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Toni Talks about PT Today

Therapy Can Do That

Published November 19, 2013 4:06 PM by Toni Patt

I think we've all reached the conclusion that cutting staff to save money means therapy will be asked to do even more with less. The unspoken expectation, at least in the places I've worked, is that therapy will fix everything. We're the ones who help them in the morning because night shift couldn't be bothered. We're the ones who take the patients to the bathroom.

Unfortunately this often translates into therapy being viewed as little more than a lifting service. Until last Friday, I chalked it up to nursing being busy and frequently lazy. Apparently with the ongoing changes in healthcare, therapy has been further demoted. How else can I explain what happened?

I was sitting at the nursing station. One of the nurses, known to be lazy, asked me for the number to our tech's phone. A patient who wasn't receiving any therapy or maintenance interventions wanted to get out of bed. A nice way to describe him would be belligerent. The patient is obese and a paraplegic but can easily be transferred with a Hoyer lift. Instead of giving the nurse the phone number, I told her the tech was unavailable because he was leaving early for the day and currently putting therapy patients back to bed.

I hadn't realized it at the time but the chief nursing officer was standing behind the nurse. Her response to that statement was to ask me if one of the therapists could get the patient out of bed for nursing. In that moment, I realized how little therapy is respected. I have an undergraduate degree, an advanced degree and two certificates of specialization from the APTA but am considered no more skilled than a CNA. The woman was shocked that I wouldn't help.

I am very proud of myself when I say I took the politically correct avenue and explained that everyone had a full caseload and didn't have time. There's so much more I could have said. I find it odd that as our census has increased, so have staffing levels in every department but therapy and yet nursing is too busy to help out.

When I left for the day, I noticed our manager was meeting with the facility administrator. No doubt word of my revolt moved quickly up the chain. I have no doubt the woman was apologizing that we couldn't help and trying to formulate a plan to resolve the situation. My guess is she's going to schedule a time for our only tech to be available to get the patient up and put him back to bed based on when the patient wants this done. We'll be told to make do in the meantime. Ironically that very morning she was expressing frustration that nursing was continuing to call him to get people out of bed.

In the end, it doesn't matter. We'll pull it together and get it done just like every other department does. There's one benefit to this. When I alerted the tech to the situation, we had a bonding moment.

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4 comments

Toni -- suggest you approach this from the safe patient handling perspective & remind nursing that no one should be lifting more than 30 pounds--inlcuding PT techs. Use of lift equipment is mandatory in many locations, and the data shows PT staff and nursing have high injury rates partially because of the insistence on NOT using this equipment.

Another suggestion is for you to read Crucial Conversations. Excellent book with strategies that guide individuals in responding to difficult situations rather than walking away frustrated.

Irene December 2, 2013 2:48 PM

Explain to nursing that Medicare would take issue with a cost report that reflected using high pay PTs to cover aide/orderly work.

I've been told that could be considered fraudulent cost allocation.

Gary November 29, 2013 2:41 PM

There continues to be a lack of understanding of what is an appropriate expectation of therapy from nursing driven by the forever nagging staffing ratio. Mind you they lack knowledge of the productivity standards the therapy staff is uphold to.

Sheila CG, SNF - Therapy Mgr/PTA, Retirement Community November 20, 2013 6:49 PM
FL

Toni,

It is funny (but not really) that nursing is so disrespectful to the therapy profession. Perhaps you should throw your degree around and insist they call you "Doctor Patt" when they are addressing you.  It may cause some bitterness but it is a degree and a title that was earned.  

Good for you for protecting the tech from being a human lift machine.  

Karen November 19, 2013 11:40 PM

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