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December 2004 - Volume 1 - Issue 5
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People In Medicine Corinne Campbell Romano, RN, BSN, CRRN Knowing When to Hold Hands and When to Let Go Makes Difference

Sometimes physical rehabilitation requires holding hands and sometimes it requires letting go. Itís a simple concept, but one thatís important for caregivers to understand completely because knowing the difference can mean a faster recovery for the patient.

"In rehabilitation, the goal is to make the patient as functionally independent as possible," said Corinne Campbell Romano, RN, BSN, CRRN, Director of Rehabilitation Services at The Rehabilitation Institute at St. Maryís Medical Center in West Palm Beach. "You need to learn when to step back and allow patients to do it themselves, even if it means it will take twice as long (for them to accomplish the task)."

This may mean allowing a patient who suffered a stroke to button his shirt by himself, a patient who had a hip replacement take a few steps unassisted, or a patient who suffered a head injury try to speak clearly enough to order her own lunch.

"In other types of nursing, you score patients based on their disability or what they canít do," said Romano. "Rehabilitation nurses score patients on their ability Ė what they can do."

Rehabilitation patients have a role to play Ė maybe the key role - in their recovery.

"We have to meet our patients where they are," she said, giving an example of a diabetic patient who must take responsibility for testing blood sugar and taking insulin. "In this respect, we transfer the responsibility for their care from the caregiver to the patient."

The nurse-patient interplay is only part of the rehabilitation process, according to Romano. Therapy, she said, goes on during the day, but nursing is 24 hours. Many times, nurses have the opportunity to reinforce concepts and therapies that the therapists introduced during the day.

"In rehab, you canít be successful unless rehab and therapy work hand-in-hand with each other," she said. "There needs to be a synergy between the nurse and the therapist."

That synergy helps both the nurse and the therapist do their jobs better.

"Individuals must have a good understanding of the entire process, of why theyíre doing what theyíre doing," Romano said. "Weíre not turning out a product, but we do get to see the fruits of our labor."

One such incidence occurred when Romano was just three years into her career as a nurse in her native New Jersey. Thatís when a three-year-old quadriplegic became her primary patient. It was, she recalls, one of the first ventilator discharges the hospital made. Romano said she went home with this child, spent the weekend with the family, helped them transition, and even became the school nurse when she was old enough to go to school.

"The reason (this case) was so incredibly influential to me was because I got to see the front and back of the case," she said. "I saw the entire continuum of care, and that changed my way of thinking."

It is precisely this case she thinks of when she requested and Tenet Health Care agreed to pay for all the rehab nurses at St. Maryís to receive their rehab certification. Such a step, she said speaks loudly of Tenetís commitment to the staff and their patients. It also creates opportunities for nurses to learn and grow.

"When nurses are able to see their ability to facilitate change and make a difference in their patientsí lives, then the spark burns brighter and brighter," said Romano, who said she fosters that spark by having an open door policy with her staff. "People donít make an appointment to have a crisis. One of the most meaningful moments I had as director occurred when one of my staff members came to me with a problem. She later told me how much it had meant to her that I had listened to her like she was the only person in the world."

That ability to touch people on an individual basis is one of Romanoís strengths. She says she understands the pressures and challenges her staff face daily, and knows how much the words "thank you" can mean at the right moment. It may seem like silly stuff, but it is far from insignificant.

"Healthcare is incredibly challenging," she said. "It is extremely rewarding to work in an environment where you can get so much back. And you do get a lot back."

Corinne Campbell-Romano, RN, BSN, CRRN, Director of Rehabilitation Services at St. Maryís Medical Center in West Palm Beach, can be reached at (561) 844-6300, ext. 26227.
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