RT over-stepping boundaries?

wooh, BSN, RN · Feb 27, 2014

I am sure you wouldnt want the RT to have over heard a conversation you had with your pt and then make a big fuss over whether you made a comment outside your scope.

Exactly. RT overhears part of a conversation between you and a patient. Then calls up your manager to inquire about scope of practice (doesn't name you, but it's easy enough to decipher if you're the only one that had patients gettings nebs, although not as easy to id as when there's only one RT in house for a shift as you claim). Then calls up the board of nursing.

You wouldn't be the least bit offended? Don't think you're going to be getting a call in to your manager's office?

TriciaJ, RN · Feb 27, 2014

If these people are operating within their scope of practice, then where is the harm in checking with management or with the Board to clarify roles? No one should be getting called into the manager's office - for what? If they are operating outside their scope, then it lets management know that policies need to be clarified and all staff need to be updated so problems don't occur inadvertently. Professionals need to have these conversations regularly and kudos to anyone who acts on concerns. OP was just asking for input. We are not kids on the playground tattling on one another.

LPNMary · Feb 27, 2014

I'm not 100% sure of the answer on this one, as RT's role in patient care is relatively new to me. I came from small, rural hospitals that allowed the nursing staff to actively place O2 on patients when they needed it. Presently, I'm employed where RT has 100% control over every aspect of patient care as it relates to oxygenation. If a patient even complains of chest pain, I cannot place O2 on the patient. I have to call RT to do it. I have to call RT for *everything* lately.

You're luck. to

jadelpn, LPN, EMT-B · Feb 27, 2014

OP, If you overheard this conversation happening, that is when I would step in to the room, state something along the lines of "Sorry to interrupt, I was just hearing that we were talking about lab values, and want us all to be on the same page" and actively join the conversation. Then when leaving the room, thank the RT for explaining the values, is there a change in orders that you could ask the MD about, how the course of their treatments are going, and anything else you need to be aware of patient education wise, so you both are in sync. Then document, RT educated patient and family on....whatever it was. It is a given that most often the family is going to ask what the RT is doing. Some "panic" at the thought they have to have suction at home, O2 at home....and a boatload of other things that look a lot more scary at the prospect than needed.

I would think that the RT may or may not have been talking about a CBC which could indicate a bacterial pneumonia, along with a CXR, and how everything works together. They are also responsible, I would think, to explain to the patient the rationale behind what they are doing, and patient education. I would also think that they could also want to discuss if their treatments are helping, is this something that needs to continue at home, that type of thing. You just need to ask that you be kept in the loop, as part of your responsibility is also patient education, and it should mesh.

Been there,done that, ASN, RN · Feb 27, 2014

I love RT!!! They know the patient as well as I do.

I'll take all the help I can get with families.

As far as hospice... it would depend on what stage the discussion was at. Most therapists are compassionate and have taken care of many hospice patients. They would provide much support in the decision.

1RN4Christ · Feb 27, 2014

I'm done with this post. I'm not sitting here being nasty or condescending. I admitted what I could have done differently and I was asking a question to merely be more OBJECTIVE. Not judgmental and rude! Religion has NOTHING to do with this and you that are so quick to point the finger forget that we are all human and fall subject to the same faults/failures.

ADeks · Feb 27, 2014

Many of the RTs I know go through an extensive program. Similar to to ADN and BSN. Many of my RT coworkers have a Bachelors degree in science. They are very well educated and are apart of the care. I wouldn't be upset that they would discuss things like lab values.

1RN4Christ · Feb 27, 2014

Exactly. RT overhears part of a conversation between you and a patient. Then calls up your manager to inquire about scope of practice (doesn't name you, but it's easy enough to decipher if you're the only one that had patients gettings nebs, although not as easy to id as when there's only one RT in house for a shift as you claim). Then calls up the board of nursing.
You wouldn't be the least bit offended? Don't think you're going to be getting a call in to your manager's office?

You are assuming I spoke with the manager. And yes, as I claim, there is only one. Policy states there has to be two at all times (manager included). I did not call the manager. Let's stick to the post.

Esme12, ASN, BSN, RN · Feb 28, 2014

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BuckyBadgerRN, ASN, RN · Mar 2, 2014

I agree! when I was in nursing school, my grand rounds presentation was on COPD. One of the RT's at my clinical site was invaluable at hooking me up and TEACHING me about ABG's and other things that were just drilled into us in nursing school, I GOT it when she explained it. She lent me inhalers, handouts and offered to show me how to conduct a breathing test that I can't recall now, in case I wanted to demo that as well. She rocked!

Many of the RTs I know go through an extensive program. Similar to to ADN and BSN. Many of my RT coworkers have a Bachelors degree in science. They are very well educated and are apart of the care. I wouldn't be upset that they would discuss things like lab values.

OCNRN63, RN · Mar 3, 2014

Just a question. I'm just trying to have a better understanding of the role they play. They are not with the patient all day long, nor do they have direct interaction with the physician.

If you had a question about the RT's role, why didn't you take up your concerns with the RT, rather than calling the state board (which has more than a whiff of trying to rat someone out)?

All of the RTs I've ever worked with had a good deal of contact with the patients' physicians. Nurses are not the be all, end all of patient care. We (most of us, anyway) work together as a team.

OCNRN63, RN · Mar 3, 2014

There is a BIG difference between a doc and a RT discussing what lab values might mean and a RT interpreting lab values for a patient or family. Even as nurses we have to be careful about telling a patient or family what lab values "mean", lest we step out of bounds and give our own medical diagnosis. IMHO, this RT is guilty of practicing outside their scope and should be disciplined for it.

You're certain this RT needs to be disciplined, even thought you weren't there to hear what he/she said, and are going only on the information the OP posted?