Aggressive Therapy

  1. Does anyone else have a problem with over aggressive therapists? Why is it that speech therapy always wants to do swallow evals and barium swallows on everyone in the building, including those on hospice? Why is it physical therapy wants to do therapy for ambulation on someone bed bound for 2+ years?
    I am so tired of being the bad guy for telling them I think they are abusing the system! HELP!! Any suggestions on how to tackfully deal with this problem?????
    •  
  2. 3 Comments

  3. by   Nurse Jenni
    I have run into situations like that. Thank god they've been few and far between...the facility I'm innow has guidlines for pt and st to "pick up" new pt's...we have to have 3 solid days of charting on either a decline or improvement in status for either discipline to even eval any pt. AND nursing has to make a written request to have said pt eval'd. So we have have control over who is seen. Now don't get me wrong all our new admits are seen by all discplines in the first week they arrive. This weeds out the problems of new staff thinking not enough is being done or the occaisoinal lucid moment that the bedrest 2+ yr people would have. ( I hope that didn't sound cold. ) The facility I was previously in, people who had become max asisst of 2-3 people just for tioleting were being picked-up for ambulation and made asisst of 1-2! (basically for the funding)<you get my point?>
  4. by   Talino
    LOL! Before you attack one of them, look closely at the resident. Your nursing assessment may not necessarily be conclusive to a therapist's point of view. Is the resident absolutely devoid of a potential for improvement? Each therapist does an initial assessment/evaluation. For him or her to put someone on therapy, they have to document a valid reason. I recommend you read their reasons. Look keenly at their objectives. Are they feasible?

    If your therapists are salaried employees (on staff), I will not direct the anger on them. Therapies reap the most revenue to a facility -- the more, the better. Regardless of the caseload though, the therapists get a fixed salary. Maybe you should look at your facility or Administration's practice instead.
    However, if you have therapists as consultants, this practice generates revenues for themselves too. The more hours they incur, the more they get paid.

    If you suspect abuse, there is a hotline you can call. As a whistleblower, you can be rewarded too. But be careful. Altho these practices appear unreasonable, if there is valid documentation to warrant it's need, then it's reimbursable. Afterall, that's probably where 50% of you paycheck came from.

    Might as well blame it on the system - Medicare/Medicaid.

  5. by   nur20
    All of the above is true.Sometimes it seems that they are justifying their position or their reason for being, setting unrealistic or unobtainable goals. They have a real hard time stating "PATIENT HAS REACHED MAXIMUM GOAL OR POTENTIAL" VISIT MY WEBSITE
    Last edit by nur20 on Oct 13, '01

close
Aggressive Therapy