Include the “Second String”

My approach to writing editorials is often to explore the “health issue of the month.” But while November has been designated as Health Awareness Month, I resisted the temptation to compose an ode to “awareness.” Instead, after delving deeper, I discovered that several weeks in November are devoted to recognition of health care professionals. 

While most honor the various nursing specialties, some recognize those members of the health care team who are integral to facilitating our work. Hard though it may be to believe, these individuals are more “silent” and unsung than NPs and PAs. They are “second-string” members of the team: the allied health professionals who complement our roles in health care delivery.

Allied health professionals provide services, such as dietary and nutrition counseling, rehabilitation, and health systems management, that assist in identifying, evaluating, and preventing diseases and disorders.¹ They are our dental hygienists, diagnostic medical sonographers, dietitians, medical technologists, occupational therapists, physical therapists, radiographers, respiratory therapists, and speech language pathologists.¹ Who of us has not, at least once a week, referred a patient to one of these colleagues? Who of us, at least once in our life, has personally needed the services of one (or more) of them?

As we move toward a “new and improved” health care system, the roles and responsibilities of each team member will advance, and more collaboration among and across the professions will occur. We see the beginnings of this in policy and position statements, issued by various health care entities, that support interdisciplinary cooperation—many of them mandating that education programs incorporate interprofessional training.

We, as PAs and NPs, also see it in the ongoing release from constraints on our scope of practice that have impeded our ability to collaborate with our other colleagues in developing, implementing, and evaluating plans of care for our patients. Our allied health professionals have an increasing role to play in this transformation, although they have been a constant in our health care system for as long as I can remember.

They have also had an impact on my professional career. In my early years as a nurse in pediatrics, it was a respiratory therapist (RT) who taught me the proper way to perform manual chest percussion on a young child with pneumonia to assist in clearing his lungs. I had learned in school that it “could” be done but had never learned the technique. I have had to perform chest percussion many times in my career—and I can still hear the RT’s voice, gently encouraging me and guiding me through the procedure.

Who taught me tricks to help a patient properly use an inhaler? The RT again. My ability to order x-rays is rooted in the education I received from my mom, who was a radiology technician. I learned what views were “standard” and which views to add if I was looking for something specific (and to let the radiologist know what I was looking for!). I also learned how to request an extended view (known as opening the cones) of a standard series of the ankle or foot to avoid having too many x-rays. Pretty cool, eh? 

When I worked in the college health setting, it was the orthopedic technician who taught me how to apply casts—not an easy feat when you are all thumbs like I am! Can you guess who taught me the proper way to fit a patient for crutches? It was a physical therapist (PT). Reciprocal gait with a cane, or painless reduction of a dislocated shoulder? The PT again. Best way to wrap a joint or limb with an elastic bandage that did not slip? Again, my PT colleague. (What a team we were!)

It was a medical technologist (MT) who taught me how to plant a culture, read a wet prep, and perform a microscopic exam on urine. It was also an MT who taught me the skills of starting an IV on a patient with, seemingly, no veins. That skill was actually a “2 for 1” special: Start the IV and draw the blood sample in one stick. Priceless! With no disrespect to all my nursing and NP instructors, the fine art of some of my work was learned at the side of many of those allied health professionals who are too often invisible.   

We have long touted the “holistic approach” in caring for the patient, but we are usually referring to caring for the whole patient by taking into consideration his/her physical, mental, and social conditions. I would like to think that we have the opportunity to pose a new definition, one that now means involving all the members of the health care team in the care of our patients and their families. No more second-string players. We need everyone on the field if we are going to win this health care battle.

Every health care provider has a role in improving the system and the lives of our patients. None of us can do it single-handedly; none of us has all the skills (or time) to do it all, much though we try. Capitalizing on the knowledge and talents of all the players on the health care team is vital to the success of the new health care system.

Each member of the team has a responsibility as a provider in the system to improve health care access and quality and to control cost—concepts that are central to helping patients progress from their injury or illness to recovery. They are also the key outcomes measures that will inform educational, organizational, and health policy as we move forward on this journey of improving the health care system. Moreover, these outcomes are now, and will continue to be, the benchmarks that influence reimbursement for our services—and, perhaps more importantly, our scopes of practice.

After more years as a nurse/NP than I care to admit, I know what I don’t know. I also know to whom I can turn for guidance:  my “other right hand,” as I call them. I have never hesitated to call on them to brainstorm or assist in caring for my patients. And I never will. 

What about you? Share your experiences with other members of your health care team by sending a note to NPEditor@frontline medcom.com.

