therapy

I feel the physical therapist should be in communication with the nurses. I think its time for a meeting between the diciplines to clear up some rules. The nurse would need to know what the therapist noticed so precautions are taken such as pain mng and ambulation. Of course you look pretty poor when you tell a family member no one seems to know whats going on with their loved one. It makes no sense to behave the way this therapist did. It almost comes across like the therapist is way above the nurse, no need to even talk to you. And as we know, all good facilities use good teamwork.

that's why it's called the healthcare team.

does rehab's notes reflect pt c/o pain?

getting an xray is appropriate.

not sharing this w/nsg, is inappropriate.

starting PT w/o xray results, is also inappropriate.

you need to confer w/your DON and let him/her speak w/PT.

best of everything.

leslie

Was the therapy begun before the xrays were taken? If not, I don't see the problem as a positive xray would have been reported. There's always a lag-time between when the xrays are read and when the actual report gets to the chart. Anything of concern, such as a fracture, would have been verbally reported by the radiologist to the PT or doc.

Something else that isn't clear:

I took an order off last week for a resident to receive PT to decrease left hip pain.

Was that order written by a physician? If so, I think the PT was doing exactly what she should by insisting on an xray before therapy.

But then again, I'm not too clear on your post just what the sequence of events were and who ordered what. And doesn't PT write progress notes? I do agree that she should have shared her concern with the nurses.

Therapy should have definitly been on hold till clear results came back, that is a very simple fact.

What bothers me is, why didn't anyone simply ask the patient if she/he was experiencing hip pain? Seems like that would have been a simple way to get some of your answers. Even a pt with dementia can sometimes tell you if they are hurting.

Sounds like a lot of poor communication. Perhaps PT was unable to find the nurses, as you were unable to find them.

The therapist wrote the order: PT to decrease left hi pain on 1/28/07. The xray order was written on 2-1-08 by the Dr. because the therapist stated the resident c/o left hip pain. The therapist told me she doesn't need to talk with the nurses....very matter of factly. Obviously the therapist doesn't even have to speak with the family either. I just don't think therapy should of bypassed nursing like this.

if complaint's of pain are not reflected in the nurse's notes you'll be lucky to paid for these x rays..

That will get someones attention.

The therapist wrote the order: PT to decrease left hi pain on 1/28/07. The xray order was written on 2-1-08 by the Dr. because the therapist stated the resident c/o left hip pain. The therapist told me she doesn't need to talk with the nurses....very matter of factly. Obviously the therapist doesn't even have to speak with the family either. I just don't think therapy should of bypassed nursing like this.

I think your director needs to have a little talk with the PT.