Rehab Nursing - A Great Career!
I wanted to change the world, make a difference, and end suffering – so, I became a nurse. A career in nursing didn’t help me change the world, but it definitely helped me make a difference in the lives of others. I feel privileged to have had the opportunity to be present during my patient’s personal journeys and to have assisted them to walk through some of the most difficult times of their lives. Not only do I feel gratification from my career helping people, but I am also grateful to all my patients who have made a difference in MY life. I am inspired by the perseverance and strength I’ve witnessed in people who’ve suffered horrible circumstances.
I began my career as a nurse on a Complex Medical Unit at an acute care rehabilitation hospital. I cared for people ranging in age from their early twenties to late seventies who suffered from brain injuries, surgical procedures that went bad, incurable wounds that extended to their bones, and diseases like Guillain Barre and Locked-In Syndrome, a rare neurological syndrome that causes the patient paralysis of all voluntary muscles except their eyes. Learn more about Locked-in Syndrome at The National Organization of Rare Disorders.
My patients had Trachs, G-tubes, Wound Vacs, Foley Catheters, Ostomy Bags, and a variety of tubes coming out of their bodies. Most of my patients were weak and unable to manage their own activities of daily living. As a rehab nurse, one of my responsibilities was to help teach people alternate ways of doing things. Such as how to use an assistive device to help them with personal hygiene, or techniques on how to conserve energy while showering or getting dressed. It’s a wonderful feeling to help someone who has become completely dependent on someone for ordinary things, like personal hygiene, obtain independence through the use of an assistive device or education on alternative ways of doing everyday tasks.
At Gaylord Hospital, the rehab hospital where I worked, Physicians, Physical Therapist, Occupational Therapist, Speech Therapist, Psychologist, Social Workers, Respiratory Therapist, Nurses, and CNAs, worked together to create an individual plan of care for each patient. I worked side by side with my CNA performing incontinent care, toileting our patients, doing bed baths, and transferring patients from their bed to a chair. My CNAs assisted me by holding a body part so I could assess or treat a difficult to see wound or they ran to the supply pyxis to gather the extra supplies I realized I needed after I already gowned in my PPE. There was no “That’s not my job” in rehab.
Mornings were always busy because not only did I have to assess, medicate, and provide treatments to my patients, I had to assist my CNAs with morning ADLs and help get people ready for their morning therapies. Time management is important in rehab nursing. Patients tend to move slow, and you must allow them time to do as much as they can independently, while at the same time have them ready on time for their scheduled therapy sessions. Somehow by working together as a team, we always got everything done.
Often patients returned from therapy with new splints, braces, or assistive devices custom designed by their therapist. Nurses and CNAs had to learn how to apply and use each new device and we collaborated with the therapist to help teach the patients how to use their new tools. We also taught our patient’s family members on how to manage the various devices.
The nurses and therapists I worked with were incredibly creative, innovating all kinds of techniques and equipment to help our patients. They used memory books to help people with brain injuries remember important information and to help them remember to do daily tasks, such as brushing their teeth. A communication board was created for our patient with Locked-In Syndrome – The board had common words and letters written on it and the patient was able to blink at the words to communicate some of her needs. Occupational therapists created special eating utensils to help patients with fine motor deficits eat independently.
One thing that I always took away from working as a rehab nurse, was the importance of maintaining your patient’s proper positioning while in a wheelchair. At Gaylord, we had specialized wheelchairs that were designed to fit each individual patient. One of my biggest pet peeves is to see someone sitting in a wheelchair, slumped over with their arm squished against the side of the chair. That is so undignified, it’s uncomfortable and damaging to the person’s extremity.
Rehabilitation nursing is heavy work. Most patients have deficits in their mobility and require assistance with turning, transferring, and walking. As backbreaking as the work can be, it’s gratifying to take part in helping a patient regain their ability to move independently.
The goal in rehab is to help a person function to their highest level within the limits of their disease or injury and that’s why patients are encouraged to do as much self-care as possible. Nursing interventions might include toileting schedules; Q 2 hour toileting – to help your patient regain bladder function. Goals for other patients may include the ability to manage their chronic wounds or self-administer g-tube feedings.
When a person experiences a catastrophic event that results in disability and long hospitalization, treatment is focused on every aspect of that person's being. Mental health issues are addressed, and patients are supported emotionally. Support and resources that help families learn to cope with their loved one’s illness or injury is provided to family members.
Like most nursing positions, rehab nurses twist and turn like Olympic superstars while trying to finagle a difficult to reach dressing or maneuver around all the patient’s tubing, and medical equipment. No matter how hard we try to maintain proper body mechanics – sometimes it’s just impossible. After eight years working in rehab, I herniated two discs in my neck – C5, and C6, the herniations caused nerve impingement and chronic neck and shoulder pain. As much as I loved the constant movement, dynamic nature, and daily challenges of rehab nursing, after eight years my neck hurt too much to continue working in such a physical type of nursing.
I left Gaylord Hospital and got a position at a small community hospital working on a post-op surgical floor. More about that in another post!
Tell us about the kind of nursing you do in the comment section below.