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Toni Talks about PT Today

Quit Complaining

Published November 25, 2009 8:44 AM by Toni Patt

Over the last few weeks my department has been undergoing some changes. After reviewing our numbers over the last few months, our manager realized we haven't been complaint with the three-hour rule. For those who don't work in a rehab setting, the three-hour rule means patients must receive three hours of therapy five times a week for a facility to be considered a rehab unit. That distinction is important when it comes to reimbursement because rehab and acute stays are paid separately. In order to retain our status as a rehab unit, we must be complaint with the three hour rule. So our manager made changes.

He didn't change the rules. He didn't change the system. He simply made each person accountable for seeing each patient the scheduled amount of time. For the few of us who were already doing that, it made no difference. Everyone else seems to believe the world as we knew it came to an end.

The complaining is endless. None of them are happy with the situation. I have yet to get through lunch without someone bringing the topic up. Every morning I hear how the daily schedules aren't right. I hear how much time we're wasting keeping track of time rather than seeing patients. One person thinks her schedule doesn't flow. Another doesn't have time to make up lost treatment time. That person does have plenty of time to send and receive text messages throughout the day.

My co-workers don't realize that if they stopped complaining and used that time and effort to treat patients, we wouldn't have a problem. Complaining never fixes anything. All it does is allow someone to vent. Then it's time to address the problem. None of my co-workers are happy, but none of them have an alternate solution. One of them is a master at shooting down any suggestion that she doesn't like. Another keeps saying the old system worked fine. It didn't. We wouldn't be in this situation if it did.

I'm tired of hearing all of it. These people need to let it go and move on. You're at work to work, not send text messages, shop on the Internet or talk on the phone. Our department leaders aren't helping. One is doing the extra work, but makes sure everyone else knows how much more she is doing. Please. She needs to refer to my previous statement of talk less and work more.

The new system has flaws. Nothing goes smoothly when it's first started. This is the time to make constructive suggestions not stomp around the floor telling everyone all the reasons you couldn't see all of your patients. That seems to be a trend. Guess what. The patients and families don't care. They just want their therapy.

I'm probably being a little hard on them. It's hard to change the way you've been doing things for many years. The changes have been in place a few weeks. The time for complaining has past. That energy needs to be put to a more constructive use. We need solutions. The best solutions will come from the person who knows the situation and that is us. Instead of complaining about a problem, figure out how to solve it.


I've got kudos for you either way this goes, but to begin with I'm a little confused.  In the beginning you said that the supervisor didn't change anything; he only made each therapist accountable to do their job.  For those of you who were doing your job correctly, you said the "change" made no difference.

Then in the middle you talk it being time to find an alternate solution.  And again toward the end you say "the new system has flaws", which contradicts your initial statement that there isn't a new system, only enforcement of the old one.  You go on to say "we need solutions", which would include yourself.  But in the beginning you indicated that for you there was no difference - that the accountability measures didn't affect you since you were already doing what was required.

If the only change was enforcement of the rules, then you are not being too hard on your co-workers.  They are acting like whiny, spoiled brats.  But, you may not be being hard enough on the supervisors.  If he/they had been doing their job to begin with (supervising staff productivity, among other things), at the first sign of neglect, the staff in question would have received appropriate discipline and would have either towed the line or found employment elsewhere.  Your co-workers have only done what they were allowed to get away with...seems I remember a post from you on that topic some months ago.  My guess is none of this has taken you by surprise :-)

If there was additional paperwork created to track accountability - and that is the "new system" with flaws that you are speaking about, you are absolutely right.  The only way to recommend constructive change is to give the current system an honest chance to work.  

I had a supervisor once who had to initiate new policy from the powers that be.  It was government run - enough said.  She knew it was a bad idea and the people who invented the policy didn't know what they were doing with regards to this, but she had been around the block a few times.  She sat us down and said, "I know this won't work, you know this won't work, and your staffs know this won't work.  But they aren't going to believe me if I just TELL them that.  What I'm asking you to do is give it 100% so in a month I can take it back to them and SHOW them that it doesn't work."

If you give it your best effort, you may find it works after all.  Then you have saved face by not making a stink about it upfront before you've even tried it.  If it fails miserably, you can say with surity it was the system that failed and not user error.  After having given it a fair trial, you will be in a more educated position to offer constructive change and suggest a different system that will meet the needs of the supervisors, staff, and patients.

Good luck with that ipod.  Maybe you'll get an itunes card for Christmas!

Janey Goude November 29, 2009 11:44 PM

Change usually is a slow process and for those not use to having accountability this is hard.  An i Pod may be the solution for you as Dean said.  

Hopefully it works better next year...give them another month.

Karen November 29, 2009 7:21 PM

You're right, the time for whining is way past it sounds like. It does sound like you have your own "backyard" in order so in light of that, might I suggest an Ipod at lunch so you don't have to be sucked into their manufactured drama? Keep your chin up, you're doing OK.

Dean Metz November 29, 2009 4:06 PM

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