Nursing Isn't the Problem
There's an ongoing struggle between PTs and nursing over who is responsible for getting patients out of bed. Both agree patients need to get out of bed. Easily transferred patients get out of bed regularly. The disagreement arises over max and total-assist transfers. There's nothing therapeutic about a mechanical lift transfer. Being out of bed is the therapy, not getting there. Every facility I've worked at has provided annual training to nursing on how to perform those transfers. And every time one needs to be performed, they seem to forget how.
As a PT, I put the blame on nursing. They've been trained. The responsibility should be shared. The unspoken assumption is that pressure is being put on nursing to help us out. That assumption isn't always true. I work in a relatively small facility. Nursing never gets anyone out of bed. Instead they've been told to call our technician to do so. This didn't come from nursing administration. Nor did it come from facility administration. It came from our rehab manager.
It seems our manager is more concerned with getting along, and I assume, remaining in the position. Rather than attempting to stop the practice, it is encouraged. If I refuse to get someone up, she calls the tech and instructs him to do so without notifying me. If nursing wants someone up, the tech is instructed to do so for them. When an order is written for someone to be out of bed who isn't on caseload, the same tech is called.
Naturally there are some consequences to this practice. The tech is so busy getting patients up for nursing, he's unable to assist the therapists with treatments. It then falls on the rehab staff to do the work of two people. Sometimes all I need is someone to follow with a chair while someone ambulates, but if the tech is busy that may not happen.
I've never experienced anything like this. Even the worst managers seemed to have a grasp on this. It's especially frustrating to hear her at our regular meetings talking about how this isn't acceptable. There is a simple solution. Instruct the tech to stop getting up people not on caseload and being at nursing's beck and call. Then enforce it. That's all. It would take the word "no" and meaning it. While there have been several discussions, not once has she actually stopped the practice.
Thus nursing will never get anyone out of bed. Our tech will. The ridiculousness of the situation becomes apparent whenever the tech is off. No one gets out of bed. It isn't nursing's fault if no one is holding them accountable and telling them no. But it does cut down on the strife within the facility.