore I was never going back. I absolutely love OT and I loved advocating for OT, but I didn't think it was for me anymore."

She came back through pelvic health. Today she's the only pelvic floor therapist at her Ivy Rehab clinic, and upper leadership reached out within months after seeing her Google reviews.

Lindsey: Brianna, thank you so much for being a guest on the OTs in Pelvic Health podcast today. I'm so excited to have this conversation with you.

Brianna: Thank you for having me.

Lindsey: I'm also so lucky to be supporting you in the Level 1 Functional Pelvic Health Practitioner program right now, where we're rolling up our sleeves. I hope the experience has been good so far.

Brianna: Yes. It's been an incredible experience and I'm so excited to keep learning more and have the lab.

Lindsey: So many good things to look forward to in our four and a half months together. I want to kick this off, because you reached out to me with some really incredible news about your career path that I think every OT needs to hear. It's such a sign of advocacy and celebration. So without further ado: what made you leave the OT field, and why did you come back?

Brianna: I became an OT in 2020. I worked in post-acute rehab and I was also PRN in assisted living facilities. Like a lot of people, there were a lot of challenges in 2020 because of COVID. I think it's important to talk about, because a lot of people either aren't happy being an OT anymore after that time, or they already left the field and tried something different.

I stayed in OT until 2023. In the beginning it was really difficult, especially in those settings, because there were a lot of problems with patients, and I also had coworkers who passed away. It was just a really challenging time. I thought that once everything with COVID was done, I'd feel better and love what I was doing again. But I didn't feel that way. Once you start in something that traumatic, it's really hard to come back from it.

So I decided to leave. I didn't go too far from the therapy world — I started working for Ivy Rehab as a patient coordinator. I was at the front desk, so I still got to talk to patients and see patients, but with less responsibility. It let my nervous system reset for a while. At that time I swore I was never going back. I absolutely love OT and I loved advocating for OT, but I didn't think it was for me anymore.

Brianna: Then after a few years, I started going to pelvic floor therapy myself, also with Ivy Rehab. I got to meet a pelvic floor physical therapist, and it opened up ideas about a new setting. In inpatient I'd been more on the neuro side of things.

I'd also been around the pelvic floor community for a while. Even in inpatient there were people who did pelvic floor therapy, and I was always the one reaching out to them and asking questions. I built a lot of connections in pelvic floor therapy, because it's a smaller world. Everyone in my community already knew me. It was almost like they all knew I'd go into it one day, and I was the one saying I don't know if I'll do that, it's nerve-wracking to get into.

So after I started going to pelvic floor therapy, I asked how you take classes for it. That's when I learned about the Herman & Wallace class. I looked it up, and I saw the lab was going to be close to my area, which doesn't happen often. I thought, should I just do it? I reached out to my pelvic floor therapist and said, do you think I should do this? I don't even know if I'm going to be an OT again, but I think it'd be fun to take the class and think about it. She texted back in all caps: DO IT.

Her name is Emily, and she gave me the courage to sign up and start that journey.

After I took the class I still wasn't sure I wanted to do this. I was becoming more open to it, but the therapy world didn't feel very safe to me, because it had been such a traumatic thing. And then I met my boss, Logan. He was going to be opening his own Ivy soon, but he was working in the clinic I was at. I felt a really great connection with him. He made me feel so safe and so supported that I decided to work for him, still as a patient coordinator.

About a month after that, I told him I think I actually want to go back into therapy. He was thrilled. We started the process of me going back. I only started taking pelvic floor patients earlier this year, so I only came back into therapy a few months ago, but now that I'm here, I can't believe I ever left. I'm so thankful for this journey to get me back here.

Lindsey: You took Herman & Wallace. Why did you decide to take the Level 1 program as well?

Brianna: I took the Herman & Wallace class because a lot of the people I talked to made it seem like a standard — oh, that's what you do. I thought that was the starting ground, the progression of becoming a pelvic floor therapist. But I also spoke to a pelvic floor occupational therapist, and that's where I found out about your class.

