95 Professionals’ perspectives of a Challenging Rehabilitation Environment Table 3. Themes involving organizational aspects. (continued) Main theme Brief description Sub-theme Description Staff aspects All team members work in an interdisciplinary way and stimulate rehabilitants to practice throughout the day. Team mix The team should be sufficiently ‘mixed’ in terms of rehabilitation skills and experience. Recommended professionals in the rehabilitation team are: nurses, physical therapists, occupational therapists, psychologists, social workers, case managers, dieticians, speech and language therapists, physicians (elderly care or rehabilitation), and volunteers. Some participants think the nurse needs a name that better reflects the role of a therapeutic rather than caring nurse, for example, “rehabilitation coach”. Regardless of the name, the nurse must be seen as a therapeutic team member. Team dynamics In an interdisciplinary team, each discipline has expertise in a particular area, but team members can look beyond the boundaries of their own field. All disciplines are equal, and there is no (in)formal hierarchy. Working in smaller teams, taking courses together, and therapists working directly on the ward are ways to improve interdisciplinary dynamics. The rehabilitant and their informal caregiver must also be part of the team. Multidisciplinary consultation in the presence of the rehabilitant is preferred and is often used to coordinate rehabilitation goals. Attitude of staff All employees should have an empathetic, motivating attitude in order to involve informal caregivers and stimulate rehabilitants to practice throughout the day. They, therefore, need to be able to see training opportunities in daily activities. The approach of the team is coordinated, so rehabilitants always know what to expect. Staff members ideally choose to work in the field of rehabilitation, are flexible, can set priorities, have an interdisciplinary mindset, and are stress resistant. Training requirements Medical guidelines are not always suitable for geriatric rehabilitants. Staff must be able to deal with this by using evidence-based practice principles, building sufficient experience and having additional training in geriatrics. 4
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