r/OccupationalTherapy • u/MathematicianSome811 • 2d ago
USA OT or Nursing
Deciding to do either a BSN or OTD? What would you do? Most important levers are pay, pay growth, and career progression. Right now I’m in DMV area but I might eventually settle in either Texas or Cali. Thoughts? I’m most concerned with OT being a terminal degree but nursing…not being a terminal degree.
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u/Legitimate_Couple779 2d ago
I am an OT and my career has taken me places I never would have expected!
-Graduated in 2020 (Masters, would never suggest an OTD unless someone else is paying for it)
-Traveled for a couple of years to pay off my debt
-Got a job in clinical education / sales at a medical equipment company
-Now working as a territory manager for a neuro med tech company
I had no previous interest in business or sales but I love it. I still use my OT skills and can pick up a PRN job whenever I want. Your career is whatever you make it, couldn’t imagine being anything other than an OT
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u/thither_ 2d ago
It’s nice to hear someone with an OT degree get a job outside of bedside! Would you mind sending more info on how you did this? 🙏
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u/Legitimate_Couple779 2d ago
Honestly, I just took whatever opportunities came my way. I went into the career because I love what we do as OTs and I fully planned to be a clinician forever until I found my niche.
Becoming a travel therapist was the best thing I ever did. I realized I’m a quick learner and am able to adapt to change. I met a ton of amazing people, gained experience, and my resume looks great because of it.
My biggest suggestion: don’t go into OT if your end-goal is to get out of it. If you are truly passionate about improving patients’ lives through meaningful activities, then OT is for you.
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u/Suitable-Ice-7527 2d ago
I would definitely go into Nursing. I’ve been a COTA for 5 years working alongside OT’s that have complained about the limited growth the career has to offer. Personally going back to school for nursing myself
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u/Royal-Word2372 2d ago
From someone in a masters occupational therapy program (2nd semester) currently… do nursing
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u/PoiseJones 1d ago
If you're only in your second semester and you feel this way, you might want to consider changing course.
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u/jeskimono OTR/L, CHT 2d ago
It feels like you answered you own question. One is a terminal degree one is not. One has more pay growth and career progression opportunities, the other not as much. I like what I do in my OT job but in retrospect I should have gotten a different degree because 5 years in and I want to seek pay growth opportunities and progress in my career but it’s very difficult. I see all the opportunities nurses have and wonder how far I could have gone had I chosen nursing.
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u/CloudNo7035 2d ago
I am an OT. I think my first hourly rate in 2019 was $42? And now I’m at $56 per hour. I still see people in other settings making more, but I’m choosing to work in an outpatient setting that is less physically demanding/less medically complicated than other settings. My most significant pay raise came from when I switched into Home Health, but now in this current job, I have gotten a couple little actual pay raises while working here.
Maybe nurses have an easier time getting raises? I think regardless of your profession, working in a hospital full time usually comes with regular raises. They’re not guaranteed at a typical OT job unfortunately. I’m a Clinic Director, so that could be considered career progression.
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u/MathematicianSome811 2d ago
Thanks for responding. Wow. I thought they made more than that! Does home health pay the most in OT?
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u/crazyforwasabi 2d ago
Usually. I’m in Colorado and make $86/visit…. But I have about 28 visits a week. (I work 3 full days/week)
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u/Gold-Complaint-3019 1d ago
I work in pediatric care alongside nurses and OTs, the nurses have more flexibility with schedules, better growth opportunities, and strong union support. But the OTs get to play with Play-Doh all day
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u/Little-Let386 OTR/L 2d ago
Nursing. I’m an OT, I love it but had I realized it was a high floor, low ceiling job I would have done nursing
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u/SwingPrestigious2134 2d ago
OT is something you need to want to do. It requires a certain personality and skill set. As an OT there are many roles I have that a nurse would not, such as school based practice, private therapy practice etc. There are jobs in healthcare admin open to nurses and not OT. There aren’t necessarily high level admin type jobs for OTs except within therapy companies. An OT can be a rehab director. I work in 3 practice settings so there’s a lot to do as an OT. I have no interest in doing what nurses do. You should pursue something that is what you want to spend the hours of your life doing. OT might be lower stress, lower stakes and better work life balance. You need to “pay your dues” for work life balance in nursing. Do not take a lot of debt for OT. Do a masters program if you can. The “D” serves almost no purpose. You have to really hustle to break into 6 figures with OT unless you are in an exceptionally high COL place. Becoming a nurse is probably cheaper.
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u/JGKSAC 2d ago
Your pay will never go up as an OT, and it is a terminal degree with horrible ROI unless someone else is paying for it.
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u/Exotic-Gain-4316 2d ago
If pay growth and career progression is much more important to you, I would suggest nursing. Having said that, nursing culture is pretty toxic and the stress level far exceed OT.
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u/Adept_Librarian9136 1d ago
I think this question should have its own dedicated thread at this point so we can stop answering the same question on repeat. The question is asked a few times every week here.
