DHMC opening 10-bed neurocritical care unit .

Massachusetts General Hospital, Boston



LEBANON — While hospital leaders ceremonially opened Dartmouth-Hitchcock Medical Center’s new neurocritical care unit on Friday afternoon, Wanda Handel hung back behind the nearly 30 colleagues with whom she’ll start caring for patients next week.

And the veteran nurse flashed back over her 22 years in the neurology department — the last 20 helping to plan for this 10-bed wing, separate from patients needing round-the-clock attention for other urgent con ditions.

Here, starting on Tuesday  , specialists will treat and monitor people emerging from surgery for strokes, aneurysms, traumatic brain injuries, and patients fighting back from complications of epilepsy, ALS, Parkinson’s disease and other chronic ailments of the nervous system.

“This is my whole career,” Handel, a clinical nurse specialist who also trains nurses to work in neurology, said after the speeches and the ribbon-cutting. “This was always my dream, to have this unit.”

Dr. Jeffrey Cohen, the neurology department chairman, is pinching himself, too. Since seeing such a facility during a neurology fellowship at Massachusetts General Hospital in the early 1980s, he has waited for not only a suite of critical-care rooms wired with the latest technology, but for a team of doctors, nurses and advanced-practice providers — aka physician assistants and nurse practitioners — specializing in what is a fast-growing field, thanks in no small part to the graying of the population.

“Particularly in the Upper Valley, we have an age shift,” Cohen said during an interview before the ceremony. “People are surviving their heart attacks and their strokes who never would have before. They’re surviving their cancer. As a result of people just living longer, neurological disease is a lot more common.”

That’s on top of people of various ages who survive car collisions, falls from bicycles and skis and other causes of head and nervous-system injuries.

Before the ribbon-cutting, Dartmouth-Hitchcock CEO Joanne Conroy told the gathering that for too long, patients with these various conditions have been wedged into intensive- and critical-care units with patients whose conditions require different kinds of care.

“Frankly, they need their own space,” said Conroy, an anesthesiologist by training. “It’s just time.”

The medical center’s technical and construction staff retrofitted part of the third-floor east wing of its patient towers to house the unit. Meanwhile, Handel and Gene Corliss, a veteran clinical-nurse educator, spent years training existing staff and new recruits, particularly of nurses, physician assistants and nurse practitioners.

As the construction and wiring process neared completion, Handel and Corliss led the 29-member neurocritical team through troubleshooting methods, simulations of a variety of situations that the care-providers can expect, and how to work with respiratory, occupational and speech therapists to help patients recover enough to go home or into lower-intensity care as soon as possible.

“We’ve been straight out for the whole week,” Handel said.

The better trained the in-the-trenches caregivers are, Cohen said, “I won’t have that primary responsibility for adjusting ventilators and IV fluids. I can be a consultant rather than that primary care person.”

Conroy said that with a separate, dedicated neuro-critical unit, “we can recruit the professionals we need. And we have an opportunity to train our own providers in handling these complicated situations.”

Maria Padin, DHMC’s chief medical officer, reminded the gathering of other long-term dividends of that education.

“All of us will be touched by somebody who will have a need for a unit of this kind,” she said. “And future generations who train in this unit will take care of us.”

David Corriveau can be reached at dcorriveau@vnews.com or 603-727-3304.