TIRR Nurse Sees Rehab Nursing as "Special Calling"

Ann Gutierrez, a longtime rehabilitation nurse at The Institute for Rehabilitation and Research, recently returned from the 100-year anniversary celebration of Texas Woman's University with another honor to her credit. The TWU College of Nursing honored their 100 most outstanding alumnae, and Gutierrez was among the honorees.

For Gutierrez, rehabilitation nursing is the best kind of nursing. It involves the essence of caring, she says. Gutierrez shares this thinking with patients, their families and TIRR staff as program educator for the Spinal Cord Injury, Comprehensive Rehabilitation, Amputee, and Pediatric Programs at TIRR. She also provides both patient and staff education in the outpatient clinic, the operating room, and urodynamics. She orients new staff, conducts staff development, serves as chairperson of the Nursing Practice Committee, and is co-chair of the Emergency Response Committee. Gutierrez also educates many of the Spanish-speaking patients at TIRR.

As a young girl growing up in East Texas, Gutierrez says she always wanted to be a nurse. She entered TWU's College of Nursing in Denton, and had the opportunity to do her "team leadership" at TIRR during her senior year.

"I fell in love with rehabilitation. During my experience at TIRR, I felt I had found my cup of tea."

After graduation from TWU, Gutierrez worked at TIRR on the 11-7 shift in the Intensive Care Unit. She left to become a missionary nurse in Nicaragua, where her many experiences included delivering more than 200 babies. While in Nicaragua, she developed a love of teaching. Gutierrez worked with mothers in prenatal clinics, teaching them proper nutrition, how to care for themselves and their families, and to prepare for the arrival of a new baby. She also saw children in well-children clinics and instructed their parents how to prevent problems related to poor nutrition, diarrhea, colds, viral and bacterial infections, malaria, parasites, etc.

Gutierrez became familiar with the Hispanic culture, and lived in an area where there were few Americans. She worked in Nicaragua from December 1967 until September 1978, when she escaped home to the United States with her husband and two sons in the midst of the Nicaraguan Civil War. Gutierrez says her experience in Nicaragua served as a training ground that provided her with opportunities for gaining a large base of knowledge, problem solving skills, and the ability to think critically.

She returned to TIRR in October 1978 and has been there ever since.

The roots of rehabilitation nursing can be traced to Florence Nightingale, Gutierrez says. In her book Notes on Nursing, Nightingale stated, "Whatever a patient can do for himself, it is better, i.e. less anxiety, for him to do for himself...." In providing care for a catastrophically injured person, rehabilitation nurses look at the whole person, not just the heart, the lung or the leg. The rehabilitation nurse is called upon to be many things and persons to the patient.

"The rehabilitation nurse provides the opportunity for each person to become an expert in his or her own care, and does this in a way that gives the patient the choice, and does not force learning," Gutierrez says.

Rehabilitation nurses act as coordinators of the patient's care, and incorporate therapies the patient has learned into that individual's everyday life. Rehabilitation nurses also act as advocates for the needs of the patient to the medical staff and other team members. Finally, rehabilitation nurses play an important role in how patients, families, and significant others deal and cope with a catastrophic injury or event.

"Rehabilitation nurses assist patients and their families in putting together the pieces of the puzzle of their lives. This assists them in returning to the community and to their roles as productive members of society," Gutierrez says. "Rehabilitation nurses must face the challenge and not miss the opportunity to lead the way in the next century in providing research-based clinical practice guidelines for better patient care. We must provide the most current information and teach the most appropriate techniques to patients and their families, so they will have the opportunity to select the best way of managing their care needs," she explains.

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©2006 Texas Medical Center

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