Dealing with unreasonable PTs, SWs etc

Nurses General Nursing

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Specializes in Med-Surg, Psych.

Have been medicating the pt for pain throughout the shift, last checked no complaints of pain. 3 minutes before the end of my shift when I am finishing my shift-to-shift report, PT comes and requests that we medicate the pt for pain right now, so she can work with the pt. The next shift nurse explained that she has not received all of the reports yet, and she needs about 10 minutes before she can medicate the pt. PT gives us a look as if we are not doing our jobs. Pt is not in acute distress, needs to be medicated prior to physical therapy. It would also make it easier if the PT department gave us exact time so we could medicate the pt prior, but it does not happen that way.

I find it frustrating when I see PTs, SW and other healthcare workers having unreasonable expectations from nurses. After all, they deal with 1 pt at a time, and they act like the patient they are working with is the ONLY patient the nurse is working with.

I would appreciate if other nurses could share experience handling similar situations.

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Specializes in ICU, PACU, Cath Lab.

Personally I would have gotten up and given the med. I mean how long does that really take? I do not find that request really that unreasonable. Having a PT just stand there waiting for 10 mintues or more...I mean they may just deal with one patient at a time, but have you ever asked how many they see in a day? Just my opinion....

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Specializes in LTC, Hospice, corrections, +.

I have always found PT and SW to be very respectful of the nurses time. I would have just smiled, said thank you very much I will get right on that, finished report and counted (if it wasn't going to be that long anyway) then reminded the incoming that PT was waiting. Now if report or count was going to be 20-25 mins I would have given the med. It is not unreasonable for PT to have to wait 10 mins. It is unreasonable for them to expect a nurse to drop everything and be able to comply with their demands. Unrealistic. The patient needs to be medicated for the max benefit of therapy. Ask PT to give you at least 30 min lead time for medicating in the future. They should have an idea of what your days are like, and that would be in the best interest of well, everybody.

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Specializes in LTC/Rehab, Med Surg, Home Care.

We have a social worker who is a complete and total PITA this way too. She never lets us know when she's coming, and gets very upset that we haven't pre-medicated for therapy. The problem is that she does not take the pts. in the same order every day, nor does she try to give us advanced warning. It's very frustrating. The other PT's, OT, etc are very good at letting us know when they need a particular pt. This PT also doesn't realize that if I give a pt. a pain pill NOW as she's taking the pt. to therapy, it's not going to act instantly, and the pt. is still going to struggle through PT.

I don't think it's too much to ask to give 30-45min notice. Except we've asked and this particular PT continues to be unreasonable. As for SW, we'll I'm a foster parent, and have always found them to march to their own beat. I've met very few who are truly reasonable people. I think it's safe to say I have issues with them!

Have been medicating the pt for pain throughout the shift, last checked no complaints of pain. 3 minutes before the end of my shift when I am finishing my shift-to-shift report, PT comes and requests that we medicate the pt for pain right now, so she can work with the pt. The next shift nurse explained that she has not received all of the reports yet, and she needs about 10 minutes before she can medicate the pt. PT gives us a look as if we are not doing our jobs. Pt is not in acute distress, needs to be medicated prior to physical therapy. It would also make it easier if the PT department gave us exact time so we could medicate the pt prior, but it does not happen that way.

I find it frustrating when I see PTs, SW and other healthcare workers having unreasonable expectations from nurses. After all, they deal with 1 pt at a time, and they act like the patient they are working with is the ONLY patient the nurse is working with.

I would appreciate if other nurses could share experience handling similar situations.

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Specializes in Med Surg, Tele, PH, CM.

I don't think it's too much to ask to give 30-45min notice. Except we've asked and this particular PT continues to be unreasonable. As for SW, we'll I'm a foster parent, and have always found them to march to their own beat. I've met very few who are truly reasonable people. I think it's safe to say I have issues with them!

This sounds like a control issue to me.... Ancillary providers are all over the hospital all day. They generally are not able to stay on a fixed schedule because of unanticipated issues and constant interruptions (in my job I interrupt them a lot). I did bedside nursing for ten years and know that you have to anticipate these things. I agree with a previous poster, I would have taken the five minutes it takes to give a pill or injection.

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Specializes in LTC/Rehab, Med Surg, Home Care.

It sounds like it's different in a hospital setting. I'm in long term/sub acute care. My point was that are other PTs seem to be able to give us a heads up "hey I'm going to be taking ______ for PT in about an hour, did they get any pain medication?"

