Spinal Injuries Unit - Acute and Rehabilitation Inpatient Wards
How we can help you
We are only one of two units in New South Wales providing care for people with spinal cord injuries. We strive to make sure our patients are empowered to achieve their maximum possible level of independence and quality of life. Our aim is that all patients and their carers feel informed and confident about treatment options and are actively involved in planning their care.
Our acute ward has 10 beds while our rehabilitation ward has 20 beds.
We will support you with:
- Respiratory problems
- Bladder and bowel management
- Skin pressure wounds
- Deep vein thrombosis (clots)
- Pain management
- Changes is sexual function
- Mental health.
We are a multi-disciplinary team of health professionals and we work together with you to set and reach treatment goals. Our team includes:
After a spinal cord injury it is likely you will lose up to 4-8kg due to the loss of muscle mass associated with your injury. Your dietitian will conduct an initial nutrition assessment to determine your specific nutrition needs. They will also provide dietary advice and education to you and your family. Our dietitian will continually monitor your weight, food and fluid intake while you are in hospital as your nutrition priorities may change.
The discharge coordinator’s role is to make sure you have a smooth transition from hospital back home. They are also involved in your education program. For example, what bladder and bowel equipment you may need and how to order it at home.
When a patient comes to the unit they would be admitted under one of our specialist doctors. He or she would be your primary treating doctor and would be responsible for your ongoing care through your journey in the hospital and sometimes after you leave hospital. You can expect to see them once a week.
The medical team also includes other doctors specialising in rehabilitation and doctors in training. Their is always a doctor available to deal with any medical problems that you may have.
Considering the complexity of spinal cord injuries we often closely work with other specialists including:
- Orthopaedic surgeons
- Respiratory physicians
- Pain specialists
- Plastic surgeons
- Infectious disease specialists
Our nurses will be involved with your care on a day to day basis. They will:
- help you to practice and achieve your rehabilitation goals
- help you to adapt to a changed lifestyle in a safe environment for you and your family
- provide education and teach you and your family new skills
- help you and your family deal with any issues of grief and loss that you and your family may expeirence
- inform you on how to prevent complications now and in the future
- help manage any pain.
Clinical Nurse Consultant
Coping with a spinal cord injury is very challenging and an important part of the clinical nurse consultant (CNC) is to provide support, education and training to you and those who support you. They will also assist you in making decisions about your personal care. Some of the areas that you may require help with include skin care, bladder and bowel care, autonomic dysreflexia education, and sexuality and fertility functioning.
We hold a patient/family education program every Thursday morning at 11am in the dining area of the Spinal Unit. This program is run with the assistance and support of the Spinal Cord Injuries Australia Peer Support Program.
The CNC will work with you, your family and your care provider to determine how much assistance and nursing related equipment you may require when you leave hospital. The CNC will help make requests for care.
Your Occupational Therapist (OT) will focus on ways to improve your independence with completing everyday tasks. Your OT sessions will initially be completed in the OT treatment area where we have access to a variety of upper limb therapy resources and equipment. As you learn to become independent ome of the OT sessions will be carried out on the ward. You will have 3-5 session per week depending on your level of endurance, medical status, functional abilities and therapy goals.
Therapy goals will be set in collaboration with you and are determined by your interests and motivations.
There will be occasions when your therapist will not see you face to face. During these times your OT will be working on setting up equipment to trial with you such as wheelchairs and mattresses and important administrative tasks related to your rehabilitation such as your home visit report, plans and recommendations for home modifications, organising equipment, and preparing applications and reports.
The treatment room hours are Monday-Friday: 9.00am – 12.00 noon & 1.00pm – 4.00pm.
The OT office is situated separately to the treatment area, at the High Street end of the Level 1 corridor, adjacent to the Physiotherapy Outpatient Reception area.
Occupational Therapy involvement will vary for each person and may include;
- Feeding, drinking, grooming, showering, dressing
- Hand and upper limb exercises
- Home access and modificatoins
- Work and study options
- Leisure activities
A major component of your OP program is set-up and prescription of equipment to assist you to regain independence. Much of this equipment is specialised and requires ongoing assessment and reviewing to optimise your function, comfort and safety.
OTs have specialist knowledge in seating and mobility relating to power drive wheelchairs and manual wheelchairs, mobile shower commodes, electric beds, pressure care mattresses and transfer devices such as hoists and slide boards.
