After a lengthy stay in an acute care hospital, many people who have suffered a serious injury or illness are not yet ready to return home safely. Oftentimes, their body is too weak to perform activities of daily life.
For these individuals, the logical next step is an intensive inpatient rehabilitation facility where they can both continue to recover and work towards regaining independence to return to their daily lives. That’s where Madonna Rehabilitation Hospitals comes in.
Comprised of a Specialty Hospital – also known as a long term acute care hospital, or LTCH – and an Acute Rehabilitation Hospital, Madonna specializes in rehabilitation of spinal cord injury, brain injury, stroke cancer and complex medical conditions. With the emergence of COVID-19, the hospital has also seen an increase of post-COVID patients needing inpatient therapy after defeating the virus.
Nurses at Madonna, especially those who work at the Specialty Hospitals on the Lincoln and Omaha campuses, are tasked with balancing providing care for even the most significantly impacted patients while also working toward the ultimate goal of rehabilitation. Last year alone, Madonna served 848 patients in their Specialty Hospitals in Lincoln and Omaha.
“Every skill you see on different floors at an acute hospital, we have all on one floor together,” said Jackie Anderson, Director of Nursing for Madonna’s Omaha Campus Specialty Hospital. “And, because we’re Madonna, we also start rehabilitating them right away. That combination of managing medical conditions and providing therapy is a really unique way to care for patients.”
Patients that come to Madonna’s Specialty Hospital many times have similar needs to patients in intensive care. Some are still on a ventilator or have a tracheostomy tube. Many also need assistance with basic skills, like walking and showering.
“The high acuity of our patients, and the high care needs they have is always a surprise to people,” said Alyssa Nelson, a registered nurse and clinical nurse supervisor. “A lot of our patients come from ICU. That’s always a surprise to people.”
Through a combination of physical, occupational and speech therapy, patients are able to improve strength and stamina. Expert respiratory therapists are also a staple for many patients on the Specialty Hospitals, especially for those weaning off of a ventilator and increasing lung capacity. Not only are Madonna’s therapists able to identify and problem solve for more common problems with rehab patients, they also develop solutions for new problems that arise with new or complex cases.
“For example, we noticed that many of our post-COVID patients have an uncoordinated breathing pattern that is inefficient and was resulting in their inability to progress with functional activities,” said Madonna physical therapist Alison Hays. “So we created Breathing Group, where we work on pairing a body movement with the breath cycle to encourage coordinated patterns. We’ve had remarkable success in teaching these new breathing patterns to patients.”
The average length of stay for someone on Madonna’s Specialty Hospital is about 30 days, which allows patients to not just learn skills and techniques, but master them and provide a solid foundation as they move toward independence. The average length of stay also allows nurses and therapists to form bonds with patients and watch the success story unfold.
“We just have everything here, the best of both worlds,” Anderson added. “The high-skilled acuity to keep skills up and we get time to build relationships. I don’t think you can ask for anything other than that from nursing.”
In addition to physical care, Madonna’s nurses provide emotional support during a patient’s stay. The rehabilitation journey is often not linear, and building that nurse-patient trust allows nursing staff to celebrate a patient’s wins and also comfort them on the tougher days.
“We’ve been through this and we’ve seen people get through this,” Nelson said. “Eventually for a lot of people, we do see the positive outcomes. It’s our job to remind them we’re always here to help them.”
When a patient is ready to leave Madonna, they, and their caregiver, are extensively trained by nursing and therapy staff on how to safely return to their daily lives. Training is tailored to each patient’s goals, hobbies and independence level.
Nelson said working with a variety of patients at Madonna, from post-COVID to stroke, brain injury or spinal cord injury, brings a new and exciting challenge every day, and she feels valued as a nurse.
“We get to see those great outcomes that everybody is hoping for,” Nelson said. “We get to see people finish their journey that they started in acute care. The patients that we take care of are unique and special. I just don’t have a desire to work anywhere else because of that.”