Im currently on my neuro prac where organising physio sessions with other appointments is a priority. We are told to plan our day one day ahead, though be flexible as things often dont pan out as they are foreseen. Last week was no exception, where a GB pt i had been seeing was organised to be SOOB for the afternoon session at 3:00. I had written on the white board in the nurses station and coordinated with the nurse looking after the pt.
When i arrived at 3:00, the pt had just started a NG feed and it was not appropriate to get him SOOB at this time. The nurse apologised saying she was told by the nurse manager to give the pt a feed at this time, and that he would be t/f'd via hoist to the chair in 15 minutes. We agreed that physio would then be commenced.
On arrival 15 minutes later, the pt had finished his feed but was still in supine and had been given a NEB. The nurse again said she was told to administer this and that he would be moved once this was finished. This was estimated to be 10-15 minutes later. On arrival at this time, the pt was just getting ready to be t/f'd and i stepped in to give the nurses a hand. Once the pt was in the correct position i had only 15 minutes with the pt that i had spent an hour with in the morning.
This situation was disappointing as the pt was deprived of a thorough treatment because the staff were unable to coordinate effictively. I had tried to plan my day and effectively treat all the pt's i had been given, but this had been insufficient. This nurse that i had been organising my treatment with was being given instructions by the nurse manager, so i think to cover my basis next treatment i will try to liase with both the nurse and nurse manager. I will also try and reinforce the importance of physio for these pt's and the time required for outcomes to be achieved. I think this is just one of the hurdles in in-pt care that must be overcome to handle a full caseload and give a number of effective treatments.
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I had a similar prac like yours where everything had to be pre organised and you had to liaise with all other staff. It worked so well when it worked and everything flowed so smoothly but when things went wrong boy did it go wrong. Sounds like there wasn't much else you could have done to prevent the situation apart from what you already suggested.
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