Rehab needs to get a clue - page 3

This might be something of a vent, but I am very tired of rehab people thinking they are the be all and end all of skilled care. I have rehab staff interrupt the med nurses for a variety of reasons... Read More

  1. by   prmenrs
    Seems like a "come together" meeting is in order: get the stakeholders (therapists and nurses and or leadership) together, and figure out how to work compatably w/each other so that the PATIENT gets the best care. That is the objective, right?

    Also, use some visual clue--a sash, tiara, special color scrub shirt--to indicate who the med nurse is. S/he is sacrosanct! Unless there is a dire emergency, all staff need to acknowledge the seriousness of this task, and the possible consequences of a med error. If she passes prn meds, too, use a communication method of some sort--clipboard, note book--to record requests. The med passer can check it periodically to deal w/that issue. You could even use one for pain meds and a different one for less urgent needs.

    Meds are important, rehab is the reason their in the facility. Both things need to happen, but preventing med errors trumps rehab in terms of potential Very Bad Outcomes.

    Best wishes as you negotiate a balance between the 2 teams caring for the pt.
  2. by   BrandonLPN
    Sorry, no way am I going to wear a sash of any kind.

    The giant pill wagon tends to tip people off.
  3. by   Bringonthenight
    Can you explain the difference between a med nurse and a rehab nurse?
  4. by   dishes
    Seems to me some LTCs do not have small enough patient/nurse ratios to provide active rehab and should not be licenced as rehab providers unless they have adequate staffing.
  5. by   Dazglue
    OMG. I thought this sort of thing only happened at my facility. Our entire med pass is based on the therapist schedules. Ok fine. But almost everyone is a high fall risk (visible armband on pt) thus requiring fall monitors at all times and letting someone know they're back from therapy. Or they'll let the pt go to the restroom alone and we find them on the floor. No one does either which means more falls and write ups for us. Management will make up a schedule for rehab but is terrified of an educational section about fall precautions.
  6. by   anotherone
    I work in acute care but can relate. I hate to be drawing up meds and have a family member of a pt I don't even know come up to me and start asking questions or expect me to drop what I am doing. same with other staff ( not nurses usually aidea). For the pts and family I want to wear a shirt that says, " ring call bell for assistance." unless it is a real emergency leave me alone while i am pulling up zofran, dilaudid, benadryl and the other 12 meds one pt gets
  7. by   THELIVINGWORST
    As a CNA, and soon to be RN in working in an acute care hospital with experience in LTC/Rehab, I would like to put my two cents in.
    If we cannot do something for a patient or family, we MUST ask the nurse. We are aides, not RNs and the RN is ultimately responsible for the well being of the patients in the eyes of the law. Most of us IMHO, would rather be able to do small things that are not in our scope of practice, but we are not allowed to. PT/OT must care for the patients as well, and it is unfortunate that many nurses have the opposite experience.

    These pts and family members will yell at us or feel like we are pushing responsibility off on others if we don't fulfill their requests ourselves, and we find ourselves in this same enigma time and time again bc EVERYONE is busy most of the time.
  8. by   Vespertinas
    Quote from dream'n
    Must be nice, only being required to do "billable" things so as not to get behind schedule LOL
    Yes yes yes!
  9. by   CapeCodMermaid
    My med nurses do more than pass meds. They do assessments, treatments, charting, assisting the CNAs....
    In Massachusetts we do not have medication aides. The issue comes up every few years but the Massachusetts Nurses' Association goes to great lengths to make sure the law doesn't change.
  10. by   savoytruffle
    Medication aides would not be a good solution in LTC. A nurse is needed to monitor these medications and the patient. Many times I'm being interrupted for therapy. I get calls from the manager to complain that the patients were not up in time for therapy in the morning. Well, we had two total beds during breakfast are are an aide short. So no, we will not be transporting them for you also today. It's not just therapy. Social work loves to drop tasks and call impromptu family meetings. No matter what I'm in the middle of. I feel I can never get anything done from start to finish. My med nurses complain about it daily. I've thought about calling a team meeting to hammer some of these things out.
  11. by   chrisrn24
    Quote from CapeCodMermaid
    My med nurses do more than pass meds. They do assessments, treatments, charting, assisting the CNAs....
    In Massachusetts we do not have medication aides. The issue comes up every few years but the Massachusetts Nurses' Association goes to great lengths to make sure the law doesn't change.
    So they're just a nurse then haha
  12. by   NurseGuyBri
    Good morning! Here is what I'm gathering out of this post and comparing it to my facility. We all have the *exact* same staff! Now, since that is not true, perhaps something else is going on here. If this is the case in so many different facilities, then there must be more to the story. Perhaps we need to look at some internal systems and come up with solutions? Our rehab has become the prime money maker for the facility, without them I don't think we would stay in business, especially with the recent cuts. What we need to work on is the communication between the departments and the managers of those departments. No, I'm not good at doing this yet, but our facility is working on it. Improving the management relationships and stoping the b*tching about what the other department does or doesnt do won't help the problem. I've recently gotten into attempting to always explain why I have the expectations that I have. For instance, if a OT asks for pain medication for a patient, I expect the nurse to complete their current patient and then medicate the patient. No questions. If OT asks for assistance to the bathroom, I expect them to either help provide it or get the CNA, not the med nurse. The assignment is posted, and they can help. Explaining WHY I do this has made a difference. I don't know what it's like to be a PT/OT/ST, and they don't know what it's like to be a nurse. There are things I'm willing to work on, there are things that I refuse to, and explaining why I feel that way sheds light on it. Now, let me disclaim here that I know this is a vent post (although has turned into more) and I COMPLETELY AGREE lol!! This is a much needed vent. Now that the vent is open, perhaps we can figure out how to control the temperature coming out? If anyone is interested in using a chat room for discussion, please let me know because I love to talk and hash these things out, it's of great importance for me as a manager.
    I think the moral of the story is to not assume what they are responsible for, do not assume they understand what we are responsible for, share the information professionally and kindly, and when that isn't possible, find out why and fix it. I could go on for days.. ;-)
  13. by   Forever Sunshine
    Quote from BrandonLPN
    Sorry, no way am I going to wear a sash of any kind.

    The giant pill wagon tends to tip people off.
    Anyone with functioning vision should be able to see that I'm passing meds.. I agree with you a sash is not needed.

    I'm so happy to see this thread because the other day at work I was thinking (during a med pass of course.. after being interrupted for something stupid) if I had a penny for each time these therapy staff interrupted me I wouldn't have work anymore. Thankfully they all are friendly and polite (except for one) but I just would like them to not interrupt us for things they could either look up or do themselves.

    I also find the location of me and the cart is related to how many times I'm interrupted. I find when I go room to room and bring the cart and put the cart in front of the patients door ... I'm less likely to be interrupted. If I keep the cart in one location against the wall, I get more interruptions. If I keep the cart at the desk and walk back and forth.. forget it.. I'm not getting anything done.

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