The Medical Team

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Included In This Lesson

Study Tools For The Medical Team

Therapeutic Communication (Cheatsheet)
Communication Tips & Tricks (Cheatsheet)
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Outline

Overview

  1. Nurses (you!) work with many professions
    1. Nursing Assistants/Patient Care Techs
    2. Practitioners
    3. Physical Therapists & Occupational Therapists
    4. Pharmacists
    5. Speech Therapists
    6. Dietary
    7. Dieticians
    8. Social Workers and Care Coordinators
    9. Respiratory Therapists
    10. Transportation
    11. Radiology Technicians
    12. Wound Nurse

Nursing Points

General

  1. Nursing Assistants/Patient Care Techs
    1. Working side-by-side
    2. Report to you
    3. Delegate tasks to
    4. Understand facility policies (what can and can’t they do)
  2.  Practitioners
    1. Physicians, Physican Assistants, Nurse Practitioners
      1. Round on the patient each day to assess
      2. Speak to you about patient updates
      3. Call them with any concerning changes of the patient
      4. Enter patient orders
        1. Patient Care
        2. Medications
        3. Testing
  3. Physical Therapists & Occupational Therapists
    1. Work on ADLs with patient
    2. Will notify you of patient progress or setbacks
  4. Pharmacists
    1. Review orders entered by you or physician
    2. Prepare or fill medications for you to give to patient
    3. Will contact you with questions about suspicious medications or doses
    4. You will contact them with medication questions
  5. Speech Therapists
    1. Work directly with patient when consulted by physican
      1. Memory problems
      2. Speech problems
      3. Swallowing problems/aspiration ->FSA (Functional Swallow Assessment)
      4. Communicate findings with you
  6. Dietary
    1. Collect and fill patient meal orders
    2. You or physican enter diet including restrictions for them to follow
  7. Dietician
    1. Assess patient to determine nutrition needs
    2. May order snacks in between meals or nutrition drinks like Ensure
    3. Order tube feedings
    4. Communicate with you on findings/orders/plan of care
  8. Social Workers & Care Coordinators
    1. Work directly with patient, health insurance companies, physicans, nurses, and nursing facilities
    2. Determine payment plans and coverage
    3. Find placement (living plans upon discharge) for patient or guide patient family in decision making
    4. Discuss and plan patient discharge plans with physician and nurse
  9. Respiratory Therapists
    1. Work directly with patient
      1. Assess patient’s respiratory status and oxygen needs
      2. Provide breathing treatments
      3. Set up BIPAP, CPAP, AVAPS
      4. Trach care
    2. Will communicate with you about patient status and needs for orders
  10. Transportation
    1. Take patients to tests/other units
    2. You must prepare patient to be taken (disconnect IV lines, connect oxygen tank)
  11. Radiology Technicians
    1. Complete radiology tests
    2. Communicate with them regarding test prep when ordered
    3. Contact them when consents are ready
  12. Wound Nurse
    1. You or the doctor may order a wound nurse consult
    2. Assesses, cleans, and dresses patient wounds
    3. Places orders for wound care

Assessment

  1. Assess the needs of your patient
    1. Let practitioner know of any patient needs (ex: speech therapy, physical therapy)
    2. Assess patient progress and notify physican daily

Therapeutic Management

  1. Other medical members may interfere with patient care
    1. Plan, but be flexible!
    2. Notify practitioner when any results come back

Nursing Concepts

  1. Clinical Judgement
    1. Which professional to contact in different situations
  2. Communication
    1. Updates and planning patient care
  3. Teamwork & Collaboration
    1. Working together to provide best possible care

Patient Education

  1. Let the patient know your name and who you are (nurse)
  2. Explain that many different people will be working with them

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Transcript

Hey guys! As a nurse, you will work with many different professions. In this lesson, we will discuss some of the most common members of the medical team including what they do, and how you are involved with them. Let’s get started with nursing assistants. 

Nursing assistants, also sometimes called patient care techs, work side-by-side with nurses at the bedside. As the nurse, you will delegate tasks to the assistant such as checking vital signs or taking a patient to the bathroom. Make sure that you understand your company policies regarding what the assistants can and cannot do so that they aren’t practicing outside of their scope. Next, let’s talk about practitioners. 

