When the Team Falls Apart
Estimated Reading Time: 2 minutes
From day one of physical therapy school, we are taught the various roles within the health care system: physical therapist, occupational therapist, speech language pathologist, nurse, and doctor. Each profession has a specific function within the health care wheel—refer, refer, refer; know your place.
I remember the first time this paradigm shifted for me as a new graduate. I was working in inpatient rehabilitation and my patient suddenly became pale and weak. I laid him down on the mat, elevated his legs, and took his blood pressure: 70/40mmHg. That can't be right I muttered to myself. Take it again: 72/45mmHg. Still not right. I called the nurse's extension and she came into the gym a few moments later. I explained the patient's situation. Her reply cut through the air like a bullet: "He's fine, just give him some water and lay him down." I felt that maybe she didn't hear me correctly. I explained again. Her reply was the same. Second bullet.
Not agreeing with her assessment, I explained that I was going to call the doctor and ask for a hold order for the morning (this was inpatient rehabilitation and there was no way this patient could handle 3 hours in a row in the afternoon after missing the morning therapies). "He is going to be mad at you if you do, he never writes hold orders," she said quickly. Third bullet. I made the call only to find out that the doctor was indeed upset with me and refused to write a hold order.
Panic swept over me. Two months out from graduation with my new job and my own license and here I was faced with a dilemma. I had not 1, but 2 members on this patient's health care team who didn't want to perform their roles. What was I going to do? How was I going to respond?
As hard as school attempts to train us on everything, it's impossible to cover every scenario that could potentially go wrong, and believe me, there are a lot of them! As a soon-to-be new graduate, you will also face many situations like this. They are inevitable in an ever-evolving, ever-changing, ever-bustling health care system. People slip through the cracks, but as physical therapy professionals, we have a unique role within the system to help seal those cracks and keep people moving forward in their healing process.
If you want to find out how this story ended as well as how to deal with other similar situations that could potentially come your way, I invite you to join me at APTA's National Student Conclave in Albuquerque, New Mexico, to learn how to navigate these challenging situations to provide the best care possible for your patients.
Join us October 31 - November 2, 2019 at APTA's National Student Conclave — the only conference for students, by students. For the best rates register by September 25, 2019.
Heidi Moyer, PT, DPT, is a board-certified clinical specialist in geriatric physical therapy and a certified exercise expert for aging adults. She is a proud graduate of Angelo State University and provides continuing education at the state, national, and digital levels. She serves in multiple capacities for the Academy of Geriatric Physical Therapy and works in the home health setting in the Chicago area.