Brenda Stidham, Maureen Merkl and Selina Doncevic are surrounded by returning service members and veterans suffering from some of the worst wounds imaginable, many the result of explosions while fighting the wars in Iraq and Afghanistan.
Still, all three nurses feel fortunate to be able to witness and play important roles in recoveries they often thought impossible.
As the only three Department of Veterans Affairs/Department of Defense polytrauma rehabilitation nurse liaisons in the country, Stidham, Merkl and Doncevic have the opportunity to assist patients from the time they arrive at Walter Reed Army Medical Center in Washington, D.C., or the National Naval Medical Center in Bethesda, Md., until they are transferred to one of the four VA Polytrauma Rehabilitation Centers around the country.Maureen Merkl, RN
Polytrauma is defined as more than one severe injury, which can include the loss of a limb, traumatic brain injury and burns.
Stidham, RN, MSPH, BSN, is the senior member of the three nurse liaisons, hired at Walter Reed in 2006. Merkl, RN, MSN, CRRN, CEN, CCNS-BC, came aboard in 2008 and works at National Naval. Doncevic, RN, MSN, joined the team in March and also is based at National Naval, although she works with patients at both facilities.
Its a lot of reading reports and reading charts and figuring out whos coming in [and who is going out], Merkl says of the role. We talk to social workers; we talk to the medical team. A lot of the day is spent just trying to assess who will possibly need polytrauma care, who either has a traumatic brain injury or significant injuries, and then working with the team to get them placed in a polytrauma rehab center.
Although the nurse liaisons spend much of their days working at a desk, their offices are where the patients are. This gives them the opportunity to have close contact with wounded service members, their families and other members of the medical team, a part of the job they treasure.Brenda Stidham, RN, MSPH, BSN, is the senior member of the polytrauma rehabilitation nurse liaison team. She has been in the role since 2006 at Walter Reed Army Medical Center in Washington, D.C.
This job really is the culmination of so many things that I love, says Doncevic, who has worked in acute rehab most of her career. I love working with the military the great camaraderie and team effort. No matter if a patient is enlisted or an officer, everyone does 110% to get that person back in action.
The conversations include messages of hope, something the nurse liaisons have seen materialize in astounding fashion. All three have stories of patients who beat insurmountable odds. Merkl recalls a wounded soldier who arrived at her facility with little chance of survival.
We were told this patient was, basically, coming to National Naval to die with his family, Merkl says. He just did tremendously well. Hes home now, leading book groups.
I think the biggest thing Ive learned on this job is never to be pessimistic. Theres always hope, it seems. They just defy what your expectations are.
Nurse liaisons also educate patients and their families about what a VA polytrauma rehab center is and how it differs from being at an acute care facility, such as Walter Reed or National Naval.
In fact, Doncevic says, where theyre going is going to be very aggressive with physical, occupational and speech therapy.
The nurse liaisons work with the VA facilities to make sure the transition goes as smoothly as possible, so Stidham and her colleagues need to know as much as they can about their patients.
We do our own polytrauma nurse assessment, Stidham says. We are looking at any kind of barriers to the rehab process and patient-specific needs that will have to be addressed when they arrive at the polytrauma center.
Stidham has played an important role in improving that process with her work in developing an electronic hand-off tool, a record that provides important information about each patient, such as types of injuries, symptoms and functional status. But Stidham never forgets the nurse in nurse liaison. Thats why when she visits the bedsides of wounded service members, no matter their level of consciousness, she takes time to speak to them.
There were many, many times when there was no response, she says, but when I learned later they were doing very well, I had to wonder, Were they listening, but they just couldnt respond? I think its being a nurse. Whatever setting youre in, youre always a nurse, and youre caring for that patient.
Tom Clegg is a member of the editorial team at Nursing Spectrum.