Pediatric Rehabilitation Nurses at TIRR Affect Child's Quality Of Life

Pediatric rehabilitation nursing is a sub-specialty of the practice of rehabilitation nursing at TIRR (The Institute for Rehabilitation and Research). Many of the underlying principles of care and service for pediatric rehabilitation clients are drawn from both general rehabilitation and developmental pediatrics. Concepts of growth and development are an integral part of pediatric rehabilitation nursing at this nationally known facility. Children are admitted with needs resulting from traumatic injuries (i.e., brain injuries, spinal cord injuries, amputations, musculoskeletal) as well as congenital and acquired physical and cognitive impairments.

Nurses who care for the children treated at TIRR are adept and knowledgeable in all diagnoses, from pediatric to adult. This is because patients benefit from the continuity of care available to them within TIRR's continuum, and many are seen from childhood through their adult years. Nurses are key members of a team that is made up of the highly specialized staff of physicians and rehabilitation professionals who practice a unified, patient focused and interdisciplinary approach to care. They are committed to promoting patient and family growth and development through the years TIRR follows the patient.

"What makes this such a rewarding type of nursing is the involvement with the patient and family member(s) as we work together to give the child the best chance of becoming a productive adult," says Dr. Kathryn Zidek, director, TIRR pediatric program. "As they are key to the discharge planning, our nurses interface with consumer agencies, school districts, and outside companies and vendors, among others."

Areas in which TIRR pediatric nurses are involved are the management of ventilator-dependent patients, wound care, pain assessment and management, as well as patient and caregiver education and training. Nurses and other team members work closely with families so they have the skills needed to maintain and enhance the child's abilities and health.

In addition to caring for inpatients, pediatric nurses are involved in the day hospital program, and the subacute care in the TIRR Stepping Stones Program. Stepping Stones is for the medically fragile and/or technology-dependent infant, child and adolescent. "An important part of our role is to help families come to terms with the illness or disability," says Lois Stephens-Newman, M.S.N., R.N., nurse manager. "Our reward as nurses is that we are doing something for someone else that affects their quality of life, whether it's through training and education to support the child and family's management of care or assessment, planning strategies of care, and intervening in ways that promote the growth and development of the child.

"The infant, child or adolescent we care for at TIRR has lost a pattern or element of his normal growth and development," Stephens-Newman says. "The nurses identify this, and work with the child and parent(s) to incorporate the re-learning of this skill into their care delivery." Examples include eating, elimination, coordinated movement needed for dressing, and play skills to allow families to comfortably interact in a safe and healthy manner with their child, maximizing their abilities.

Nurses who come to TIRR may have a pediatric and/or medical/surgical background, but have not practiced in the rehabilitation environment. Because of the well-developed rehabilitation nursing education program available at TIRR, a nurse with pediatric experience could easily transition to the role of pediatric rehabilitation nurse, Stephens-Newman says.

- NANCY HUDGINS

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©2006 Texas Medical Center

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