Working closely with PT and OT and ST...ever want to tell them to shut up?

Spotty44 · Mar 13, 2009

Well, sometimes it goes both ways. I'm grateful to have worked as a Physical Therapy Aide for 6 years prior to nursing school. I feel like I can accept the fact the PT/OT/ST has a job to do and I know they can accept that I have a job to do as well.

MySimplePlan · Mar 13, 2009

only she left the microwave going and left the break room and it blew the microwave up and caused the fire alarms to go off.

LOLOLOLOLOL.

lamazeteacher · Mar 13, 2009

".........................PT said recently they need to be more involved with things like wound care and dressing changes. It seems like everyone wants to take over the nurse's job."
Do you ever feel this way?

I think it's great that other workers want to go outside the envelope/box, to assure that good care is given. If a dressing is not secured well, or draining excessively, it's in the best interest of the patient to change or reinforce it. As long as what they do is charted acurately, and they use proper sterile technique (if that's what has been ordered), I'd make sure they had the materials on hand to do it. We need to work as a team and share the POC. If you're worried that your job is threatened by that, don't be. Requirements for facilities are that nurses do most of the personal care for patients, give meds, observe for aberrant reactions, complications, etc. We need to oversee that correct technique is used and orders followed, as well as teach those other people what to do, as if they were family at home, doing it.

HippyGreenPeaceChick · Mar 13, 2009

There is nothing like thinking outside the box

casi, ASN, RN · Mar 13, 2009

I think it's great that other workers want to go outside the envelope/box, to assure that good care is given. If a dressing is not secured well, or draining excessively, it's in the best interest of the patient to change or reinforce it. As long as what they do is charted acurately, and they use proper sterile technique (if that's what has been ordered), I'd make sure they had the materials on hand to do it. We need to work as a team and share the POC. If you're worried that your job is threatened by that, don't be. Requirements for facilities are that nurses do most of the personal care for patients, give meds, observe for aberrant reactions, complications, etc. We need to oversee that correct technique is used and orders followed, as well as teach those other people what to do, as if they were family at home, doing it.

I have a strong feeling that you can legally delegate dressing changes or reinforments to a physical therapist.

czyja, MSN, RN · Mar 13, 2009

I think it's great that other workers want to go outside the envelope/box, to assure that good care is given. If a dressing is not secured well, or draining excessively, it's in the best interest of the patient to change or reinforce it. As long as what they do is charted acurately, and they use proper sterile technique (if that's what has been ordered),

Dressing changes are not in the scope of practice of PT/OT. To allow them to do this strikes me as negligence.

I am still a student but I must say the OP has a point. While I greatly appreciate PT and OT I have noticed that some of them can be rather, well, assertive.

catshowlady · Mar 13, 2009

Dressing changes are not in the scope of practice of PT/OT. To allow them to do this strikes me as negligence.
I am still a student but I must say the OP has a point. While I greatly appreciate PT and OT I have noticed that some of them can be rather, well, assertive.

I'm thinking that scope of practice can vary by state, so dressing changes can be in their scope of practice depending on the state's Nurse Practice Act (and whatever the PT/OT equivalent of that is). In my state, PT can do dressing changes, along with whirlpool therapy treatments.

I am happy to have the input of PT/OT. Remember that they have the same goal we do: to help improve the pt's well-being.

That being said, I'm wondering if the PT/OT people you are working with lack finesse in their approach. They may have a valid point to make, but if they are disrespectful in their communications with you, then it prevents collaboration. :twocents:

lpnflorida · Mar 13, 2009

Physical Therapists are very much trained in regards to wound care.

I am appreciative that our various therapists are involved in our patients care. Sometimes they see things from a perspective that we do not see. Often times a therapist whether it is a PT, OT or Speech will come and request pain medication. Often they see a patient's discomfort while working with them in circumstances that we as nurses do not see. I have now gotten to where I stop by the therapy gyms to observe for a short time how my patients are doing. I am able to see if they are comfortable or not. I also get alot of tips during the observation on how to better assist my patients in their transfers. We are a team. Each of us brings value to our patients because of it.

What was difficult when coming to a Rehabilitation hospital was the idea that we were not necessarily under the Medical Modality. We are more Rehabilitation focused. Which means the main focus is how is the patient doing in therapy, are they progressing in their therapies. Yes we have multiple physcial co-morbidities which keeps we the nurses very busy. Yes the medical care of the patient is important , yet if a patient is not meeting the criteria of being able to do therapy 3 hours a day then they do not meet the criteria for staying in a Rehab hosp. In this way it feels we nurses take a back seat to therapists.

morte, LPN, LVN · Mar 13, 2009

i think some of the respondents here, have missed the point that the speech therapist was totally out of line and stupid!.....yes, PT does drsgs post wp treatment, havet met one yet that would be doing any others drsgs

Jo Dirt · Mar 13, 2009

i think some of the respondents here, have missed the point that the speech therapist was totally out of line and stupid!.....yes, PT does drsgs post wp treatment, havet met one yet that would be doing any others drsgs

Yes, most everyone so far has totally missed the point.

systoly · Mar 13, 2009

Sorry, but I don't see the problem here. Altered pain response is not uncommon in LTC, but suppose there was no evidence to support the St's assessment, all you have to do is say, "thank you for your observation", and go on. Of course, I would have immediately offered to provide rehab services with an inservice on how to not blow up stuff.