I always felt there was something I was missing. I felt like I was trying to be something I wasn't, in a way. Like I had more to offer. That's when I started looking into your class, and as I'm going through it now, these are the missing pieces I've been wanting to add.

Lindsey: I want to ask you something really directly, because I get a lot of OTs who ask if they should also take Herman & Wallace. What would your honest answer be if someone came to you just starting their journey? Do they need to do both Herman & Wallace and my Level 1 program?

Brianna: I'm not fully through the class yet. But I don't think someone would have to do that. Your class seems to be way more thorough, and we're getting the same information and more. The only thing I can't compare is the lab experience, because I haven't done that yet. That was the most useful thing from the other class, actually getting the hands-on experience. So I can't speak to that yet, but I don't think you'd have to take both classes.

Lindsey: My journey was that I took Herman & Wallace. There was no Level 1 or OT Pioneers available, so I built it to fill that gap. But I always want to ask people, to help other OTs triage their path with limited time and resources: what would you recommend? I appreciate you sharing your opinion on that.

Brianna: I also feel like your class is way more organized, and there are way more touch points. With the Herman & Wallace class, a lot of it is: okay, you're going to watch all this beforehand, and then you have a two-day lab. In your course we go through everything together and we have opportunities to ask questions throughout. So it's not like, all of a sudden we're a few months in doing the lab and you've forgotten some of the earlier things. It's more thorough and structured that way as well.

Lindsey: Thank you. That was really important to me. I wanted a scaffolding approach. I wanted OTs to feel seen, heard and supported, and to go out there in confidence. At the end of the day, that's what we want. We want more OTs in the field doing this, and whatever I can do to give them support and help them step into the confidence they deserve — that's my life's mission.

Learn with me for free

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Lindsey: I want to get to the really exciting part of our conversation, which was something you shared with me. When I got your email I was grinning from ear to ear. Tell us how you got recognized by your company's leadership recently.

Brianna: At the clinic I'm at, it's just me and one other therapist. It's not like I'm around a lot of people who get to see what I do very often. The person I work with is a physical therapist, but doesn't do pelvic floor therapy. So I'm the only pelvic floor therapist, and the only OT, in my office.

Sometimes we have different therapists come into our office to help out if we need more hands. Whenever I'm working with someone, they'll ask, oh, why are you doing this? They're very curious, because they've realized I do things differently than them. At first that was very intimidating. It's scary to justify yourself to somebody else.

But I started to get excited about how unique I am. So I've been recognized in some ways just by being different, and people noticing as they see me in the clinic. Outside of that, I've been recognized by upper leadership through Google reviews. It's really exciting when you're first starting and you have people bringing in reviews — this is the experience I had, this is what Brianna did. To have people in upper management take the time to look at that and then reach out and say, hey, I noticed you're doing this, that was really special. It makes me feel excited that they see what I'm doing, even if they aren't physically here to see it.

Lindsey: That's incredible. You've described such a nurturing environment, from Logan making you feel safe and being that gateway back into OT, to leadership taking the time to look at reviews and follow up with you. That's the way all therapy practices should be. That level of support and compassion and recognition is what lifts everyone up and makes us thrive and feel good about showing up to work.

Lindsey: Have you ever felt pressure to practice more like a PT to fit in? And if so, how do you handle that?

Brianna: I definitely felt, especially in the beginning, that I wanted to prove myself — like, I'm just as good as a physical therapist. That's what made me most nervous at first, thinking about what other people were going to think of me. I wanted to make a good impression for OT and for pelvic health. But being very new to it, it was scary. When I was thinking about being a PT, I was like, I don't know what to do, because I'm not a PT.

So one thing I did is I brought out my OT Practice Framework and I read it. And immediately I felt so comfortable, because I thought: this is what we do. Then I'm just applying what I want to do with someone based on this framework.

