One thing about our hospital is we tend to do some treatments for really stupid reasons, as you probably know by now by reading my blog. I'm not complaining, merely stating my observation.
We have one surgeon who orders "treatments QID." That's exactly how he writes the order. What he wants is Albuterol neb, cpt and IS * 3 days.
We have a urologist who likes to order Albuterol Q4 on all of his patients who develop crackles or a fever. I have no idea what he expects to gain by doing these treatments, but it provides some neat material for my 'olin list.
Believe it or not, I feel stupid doing txs on most of these peeps, because there's no reason for it.
We RTs joke here at Shoreline that once a treatment is ordered, even if the patient is no longer having trouble breathing, the treatment must never be dc'd.
The other day when I worked a patient asked me, "Hey, Rick, when are you going to stop giving me these treatments I don't need?"
I said, "When you are discharged. Our docs like to give treatments here."
Keep in mind I have no problem giving a neb, it's not hard to do. It's just the principle here. It seems like it's a waste of money for both the hospital and the insurance company. But, I have to do what I'm told. And I don't complain (too much).
So, yeah, it would be cool to have a protocol to get rid of these txs, but then again I suppose it is work, and work guarantees we get all our hours.
That's the big fear of RT Bosses is that we'd protocol ourselves out of a job and have to lay one of us off. I'm wondering here if this fear is true. Hey, if one of my readers works at a hospital new to the protocol idea, let me know if it increased or decreased your patient load.
I've read studies that showed that the workload after the initiation of an RT treatment protocol actually stayed the same, considering the RTs were doing more assessments and doing treatments on people they thought needed them, and when they were needed instead of when they were scheduled by the doctor.
Still, I'd be curious to know what you guys thought on this matter. We are hoping to go this
route soon (fingers crossed). Perhaps we'd be stabbing ourselves in the foot. Perhaps not.
Jane Sage and I wrote an RT Consult that we are hoping to get implemented after our vent protocol is redone, and it would be nice to have more ideas. So if you guys have any, your advice would be greatly appreciated.
Basically, I'm thinking that there are enough RT protocols, or RT Consults, in hospitals now for us to learn from. If there's something that works well, we'd like to incorporate that into ours. If your protocols have something you hate, we'd like to avoid those problems.
One of the big fears of at least one of my fellow RTs is that an RT Consult would lead to more unnecessary work. Does the protocol create extra paperwork?
I certainly want our RT Consult to work. I want it to be ideal for the patient, the doctor and us RTs.