The Memory Unit OT

When I was a new-grad working in skilled nursing, I was absolutely terrified to speak with a physician. I was afraid they would see right through me, that I wouldn’t be taken seriously, or that I would be flat out ignored.

With time and rapport building, talking with the physicians is now just part of the job. But if you’re in that place I was in, here are some tips that might help you fine-tune your skills.

Know the Team and their Schedule

In some facilities, there’s an MD who comes into the building once a week or so, with attending PAs and/or NPs who staff the facility throughout the week. If you acquaint yourself with who everyone is, as well as the days and times when they’re in the building, you’ll not only make your own life easier (because you won’t be trying to chase down a PA all day), but you’ll also have a better chance of meeting with the MD or NP at a time when they’re able to stop and talk with you for a few minutes.

Keep your Information Short and to the Point

In my experience, a lot of doctors (and their teams) are contracted. They are employed by an outsourcing company and service multiple buildings. Which means their schedules are busy. They’re on the phone a lot. They’re driving all over the place. And they’ve got a lot of Patients and Residents to keep track of.

So if I approach them with a long 15-minute spiel about a Resident, I run the risk of getting dismissed, damaging my rapport, or not having the full picture understood. And that’s not because the physicians are rude or unkind. They’re just busy. They’ve got a lot going on, and it’s the opposite of helpful for me to give more information than necessary.

Instead, I give a concise report (including all essential information), with objective data. This allows me to clearly ask a question or request a more specified assessment, order, referral, or medication review.

Have your Data Ready

Objective data talks. It’s one thing to say “Hey, I sort of feel like this Resident seems off, like they’re getting weaker even though we’re doing therapy”. It’s another thing to say “This Resident’s been making strong gains, but over the last 2 days he’s declined from a min assist for transfers to a max assist of 2 people with increased reports of pain.”

See how those two statements present differently?

While you absolutely have the skills to make clinical observations and assessments, subjective-style comments alone are not enough to advocate for your Patients and Residents. It’s more effective and appropriate to show clear changes in an individual’s status or performance to back up those more subjective observations.

And it’s the objective data that will also establish a better case to the insurance companies that are paying for the skilled level of care that both you and the physicians provide.

Remember they’re Human

Doctors are people too. When you pass them in the hall or see them at the nurse’s station, say ‘hello’. Make the quick chit-chat if you’re at the coffee machine together. It’s okay to ask how they’re weekend was if you notice they’re not elbow-deep in an assessment or document. Let them know about the doughnuts in the breakroom. Talk to them like human adults.

As a new grad, I used to think that socially doctors were at the top and I was not. But once I broke that perception and just interacted with them like normal human people, the fear to approach them with a clinical question or remark quickly went away.