Just Do What the Family Wants
Earlier today I had a conflict with a demented, agitated patient's wife. She wanted me to get the man out of bed with a gait belt and hoist him over into the chair. I declined, stating I didn't feel comfortable doing that and it wasn't very therapeutic. She insisted. I apologized and told her I would assign the patient to someone else tomorrow who was strong enough to complete the transfer. She was still upset.
I spent the rest of the morning defending why I didn't want to "fling" a patient into a chair who didn't want to go there. He might have been confused but he knew he didn't want to get out of bed. Somewhere along the line, one of my OT coworkers told me I need to learn better customer service. Just do what the family wanted to keep them happy. I was too proud and pride comes before the fall.
There is nothing therapeutic or safe about flinging a person into a chair. Sitting up in a chair might have been therapeutic except for the fall risk from his restlessness. I used my clinical judgment and decided getting him into a chair wasn't a great idea. Being told to do it anyway is wrong on so many levels. Being told to do something simply because the family wants it without consideration of therapeutic value or skill is ridiculous.
We are supposed to be providing skilled therapies. There was nothing skilled about flinging someone into a chair. Charging a service as skilled when it isn't is a form of fraud. Doing something contraindicated because the wife wants it is not only unsafe but wrong. It also eliminates any chance of transfer training, neuromuscular reeducation and motor learning.
When did keeping the family happy become more important than providing therapy? More and more, PTs are being asked to bypass the skills we worked so hard to master and become lifting services. There's so much more to what we do. In this case, standing up for myself and my profession made me the bad guy.
There's more to good customer service than simply doing whatever the family demands. All that does is encourage them to become more demanding. Not only will those people never be happy, but all the other patients who aren't seen will also be unhappy. How does that help patient satisfaction?
In this case, I think the man is deteriorating mentally and physically and his wife is refusing to see it. She isn't going to be happy unless he does whatever he was doing before he was hospitalized and that isn't going to happen. I was wrong because I put safety first. I was wrong because I stood up for my profession.