I work in LTC, with an in house rehab. I am fairly new to this facility. (3-4 weeks) This patient comes back from the hospital (had been in the hospital since I had been working there.) One of the therapy staff had come up to me when I was on my med pass, asking all sorts of questions. She said that she had read the pts chart and knew they were admitted to hospital for dehydration and urosepsis. Well, (Keep in mind I had this patient for a total of 2 hrs. and hadn't even given him any meds yet) she let me know that this was one of her favorites (that's ok, I have mine too) and wanted to know how he got his fluid intake - peg tube. Wanted to know why he wasn't given enough water. I told her I wasn't sure, this was my first time having him, but in report several times, was warned about his combativeness. Told her this. She said that is rediculous. He can't refuse that.
She has been on my case ever since. Stopping me in med pass to change dressings - I'm new to this facility and trying to get my routine down.
She came in same pts room the other day, he is on contact isolation, (for his wounds) I was giving his meds and flushing his tube, I had on gloves. She comes in the room and says "I'm confused, I thought he was on contact isolation. I told her that was right. She said --You don't have a gown on. I said "I'm not in his wounds, I'm giving his meds. This is totally ok.
She has now started complaining about everything, and is making me have bad days:crying2:.
What would you do? Am I crazy? I try to get along with everyone, do my job, take care of my patients. This girl is killing me!
Definetely, set your limits especially working in long term, I have run into a few of those therapist myself and they are a pain. I think she's also taking advantage because she knows your new. Just be upfront and clear, do not back down!
I think that girl(therapist) has too much time on her hands, She doesn't know what to do with it, and she is very nosey!! In the beginning of my nursing, I had those kind of people too and still to the day. That type of people weren't concern about the patients. they were questioning your credibility. I know that kind of people irritate you and make you day go worse! but as someone said earlier, focus of your patient care. after all you are the one who is responsible about the patient's outcome at the end of the shift.
Specializes in Occupational health, Corrections, PACU.
If you go to your supervisor, you can phrase a question in a non-complaining way. Just say something like " I just need clarification on a point so that I can understand. Do the therapists that work with the patients need to know aspects of their care such as fluid intake?" Say that you are confused about where their territory ends and yours begins. And just say in a very general way that you are caring for a patient with many medical issues, and a therapist has told you they have been reading the patient's chart regarding fluid intake, bandage changes, etc. Ask her/him if that is "normal". There is a lot of leeway when you are new and just asking questions to see what is a normal process for an institution. Play dumb and it will take you far.
I'm a huge fan of the "stupid" answer, myself. And the more stupid, the better.
"Oh, I never give water through a peg tube, because there could be goldfish swimming in it and that's dangerous for the goldfish and for the patient."
"I'm waiting for it to rain, because I only give my patients very fresh water."
Stupid answers deny people the information they're asking for. They also show that you don't take the questioner seriously....but best of all, they sound even more stupid when they're repeated (to a manager). It's one thing to complain that a patient is not getting "enough" water, but it's just stupid to claim that a nurse refuses to give a patient any water because of a goldfish infestation.
I guess this approach is not for everyone, but I'm goofy and love to shut up difficult people without stressing myself out.
I like the answer about interrupting med pass. Very good. When she starts interrupting you, ask if it's an emergency. If not, can she leave you a note, or wait until you are done. If you have an extension, can she leave you a voicemail?
It's important that she not continue to interrupt your med passes.
I always discourage talk about "favorite" patients (even if I have some) by saying "all my patients are my favorites" or something along those lines, or even a flat out "I don't play favorites with my patients." Sometimes that will have the effect of embarrassing the other person enough to shut them up on the subject for good.
Also, according to HIPAA, medical information is given out on a need to know basis. A therapist does not need to know the intricacies of the patient's medical care, and when you come up against those situations the best thing to say is "I can't give you that information." Or even "you know I can't give you that information."
Again that makes it known to the therapist that you are aware that they are crossing a boundary line and that you know that they know it and they need to back down.
It would be worth mentioning this to the DON or the head of the therapy department, they might not do anything but at least it's out there. So when the therapist goes running to them to complain they will know what's going on -- although that probably won't happen.
I wouldn't be surprised if you aren't the only one having this problem, and sometimes if enough complaints pile up they will have to realize that there's a situation that needs to be addressed.
Sometimes when people push you just need to push back. Remember, you want what's best for the patient too and she is getting in your way.
I'm a huge fan of the "stupid" answer, myself. And the more stupid, the better.
"Oh, I never give water through a peg tube, because there could be goldfish swimming in it and that's dangerous for the goldfish and for the patient."
"I'm waiting for it to rain, because I only give my patients very fresh water."
Stupid answers deny people the information they're asking for. They also show that you don't take the questioner seriously....but best of all, they sound even more stupid when they're repeated (to a manager). It's one thing to complain that a patient is not getting "enough" water, but it's just stupid to claim that a nurse refuses to give a patient any water because of a goldfish infestation.
I guess this approach is not for everyone, but I'm goofy and love to shut up difficult people without stressing myself out.
Yeah, and they'd probably think you were psychotic too, as would the person that they repeated it to.
You should talk to your DON. I promise you are not the only nurse the therapist questions. The DON will be able to give you advice and probably knows her behavior and how to deal with her. After you talk to your DON, if she interupts you during your med pass, tell to her that she seems to have a lot of care concerns and maybe she should discuss them with the DON.
I think its good that therapist, or even different nursing staff, have favorites, it gives the patient someone extra to talk to, but sometimes they over step their boundaries, and need to be told about it. They just dont always understand why we do what we do, or even why the patient does what they do due to a certain illness or condition.
Specializes in Gerontology, Med surg, Home Health.
Where I agree that therapists shouldn't interrupt nurses during med pass unless it's a true emergency, I don't see any issue with a therapist who is a licensed individual asking about fluid intake. They don't just treat the legs or the arms. They are treating the whole person. Since fluid intake can have an impact on the resident, it seems to be a good thing to know.
I'm new to this facility and trying to get my routine down. 
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lpnwkids
15 Posts
Wow! Thanks so much for all the good input! I'm feeling better now. You guys are awesome!