Internal Medicine

REHABILITATION AND RHEUMATOLOGY SERVICES INPATIENT CARE

Inpatient Rehabilitation Unit

Rehabilitation is a term used to describe the process of recovery from a disabling illness or injury, to a point that results in the individual’s maximum physical and mental functioning. 

At the Saint John Regional Hospital, the Rehabilitation Unit refers to a specialized setting that accepts patients who are over the acute phase of illness or injury, and who require a structured inpatient rehabilitation program.  Patients who are accepted into the Internal Medicine Rehabilitation Unit must be physically able to participate in three hours of intensive therapy per day.  Generally, patients are under the age of 65 and are not considered “frail”.

The Internal Medicine Rehabilitation Unit at the Saint John Regional Hospital is located on the 4^th floor (4CS), and is able to accommodate 12 patients at any given time.  Care is delivered to patients by an interdisciplinary team and is individualized around the patient’s needs.  Many different professionals can be involved in a patient’s Rehabilitation Program including Nurses, Physicians, Psychologists, Dietitians, Physiotherapists, Social Workers, Recreation Therapist, Occupational Therapist, Speech Language Therapists, Prosthetic Specialists, Clergy and other rehabilitation support staff.

With the many professionals involved in the rehabilitation process, it is necessary to have one person available who can coordinate services and ensure that the care plan is appropriate.  This person is called the Case Manager, and it is his or her job to make certain that the patient receives the most benefit from his or her rehabilitation.  The Case Manager identifies those resources, and those resources necessary once the individual is discharged from the Unit.  As a facilitator, the Case Manager removes any obstacles that may slow a patient’s progress.  The Case Manager also provides ongoing support to patients and families.  Since the introduction of Case Management, the rehabilitation process has become more focused and “seamless”. 

Immediately after the acute phase of hospitalization, the Case Manager works with the individual Nursing Units to begin the rehab process for the patient until the individual is physically transferred to the Rehabilitation Unit.  For those individuals who have suffered a stroke, this has made a significant difference. 

Rheumatology Services

Rheumatic diseases, which encompass a spectrum of over 100 different disorders, are known to affect 1 in seven people.  Many of these disorders cause severe limitations in life style and can require moderate to acute medical intervention.  The main goal for treating patients with rheumatic disorders is to assist individuals to learn to manage the challenge of a chronic condition.

One of the most common rheumatic diseases is Rheumatoid Arthritis (RA), an inflammatory joint disorder that affects one in 100 persons.  RA often shows itself by pain, swelling, and stiffness in the joints and can be accompanied by fatigue and reduced flexibility.  Most people know of someone who has Rheumatoid Arthritis.

Rheumatology includes two distinct components:  (1) inpatient care for patients with acute needs; and (2) the Rheumatology Wellness Program which includes a follow-up service.

Inpatient care for Rheumatology patients may be required for those who have complex medical problems, and for those requiring a more lengthy period of observation and assessment to determine a diagnosis and treatment plan.  The average occupancy for Rheumatology beds is 90%.  Patients suffer from a range of Rheumatic diseases including Rheumatoid Arthritis (RA), Osteroarthritis (OA), Lupus, Polymyositis, Bursitis and other inflammatory diseases.

The Rheumatology Wellness Program has several components aimed at diagnosis and treatment as well as promoting education and self-management skills needed to face the daily challenge of living with a chronic illness.  The Program has a multi-disciplinary Team that includes a Rheumatologist, Nurse Case Manager, Physiotherapist and Occupational Therapist.  Patients may be involved with the Team as an inpatient, or may enter the Program as a Day Medicine outpatient usually referred by the Rheumatologist.  Each patient is assessed and evaluated by the Team and an individualized treatment plan is developed.  This involves follow-up visits with the Nurse Case Manager as well as participation in four weekly education sessions.  During these sessions pain management, joint protection, exercise, nutrition, medications, and overall health management are discussed.

The goal of the Rheumatology Wellness Program is to educate and support all patients in the self-management of a difficult and chronic illness.  Patients are encouraged to include family members or other support persons in the understanding and management of their disease, and to access available support networks, such as the Arthritis Society, to assist them with their treatment goals.

Last Updated: 2005-07-21