Rehab "team"?

  1. I've been working at a free standing acute rehab hospital for about 4 months now. I have noticed that in my facility, the nurse is not valued as a member of the rehab "team". I had patient for a month and a half with 3rd degree burns over 80% of her body...the dressing changes took me nearly 1.5 hours per day. On the day the patient was leaving, the PT,OT, MD and case manager all came in to the room as I was finishing up the dressings(not expecting me to still be in there). They presented a gift to her from the "team" saying they all pitched in for this little something. I had no knowledge of this, nor did they expect me to still be in the room. I felt like all the hard work I put in for this patient was completely undermined by the other staff, as if the care I provided to this patient wasn't important (which I know is not true). I see this lack of respect on a daily basis. I've had therapists come up to me while I have my hands full of meds or dressing supplies, clearly in the middle of something, to tell me that so and so needs to use the commode. Since when, in a rehab hospital, are therapists above toileting people? I can't say this is true of all of them, but it happens often. I am just wondering if any other nurses find this true of their facility and is this something I should just get used to? When I took the job, I was so excited to get to be a part of the team, but I certainly don't feel that way at all.
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  2. 8 Comments

  3. by   blackberry
    Wow, I would have brought this up to my manager. When the therapists let you know that a patient needs to get on the commode, tell them that you are going to be with another patient and that they will need to ask the nursing aide to toilet the patient. Negotiate with them. Ask them to put the patient on the commode and you will take them off ( of course only if you can leave the patient alone).

    In my unit, if a therapist enters the room to start therapy and the patient requests to be toileted, the therapist will toilet the patient. The therapist uses this as a teaching moment. Our therapists have cleaned up a patient's emesis and dirty diapers.

    It sounds like the director of your unit needs foster a team environment. Direction for the therapists to take care of the ADL's you mentioned needs to come from above.

    Being able to transfer to the toilet and to sit on a tiolet without tipping IS an ADL that is part of REHAB. Therapists are missing out on a big assessment.
  4. by   TheCommuter
    I work on a short-term rehab unit at a SNF, and have observed that nurses seem to be regarded as very low on the interdisciplinary food chain at my workplace.

    PT assistants will roll or ambulate patients back to their rooms after therapy sessions end, and then inform the nurses station that that same patient is requesting to use the bathroom or be placed in bed. Why didn't the PT assistant take the extra few minutes to put the pt. in bed when they were just in the room? They could have used the opportunity to provide patient teaching about proper transfer methods.

    PT, OT, and ST have more credibility with the many of the patients and family members than the nursing staff. Dietary, case mgmt, social services, the business dept, and other departments seem to receive more recognition than nursing, when the nurses are quite integral to the total outcome of each and every patient. Without the nurses, the doctors would have nobody to follow through with their orders or provide the much-needed care.
  5. by   Mister Chris
    I am a member of a very dynamic rehab team that all work together - as a team! Our situation is a medium secure psychiatric setting with many different types of cases, but our clients are not physically ill. However, we do the job of rehabilitation working with the ward nurses on all the individual programs doing whatever is necessary. Every member of our rehab team has a speciality, Recreation, social worker, psychologist, diversional therapist, physio, nursing (thats me), and we all work with the ward staff - including supervision and assistance when appropriate with ADL's.
    I have worked in rehab in a general hospital in Australia and sympathise with your position. As a nurse you are a very valuable member of the rehab team it is sad if you are not recognised as such.
    Keep your chin up and I am sure you will be recognised more sincerely one day soon.
    Nurses are special people.
    Hugs, smiles and kisses from Mister Chris
  6. by   TheCommuter
    Quote from Mister Chris
    Our situation is a medium secure psychiatric setting with many different types of cases, but our clients are not physically ill.
    In the US, rehabilitation nursing refers to the reconditioning of patients who are physically debilitated due to CVAs, acute MIs, weakness, chronic illness, recent surgery, etc. They become reconditioned through physical therapy (PT), occupational therapy (OT), and sometimes nursing rehabilitation. This specialty does not pertain to people with psychiatric illness; for that, we have psychiatric nursing.
  7. by   1studentnurse
    Quote from TheCommuter
    PT assistants will roll or ambulate patients back to their rooms after therapy sessions end, and then inform the nurses station that that same patient is requesting to use the bathroom or be placed in bed. Why didn't the PT assistant take the extra few minutes to put the pt. in bed when they were just in the room? They could have used the opportunity to provide patient teaching about proper transfer methods.
    This is often the story of my life. In one situation, we had a patient over 250 lbs who was brought from therapy to toilet on the unit because "the therapy toilets wouldn't hold him."

    The therapy toilets were the same as the ones in the patient's room. The therapists just didn't want to toilet this man.

    Some people are very prejudiced against obese people and it doesn't matter if they're rehab staff or others. It's just sickening.
  8. by   10ACGIRL
    I Am A Rehab Nurse Tech @ Central Georgia Rehab Hospital. This Is For Cardiac Patients Of By-pass Surgery Trying To Get Back To Normal Daily Living And For Stroke Patients, Trauma Accident Patients, Ect. It Sounds Like A Rehab Nursing Home But Its Not. Its An Outpatient Clinic And They Also Have Patients That Go In As Inpatient For 16 Day Therapy.
  9. by   10ACGIRL
    I Couldn't Agree With You More. I Agree With You 300% And Then Some!!!
  10. by   10ACGIRL
    AT www.mccg.org., u can click on careers and then job openings, you will c the rehab nurse tech and click on it to read the qualifications.

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