Toronto Rehab nurses
The graduates: Registered Nurses Thania Nolasco (left) and Rosemarie Pinnock (right), with Advanced Practice Nurse Educator Wanda Kiersnowski (centre). (Photo: UHN)

Rosemarie Pinnock is no stranger to pressure. As a registered nurse in Toronto Rehab's Geriatric Rehab Program, she knows that if she's not on her game, the quality of her patients' care is at stake.

That's why, when presented with an opportunity to go back to school and improve her professional skills, she said 'yes'.

"At my young age, I didn't know if I'd be able to keep up," Rosemarie, 46, says jokingly.  "But I was motivated to make sure that my patients are getting the best care possible."

Rosemarie completed the 12-week Patient Assessment – Rehabilitation course in March. The course was developed by Toronto Rehab, for Toronto Rehab nurses, in partnership with Humber College.

The goal of the course is to enhance the physical assessment skills nurses use every day, as they serve the changing needs of patients.

"Patients aren't coming in with just one condition anymore," explains Rosemarie. "Now, we look at a combination of impacted systems, such as vascular, neuro, cardiac, and abdominal."

A commitment to advancing nursing skills

When Toronto Rehab integrated with UHN in 2011, it became clear the needs of inpatients were different then in the past and there would be an increase in complexity over time, says Susan Jewell, Senior Vice President and Executive Lead of Toronto Rehab.

"To ensure that our teams were well prepared to provide optimal, safe care, we made a commitment to support all our nurses in advancing their skills through focused education. This remains a key priority going forward," Susan says.

To that end, over the past five years, Toronto Rehab has been engaged in a formal strategy called Revolutionizing Care – designed to enable the best care and outcomes possible for patients.

"The most recent phase of this strategy focuses on developing enhanced competencies in patient physical assessment," says Nancy Boaro, Director Professional Practice at Toronto Rehab.

"This course helps us achieve our goal of providing care to complex patients."

Getting a fuller picture

Among other outcomes, the course focuses on enhancing skills in the areas of patient-centred interviewing, critical thinking and diagnostic reasoning, and using evidence-based assessment tools.

The course runs twice a year, from September to December, and from January to April, and the cost of the course and materials are covered by Toronto Rehab.

"My assessment process today is quicker, more detailed, and more accurate than before," Rosemarie says. "I'm asking the right questions, and getting a fuller picture of the patient. I wasn't always getting all that information."

Identifying breathing sounds has become a particular source of pride for Rosemarie, who can now pick up the sounds of crackling or wheezing more easily.

"Before, I wouldn't be too sure what I was hearing," she says.  "But now, I'm more confident. I know the different breath sounds, and where they're located."

'I feel way more comfortable delivering my own findings'

That same confidence is extending beyond the actual assessment and into her partnerships with colleagues and patients.

"I feel way more comfortable delivering my own findings to doctors and therapists because I have data to back me up," Rosemarie explains. "Now, I can say, 'I did A, B, and C. This is my assessment and this is my recommendation."

When patients ask questions, Rosemarie says she's able to explain more about test results, medications, precautions, and expected improvements.

"My knowledge is translating to my patients," she says. "By engaging them with more in-depth information, I'm decreasing their fear and anxiety."

Like anything new, going back to school can seem intimidating at first. But Rosemarie's message to other Toronto Rehab nurses is clear: "Once you jump in, it's awesome. And when you finish, not only do you get a certificate, but you really know your stuff."​

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