Community hospitals are key in the further rehabilitation and care of patients discharged from acute or emergency settings.
Promoting independence for older people has shaped local and national health policy, and has led to an increase in the number of specialist rehabilitation units. In an undergraduate nursing programme, the importance of grasping the concepts of multi-disciplinary team working and leadership and the need to understand the full patient journey - from acute units to community settings - is crucial, as it ensures future nurses become aware of the entire healthcare process.
My most recent placement, in a community inpatient unit, gave me the opportunity to see the breadth of care needed amongst rehabilitating patients - those in the latter stages of the patient journey. I was a little apprehensive about whether a rehabilitation environment, with a set of admission criteria in this instance, would be fast-paced enough for me to feel like I was learning as much as I perhaps could in another area of care.
I was wrong. As the weeks went by I was amazed at the pace as well as the level of leadership and teamworking the staff demonstrated. I worked with a wonderful variety of healthcare professionals, from physiotherapists and social workers to those assisting with mobility and home care. There was a real sense of holistic nursing in practise and I felt privileged to be a part of the process. I built on core skills in assessing, communicating, pressure-area monitoring and wound healing. I recognised my emerging passion for palliative and end of life care, and involved myself in a number of discussions with my mentor about the skills to equip yourself to ensure you are delivering quality care in this area. In turn, this meant I felt confident and supported in practising syringe driver preparation, pressure area care and pain management and able to use my ever-developing clinical judgement to provide high quality care for patients as well as my care after death skills in helping relatives through the initial bereavement process.
This area of nursing provides key opportunities to build on a wealth of core and principle nursing skills. I vow to remain optimistic and open about any and all learning environments from now on.
I have put together the following rehab tool which I hope will be of assistance to you if you experience this placement area:
R – Recognition, Reassurance and Rehabilitation
It is important that we as professionals recognise patients’ self-care abilities and promote these through empowerment and belief. Reassurance can be used to help patients remember they are on the road to recovery and rehabilitation.
E – Exercising
Exercise can encompass mobility, communicating and developing self-care skills, such as independent eating or transferring. All forms of exercise will be crucial in helping patients remain safe in any environment.
H – Helping Hand
Ensure that you empower the patient to seek independence and provide assistance only where necessary. Helping patients regain independence is one of the keys to rehabilitation nursing.
A – Assessment
Thorough assessment of the individual and family’s needs should be incorporated into daily nursing care to recognise where nursing intervention is needed.
B – Behaviour
Recognition of certain types of behaviour, such as reluctance to partake, can be a sign of patients needing more input from us as nurses. Ensure you adopt a compassionate and empowering approach when helping any patient.
Callum Metcalfe is a second year student nurse studying Adult nursing at University of East Anglia