Toni Talks about PT Today : Ethics & Legal Issues

'I Am a Troublemaker'

Toni Patt — Tue, 14 May 2013 13:05:00 GMT

Last week I described being warned not to make trouble by reporting the nurses watching the baby camera while at work. I've been thinking about that. Why would I be the troublemaker for reporting someone else doing something wrong? Shouldn't it be the...(read more)

The Baby Cam is Not Skilled Therapy

Toni Patt — Tue, 07 May 2013 16:42:00 GMT

There has always been some conflict between therapy and nursing. Each complains about what the other does or doesn't do. Last week I saw something that floored me. I went into the nursing office looking for a chart. I didn't find the chart. I did find...(read more)

Old School and New School

Toni Patt — Tue, 16 Apr 2013 17:19:00 GMT

No matter where I am, I hear the old school/new school discussion. In simplest terms, it's a comparison of how we did something years ago compared with how we do it now. In more unkind terms, it can become a condemnation of those who went to school back...(read more)

Finally Something I Enjoy

Toni Patt — Tue, 09 Apr 2013 18:31:00 GMT

Anyone who reads my blog with regularity knows the last year has been a struggle for me. I lost my beloved job. I was fired for being ethical. I encountered more than my share of unethical and self-serving people. During all of that, I hung on and kept...(read more)

How Many Minutes Are Enough?

Toni Patt — Tue, 02 Apr 2013 15:57:00 GMT

This morning I was involved in a discussion about getting the most minutes from each patient. This can be taken two ways. Financially more minutes translates into better reimbursement. Therapeutically it results from the belief that every patient should...(read more)

Continuing Education Should Be Evidence-Based

Toni Patt — Thu, 28 Mar 2013 20:53:00 GMT

I'm a peer reviewer for the Texas continuing education program. I review submissions for neuro, geriatric, acute and general so I get to see a lot what is being proposed for continuing education. Texas has a specific form that must be completed for each...(read more)

‘I Can't Help, My Back Hurts'

Toni Patt — Tue, 19 Mar 2013 15:03:00 GMT

This morning there was a patient on the floor so the request went out for lifting help. Four people responded, including me, a PTA, a male CNA and the patient's nurse. The patient was a big man, weak and in a narrow space so it wasn't going to be easy....(read more)

Not All Patients Work on the Weekend

Toni Patt — Tue, 12 Mar 2013 20:03:00 GMT

This morning while I was walking a patient, I overheard another patient walking behind us. She was telling the CNA taking her to the dining room that she recognized me from the weekend. She was upset with me because I came to take her to therapy and she...(read more)

What Do I Include in CEUs?

Toni Patt — Tue, 05 Mar 2013 15:22:00 GMT

Recently I took on another challenge, writing a CEU module. When I agreed to do it, I thought no problem. This is what I teach. I already have an outline and references. I can just fill in the words. After I started writing, I realized something. When...(read more)

Maybe it's a Question of Time

Toni Patt — Tue, 26 Feb 2013 18:08:00 GMT

Last week I questioned what the definition of skilled therapy was . I had worked with several patients the previous weekend whose only deficit was the need for supervision. I've realized I wasn't clear in describing those patients. All of them had been...(read more)

What Is the Definition of Skilled Therapy?

Toni Patt — Tue, 19 Feb 2013 18:28:00 GMT

I've been noticing a disturbing trend lately. More and more facilities are considering the need for supervision as a need for skilled therapy. Back in the day, patients referred to SNFs and outpatient had an obvious need. They had trouble walking. They...(read more)

It's Legal but Is It Ethical?

Toni Patt — Tue, 12 Feb 2013 15:58:00 GMT

Someone was fired last week. The rumor is going around that she was fired because she didn't smile. I don't know if that's true or not but in Texas it is legal. Here an employer can fire an employee for any reason, even if they make it up. Nor do they...(read more)

Time and Money

Toni Patt — Tue, 29 Jan 2013 18:55:00 GMT

Now that I'm home from CSM, I've had an opportunity to process all of the information. Most of the presentations were excellent. Those that weren't purely theoretical had a common theme. We have to maximize what we do because we're spending less and less...(read more)

Learning from My Mistake

Toni Patt — Tue, 15 Jan 2013 15:52:00 GMT

Because I ride horses competitively, I spend many hours taking lessons. Just like my patients, I'm trying to learn and master motor skills. Sometimes I get it right, sometimes not. This morning it hit me how similar my learning experiences are to those...(read more)

Something is Wrong With This Scenario

Toni Patt — Tue, 08 Jan 2013 22:15:00 GMT

Yesterday I heard something that's still bothering me. I was evaluating a woman. Her husband told me the following. He couldn't tell me when the problem started, just that for the past few weeks she couldn't sit up without leaning on something. He had...(read more)