As a nurse, you will be working with practitioners such as physicians, physician assistants, and nurse practitioners. They will round on your patients and assess them to change or add any orders that they see needed. Orders may include medications, tests, or patient care orders. For most units in the hospital, practitioners are not always present as they see many floors. It is important to keep communication open with the practitioner and call them with any concerns or changes with the patient. Now let’s move on to physical and occupational therapists. 

Physical therapists and occupational therapists work with many patients in the hospital to help get them back on their feet and able to perform activities of daily living or ADLs. They will notify you of any progress or setbacks that the patient is having. This information is important for you and the assistants to know how to get the patient up to the bathroom or chair. Next, let’s discuss pharmacists. 

Pharmacists work in hospitals where they review all of the physician and nurse medication orders to reduce errors. They prepare medications that are ordered or requested so that you may give them to the patient. They will contact you if any orders look incorrect or suspicious so that they may be corrected. You will contact them when you have questions about certain medications such as whether they are compatible or not. Alright, let’s move on to the speech therapists. 

Speech therapists are consulted by the practitioner to work with the patient if they are having memory problems, speech problems, or difficulty swallowing. For example, if your patient is eating dinner and they start coughing and it sounds like they may have aspirated, you will contact the doctor and notify them of your concern so that a speech therapist may be ordered. The speech therapist would then be able to assess them and complete an FSA or a functional swallow assessment to determine if they aspirate on food or drinks. They will communicate their findings with you and provide orders such as nectar thick liquids or no straws. Next, let’s touch on dietary. 

Dietary will collect and fill the patient’s meal orders. What the patient may have depends on what you or the practitioner enter for the diet order. For example, if a patient is on a diabetic diet, they will be restricted in carbs. Now let’s explore what the dietician does. 

The dietician assesses the patient to determine what their nutritional needs are. They may have you order things like snacks in between meals, nutritional drinks, or tube feedings. They will communicate their findings and plan of care with you. Now let’s get into the social worker and care coordination roles. 

Okay, let’s talk about social workers and care coordination. These guys are super important and not only work with you, but also the patient, health insurance companies, physicians, and nursing facilities. They help to determine patient payment and coverage and are involved in the discharge planning with you and the practitioner. If a patient is not fit to go home, the social worker and care coordination will work to find placement for them whether it be a skilled facility or a nursing home. On my med-surg unit, we have discharge planning every day where the nurse, charge nurse, care coordinator, and physician round to each room and discuss the discharge plan. Alright, next let’s discuss the respiratory therapist. 

Respiratory therapists work directly with the patient by assessing their respiratory status and oxygen needs. They provide breathing treatments and set up the BIPAP, CPAP, and AVAPS settings for assisted breathing. They also provide trach care and suctioning when needed, although you will be doing this too. You will see them a lot more if you work on a pulmonary floor like I do where you get a lot of patients with respiratory failure. In my hospital, we call the respiratory therapist when the patient needs a breathing treatment because they work on many floors. Now let’s touch on the transporter’s role. 

Transporters come and pick up the patients when they need to go to a test or to another unit. You will need to prepare the patient in some cases like if they have oxygen that needs switching to a tank or IV lines that need disconnected. Okay, let’s move on and discuss the radiology technician. 

The radiology technicians will complete any radiology tests ordered such as an XRAY or CT scan. As the nurse, you will communicate with them regarding a preparation required before the ordered test. If consent is needed, you may have to contact them when the consent is complete. Okay, let’s move on to our last medical team member the wound nurse. 

The wound nurse may be consulted by you or the doctor. They assess, clean, and dress the patient’s wounds and place specific wound care orders for you to follow. Next, we will discuss assessing your patient’s needs. 

It is super important to assess the needs of your patient and notify the doctor of any needs such as a wound nurse consult or speech therapy consult. Assess the patient’s progress and communicate with the physician daily. Okay, let’s talk about patient education. 

Always introduce yourself to your patients when you first come on your shift and let them know that you are their nurse. Let them know that different people will be working with them as they are in the hospital. Let’s explore the management of care. 

So, other medical team members will at some point interfere with your patient care. It’s important to plan, but be flexible. Move on to your next task with another patient and then come back. Guys, it’s also really important to notify the practitioner when any results come back. 

The priority nursing concepts for the medical team are clinical judgment, communication, and teamwork and collaboration. 

