by Cara O'Brien
In the next two weeks Cindy Graff will go on excursions for hunting, fishing, cycling, kayaking, scuba diving and rafting.
Tucked in Graff’s backpack will be sunscreen and water, ventilator equipment, multiple syringes, myriad medications, extension cords, a first-aid kid, saline, a stethoscope, towels and Depends.
Graff is the therapeutic outings nurse for Craig Hospital. It’s a role she’s fairly certain no one else in the country holds, and it’s a job she feels extremely lucky to have.
She is the nurse for the brain and spinal cord injury rehabilitation hospital who is dedicated to going with patients on outings, be they down a roaring river or on a shopping excursion to Target.
“It gets them out, it gets them acclimated to the community,” Graff said. “The more they go out, the better they do.
“They need to relearn a lot, they have new bodies.”
And they have new bodies that were, in many cases, used to a life of risk-taking and high activity. Graff’s job is to make reclaiming that lifestyle medically safe.
“It’s a varied role,” she said.
Graff has been a nurse at Craig for 19 years; and when it became clear five years ago that the facility needed an outings nurse, Graff was the first one with her hand in the air.
The vibrant blonde talks quickly and enthusiastically about her job, and about her patients, and about Craig Hospital, itself.
“I was here a week and I just loved working here,” she said. “I love Craig Hospital.”
In her job she gets to meet most of the patients that come through Craig’s doors.
And she gets to find ways to get them out doing the activities they love.
She has found ways to teach patients paralyzed from the neck down how to pull the trigger on a hunting rifle.
She has taken quadriplegics white water rafting. Patients paralyzed from the waist down get to relearn to bicycle using hand-cycles.
“People will really high level injuries can adapt and do all kinds of things,” Graff said.
“Name an activity, and we probably do it. We don’t believe in the word ‘can’t.’”
Before she came to Craig, Graff had a varied, meandering nursing path. She chose nursing after her plans to compete in gymnastics evaporated with a shattered arm, and she landed in a summer job at a nursing home.
A nurse at that nursing home told her she simply had to go into nursing, and after applying to just one program, Graff found herself in nursing school.
After graduating from the nursing school at the University of Pennsylvania in 1976, she worked on ambulances, in home care, in hospitals and at a camp for developmentally disabled children.
“I have a pretty diverse background,” she said.
She has always had an affinity for neurology and when she decided she wanted back in a hospital setting she applied for an opening at Craig, which met both interests.
Her current job also draws from her younger years, when Graff was involved with sports and planning to become a physical education teacher.
“Pretty much sports was all I knew,” she said.
The bulk of Graff’s job as the therapeutic outings nurse involves preparation and education.
She screens patients before every outing to be sure they are ready for the activity.
And, once cleared, she prepares every medication they will need, all the equipment they will need and readies them and her backpack for every possible contingency for every patient.
In addition to that, she educates the patients and their caretakers and families on the realities of their conditions outside the walls of Craig hospital.
She teaches them how to keep the patient warm given that patients with spinal cord injuries have decreased sensation.
She teaches them that many medications cause increased sensitivity to sun and light.
She teaches them that those in a wheelchair need to take pressure off their lower half to avoid pressure sores.
“What I like the most is my exposure to so many patients,” Graff said.
“I get to meet them and I get to educate them on what the rest of their life will be like.
“Each and every outing offers different challenges.”
But facing those challenges early, Graff said, helps the patients immensely.
She said patients who go out on the hospital’s offered outings do better once they leave the hospital than those who do not go on outings.
Many rehabilitation hospitals offer outings, but Graff said she does not believe any have a nurse dedicated to those outings.
She said in the future she would like to speak to others, or perhaps do some training about her job at Craig Hospital. She said it is something she has been approached about in the past.
In the meantime, her job is constantly evolving, she is constantly learning, and she is consistently going out on outings on rivers, in mountains and to the movies.
“Nothing that I do is textbook,” she said.