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Merry Dreier (right), RN, CRRN, ONC, a rehab nurse at Marianjoy Rehabilitation Hospital in Wheaton, Ill., makes sure patients are continuously working toward their specific rehabilitation goals. Here, she reviews the patient education notebook with orthopedic patient Judy Gustafson.

The elevator door opens onto the second floor of the Marianjoy Rehabilitation Hospital in Wheaton, Ill., and it's quickly apparent what kind of unit this is. A row of wheelchairs lines the wall. At the end of the wide, blue-carpeted hallway is a busy nurses station and shiny, steel walking and exercise devices. The men and women using these devices are moving slowly.

This wing, housed in a facility near Chicago, is where people come to rebuild themselves. Marianjoy is, in essence, the second leg of their long journey back-usually after many days spent recovering somewhere else from a gunshot wound, a motorcycle accident or a hip or knee replacement. They come here to work their bodies in great and small ways, and to regain at least some of the normal movements and activities of the life they used to know.

This is where Merry Dreier works. Dreier, RN, CRRN, ONC, is one of more than 100 rehab nurses at Marianjoy. While she floats occasionally to various parts of the hospital-and thus has tended to nearly all types of cases-she works most days on this second-floor wing. The majority of the patients here are elderly people who either have suffered a serious injury or have just undergone any one of a number of joint replacement operations.

A small woman with straight sandy brown hair and glasses, Dreier exudes a good natured but no-nonsense demeanor. She's been practicing rehab nursing for 14 years and has written numerous articles about various aspects of her work. Observing her on the job for several hours on a recent winter morning, NURSEWEEK captured a picture of the work Dreier and her fellow rehab nurses do.

After all, rehab patients are different than most. They are not just trying to mend, but to once again thrive. Although their bodies have already undergone tremendous healing, it is now up to the patients to finish the work. For the men and women who serve as their nurses, that means playing several roles: cheerleader, taskmaster and friend.

Departure

It's just after 9 a.m. and Dreier is saying goodbye. A silver-haired woman is headed home two weeks after arriving from a hip replacement surgery.

Part of Dreier's daily routine is to see her patients off-and there's a lot more to it than just a hug or a handshake.

After chasing down the doctor on call to clear up the woman's confusion about her medication dosage, Dreier spends several moments reviewing home care instructions as well as specific rehab activities with her patient and the friend who has arrived to drive her home. She then helps the woman into a wheelchair and takes her down to the lobby, offering her both words of encouragement and caution for her long rehab journey ahead.

Wearing nothing over her short-sleeved nursing blouse, Dreier rolls her patient through the automatic glass doors of the lobby into the icy winds of a mid-January day as the woman's friend drives up from the visitor parking lot. Rehab nurses, Dreier said, usually see their patients all the way out the door. Helping them move from their wheelchairs or walkers into a car seat is often a difficult and delicate procedure.

"The worst thing would be for them to injure themselves on the driveway and have to go right back upstairs," she said. "And it's happened."

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