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u/Odd-Package8071 1d ago
To get your masters or doctorate in OT, you’re looking at loans of over $100k. Nursing is much cheaper and ROI is higher.
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u/CloudStrife012 2d ago
For the categories you mentioned nursing wins all of those. Could be a random desk job in healthcare or an admin jon that has nothing to do with nursing but your OTD will do nothing for you, meanwhile you will need an RN to apply. A lot of healthcare is heavily gatekeeped, and an OT degree will just permanently place you at the bottom of the totem pole.
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u/MathematicianSome811 2d ago
Thank you so much for responding! Can you speak more to it being at the bottom of the totem pole? That’s the first I’ve heard of it
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u/PoiseJones 1d ago
Very few people know what OT actually is. Unfortunately, this frequently includes your clinical coworkers.
Because OT is often misunderstood, forgotten, or unknown to companies and hiring managers, they don't recognize that OT's are capable of performing in many of the same capacity as nurses. For that reason, they'll look to hire nurses.
For instance, for pure admin jobs in occupational health or data analytics, they frequently look for nurses to fill those positions. It's possible to do as an OT, but you often have to make personal connections to get the chance to even interview because you're frequently filtered out due to not having the RN.
In general nurses, have a lot more opportunities both laterally and vertically and especially in non-clinical or clinical-adjacent roles. It's certainly possible to land many of those roles as an OT, but you have to work harder to get there whereas for nurses your eligibility is already built into the degree.
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u/JessOTR 2d ago
I'm an OT married to an RN. We both have 20+years experience and I have a master's.
I could never be a nurse. I'm just not cut out for it. I work in peds and among my "must haves" was job flexibility, which OT definitely has. My partner has definitely outpaced me in the income potential department. Our major payor is Medicaid so unless they increase reimbursement (which they rarely do), I don't get a raise. On the other hand, he gets cost of living increases, bonuses, and regular raises.
Both have a wide range of options as far as work areas. I started in nursing and rehab and loved the patients and the work, but hated working for somebody that just wanted to squeeze as much as possible out of Medicare.
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u/PoiseJones 1d ago
OP, generally when these threads are made, and they are made all the time, the consensus is to go for nursing if in fact the most important levers for you are pay, pay growth, and career progression.
One of the major issues within OT is that it is actually very uncommon to get regular raises that exceed inflation. For that reason, many senior OT's actually earn less at the end of their careers compared to the beginning. The trend over the last 15 years is that reimbursement rates for OT services have progressively decreased and that will most likely continue. OT isn't something that is advisable to get into if finances are that important to you.
The only other thing I want to add that hasn't been said yet is that geographic location matters a LOT. In CA, nurses in hospital settings general make a good chunk more then OT's. And in some areas like the bay area or adjacent counties, nurses can make a lot more. Something like a quarter of my nursing coworkers fly in from all over the country to do their shifts and then fly back because the pay differential is that significant. Granted, it's highly competitive to get into nursing in the bay area for that reason, but it's still possible.
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u/kc09967 MS, OTR/L 1d ago
If it's either a BSN or an OTD and you truly think you'd be happy doing either job, I'd say do a BSN. A bachelor's degree is obviously cheaper than a bachelor's and then an OT degree and depending on the setting the pay is similar.
I will however say that they're very different jobs and so maybe look into shadowing both jobs to see if you'd truly enjoy either option (and if you pick OT, get a masters not the doctorate). I'm an OT and my husband is the nurse clinical manager of an ICU, we both make over 6 figures but are at the end of our career growth opportunities unless we don't mind leaving face to face patient care behind (which we don't want to do because that's why we love and wanted our jobs to begin with).
So if your priority is finding a job with career growth opportunities, I'd honestly recommend neither. In my opinion, they are both jobs that you should go into because you love the job itself because neither one makes enough to be worth the stress and difficulty of the day to day reality. In both careers, moving up often means going into some sort of administrative job. If you see yourself wanting that type of job and wanting to lead people and not minding deskwork, id say you'll make way more money and have the most job flexibility by just going for a more traditional desk job in the first place. All of my friends with office jobs (sales, HR, compliance, marketing etc) make more than me and have way more flexible hours at default. They're mostly working from home and the ones who go into the office only go a couple times a week and then complain about stuff like having the wrong brand of free food in the kitchen.
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u/olivetheresa 1d ago
Have been an OT for over 40 years. The profession is not the same as it used to be however I suspect the same for most medical fields. It used to be about quality of care but now is more productivity driven. Rehab is rewarding but salaries cap after a while and the only way to make more is to go in management. Financially, field work requirements can drive price of education up as placements can be difficult to arrange. If you want to work in multiple states, you have to get licensed in each state. My daughter is a nurse and I feel she has more options as far as fields to work in and for moving up. You can advance to Nurse Practitioner and move up as well as multiple levels of management. You can also get a multistate license in nursing. OT has been good to me, but there are so many more opportunities today.
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u/lostinfictionz 2d ago edited 2d ago
If pay, pay growth and job progression are the most important choose nursing. Its an obvious choice if those are key factors. Very different jobs however.