Close Collaboration Leads to Outstanding Patient Care

When nurse Betsy Clemente starts her workday, one of her first phone calls is with physical therapist Betty Ayetiwa. “We share many patients, and so we exchange information about them,” says Betsy. “If a patient has a certain issue, one of us will alert the other about it so we can prioritize that need. I call the two of us ‘The A Team!’” Adds Betty, “We’ve been working together the past several years. We speak every day, and I’m loving it!”

In addition to working closely with physical therapist Betty and other colleagues to coordinate each patient’s care, nurse Betsy is careful to prepare patients emotionally and mentally by explaining to them exactly what they can expect from their home care clinicians and treatment. In the case of her recent knee replacement patient Sharon (not her real name), who is prone to anxiety and also doesn’t tolerate pain well, this approach was especially helpful. “When I arrived for my first visit, she was very upset,” recalls Betsy. “She had gone through surgery, and her incision was closed with a line of staples, which made her nervous. I was very gentle with her. I spoke lightly to her, explaining our services, talking about the side effects of the medication she is taking, and telling her not to be afraid of taking the pain medicine, because she would only be taking it for a short time. By the end of that first visit she was very different—she was happier, eating food, and taking her pain medication.”

Later that same day, Betty followed up with a home visit to provide physical therapy to the patient. “Betsy and I basically tag team each other,” says Betty. “She’s the motherly type, and I’m the type that says ‘Get up, let’s do this, let’s move!’ So we work well together. With Sharon, I just walked in and treated her like she needed to be treated, as I always do. My approach basically follows the Golden Rule, which is to treat others the way you would want to be treated.”

Like Betsy, Betty works to reduce patients’ anxiety by explaining all the aspects of their treatment to them. “I always use the Visiting Nurse planner,” she says. “I pull the planner out and circle the days that I’ll be coming, then write the expected time of my visits. I also always give a phone call an hour before I make a visit and remind the patient to take their pain medication so they’re not uncomfortable during therapy. When I left Sharon that first day, she was much calmer because she knew what to expect. I also gave her three exercises as homework and explained what she needed to do between then and when I would see her the following day. So she wasn’t left in the dark.”

When Sharon, who lives in a townhouse, was reluctant to leave her bedroom that first week, says Betty, “I told her, ‘I need you downstairs when I come so we can focus on your therapy—no more lying in bed upstairs.’ She responded to that.” In addition, Sharon was initially complacent about the CPM machine, which passively bends the patient’s knee to increase its range of motion. “She felt she did not have to do it,” says Betty. “But I told her, ‘I know your doctor pretty well. And if you walk in to his office next week with the limited range of motion you have right now, he’s not going to be happy—so let’s do this! After daily visits the first week and every-other day sessions the second,” adds Betty, “she was flying up and down the stairs of her home!”