Reference

1. Association of Schools of Allied Health Professionals. www.asahp.org/definition.htm. Accessed October 17, 2013.

My approach to writing editorials is often to explore the “health issue of the month.” But while November has been designated as Health Awareness Month, I resisted the temptation to compose an ode to “awareness.” Instead, after delving deeper, I discovered that several weeks in November are devoted to recognition of health care professionals. 

While most honor the various nursing specialties, some recognize those members of the health care team who are integral to facilitating our work. Hard though it may be to believe, these individuals are more “silent” and unsung than NPs and PAs. They are “second-string” members of the team: the allied health professionals who complement our roles in health care delivery.

Allied health professionals provide services, such as dietary and nutrition counseling, rehabilitation, and health systems management, that assist in identifying, evaluating, and preventing diseases and disorders.¹ They are our dental hygienists, diagnostic medical sonographers, dietitians, medical technologists, occupational therapists, physical therapists, radiographers, respiratory therapists, and speech language pathologists.¹ Who of us has not, at least once a week, referred a patient to one of these colleagues? Who of us, at least once in our life, has personally needed the services of one (or more) of them?

As we move toward a “new and improved” health care system, the roles and responsibilities of each team member will advance, and more collaboration among and across the professions will occur. We see the beginnings of this in policy and position statements, issued by various health care entities, that support interdisciplinary cooperation—many of them mandating that education programs incorporate interprofessional training.

We, as PAs and NPs, also see it in the ongoing release from constraints on our scope of practice that have impeded our ability to collaborate with our other colleagues in developing, implementing, and evaluating plans of care for our patients. Our allied health professionals have an increasing role to play in this transformation, although they have been a constant in our health care system for as long as I can remember.

They have also had an impact on my professional career. In my early years as a nurse in pediatrics, it was a respiratory therapist (RT) who taught me the proper way to perform manual chest percussion on a young child with pneumonia to assist in clearing his lungs. I had learned in school that it “could” be done but had never learned the technique. I have had to perform chest percussion many times in my career—and I can still hear the RT’s voice, gently encouraging me and guiding me through the procedure.

Who taught me tricks to help a patient properly use an inhaler? The RT again. My ability to order x-rays is rooted in the education I received from my mom, who was a radiology technician. I learned what views were “standard” and which views to add if I was looking for something specific (and to let the radiologist know what I was looking for!). I also learned how to request an extended view (known as opening the cones) of a standard series of the ankle or foot to avoid having too many x-rays. Pretty cool, eh? 

When I worked in the college health setting, it was the orthopedic technician who taught me how to apply casts—not an easy feat when you are all thumbs like I am! Can you guess who taught me the proper way to fit a patient for crutches? It was a physical therapist (PT). Reciprocal gait with a cane, or painless reduction of a dislocated shoulder? The PT again. Best way to wrap a joint or limb with an elastic bandage that did not slip? Again, my PT colleague. (What a team we were!)

It was a medical technologist (MT) who taught me how to plant a culture, read a wet prep, and perform a microscopic exam on urine. It was also an MT who taught me the skills of starting an IV on a patient with, seemingly, no veins. That skill was actually a “2 for 1” special: Start the IV and draw the blood sample in one stick. Priceless! With no disrespect to all my nursing and NP instructors, the fine art of some of my work was learned at the side of many of those allied health professionals who are too often invisible.   

We have long touted the “holistic approach” in caring for the patient, but we are usually referring to caring for the whole patient by taking into consideration his/her physical, mental, and social conditions. I would like to think that we have the opportunity to pose a new definition, one that now means involving all the members of the health care team in the care of our patients and their families. No more second-string players. We need everyone on the field if we are going to win this health care battle.

Every health care provider has a role in improving the system and the lives of our patients. None of us can do it single-handedly; none of us has all the skills (or time) to do it all, much though we try. Capitalizing on the knowledge and talents of all the players on the health care team is vital to the success of the new health care system.

Each member of the team has a responsibility as a provider in the system to improve health care access and quality and to control cost—concepts that are central to helping patients progress from their injury or illness to recovery. They are also the key outcomes measures that will inform educational, organizational, and health policy as we move forward on this journey of improving the health care system. Moreover, these outcomes are now, and will continue to be, the benchmarks that influence reimbursement for our services—and, perhaps more importantly, our scopes of practice.

After more years as a nurse/NP than I care to admit, I know what I don’t know. I also know to whom I can turn for guidance:  my “other right hand,” as I call them. I have never hesitated to call on them to brainstorm or assist in caring for my patients. And I never will. 

What about you? Share your experiences with other members of your health care team by sending a note to NPEditor@frontline medcom.com.

