The outcome of any successful orthopedic procedure depends in great measure on the quality of not only post-operative rehabilitation but also on the “pre-hab” prior to surgery where realistic patient expectations are established. Adherence to nursing and rehabilitation guidelines established by the hospital and treating physician are essential to success. Failure to follow nursing and rehabilitation standards and departure from prescribed protocols will adversely affect the patient outcome. I have extensively been involved in pre-hospital educational programs and design and implementation of post-operative management protocols.
I have been a clinical instructor for the Arizona State University College of Nursing in the graduate level nurse practitioner program. Having had the opportunity to learn from these experienced nurses as well as to instruct them in musculoskeletal conditions I have gained a thorough knowledge of the nursing profession and the interface between nursing care and clinical outcomes. For the past nine years one of my former students has been my partner in clinical practice.
I am of the opinion that “an X-ray is the orthopedic surgeon’s stethoscope, and physical therapy his or her penicillin.” The physical therapist and orthopedic surgeon team must be established with goals and limitations clearly delineated at the start of the patient’s care. Failure to communicate or departures from treatment limitations form the basis for most claims against physical therapists. I have been called upon to testify on these issues with respect to both the physical therapists’ actions as well as in cases of rehabilitation institutional liability. I am well acquainted with these standards having worked closely with physical therapists in my employ as well as assisting community therapists in the establishment of treatment protocols in their private practice.
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