Can a RN delegate wound care to a physical therapist?

IF the P.T. is QUALIFIED to care for your wounds...

There is a chance that just because s/he is a P.T. in title doesn't necessarly mean that s/he doesn't have more qualification your not aware of.

If you feel odd about this, tell them so.

If you inform them that you feel you should see a doctor, then they should send one in. You might need to wait if they are busy and your issue isn't life threatening but it is worth it for the peace of mind...

It NEVER hurts to ask!

The RN can tell the PT that the doctor has put in wound care orders but the RN can't diagnose and treat a wound independent of an MD first seeing the problem. So yes, the RN can boss the PT around to take care of the wound upon orders from an MD. If the PT does not think it is his or her job, it is up to the PT to have the MD determine this.

YES, CUZ AN RN IS LIKE A DOCTOR AND IF THE RN IS LEFT IN CHARGE THE PT HAS TO OBEY THE RN...

I don't know why an RN would delegate wound care to a physical therapist, unless the PT has had training and experience in wound dressings, etc. Since this is a sterile technique that has to be used, the person performing the task must have been trained on how to do it correctly, otherwise infection could result. I would double check this with your doctor or the facility that this happened in to see what the policy is, but I've never heard of a PT doing wound care.

Apparently, some physical therapists are certified to do wound care, but I've never heard of a nurse being able to make the referral. It seems to me that it would take a doctor's recommendation.

People I know who need wound care go to a specialty office, just for that type of injury. I'd be worried about having someone without a lot of training and with a work area not conducive to keeping out infection working on my wounds.

This is somewhat of a tricky question depending on in what context are you referring.

First, can an RN "order" wound care for a patient that has no previous orders for wound care? No. However, a nurse practictioner (NP) CAN initiate an order (and is usually signed later on by the MD).

Next, the nature of wound care will determine if a physical therapist or RN is more appropriate to complete the task and may be subject to your particular state laws, the training of the person and the type of modality used.

Simple dressing changes and enzymatic debridement is really at the core of an RNs job and there is no functional reason to have a PT do this. Furthermore, a PT cannot charge for dressing change...so it becomes lost revenue if builed to an ins company (or the patient is responsible for the fee). However, PTs can charge for debridement type procedures if they have such training. This might include, but is not limited to pulsed lavage, sharps debridement, whirlpool (ugh!), etc.

In the end, an RN cannot "delegate" wound care tasks to the PT if he/she simply just doesn't want to do it. However, if the scope of the wound care determines that someone with more specific training (be it a PT, OT, etc) is required to do it, then so it should be. This might vary between facilities.

In all cases, however, there should be a standing wound care order from a physician.

As an example, we primarily treated wound at our facility until the technology of medication and enzymatic debridement started to improve and the task was shifted back to nursing at our wound care center. Yet, we still get occasional orders for pulsed lavage in the PT department.