You will trial various options of equipment, depending on your needs, and specialised equipment required for ongoing use will be ordered through available funding sources.
Home access and modifications
Your specific needs will be discussed with you. Where necessary a home visit will be made to identify what modifications can be made that will support you to stay safe and independent within your home. Home modifications rely on accessing funding. What funding is available will vary depending on where you live.
Work and study options
Another part of the OT program is a service called In-Voc which provides vocational rehabilitation. In-Voc works collaboratively with you and your current employer to help you to identify and explore work or study options.
Various leisure pursuits will be introduced to you. You will be invited to join the rehabilitation team in regular outings arranged by the sports and recreation officer. No allied health therapy sessions take place on scheduled outing days
A spinal cord injury is considered a traumatic event and is often life changing. It will affect you physically, emotionally and socially. These challenges and difficulties can initially appear devastating as virtually all aspects of life is disrupted. At this time, you may not know what to expect from your injury and may find it difficult to make sense what has a happened.
You will be seen by a psychologist following your spinal cord injury who will work with you to address your individual needs. These needs may be addressed by yourself or with your significant other or family. The psychologist commonly assists with:
- Counselling for psychological reactions such as shock, anger, disbelief, grief
- Therapy to address your beliefs about your sense of self and your future
- Counselling relating to altered sexual image and functioning
- Stress management and coping skills
- Pain management strategies
- Neuropsychological assessment and referrals when traumatic brain injury accompanies a spinal cord injury
- When necessary, the psychologist works closely with the treating psychiatrist
- Referral to ongoing psychological Services where appropriate
The psychologist is part of a multidisciplinary team, and with your permission will communicate to other team information regarding counselling issues and your progress when appropriate.
Our Physiotherapy team offers specialised knowledge and skills aimed at optimising your physical capacity and independence. The role of physiotherapy will depend on your needs and may include respiratory management, strength, fitness and flexibility programmes, functional task retraining, aquatic therapy and treatment of musculoskeletal conditions.
On the acute spinal ward your physiotherapist will assess your lung function, strength and flexibility and implement a therapy program based on your needs. Your physiotherapist will work closely with other members of the team to get you up and moving as soon as possible. Once you are medically well enough, your physiotherapist will commence your rehabilitation program in the physiotherapy gym setting.
Your first gym session(s) will involve different assessments to look at your strength, flexibility, endurance and ability to perform various functional tasks. From this assessment your physiotherapist will be able to identify your specific physical problems and needs to develop an individualised physiotherapy program. All spinal cord injuries and people are different, therefore your physiotherapist will work closely with you to optimise your potential function and achieve your personal goals. Some of your physiotherapy sessions may also be held on the ward to look at various aspects of your function. This is to make your function part of your day to day living and help with the transition back to life at home.
Your physiotherapist will also work with you to plan for leaving hospital. This will involve investigating options for ongoing exercise (home exercise program, equipment or ongoing services) to maintain and perhaps even further improve your function. This will be different for everybody and therefore your physiotherapist will tailor your plan to your ongoing goals and home environment.
Respiratory function may be affected with injuries above T12. This may affect the ability to take a deep breath, or to cough. Your physiotherapist may be involved with assisting and implementing strategies to improve your ability to cough or to breathe in.
Strength training program
Weakness is a common consequence of spinal cord injury and can have significant effects on one’s ability to perform day to day tasks. Your physiotherapist will provide you with a strength training program targeted at key areas to assist your function. This may involve strengthening the muscles above the level of your injury, or optimising muscles that have neurological weakness. Muscles that are completely paralysed do not respond to strength training.
Cardiovascular fitness program
Maintaining your fitness is beneficial for your cardiovascular health, stamina, well-being and ability to perform day to day tasks. Your physiotherapist will work with you to build a fitness program suited to your function.
Maintaining flexibility and preventing joint contracture may be achieved by a stretching program. Your physiotherapist may prescribe splints or various positions as part of your stretching program. Your stretching program will be tailored to your needs to optimise your function.
Spinal cord injuries involving the cervical spine may result in changes in the upper limb and hand. The severity and level of your injury will determine the changes and the effects on upper limb function. Your physiotherapist will work with the occupational and hand therapists to optimise your ability to use your upper limbs.
