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Implications and Experiences in Postacute Care—Rehabilitation, Long-Term Acute Care, and Skilled Nursing

ARN Board Member Mary Ellen Hatch explores long-term COVID-19 implications in new article 

Last year began with plans to celebrate nurses as the World Health Organization designated 2020 as The Year of the Nurse and the Midwife. Then just a few months into the new year, the COVID-19 pandemic created a massive challenge that nurses and healthcare providers worldwide stepped up to handle. Now as these same nurses and healthcare providers begin reflecting on the past year to both continue fighting COVID-19 as well as to begin assessing how to take steps into a post-pandemic future, leaders like Mary Ellen Hatch, MSN RN CRRN, are beginning to publish their insights and experiences.  

A current ARN board member, Hatch is also vice president, nursing operations, for ARN Institutional Member Encompass Health. In this capacity, she has seen firsthand how nurse leaders have stepped up throughout the COVID-19 pandemic to a seemingly unending marathon of crisis management. In a new article titled "Implications and Experiences in Postacute Care—Rehabilitation, Long-Term Acute Care, and Skilled Nursing," published in the journal Nursing Administration Quarterly, she shares some of what she's learned from this past year and what she expects for the future of rehabilitation nursing in a post-COVID-19 world.

Backed by published research and interviews with postacute care providers, Hatch shows how waivers announced by the Centers for Medicare & Medicaid Services (CMS) allowed long-term acute care (LTAC) hospitals and in-patient rehabilitation facilities (IRF) to treat COVID-19 patients facing an extended recovery. These so-called "COVID long-haulers" have much to gain from the postacute specialization of these healthcare settings, and finding postacute treatments for COVID-19 patients helps free valuable space for new patients as well.

Postacute care nurses are experienced in patients needing longer lengths of stay, as well as the complexities of witnessing the sometimes subtle improvements patients may experience in this stage of recovery. They also have experience coping with staff burnout among their peers and colleagues, though the pandemic has brought issues of depression, anxiety, and overwork to unprecedented levels among healthcare professionals.

We are still learning about the long term effects of COVID-19 and the various health conditions that may accompany a patient even after recovery. As the medical field continues to address the ongoing crisis, Hatch makes the compelling case that postacute care nurses will play an integral role — after all, it is in postacute care that "long-haulers" will spend the majority of their recovery. As long as CMS's waivers are in place to grant COVID-19 patients access to postacute care, expect these specialists in respiratory diseases, long-term recovery, and transitioning into different levels of healthcare to be on the frontlines.

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