CAREERS IN NURSING
TEAM APPROACH – NURSES AND PHYSICAL THERAPISTS SHARE EXPERTISE
by James Coburn – Writer/Photographer
Nurses and physical therapists work hand-in-hand in home health.
“You really can’t have one without the other technically,” said Nena Ray, a registered nurse and the administrator of HealthBack Home Health in Oklahoma City.
“The goal is to get patients better, so that they can stay independent in their own home,” Ray said.
Home health depends on a team approach to reach those goals. She said the HealthBack nursing staff works closely with Marcland Luster, a physical therapist, who works closely with patients having trouble being ambulatory or have had prolonged hospital stays and need further care.
“That’s where Marcland comes in to help them get back on their feet and help them gain that strength back to drive, to be able to go out, to be able to maneuver on the stairs of their homes. We want to keep them in their home,” Ray said.
A nurse will go to a home and order the physical therapy. Without physical therapy, a lot of times there is no need for nursing, she said. A majority of patients need therapy and strengthening because they are aging.
Ray said that some clients are becoming frail and weak so care is directed to keep clients safe and strong at home.
Luster has been an important staff member of HealthBack for six years, said Christy Evans, owner of HealthBack. He earned a Bachelor of Science degree in Physical Therapy from Langston University 23 years ago.
“It’s a doctoral program now. I’m real proud of the things they are doing with the programs,” Luster said.
Ray said he loves home health. Early in his career he was doing a lot of rehab work in hospitals with set schedules for patients. He said home health provides nurses and therapists more one-one contact with patients.
“I can just really concentrate on them. I’m in their home so I feel more comfortable there than I would be in a rehab or hospital setting,” Luster said. “It’s just a real joy when being in someone’s atmosphere. They open up to you.”
“I’ve learned a lot, especially from the nurses and that component as well. It’s a real team atmosphere.”
He works alone in the patients homes, but at times calls upon the nurses to learn aspects of patient care that deal with medicine.
“They do the same thing with us when it comes to equipment that they need,” Luster added. “There are walkers and wheelchairs. They may need grab bars in the bathrooms.”
Ray said communication is important when updating subtle nuances in patient care so that the team is on the same playing field. When a new patient needs home health, a nurse will communicate to Luster why physical therapy is needed. There may be a patient who has had a joint replacement after having frequent falls, Ray said.
“After that is done the physical therapist does their evaluation and the orders come through, and we see them two times a week or three times a week, whatever is needed by that patient,” Ray said.
Luster will write a note to the nursing staff if a patient’s blood pressure is high. The nurse then comes into play and will call the physician, Ray said.
Medication changes will be provided by the nurses if needed. There may be an extra visit by a nurse to visit the patient along with Luster.
“A lot of times in the home, the physical therapists know a little more about a patient than the nurses do,” Ray noted.
She said nurses are focused on medication, education, wound care and other things. Physical therapists are focused on strength training and mobility. So when Luster is doing that, he learns much more about the information that nurses need.
A patient’s goal might be walking to their garden, Ray said. The secret of his connection with patients is finding out what they want to achieve.
“They learn a lot more personal things about them,” Ray said. “That’s why a lot of patients love their physical therapists.”
Patients want to be at thier personal best. They will say that they want to walk their daughter down the wedding aisle, Ray said.
“Those life moments that you’re a part of and can make happen gives me chills now just kind of thinking about it,” Luster said. “I’ve done this for 23 years and have numerous stories of getting people back to where they were or as close as they can. It’s amazingly enriching to my life.”