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It's far from a commentary that the work is easy, but
Michelle Behrens, RN, can do her job with her hands
tied behind her back. In fact, being a rehabilitation
nurse requires that.
Behrens, 39, works with patients struggling to regain
independent lives at Metropolitan Hospital in Grand
Rapids, Mich. Her patients have undergone orthopedic
surgery, had a stroke or are suffering from deconditioning,
the result of a debilitating illness, and need to get
stronger. "Most of our patients need some type
of assistance with moving. It's a very physical job,"
Behrens said, but "the hard thing is keeping my
hands tied behind my back."
It's tempting to help patients put their legs in bed,
for instance, but if she does that, they learn nothing.
So from 7 a.m. to 7 p.m., Behrens moves them with what
she describes as gentle firmness. "A lot of them
say, 'I can't do that,' and you kind of get at them
and tell them, 'Even though you can't, you have to try.'
Can't translates into won't try."
She said she tried a management role for a summer and
moved back to the bedside, where educating and motivating
patients is her passion. "I'm not going home with
you," she said she tells patients, and explains
that the alternative to reclaiming an independent life,
even if it's one with adaptive equipment, is an extended
stay in a long-term care facility.
Progress comes in inches, small improvements that patients
may not perceive as significant. "You've got to
point it out to them because a lot of times, they won't
see what gains they've made. My patients don't want
to be in rehab after surgery. They want to go home,"
she said.
That's especially true of younger ones, such as those
who have undergone knee replacement. "In today's
society, being such a go-go society, all of a sudden
they're being slowed down. They get very frustrated
and they have a tendency to take it out on us, thinking
it's our fault that we're not getting them better."
To counter such frustration, patients dine together
in the multipurpose room at the center of the 29-bed
unit. It's just down the hall from a physical therapy
gym where among other things they use parallel bars
to reacquire a steady gait, and learn to negotiate vehicles
by slipping into and out of a half-car in the gym. "We
try to encourage camaraderie between the patients. They
all meet for lunch. They're all in the same boat, and
they say, 'I'm not in this alone. All these other people
are going through the same thing,' " Behrens said.
She is equally attuned to the importance of family
support. With widows and widowers, "You notice
they're not as apt to want to go home as quickly as
somebody who has family to support them," she said.
But 90 percent of patients do go home after a few days
or a few weeks. Among them was Behrens' most memorable
patient, a young woman who was a paraplegic as the result
of a stabbing. She "did so remarkably" in
her recovery from multiple injuries, Behrens said. "She
went home and was basically able to take care of herself."
Years later, the two met again when the former patient,
by then out of college, served as the closing officer
on the purchase of Behrens' house. "It was funny
her working for me instead of the other way around,"
she said.
It's when patients wind up in long-term care that rehabilitation
nursing is most trying, Behrens said. "You feel
like, 'Could I have done something more to make them
more independent?' "
But such thoughts quickly give way to the challenges
and rewards of nursing as a career. It was a choice
Behrens made early in life, as a young teen helping
a neighbor with yard work.
"She was a nursing instructor and all the time
I spent working side by side in her yard with her, she
would always talk about nursing," said Behrens,
who graduated from the diploma program where the neighbor
taught surgical nursing. She said she still sees the
retired instructor on occasion and "We still kind
of laugh about how I got into it. I would have to say
she was quite the influence in my life."
Behrens said she can't imagine more satisfying work.
"You can have the most frustrating day," she
said, "but yet you can turn around and a patient
takes your hand and says, 'You know, without you I wouldn't
have made it through the day.' And it's like whatever
bad happened that day is gone. The little rewards mean
so much."
Pulse
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