A Hostile Environment
I don't like my job very much right now. It was never my dream job, just a means to an end. The biggest attraction to me was the ability to leave work in time to ride my horses and do it whenever I want. The patients and other therapists I work with are nice. I thought it would be enough. I was wrong. This is the first facility I've ever worked at where there is open hostility between therapy and nursing.
Two mistakes have been made in the last week. Neither is a result of anything therapy did. One involved a patient leaving against medical advice. She wanted a different room but was told that wasn't possible. So her husband took her home. There was also an issue with her pain medicines. That happened on Friday evening. On Monday when I returned to work, I was told the reason was she was in too much pain from the CPM therapy. It turns out that was the story nursing told the administrator after the woman left.
The second involved some miscommunication with a family member. We were discussing the eventual discharge of his wife. I told him she could go home but would require 24/7 supervision and discussed options with him. When asked, I told him strength wasn't her problem, cognition was. I'm chalking this up to a case of selective hearing. He heard she was ready to come home and proceeded to try to make that happen. Eventually the MDS coordination became involved. Rather than ask me what I said, therapy was blamed for creating a problem.
I find the whole situation unnerving. These are basic principles of care and teamwork. When I brought them up with my supervisor, I was welcomed to long-term care. I didn't realize long-term care made nurses forget basic principles of patient care and responsibility. I've worked in other long-term care facilities and never run into anything like this.
It's bad enough that the nursing care is questionable at best. That doesn't particularly surprise me. And therapy is usually the scapegoat for anything that goes wrong, but really. How can supposed professionals behave this way? What happened to, the patient comes first? Why not sit the husband down and explain to him why his wife isn't ready to go home instead of blaming therapy and making the problem worse?
I'm not even sure where the problem lies. It is one person or several? If nursing wants me to communicate and document every little thing, I will. The downside is that pretty soon I might decide riding only a few times a week is acceptable and look for something else. The people who will suffer are the patients.