Preparing for your admission
To begin with, it is likely that you will be admitted or transferred to Osborn 1 during your first few weeks at the Princess Royal Spinal Cord Injuries Centre. Here our dedicated staff will focus on supporting you on your journey towards achieving your individual potential in rehabilitation, so that we can help provide you with the physical, psychological and emotional skills to begin this journey. This philosophy will continue throughout your whole stay within the Centre.
The first few days after admission may be overwhelming. You will meet many members of our specialist multidisciplinary team. Over time you will get to know the team, who will work positively and compassionately with you and your family to provide you with the expert care and professional support you need to adapt to your new life, both physically and psychologically.
Remember your rehabilitation starts from the time of your admission and is not restricted to your therapy sessions alone.
The first 24 hours
On arrival you will be met by a member of the nursing team who will carry out a few assessments.
These could include:
- Weight and observations
- Skin check (if you have a pressure ulcer, this may be photographed)
- Recording some information about you, such as your next of kin details
- Assessment of bladder and bowel management
You may need your catheter changing to a larger size. This will be discussed with you in advance if it’s required.
You will meet a member of the medical team who will assess you and review your medical history including:
- Undertaking a full physical examination including neurological assessment
- Reviewing scans and arranging for any further investigations required
- Reviewing your current medication
You will have a named consultant who will oversee your rehabilitation journey. Your consultant will advise you on your current medical condition and care management plans.
Even if you have been getting out of bed or sitting up in bed at your previous hospital, you may need to be on monitored flat bed rest until the medical team are happy that your spinal column is stable. This may require liaising with your previous medical team and sometimes obtaining additional imaging. The consultant review will also address specific issues such as pain and spasticity management.
On Osborn 1, the ward round takes place every Tuesday – this is an opportunity to discuss your management and progress with the multidisciplinary team. There is also a shorter Friday morning ward round but there is medical cover available 24/7 that can be called upon when needed.
What can I expect in the first 48 hours?
You will be assessed by an occupational therapist and physiotherapist within your first 48 hours of admission.
The occupational therapist will complete an initial assessment to gather information about your home and personal circumstances (who you live with, what you do as a job, etc.) and they will also talk to you about what might happen with regards to assessing your home environment ready for when you leave the Centre.
If your upper limbs have been affected you will be assessed for upper limb management, such as splinting, bracing, casting and management of swelling.
The physiotherapist will complete their own initial assessment, this time looking at things like joint range, tone, muscle power and sensation. They may also carry out initial appropriate treatments whilst you are on bed rest.
If your breathing has been compromised the physiotherapist will provide chest care.
You will be seen by or referred to the other members of the multi-disciplinary team such as the speech and language therapists, pharmacists, psychology team and the Dietician if appropriate.
Rehabilitation takes place 24 hours a day, 7 days a week. Outside of your therapy sessions, the specialised nursing team will support you in developing your independence.
Once your team is happy for you to start mobilising (getting out of bed), a member of the therapy team will assess and measure you for an appropriate wheelchair to allow you to get around the ward and building.
The nursing team will initially transfer you out of bed via a hoist until your therapist has assessed for an appropriate transfer technique. You will then be encouraged to gradually increase the time you spend sat out of bed.
Once you are able to sit out of bed for four hours, you will be provided with a therapy programme and start attending sessions in the therapy department. You will be expected to attend all therapy sessions allocated unless you are unwell or have other appointments.
Discharge planningDischarge planning will commence as soon as you arrive with us. It may seem strange to start planning for your departure when you’ve only just arrived, but discharge planning can be a lengthy process as there is often a lot to consider.
You will be allocated a discharge coordinator who will keep you up to date with information about this process.
Around 2-3 weeks after your admission, your discharge coordinator will provide you with a letter detailing your planned discharge date.