注册护士克里斯汀·弗雷切特的办公室， 以任何标准衡量都不算大. The space has three desks pressed into a tiny room that she shares with her two colleagues.
“It’s definitely tight,” says team member Hilary Scruggs, RN, who is on Frechette's team at 十大网赌平台推荐希区柯克医疗中心的心脏 & 血管中心.
斯克鲁格斯擦过一排排笔记本, 文件, 剪贴板, calendars and whiteboards to what this three-member team seems proudest to show: a shelf of folded and newly designed shirts for graduating cardiac rehabilitation program participants.
For Frechette and her colleagues Scruggs and exercise specialist Katherine Chwasciak, the most gratifying work occurs outside their office with their patients. That work includes patient consultations on the hospital floor and cardiac rehabilitation sessions at their gym.
“Our goal is to give our patients the confidence to be able to go back and do the things they love,弗雷切特说.
三个阶段的程序
“我们强大的团队”的工作,弗雷切特亲切地称呼这三人组, 可以分为三个阶段吗. 第一个研究重点是已经植入支架的患者, 心脏病, 心脏衰竭, 或者开胸手术. 一名团队成员拜访病人, 讨论风险因素修改, 提供运动指引, 建议一个离家近的心脏康复计划, 并在合适的情况下提供推荐. 在第二阶段, the two remaining team members lead hour-long classes for qualifying patients at their own cardiac rehab gym. On average, each of their patients participates in 18-36 classes offered three days each week.
“Participation rates average 84%, compared to a national rate of around 30%,” Frechette says proudly.
事实上, 许多参与者在毕业后变得如此投入, they return to join the third phase of the program when the gym is opened up for two 90-minute sessions weekly.
说到同志情谊. 其中一些人已经来了15年以上. 他们发送照片. 他们都很棒，”弗雷切特说.
获得自信，传播快乐
Frechette and her colleagues’ passion and commitment toward their patients is palpable and enduring.
“As a nurse, I get to see patients regain confidence and strength after their diagnosis. 能成为这一过程的一部分，我感到很谦卑,” Frechette said in 2018 when receiving Dartmouth Hitchcock Medical Center's 25-year service award.
五年多过去了，弗雷切特的观点仍然没有改变.
“我总是被他们的感激所淹没. 他们非常感激. 在我们的一个班, we have a guy who works the night shift doing manual labor and still makes the commitment to drive 45 minutes here three times a week. 今天早上, 他在一个医生和一个会计旁边锻炼, 他们都在胡扯, having already sat out in the waiting room chatting for 15 minutes before they came in. 谈谈同志情谊，”她说.
斯克鲁格斯对此表示赞同，并强调了他们管理的项目的好处. “这太鼓舞人心了. 他们觉得自己对班级负有责任. 他们互相学习."
“Our goal is to give our patients the confidence to be able to go back and do the things they love.”
Kristen Frechette，注册会计师
And it’s not just the current team members whose passion and commitment endure. Frechette’s predecessor, who started the program almost 50 years ago, still regularly visits.
弗雷切特总结道:“能加入这支球队真是令人兴奋."
《十大赌博靠谱信誉的平台》(the Mighty Team)在康复中心的一个典型周三
7:30 am
Frechette和她的同事们走过正门—一大玻璃杯, 十大网赌平台推荐希区柯克医疗中心的入口通道, 然后上楼去健身房旁边的办公室. 他们刚到的时候，这里很安静. 三个人一起喝茶或喝咖啡，计划一天的工作. They review the census of cardiac patients currently checked into the hospital and determine who is eligible for their local rehab program. 他们还审查了 参与他们的康复计划的进展和状态.
8:20 am
音乐开始了—an energizing playlist of rock-and-roll songs from the 1960s, '70s, and '80s. 一名队员离开去巡视医院的病人. “She meets with those folks in the hospital, and we talk to them about risk factor modification. 我们给他们提供锻炼指南. Most importantly, we try to get them involved in a cardiac rehab program,弗雷切特说.
The remaining two prepare the gym for the upcoming hour-long exercise classes by making sure that all equipment is wiped down, clean towels are stacked and the cloth straps participants wear are labeled with pink tape indicating the patient’s first name. Each strap has a pouch in which they place a small telemeter that monitors real-time heart data on screens displayed throughout the room.
8:25 am
The cardiac rehab patients start filing in, hanging their coats and picking up their telemetry wear. U每节课10人. 两名队员向他们打招呼, 询问他们前一天做了什么锻炼, 测量他们的血压, 并了解每个人都在做什么. 患者范围从20多岁到年龄大得多的成年人. “我们也有很多运动员，”弗雷切特说.
上午8:45到9:25
课程以40分钟的有氧运动开始. A team member has identified patient goals and determines the appropriate exercise prescription during their first visit. 目标因人的特点而异.
“如果有人是消防员, I'm going to have very high goals for them in terms of their work capacity. 然而，如果你80岁了，喜欢飞鱼, 我给你的关卡目标会低很多,弗雷切特说.
Although the wall monitors are in view, the class is not staring at them. “我不想让他们把自己的生活医学化，”弗雷切特说. “很多人的运动手表并不总是准确的. 相反，我们关注的是一种叫做感知消耗量表的东西. 我们根据他们的感受来调整他们的运动. 如果感觉很轻，我们就把它调大. Everything should be fine if they're in that moderate to somewhat hard zone. 心脏康复不是压力测试. We never want them exercising in the very heavy zone; that’s not something they can sustain. 你不需要看表来了解自己的感受. 我们所做的很大一部分是安抚和建立信心.”
上午9:25到9:35
这支队伍在五分钟的抗阻训练中领先全队. 有些人用手举重物. 有些人用他们的体重工作. Afterward, there is a five-minute session of stretching and cooling down.
上午9:35到9:45
The exercise class closes with an education session around nutrition, exercise and stress. “A lot of our people have stress and depression, particularly our surgical patients.“今天的话题是钠. “It's a little nugget of heart-healthy information for them to go home with,弗雷切特说.
上午9:45到10:15
病人离开房间. 队员们打扫卫生，准备下一组, 检查遥测数据, 写报告，吃点快餐.
上午10:30至11:45
第二组人到达时也同样忙着办理登机手续. “我们监控课程的结构与8:45的课程相同. Afterward, we clean the room and prepare it for the afternoon group,弗雷切特说.
上午11:45至下午1:45
这是补课时间. The three women return to their small office and do their daily patient reports. They fill in mandatory individual treatment plans for each patient that document progress. 他们吃午饭, 走出健身房, 充电, 审查待处理的转介, 处理一些行政事务，打电话给病人.
下午1:45到3:00
第三节车厢到了. “We have the same bumping music and great energy,” Frechette explains. “这是一个非常有活力的房间.”
下午三点到四点
The team cleans up again and fills out the remaining end-of-day reports. They organize for tomorrow and review the hospital schedule to determine whom to visit in the hospital tomorrow.