Productivity: the push button topic in the SNF world. If you’ve ever felt torn between what’s ethical and what’s expected, this episode will hit home.

Instead of a research article, we dive into Akyko S. West’s dissertation on productivity requirements and moral distress in SNF rehab therapists (SLPs, PTs, OTs, RTs, and their assistants). This paper READS like every conversation we’ve had in break rooms for yearsss.

In this episode, we cover:



Why productivity expectations in SNFs feel impossible




What West discovered about moral distress across 152 rehab clinicians




How difficult-to-meet productivity demands impact clinical judgment




Why negative consequences—not productivity alone—drive distress




The ethics conversations no one wants to have but everyone needs




Personal stories from the field (PRN trauma included)




Why the “sweet spot” for ethical productivity still doesn’t exist




What therapists can realistically do to protect patients and themselves




We get real about navigating profit-driven healthcare, maintaining integrity, advocating for yourself, and knowing when to walk away.

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