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Toni Talks about PT Today

We Should Always Be Professional

Published February 23, 2009 11:42 AM by Toni Patt
This week my assignment is a smaller hospital in the suburbs of Houston.  I've been there before on weekends and some holidays.  I was looking forward to being there.  Now I'm looking forward to leaving.  The lack of professionalism I've experienced there has shocked me.  I've heard some things that I never expected to hear from a PT or PTA especially to and in front of patients.  In their defense, nothing I heard was meant in a negative or derogatory manner.  It's possible no one realized how what was said actually sounded to someone else.  Still, we're professionals.  We should act professional.

The thing that surprised me the most was the manner in which one of the PTAs interacted with her patients.  Now I realize in smaller departments the staff is going to be more familiar with the patients.  However, it's never appropriate to discuss patients by name in front of patients.  Several times I heard her talking to a PT about patients by name while treating someone else.  That is a HIPPA violation.  Worse, the other PT, who is the inpatient supervisor, responded in the same manner.  These conversations happened several times and in a busy treatment area.  I got the feeling it was standard practice.

I overheard the same PTA talking baby talk to her patients.  I hate that in any circumstance. These were outpatients who could easily understand adult conversations.  The worst I heard was her reference to slough as "loosey goosey" that needed to be cut off.    I never heard her explain what she meant to that patient.  This patient was a chronic wound patient.  He would have understood removing dead tissue.  There is no excuse for talking down to someone.  I was offended for the patient.

The manager might want to review her HIPPA rules.  The schedule board is in a cabinet behind hinged doors because it is in a high traffic area.  More often than not at least one of the doors is open.  Anyone walking by could easily see patient names.  Yes, the printing was small and difficult to read unless up close. That doesn't mean the doors should be left open.  While she's at it, she should review sterile technique.  I'm not sure why they insist on sterile technique for every wound procedure.  Research has shown clean technique to be as effective. However, if one is wearing personal protective equipment, it should be removed when walking away from one patient to cross the room to give an opinion about a different wound.  There are curtains which indicate room "walls."  Passing through the curtain is the same as leaving the room.  The protective equipment should have been removed and freshly donned upon re-entering the "room."

I was assigned to do wound care on inpatients.  Because that can be challenging, I was assigned a tech to assist me.  As I was reviewing the list with the tech, she informed me she couldn't help with one of the patients because he was too big for her.   She later refused to help me reposition a patient after treatment because he was dead weight and hard to move.  Even after I explained that I didn't want to leave him in a bad position she refused, telling me the nurses would eventually do it.  Since I couldn't find the nurse, I did the best I could and used pillows to prop up the involved foot to prevent additional pressure.  I have never had a tech refuse to help me reposition someone before.  To make matters worse, the tech is trying to get into PT school.  I found out later she wants to work in fitness and not with sick people.  I think she might want to rethink her chosen profession.

I don't expect this sort of behavior in hospitals.  Anyone who works in a hospital has HIPPA drummed into their head.  I'm not saying referring to patients by diagnosis or body part is much better.  However, at least no one else knows who I am talking about.  My preference for HIPPA compliance is to use room numbers.  I don't think it's the facility.  I've worked with the OP side of the department and never heard anything amiss. At one time those therapists knew better.  That's no excuse for acting unprofessionally. PTs are professionals.  We must remember to always behave that way.



Great blog.  

Too bad we couldn't remind others about HIPPA without causing a commotion. Some become offended by a reminder of the law.  

I hear demeaning comments from the therapy staff when we do group therapy like, "Mrs. X has cankles, keep moving"  In smaller dept.'s HIPPA is often violated with an idea that everyone knows everyone else and we, as therapists, should help spread that information.  

Perhaps a mandatory HIPPA CEU every 6-12 months would reinforce the doctrine - then again maybe not.  Room numbers are the easiest way to communicate information in acute care.  

I am surprised a name board still exists in a dept.  They should have a computer and print out a list of patients.  It can be placed in a notebook.  Or if an erase board is used list by initials only (first letters of last name, etc.)

If we are striving for more autonomy and increaseing education, we should expect more professionalism.  "With great power comes great responsibility" - attributed to Benjamin Parker

Jason February 28, 2009 12:07 AM

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