Resolving to Work as a Team
The beginning of a new year is a time for change. It's a time to make resolutions and strive to be better. Even though I'm not much of a resolutions person, I'm making one this year. My resolution is to search nursing texts to find where it is written that nurses don't help mobilize patients. It has to be in there somewhere. Why else would nurses everywhere think that "OOB with assist" and "ambulate with assist" are PT orders. Physical therapy is not found in those phrases. Yet, somehow those orders find their way to the rehab department.
I'm not picking on nurses. They have a hard job with lots of responsibility and little appreciation. Being overworked and understaffed is a universal problem in health care. This is confusing to me. Why do nurses think I have so much extra time that it is my responsibility to get every patient in the hospital out of bed? Why should I drop whatever I'm doing to go immediately to the nursing floor when summoned to help a patient get into/out of bed? It's much easier for a nurse to get help than it is for me to do so. And I really don't understand why nurses call me when the patient "is too big and I don't want to hurt my back" and then disappear because I can do it by myself? Do they think I want to hurt my back? I don't have the luxury of refusing to get someone up because he or she is "too big."
Everyone in health care knows patients need to mobilize. There are numerous studies supporting the benefits of early mobilization in terms of shorter stays and lower costs. Being out of bed is therapeutic. However, just because being out of bed is therapeutic, it doesn't necessarily follow that the transfer was also therapeutic. There is nothing therapeutic about a dead lift. Nor is there anything therapeutic in sliding someone into a neuro chair. Physical therapists work on transfers because there is a therapeutic benefit of increased independence, increased strength or increased balance. I admit I'll get low arousal patients out of bed a few times to see what happens. I don't continue it unless I see positive changes from the action. Yet, for some reason these transfers seem to fall to PT. Where is the skill in that?
Alright, I've gotten that off my chest. I feel better. I don't expect much success with my resolution but some progress in the right direction would be nice. I'm lucky in a way. On my neuro floor we all work together to mobilize the patients. I help the nurses. They help me. Every other floor is the problem. Some of the nurses I work with on the rehab unit on the weekend are also very good. I also know a few PTs who are worse than nursing about not helping mobilize patients. The PT profession needs to make a resolution. We need to resolve to work as a team to make everyone's job easier.