Alright, let’s review the key points of this lesson. All of the members of the medical team work together to provide the best patient care possible. As the nurse, you will determine the needs of the patient and discuss them with the physician. It is important to plan, but remain flexible as others may interfere with your plans. Notify the practitioner of any results that come back like radiology reports or FSA results. Let the patient know who you are and that different personnel will be working with them while they are in the hospital. Remember, communication is the key to working together. Ask questions if you need an answer. I know this may seem like a lot of people to keep up with, but keep in mind that most of these different medical workers will be charting in the patient chart so that all members of the team may stay in the loop. 

Okay, guys, that’s it on the medical team. Now go out and be your best self today, and as always, happy nursing!

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Med Surg

Concepts Covered:

  • Gastrointestinal
  • Upper GI Disorders
  • Respiratory Emergencies
  • Immunological Disorders
  • Hematologic Disorders
  • Intraoperative Nursing
  • Medication Administration
  • Newborn Complications
  • Noninfectious Respiratory Disorder
  • Peripheral Nervous System Disorders
  • Studying
  • Central Nervous System Disorders – Brain
  • Sexually Transmitted Infections
  • Infectious Respiratory Disorder
  • Disorders of Pancreas
  • Liver & Gallbladder Disorders
  • Disorders of Thermoregulation
  • Musculoskeletal Trauma
  • Disorders of the Posterior Pituitary Gland
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Emergency Care of the Trauma Patient
  • Neurological Trauma
  • Disorders of the Thyroid & Parathyroid Glands
  • Male Reproductive Disorders
  • Oncology Disorders
  • Postoperative Nursing
  • Renal Disorders
  • Renal and Urinary Disorders
  • Central Nervous System Disorders – Spinal Cord
  • Integumentary Disorders
  • Shock
  • Acute & Chronic Renal Disorders
  • Respiratory Disorders
  • Vascular Disorders
  • Lower GI Disorders
  • Respiratory System
  • Disorders of the Adrenal Gland
  • Neurologic and Cognitive Disorders
  • Infectious Disease Disorders
  • Female Reproductive Disorders
  • EENT Disorders
  • Respiratory
  • Emergency Care of the Respiratory Patient
  • Neurological Emergencies
  • Communication

