The Medical Team

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

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)
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
Physical Therapists & Occupational Therapists
1. Work on ADLs with patient
2. Will notify you of patient progress or setbacks
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
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
Dietary
1. Collect and fill patient meal orders
2. You or physican enter diet including restrictions for them to follow
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
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
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
Transportation
1. Take patients to tests/other units
2. You must prepare patient to be taken (disconnect IV lines, connect oxygen tank)
Radiology Technicians
1. Complete radiology tests
2. Communicate with them regarding test prep when ordered
3. Contact them when consents are ready
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

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

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

Nursing Concepts

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

Patient Education

Let the patient know your name and who you are (nurse)
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.

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Outline

Overview

Nursing Points

General

Assessment

Therapeutic Management

Nursing Concepts

Patient Education

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