Reference

1. Association of Schools of Allied Health Professionals. www.asahp.org/definition.htm. Accessed October 17, 2013.

My approach to writing editorials is often to explore the “health issue of the month.” But while November has been designated as Health Awareness Month, I resisted the temptation to compose an ode to “awareness.” Instead, after delving deeper, I discovered that several weeks in November are devoted to recognition of health care professionals. 

While most honor the various nursing specialties, some recognize those members of the health care team who are integral to facilitating our work. Hard though it may be to believe, these individuals are more “silent” and unsung than NPs and PAs. They are “second-string” members of the team: the allied health professionals who complement our roles in health care delivery.

Allied health professionals provide services, such as dietary and nutrition counseling, rehabilitation, and health systems management, that assist in identifying, evaluating, and preventing diseases and disorders.¹ They are our dental hygienists, diagnostic medical sonographers, dietitians, medical technologists, occupational therapists, physical therapists, radiographers, respiratory therapists, and speech language pathologists.¹ Who of us has not, at least once a week, referred a patient to one of these colleagues? Who of us, at least once in our life, has personally needed the services of one (or more) of them?

As we move toward a “new and improved” health care system, the roles and responsibilities of each team member will advance, and more collaboration among and across the professions will occur. We see the beginnings of this in policy and position statements, issued by various health care entities, that support interdisciplinary cooperation—many of them mandating that education programs incorporate interprofessional training.

We, as PAs and NPs, also see it in the ongoing release from constraints on our scope of practice that have impeded our ability to collaborate with our other colleagues in developing, implementing, and evaluating plans of care for our patients. Our allied health professionals have an increasing role to play in this transformation, although they have been a constant in our health care system for as long as I can remember.

They have also had an impact on my professional career. In my early years as a nurse in pediatrics, it was a respiratory therapist (RT) who taught me the proper way to perform manual chest percussion on a young child with pneumonia to assist in clearing his lungs. I had learned in school that it “could” be done but had never learned the technique. I have had to perform chest percussion many times in my career—and I can still hear the RT’s voice, gently encouraging me and guiding me through the procedure.

Who taught me tricks to help a patient properly use an inhaler? The RT again. My ability to order x-rays is rooted in the education I received from my mom, who was a radiology technician. I learned what views were “standard” and which views to add if I was looking for something specific (and to let the radiologist know what I was looking for!). I also learned how to request an extended view (known as opening the cones) of a standard series of the ankle or foot to avoid having too many x-rays. Pretty cool, eh? 

When I worked in the college health setting, it was the orthopedic technician who taught me how to apply casts—not an easy feat when you are all thumbs like I am! Can you guess who taught me the proper way to fit a patient for crutches? It was a physical therapist (PT). Reciprocal gait with a cane, or painless reduction of a dislocated shoulder? The PT again. Best way to wrap a joint or limb with an elastic bandage that did not slip? Again, my PT colleague. (What a team we were!)

It was a medical technologist (MT) who taught me how to plant a culture, read a wet prep, and perform a microscopic exam on urine. It was also an MT who taught me the skills of starting an IV on a patient with, seemingly, no veins. That skill was actually a “2 for 1” special: Start the IV and draw the blood sample in one stick. Priceless! With no disrespect to all my nursing and NP instructors, the fine art of some of my work was learned at the side of many of those allied health professionals who are too often invisible.   

We have long touted the “holistic approach” in caring for the patient, but we are usually referring to caring for the whole patient by taking into consideration his/her physical, mental, and social conditions. I would like to think that we have the opportunity to pose a new definition, one that now means involving all the members of the health care team in the care of our patients and their families. No more second-string players. We need everyone on the field if we are going to win this health care battle.

Every health care provider has a role in improving the system and the lives of our patients. None of us can do it single-handedly; none of us has all the skills (or time) to do it all, much though we try. Capitalizing on the knowledge and talents of all the players on the health care team is vital to the success of the new health care system.

Each member of the team has a responsibility as a provider in the system to improve health care access and quality and to control cost—concepts that are central to helping patients progress from their injury or illness to recovery. They are also the key outcomes measures that will inform educational, organizational, and health policy as we move forward on this journey of improving the health care system. Moreover, these outcomes are now, and will continue to be, the benchmarks that influence reimbursement for our services—and, perhaps more importantly, our scopes of practice.

After more years as a nurse/NP than I care to admit, I know what I don’t know. I also know to whom I can turn for guidance:  my “other right hand,” as I call them. I have never hesitated to call on them to brainstorm or assist in caring for my patients. And I never will. 

What about you? Share your experiences with other members of your health care team by sending a note to NPEditor@frontline medcom.com.

Reference

1. Association of Schools of Allied Health Professionals. www.asahp.org/definition.htm. Accessed October 17, 2013.