My Specialty

Acute Rehabilitation, Shannon Bocalbos, PIH Health Good Samaritan Hospital

Helping patients regain independence after serious illness or stroke

Shannon Bocalbos RN, BSN, CRRN
Department Supervisor Inpatient Acute Rehabilitation
PIH Health Good Samaritan Hospital
Los Angeles

Tell us about the arc of your nursing career.

I’ve been a rehab nurse for 21 years. I became a nurse back in March 2001. I had originally wanted to focus on emergency nursing, but when I was a new grad, the CNO at one of my former employers offered me a position in the inpatient rehab unit. Within 12 months, I was offered a charge nurse position. Since then, my love of the specialty has grown exponentially.

What is the inpatient acute rehabilitation unit and what is its mission?

It’s a 23-bed inpatient unit where we focus on helping the patient gain increased independence in the activities of daily living.

We see patients who have suffered debilitating illnesses or incidents such as strokes; who have neurological disorders that require intensive therapy to increase the patient’s quality of life; and who are recovering from major surgery, including heart surgery and spinal surgery. PIH Health Good Samaritan Hospital has Comprehensive Stroke Center certification, so the majority of the patients on our unit are stroke patients.

We get people ready to go back into the community and lead the most functional and independent lives possible based on their condition, age, potential for rehabilitation and other crucial factors.

What do you love most about your specialty?

In rehab, you get to see the positive outcomes from the hard work that patients do. Patients come into the unit requiring a lot of care from both therapy and nursing.

When they leave, usually within 10 to 14 days, they more often than not are able to experience modified independence, meaning they can go about their daily lives with a minimal amount of assistance. That’s basically the goal of the inpatient rehab setting: We not only provide positive outcomes for patients, but also improve their overall quality of life after surgery, stroke or other health event.

What are some common patient struggles that you see?

As nurses, we tend to focus a lot on the physical aspects — we want patients to get physically better. If we’re not careful, we can lose sight of the emotional and spiritual aspects of the patient’s loss and grief. The psychosocial issues are very important.

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We have some patients who realize how debilitating their illness is, which can be very hard. Patients can also lose sight of the nonphysical parts of rehab, so we need to help them keep that focus.

How does a rehab nurse help a patient on all of those levels?

We have a core group of team members who provide our patients with multifaceted support. In addition to nurses, there are therapists, social workers, physiatrists, chaplains and case management coordinators. Our nurses and rehab team lean in and make sure patients’ needs are met. We also actively encourage patients’ families and loved ones to be an essential part of the team.

How has COVID-19 impacted family involvement?

I’m a big believer in family involvement and support — it’s one of the biggest factors in patients’ rehabilitative recovery. Unfortunately, the pandemic really limited how much families could be involved.

We needed to curtail visiting hours for families, so we had to be creative and innovative in finding alternatives. From the very beginning of the pandemic, the hospital provided iPads for patients so they could maintain their connections with family.

It wasn’t the same as having them at the bedside and holding their loved one’s hand, but it certainly helped mitigate the stress and the loss involved in the limitations imposed by the pandemic.

What characteristics do you look for in rehab nurses?

As with all forms of nursing, I look for nurses who are motivated, thoughtful and hardworking. To be a rehab nurse, you need to be very patient and conscientious. Rehab nurses also need to be go-getters who have a proactive attitude and are always willing to take the initiative. In rehab nursing, you deal with a wide array of people, including families, patients and colleagues.

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Rehab is not a nursing specialty based on adrenaline; it’s focused on relationships. You have to be on top of your game, and you need to provide unlimited amounts of education and emotional support — not just for patients, but also for patients’ families.

Rehab nurses need to be invested in helping patients experience the highest level of dignity possible during this process, and in facilitating the most seamless possible transition home. You need to empower patients and help them live as dignified human beings, no matter their disability or rehab status upon discharge.

The work is very physical. It’s very similar to what a PT or OT will do: There’s a lot of gait training, therapeutic interventions and exercises. When the physical therapists go home for the day, the nurses are still there around the clock.

We have to remain involved to ensure that rehab continues 24/7 during the patient’s stay, which can be as long as three to four weeks.

What about certification?

When I became a rehab nurse more than 20 years ago, I wanted to complete my certification, but I actually didn’t receive mine until about five years ago. Each nursing specialty has its own certification, and I always highly recommend getting certified in something that you love to do, which is also true for rehab. Certification demonstrates expertise and unwavering professional dedication to one’s specialty area; it shows your willingness to go beyond normal expectations.

Skilled nurses without certification can certainly find a position in rehab nursing. Once they enter the specialty and find they love it, then the CRRN certification is something I strongly recommend.

What are your career plans from here?

I’m not discounting the possibility of obtaining a master’s degree in nursing, but no matter what the future holds, my passion lies in gerontology. Our average patient in the acute rehabilitation setting is an older adult, and I would like to specialize in that population, perhaps in the role of clinical nurse specialist.

In my Filipino culture, a great deal of respect is paid to elders. I remember even as a young child wanting to help people and make a difference in the lives of others.

My professional focus is on increasing awareness of the needs of older adults and creating policies that promote safe and effective patient care and positive outcomes. I feel that we can do a great deal more to protect this population. The elderly can end up in such unfortunate circumstances without proper support.

If a patient on our unit doesn’t have anyone to rely on, I go out of my way to reassure them that we’re there with them every step of the way. I let my patients know beyond a shadow of a doubt that we’re their family while they’re under our care.


KEITH CARLSON, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and offers expert professional coaching at www.nursekeith.com.


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