Study Plan Lessons

05.01 Pancreatitis and Large Bowel Obstruction for CCRN Review
Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)
AIDS Case Study (45 min)
Airway Suctioning
Anemia for Progressive Care Certified Nurse (PCCN)
Anesthetic Agents
Anesthetic Agents
ARDS Case Study (60 min)
ARDS causes Nursing Mnemonic (GUT PASS)
Artificial Airways
Aspiration for Certified Emergency Nursing (CEN)
Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)
Asthma for Certified Emergency Nursing (CEN)
AVPU Mnemonic (The AVPU Scale)
Azithromycin (Zithromax) Nursing Considerations
Barbiturates
Brain Death v. Comatose
Brain Tumors
Bronchoscopy
Carbon Dioxide (Co2) Lab Values
Chest Tube Management
Chest Tube Management Case Study (60 min)
Chronic Obstructive Pulmonary Disease (COPD) Case Study (60 min)
Chronic Obstructive Pulmonary Disease (COPD) for Certified Emergency Nursing (CEN)
Cirrhosis Case Study (45 min)
Cold Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Complications of Immobility
Coronavirus (COVID-19) Nursing Care and General Information
Day in the Life of a Med-surg Nurse
Diabetes Insipidus Case Study (60 min)
Diabetes Mellitus Case Study (45 min)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Disseminated Intravascular Coagulation Case Study (60 min)
Dysrhythmias for Certified Emergency Nursing (CEN)
Enteral & Parenteral Nutrition (Diet, TPN)
Erythromycin (Erythrocin) Nursing Considerations
Fractures (Open, Closed, Fat Embolus) for Certified Emergency Nursing (CEN)
General Anesthesia
Head and Spinal Cord Trauma for Certified Emergency Nursing (CEN)
Heart Failure Case Study (45 min)
Heart Failure for Certified Emergency Nursing (CEN)
Hemorrhagic Fevers for Certified Emergency Nursing (CEN)
Histamine 1 Receptor Blockers
Hyperthyroidism Case Study (75 min)
Hypothermia (Thermoregulation)
Infectious Diseases: Influenza for Progressive Care Certified Nurse (PCCN)
Intraoperative (Intraop) Complications
Leukemia Case Study (60 min)
Levofloxacin (Levaquin) Nursing Considerations
Local Anesthesia
Lung Cancer
Malignant Hyperthermia
Melanoma
Meperidine (Demerol) Nursing Considerations
Metabolic Acidosis (interpretation and nursing diagnosis)
Miscellaneous Nerve Disorders
Moderate Sedation
Montelukast (Singulair) Nursing Considerations
Morphine (MS Contin) Nursing Considerations
Myocardial Infarction (MI) Case Study (45 min)
Nephrotic Syndrome Case Study (Peds) (45 min)
Neurological Disorders (Multiple Sclerosis, Myasthenia Gravis, Guillain-Barré Syndrome) for Certified Emergency Nursing (CEN)
Noncardiac Pulmonary Edema for Certified Emergency Nursing (CEN)
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Psoriasis
Nursing Care and Pathophysiology for Scleroderma
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Pneumonia
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Activity Intolerance
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Aortic Aneurysm
Nursing Care Plan (NCP) for Aspiration
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Bowel Obstruction
Nursing Care Plan (NCP) for Brain Tumors
Nursing Care Plan (NCP) for Bronchoscopy (Procedure)
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Chronic Obstructive Pulmonary Disease (COPD)
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for Emphysema
Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Gastroesophageal Reflux Disease (GERD)
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Guillain-Barre
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) for Hydrocephalus
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Care Plan (NCP) for Hyperthermia (Thermoregulation)
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Lung Cancer
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Nursing Care Plan (NCP) for Mumps
Nursing Care Plan (NCP) for Myasthenia Gravis (MG)
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Nephrotic Syndrome
Nursing Care Plan (NCP) for Osteoporosis
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Restrictive Lung Diseases
Nursing Care Plan (NCP) for Rubeola – Measles
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Syncope (Fainting)
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing Care Plan (NCP) for Thoracentesis (Procedure)
Nursing Care Plan (NCP) for Thrombophlebitis / Deep Vein Thrombosis (DVT)
Nursing Care Plan (NCP) for Tuberculosis
Nursing Care Plan for Cirrhosis (Liver)
Nursing Care Plan for Distributive Shock
Nursing Care Plan for Nasal Disorders
Nursing Care Plan for Pulmonary Edema
Nursing Care Plan for Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care Plan for Scleroderma
Nursing Case Study for Breast Cancer
Nursing Case Study for Cardiogenic Shock
Nursing Case Study for Hepatitis
Nursing Case Study for Pneumonia
Nursing Case Study for Type 1 Diabetes
Obstruction for Certified Emergency Nursing (CEN)
Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)
Ondansetron (Zofran) Nursing Considerations
Opioids
Pancreatitis For PCCN for Progressive Care Certified Nurse (PCCN)
Patient Positioning
Pentobarbital (Nembutal) Nursing Considerations
Peritonitis for Certified Emergency Nursing (CEN)
Pleural Space Complications (Pneumothorax, Hemothorax, Pleural Effusion, Empyema, Chylothorax) for Progressive Care Certified Nurse (PCCN)
Positioning (Pressure Injury Prevention and Tourniquet Safety) for Certified Perioperative Nurse (CNOR)
Post-Anesthesia Recovery
PPE Precautions (Personal Protective Equipment) for Certified Perioperative Nurse (CNOR)
Propofol (Diprivan) Nursing Considerations
Respiratory A&P Module Intro
Respiratory Alkalosis
Respiratory Course Introduction
Respiratory Depression (Medication-Induced, Decreased-LOC-Induced) for Progressive Care Certified Nurse (PCCN)
Respiratory Distress Syndrome for Certified Emergency Nursing (CEN)
Respiratory Failure (Acute, Chronic, Failure to Wean) for Progressive Care Certified Nurse (PCCN)
Respiratory Infections (Pneumonia) for Progressive Care Certified Nurse (PCCN)
Respiratory Infections Module Intro
Respiratory Procedures Module Intro
Respiratory Trauma for Certified Emergency Nursing (CEN)
Respiratory Trauma Module Intro
Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Spinal Cord Injury Case Study (60 min)
Stroke Assessment (CVA)
Surgical Wound Classification Documentation for Certified Perioperative Nurse (CNOR)
Systemic Lupus Erythematosus (SLE)
The Medical Team
Thoracentesis
Trach Suctioning
Tuberculosis for Certified Emergency Nursing (CEN)
Vaccine-Preventable Diseases (Measles, Mumps, Pertussis, Chicken Pox, Diphtheria) for Certified Emergency Nursing (CEN)
Ventilator Settings
Wound Dressing Maintenance for Certified Perioperative Nurse (CNOR)