You take each moment as it comes to you in life, never thinking anything could happen and then bam…you land in the hospital for injuries or surgeries. Things that are out of your control. By this happening your body starts to become decompensated due to the immobility changes and pain that inhibit you from moving about. Whatever the issue it is you need to mend and get to a better place of independence and well-being. So, it begins in the hospital as Physical therapists begin the process of movement and exercises all based on the doctors’ orders. Nurses and nursing assistants also help in the process from the moment the patient is awake, alert and oriented and willing to learn and understand the necessity to regain their mobility and independences. I took care of open-heart patients and they were out of bed post operatively within 12 hours of coming out of surgery baring any problems. As a patient myself with a colon resection and ileostomy I was out of bed the next morning and the ileostomy nurse at the bedside helping to guide me through the care. I knew a lot from taking care of my own patients, but when it’s yourself, you kind of have to put your brain in a different frame of mind to get better. The goal at this time is the Rehabilitative phase where we are to restore our patients to the highest level of functioning. Also, the goal of restorative care where we try and keep the patient at the level achieved by the rehabilitation.
Rehabilitation services are aimed at helping different areas from physical needs which focus on helping individuals regain function and mobility. Cognitive services are designed for individuals recovering from brain injuries or cognitive impairments. Therapies are designed to improve memory, attention and problem solving enabling the individual to regain independence in their daily activities. Addictions to substance abuses are designed for the individuals with detoxification, therapy and after care for the long-term support. Mental health services focus on offering medication assist therapy and sometimes use a holistic approach to address conditions such as depression and anxieties.
There are nine problems related to inactivity and immobility you should be aware of: loss of self-esteem, depression, pneumonia, UTI (urinary tract infection), constipation, blood clots, dulling of one’s senses, muscle atrophy (wasting away), and contractures. As nursing assistants, you should never ignore any setbacks residents may develop, you need to report to your team leader based on the chain of command. You will encourage and guide your residents/patients to recovery helping to develop and gain their independence. Depending on what the situation is with your patient/resident take your time in helping them never rushing the tasks that they are learning and break down into simple steps as needed so as to not overwhelm and cause anxiety and frustration.
When residents/patients have a regular routine of exercises and ambulation (walking) they will help to improve their circulation and blood flow, strength, mood, self-esteem, appetite, bowel elimination and oxygen levels. There are assistive devices that can help your patients perform their activities of daily living providing impendence and self-worth. Some of the devices you may need to learn how to use and help the patients are walkers, rollators and canes from a single foot to a quad foot base. Your patients need to be encouraged to use the devices to prevent any further injury or falls. Of course, never use any device without the approval of the physical therapist or team leader. Walkers are used when one has difficulty with balance, but are able to put weight on both legs. Walkers should be available to each unit. If they are not asking where they are stored would be helpful to you. Canes are used for patients on the stronger side of their body. Again, do not use unless permission is granted. Some patients do not realize they may need more help than not. When you are walking with your patients/residents make sure that their bodies are in alignment to the devices and that you are next to them guiding them and praising them on their accomplishments that they are making. This helps to gain their trust, and self-esteem and even their pride knowing they are helping themselves to a better day. It’s always what you are doing for today, yesterday is past and tomorrow is our goal. This is why rehabilitation is so important to helping individuals overcome various health challenges.