Your physiotherapy program may involve the hydrotherapy pool. The pool can be used for therapeutic and also recreational purpose (eg return to swimming or water sports). There are certain criteria that we require for any patients using the pool. This can be discussed further with your physiotherapist.
Treatment of musculoskeletal or orthopaedic issues
Injuries to other parts of the body may be sustained following your spinal cord injury, such as shoulder pain, fractures associated with your original injury. Your physiotherapist may be involved with managing and progressing these injuries throughout your rehabilitation program.
Functional task retraining
No two people with a spinal cord injury are the same, therefore everyone undergoing a rehabilitation program will have unique goals. Your level of injury and the severity of your injury will impact on what goals you may work on with your physiotherapist and the functional training you may undertake. Your physiotherapist will tailor your rehabilitation program and functional task retraining to optimise your ability to perform various tasks. These tasks may involve improving your upper limb function, ability to get in and out of bed, ability to transfer, use your wheelchair and or to walk.
Equipment and exercise prescription for discharge home
Your physiotherapist will provide you with a tailored home exercise program to continue when you leave hospital. Various equipment may be needed for you to perform this program, and will be dependent on costs, insurance status, space and access at home. Your physiotherapist will work with you to discuss appropriate options for your situation.
Ongoing Physiotherapy / Maintenance program
When leaving the hospital some people may need an ongoing maintenance program, whereas others may require ongoing physiotherapy input to achieve outstanding physiotherapy goals. Your physiotherapist will discuss what your ongoing physiotherapy needs may be and discuss suitable options with you.
Physiotherapy Service Times
Physiotherapy Spinal Service from 8.00am-430pm Monday to Friday.
Gym Opening times: 9am-12pm and 1pm-4pm Monday to Friday. Sessions as per patient timetables. Our partners
Sport and Recreation Officer
Sport and Recreation is an important aspect of life. This is no different for people who have had a spinal cord injury.
The Spinal Injuries Unit has a Sport and Recreation Officer who will assist you to pursue your particular sporting and recreational interests.
The Sport and Recreational Officer organises monthly community visits and other activities away from the hospital. These are very important because they not only provide a break from regular treatment programs but are also very beneficial in the process of adjustment back into the community.
As well as these regular community access visits, the Sport and Recreation Officer will arrange attendance and participation in a variety wheelchair sports ‘come and try’ sessions and other activities which frequently occur outside normal working hours.
The Sport and Recreation Officer also can advise you a many other aspects of your recreational life such as access issues, public transport, accommodation, travel, etc. and has a wide range of resource material to which you can refer.
From a clinical perspective the Sport and Recreational Officer works in the Physiotherapy Department and assists the physiotherapists with your physiotherapy program, conducts any hydrotherapy sessions (under the guidance of the physiotherapists) and will be responsible for any wheelchair skill training where appropriate.
The Social Worker is here to assist and support you, and your support networks with practical assistance, as well as the grief and loss issues you may experience because of your injury.
It is normal for people to experience shock and disbelief about what has happened to them after a spinal cord injury. Social Workers offer a confidential environment for you to discuss whatever you may be concerned about and help you to deal with the adjustments you may now require.
Many practical matters still need your attention when you are admitted to hospital. We can guide you on community services and supports, government assistance available and potential funding which may be available. Social Workers can help you access these different resources and help you to apply for them.
Social Work can assist in the following areas:
- Finances – Centrelink/income protection/superannuation
- Legal matters – Assisting you to contact agencies who can provide information
- Transport – Making you aware of community services and entitlements
- Personal care – Arranging for appropriate care at home when needed
- Insurance – Liasing with your insurance agency
- Accommodation – Assisting with applications for Public Housing or rental
- Equipment – Help to apply for equipment which may be needed on discharge
- Links to community support organisations
We also offer a number of social and other events including:
Community Access Outing
Different each month
Spinal Unit Dining Area
Physiotherapy Sport and Fitness Group
Spinal Unit Dining Area
Upper Limb Group
Occupational Therapy Dept
Thursday every 2- 3 weeks
Please let us know if you need an interpreter. You can contact us telephoning the Translating and Interpreting Service (TIS) on 131 450. Tell the operator what language you speak and then ask the interpreter to set up a telephone conversation between you, an interpreter, and the healthcare professional you want to speak with.
We are a teaching hospital and you may be asked to be involved in research or for a student to be present at your appointment. You have a right to say no. If you do so, this will not impact in any way on the services we will provide.