If anyone ever feels like they have to be like a PT because that's what's known — and we do have more pelvic floor PTs in our company, there are over 600 clinics with Ivy Rehab, so pelvic floor PT is more dominant — that's what I decided to do. I had to go back to my roots and truly own OT. And all of a sudden everything made sense.

Lindsey: I adore that for so many reasons. It's very unique that we have a practice framework. I don't believe speech or physical therapy have that, and I think that makes us incredibly special. Anchoring back into it makes all the difference. It's like a North Star. It calibrates us again.

That's exactly what I did when I created the Certified Functional Pelvic Health Practitioner certification. It's tied back to 200 core competencies from our practice framework, and I think we should be celebrating that everywhere we can, whether you're in pelvic health, hands, peds, whatever field you're in.

So I'm going to reiterate what Brianna just said: if you're in a moment of doubt in whatever environment you're in, whether that's from your colleagues, your administration, or even personal self-doubt, look over the practice framework. I know that sounds geeky, but a wave of confidence and serenity comes over me when I look at that document, because it realigns what we know we need to be doing every single day.

Lindsey: You mentioned there are a lot of PTs at Ivy. Generally speaking, what are some things you've learned from your PT colleagues?

Brianna: There was about a year between taking the Herman & Wallace class and actually practicing. In that time I was shadowing a pelvic floor physical therapist, because there wasn't another OT for me to shadow. A lot of what I learned, and what a lot of us can learn from physical therapists, is different mobilization and manual techniques. Also, because Ivy Rehab is very ortho-based, I got to learn more of the ortho side, like back and hip.

Lindsey: Do you integrate some of those things in your sessions?

Brianna: I do. I know OTs are more holistic, so it's not like this is exactly what I'm going to do, but where it feels appropriate I've been adding it in.

Lindsey: Do you feel confident integrating those manual techniques just from that mentorship?

Brianna: I do. I'm so early in all of this that there's so much more I can learn. I also think it's important to see what a lot of different people do. I've been to pelvic floor therapy with three different therapists at different times in my life, and each of them was very different and did very different things. You can learn something different from everybody.

Lindsey: I asked because I hear a lot of OTs who aren't sure about the ortho piece, or feel like a fish out of water if they take a course, or aren't sure whether the OT approach is enough in pelvic health. What I love about your story is that the mentorship you were given was enough for you to say: I see how this can be incorporated, I can do it, and I can also continue to practice the OT way. That highlights the confidence and go-getting nature you have, and I want anyone listening who feels doubtful about that part to know it's possible, and possible to do it your way, through the OT lens.

Lindsey: For any OT listening who might be the only one in their clinic, and maybe feels like they're constantly justifying their approach — is there anything you'd tell them?

Brianna: My perspective is a little different, because people were so excited for me to begin when I was ready. I know I'm spoiled in that way. But my advice is to continue to be confident at being unique. Keep doing things that are different, and keep educating the people around you.

When I started to get excited rather than nervous, it showed other people the value I bring. So having confidence, or at least trying your best — because sometimes it is super intimidating — can help people understand why we're doing what we're doing.

Lindsey: When you reached out and mentioned how well things were going at Ivy, your note said: this is only the beginning. What's next?

Brianna: I was thinking I'm so excited to be recognized in any way, knowing I'm only a few months in, and this is truly just the beginning of my pelvic floor career. Overall I want to get certified in a trauma-based approach as well. I want to work with people with a history of abuse or sexual abuse. I know that takes time, and I want to make sure I'm doing it correctly. So although I'm seeing pelvic floor patients now, I want to continue my education to see how I can better serve the community.

Lindsey: Such a pleasure having you on the podcast today. I appreciate you sharing your journey, and I know it's going to be incredibly inspiring to so many OTs. Thank you for being so brave and sharing everything you did today.

Brianna: Thank you so much for having me.