I was on a neuro placement earlier on this year, and had to treat this patient 2x daily (once in am, once in pm), this patient also had a OT Reassessment in the morning from 10-11am. I was aware of this and had organised the day before with the nurse to have him ready earlier the next morning (eg to have shower done). The nurse that was looking after the patient the previous afternoon said it was alright and that she will pass the message onto the nurse on duty for the next morning.
So I turned up the next day and was expecting the patient to be getting ready but he was still in bed. I went to the nurse on duty that morning and the nurse appeared to be quite “stressed out”. I asked her nicely if she could get the patient showered to go for PT and I explained the situation – he had to go to OT and visitors will be coming later and if he went to PT now he won’t be showered until really late in the day. The nurse told me to come back later because she was too busy and there was no way she can shower the patient anytime soon. So I went to the OT that will be working with the patient that day and explained the situation. I told her I would like to get Physio done in the morning but the nurse hasn’t got him ready yet. By then, if i started physio it would be too rushed if I had to have it done by 10am for OT.
We negotiated so that OT started earlier, nurse showered him after OT and I went to get him for physio later in the morning, and still managing to get another session done later that day. So in the end, we were all able to get our work done. I think the situation ended pretty well and if this was to happen again, I will hope the nurse is more cooperative, and I will go and check with the nurse coordinator in the morning to double check/triple check if they can get the patient ready. I will also be more assertive and should have told the nurse we HAVE to do pt that morning and explain to the nurse that physio is better for this patient in the morning.
2 comments:
I am currently on neuro prac at SCGH. It is certainly more difficult to coordinate patient treatments with allied health and nursing staff in the neuro setting, due to the length of treatments, and the fact that treatments are often carried out away from the patient's room.
It is sometimes an option to combine the PT sesion with the OT session, as many aspect of rehab and treatment overlap, and it is also important for the 2 therapists to understand what the other is trying to achieve. This may not be able to happen each session since not all aspects of OT therapy are applicable to physio, however for the odd case when there is issues with timing with nurses, this could be one option. I would however avoid, altercations with nurses as much as possible, since we will have to rely on them in other stressful times (eg. exam pts).
I have found that depending on what ward you are on, the emphasis placed on physiotherapy can vary significantly.
While on my neuro prac I found that physiotherapy treatment sessions are of a similair priority to those of OT, SW, and SP. However on my recent Ortho prac I found that Physio input appears to have a higher significance to a patients condition. This appears to be due to the high turn over on an orthopaedic ward (the ward I am on has very very few elective patients, with the patients being primarily trauma), and the importance of dishcarging patients as soon as safe in order to free up beds.
I do not think that physio input has any higher significance one ward to another (pending a patients condition), but in certain wards the rest of the allied health team can place the Pt intervention at varying levels of priority.
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