Working closely with PT and OT and ST...ever want to tell them to shut up?

[Jo Dirt]

Since the nursing home where I work started doing rehab we have to share the facility with all kinds of therapists: PT, OT, ST, RT and all the helpers that go along with those departments. I imagine there is a beaucoup of money in these areas because the nursing home build on a special wing just for them.

It seems like many of them want to get involved in the nurses' jobs, and I know an interdisciplinary approach is needed but do you ever feel they sometimes cross the line by wanting to decide what nursing judgements you should make and what you should do?

For example, ST decided a patient was in pain. This patient is nonverbal and was not grimacing or fidgeting or showing any other signs of being in discomfort. The ST decided because she had her head cocked to one side she was in agony and needed pain medication, nevermind this is how the patient was all the time and that she was on scheduled pain meds. She didn't like the answer the nurses gave her, either (the patient was showing no acute distress and pain medication could not be justified right now.) Not satisfied, the ST decided to use her own comfort measure and put a dry towel in the microwave to warm up and put around the patient's neck, only she left the microwave going and left the break room and it blew the microwave up and caused the fire alarms to go off.

PT said recently they need to be more involved with things like wound care and dressing changes. It seems like everyone wants to take over the nurse's job.

Do you ever feel this way?

[RNperdiem, RN]

Maybe I'm missing the point too.

I appreciate when a physical therapist lets me know that a patient seems to be in pain. Now that doesn't mean I have to give it, but it does show me that nurses don't hold the patent in patient advocacy.

As long as they are acting in their scope of practice and communicating with me, PT/OT is welcome to help the patients.

[lpnflorida]

We are not allowed to put anything other than food in a microwave. I personally did not bother to address this as I assumed the speech therapist learned her lesson. I also did not address the fact that other than a physcial therapist heat wraps can not be used and then it must be ordered by a doctor. Nurses get to use K-pads not heat wraps. I chose instead to look at how in rehab therapists many times have a voice over nursing.

[jnrsmommy]

Dressing changes are not in the scope of practice of PT/OT. To allow them to do this strikes me as negligence.

I am still a student but I must say the OP has a point. While I greatly appreciate PT and OT I have noticed that some of them can be rather, well, assertive.

Actually, PT can become certified to do wound care. Have worked at several places where they did the txs.

[CoffeeRTC, BSN, RN]

Years ago, therapy ruled the LTC when medicare was paying more. Their role has shifted a bit since and they still play an important role in LTC.

I totally understand where the OP was coming from. I've had my share of the attitude from some of them. Some of them are right up there with surgeons with attitudes BUT...I've also have seen my share of great therapist who really get the ins and outs of LTC.

I tell you what bugs me.....Our therapies service sends out surveys to patients when they are dc'd. Before they are dc'd, I've overheard some of them push the patients and families to fill them out. Seems like the PT/OT's are getting a lot of praise etc...it isn't like nursing is there 24/7.

[pagandeva2000, LPN]

I think I get the point; there are times where other disciplines do become intrusive. Now the example I have to share does not relate to PT or OT, but I remember once, while working as a CNA that the beautitican, who comes every Thursday after lunch and grabs whatever patient she wants to do their hair. I had a patient who I knew needed a change before she left, so, I tried to find her, could not and took the patient back to the room to change her clothes, clean her, etc...to be more presentable. The beautitican reported me to administration for this and they started trying to say that I should have changed her sooner, that I was not working in a timely manner, etc...

Now, the reason why she wasn't changed earlier was because I was getting others ready for lunch, and she didn't need it then. If I sent her downstairs that way, I would have been in even worse trouble. We do have the overzealous types of personalities that believe that because they work in the atmosphere, they know the ins and outs, and that is not true. I work along the side of housekeepers, but does that mean that I know what products they use to mop the floor versus what they use to clean a chemical spill? Probably not. That is what I think the OP meant.