Inappropriate orders

[Siggy]

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You and your cohort don't have a clue what you're doing or what you're talking about with regard to rehabilitation so I'd suggest you guys just do your own job, get over yourselves and never have any say whatsoever with regard to rehab ever again.

Yep.. I don't have any idea about rehab. If I did, I would have specialized in PM&R. I didn't... so when I have a rehab question, I place a consult. Now go do your job. You know... that thing you're supposed to be paid to do... and rehab my patients so I can dispo them off my list.

 

[Fiveoboy11]

Say this to me in person. I'll take care of that attitude real fast.

I think it's just what you need. A lot less of people telling you what you want to hear might make a big difference in a positive way in the long run.

 

[Fiveoboy11]

dude, you need to get over yourself....one why are you even in this forum? but two the "trivial" part is that practically every person >70 is m/l will benefit from the PT and the OT consult...night float usually misses it because they are thinking about the NOW things to do...not something that will take place the next weekDAY, and it many times it doesn't get addressed until the day before the pt is leaving...

i have no problem if the nurse puts in the order under my name...i'll probably think "thanks!" and co sign the order...i can't think of a time this order would create a problem for me...hence the "trivial" aspect of the order...

though i'm not sure why PT in many places don't think there is a need for them to see the pt on say, the weekends...

You think physical therapists have anything whatsoever to do with weekend scheduling? It's not up to us to decide but I have worked nearly every weekend for the past 4 years at the two hospitals I work at. Many disciplines (? except RNs) seem to be short staffed on weekends (case managers, physicians).

 

[Fiveoboy11]

Look, it's a trivial order because it's one that cannot hurt the patient.

If the nurse puts an order in my name for a medication? Potential to harm the patient. Even things such as tylenol could potentially be contraindicated for whatever reason. Heck, the only completely benign pharmacological treatments I could think of would be things like osmotic laxatives, and even they have contraindications.

Nurse puts an order for oxygen under my name? Happens all the time. Or they do it without an order. Still has the potential to harm the patient, whether through worsening a V/Q mismatch (causing potential for more CO2 retention), the haldane effect, reducing the respiratory drive, or anything else.

On the other hand, if the nurse uses my name to order a PT, OT, nutrition, social work, or other ancillary service consult? It may be too early to do any good, but it doesn't have the potential to actively harm the patient. *Most* patients have some component of deconditioning. All patients have the question of their ultimate disposition. When it's not obvious, we consult our colleagues in physical and occupational therapy to assist us with evaluation and management of the patient.

I have the utmost respect for both disciplines... but the act of placing the consult order itself is trivial.

Too early to do any good? It happens but is rare. Too late happens 10x more often with many negative consequences.

 

[evilbooyaa]

It's clear you know little to less than nothing about what you just babbled about. Very superficial and uninsightful.

I said the basics, and I'm talking about in-hospital only.

Get off your high horse lol; this level of uppity-ness is not reasonable for pretty much anybody.

Or continue to get butt-hurt from random comments on the internet. Whatever, it's your stress level that you're worsening.

 

[Top Gun]

Trivial "PT/OT" consult? The only things that are trivial and routine about it is your understanding. How many observation hours do you have with a licensed PT? Zero? Do you really comprehend that physical therapy and occupational therapy are separate professions and so the "PT/OT" nonsense is nothing more than a reflection of your incompetence and ignorance? What classes in rehabilitation have you taken?

Oh, for the love of God, nobody is saying that physical or occupational therapy is trivial. I order it everyday because my patients need to have improved mobility before I can discharge them. I also read the PT notes so I can determine whether rehab, SNF, or home is the best place to discharge them. What we are saying is trivial is the order for the PT/OT consult. It's not like it can be ordered wrongly, and there's no such thing as physical therapy posing an immediate threat to life or limb. What does pose an immediate threat to life or limb are orders for wrong medications. Learn to read for context so you don't get butt-hurt every time the SDN crowd makes an innocuous comment. Jeez!

 

[Siggy]

Too early to do any good? It happens but is rare. Too late happens 10x more often with many negative consequences.

Thank you for making the point on why no one cares if a nurse puts an order in for PT without talking to someone first. Now go get your shine box.

 

[Fiveoboy11]

Oh, for the love of God, nobody is saying that physical or occupational therapy is trivial. I order it everyday because my patients need to have improved mobility before I can discharge them. I also read the PT notes so I can determine whether rehab, SNF, or home is the best place to discharge them. What we are saying is trivial is the order for the PT/OT consult. It's not like it can be ordered wrongly, and there's no such thing as physical therapy posing an immediate threat to life or limb. What does pose an immediate threat to life or limb are orders for wrong medications. Learn to read for context so you don't get butt-hurt every time the SDN crowd makes an innocuous comment. Jeez!

I would strongly question your competence to decide home vs rehab vs SNF from a rehab perspective.

 

[Raryn]

I would strongly question your competence to decide home vs rehab vs SNF from a rehab perspective.

That's why we consult PT. To ask them.

 

[gutonc]

This thread has run it's course and deteriorated into a ridiculous pissing match.

Closing.