It's not a control issue, it's a collaborative care issue. Some get it, some don't. And I disagree with the previous poster. It's rude to come and interupt during report, expect the offgoing nurse to wait to leave her shift (especially when so many of us complain that management gets on our case if we don't punch out on time), knowing that the nurse is probably going to be bombarded with 10 other questions, concerns, etc as soon as she leaves the room. The PT that I find difficult to work with is very demanding, and does expect me to drop everything to address what she needs NOW. Of course they are busy too, but if they are "running all over the place", why not make their life easier and give a heads up to nursing?

This sounds like a control issue to me.... Ancillary providers are all over the hospital all day. They generally are not able to stay on a fixed schedule because of unanticipated issues and constant interruptions (in my job I interrupt them a lot). I did bedside nursing for ten years and know that you have to anticipate these things. I agree with a previous poster, I would have taken the five minutes it takes to give a pill or injection.
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Specializes in Cardiac Telemetry, ED.
Have been medicating the pt for pain throughout the shift, last checked no complaints of pain. 3 minutes before the end of my shift when I am finishing my shift-to-shift report, PT comes and requests that we medicate the pt for pain right now, so she can work with the pt. The next shift nurse explained that she has not received all of the reports yet, and she needs about 10 minutes before she can medicate the pt. PT gives us a look as if we are not doing our jobs. Pt is not in acute distress, needs to be medicated prior to physical therapy. It would also make it easier if the PT department gave us exact time so we could medicate the pt prior, but it does not happen that way.

Mountain out of a molehill. Since you were almost finished giving report, and the oncoming nurse still needed to get report on their other patients, I'd have simply told PT that I'd be there in a minute, finished report, then gone ahead and medicated. No biggie.

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Specializes in Med-Surg, Psych.
Personally I would have gotten up and given the med. I mean how long does that really take? I do not find that request really that unreasonable. Having a PT just stand there waiting for 10 mintues or more...I mean they may just deal with one patient at a time, but have you ever asked how many they see in a day? Just my opinion....
:down:

I had only 3 minutes left before the end of my shift, just enough to finish report. It usually takes 5-10 minutes to get pain med out as there is usually a line at the pyxis station. It would make me clock out late, I would have to return to staff room and write down an explanation why I stayed overtime (which would take another 5 min), and I would not be able to get home when my daughter arrives from school.

And by the way, I have a life outside of work, and I have to be home on time when my daughter comes from school. If it was just as easy as it sounded in your post, I wouldn't bother to post this thread at all.

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Specializes in ER/EHR Trainer.

This is tough because moving a patient without pain meds makes them less likeley to perform PT-from the patient perspective and care I'd say medicate.

HOWEVER

Why isn't there advance notice? Normally it takes awhile for meds to work, why wouldn't there be a loose schedule for PT or anything else? AND WHY would PT come during shift change without notice?

I think it's poor time management on the part of the ancillary staff, either way the patient suffers.

As for the OP, I understand completely how she would feel and the dilemma about report. Why not just walk to the pyxis with the oncoming nurse while giving report. Report doesn't have to be in a seated position. Let the new nurse pull the med and medicate. You go on your merry way.

We frequently do a walking report and in some cases I prefer it.

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Specializes in Geriatrics.
Personally I would have gotten up and given the med. I mean how long does that really take? I do not find that request really that unreasonable. Having a PT just stand there waiting for 10 mintues or more...I mean they may just deal with one patient at a time, but have you ever asked how many they see in a day? Just my opinion....

My problem with this is simple. If I do it for one I have to do it for all, result, a 10 minute shift report lasting two or three times longer.

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Specializes in rehab; med/surg; l&d; peds/home care.

I've done sub-acute rehab, and yes, this was always an issue. When docs or anyone else writes for "medicate 30 minutes prior to PT"...it's never done. WHY? Because we NEVER had a schedule for the patients of when they are due to go to PT/OT. It was like a "classified" secret. Plus, every day it changed, esp on the weekends.

What worked BEST for us was to put most pt's on routine pain meds, with break-through/PRN meds available as well for those times when they needed it. The patients were happier, nurses weren't constantly interrupted, and PT/OT didn't have to go ask for the pt to be medicated. It didn't solve every instance with pain control, but it worked much better. I don't know if that would be a solution to try?

I've been in this situation before, where I'm interrupted in report, just minutes to go before I'm supposed to be off-duty. Where I worked, we'd be reamed if we worked late (even 1 minute...we'd be written up for it!), and reamed if something like this happened and we didn't get right up to medicate.

I'm sorry you had a rough shift.

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I kinda had a thought that this was in a SNF. LOL. Our SW thinks she is a nurse and our PT thinks he is a doctor or God. LOL

A little bit of warning would be nice. You were on top of this resident's pain all day long so the 10 minutes PT needs to wait is okay. Heck....PT is going to need to wait longer than that because it won't start working for a bit. DUH.

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