Journal of the Australasian Rehabilitation Nurses' Association

Objective To understand wellbeing and factors influencing wellbeing, from the perspective of inpatients on subacute and rehabilitation hospital wards.

Background Wellbeing is a term increasingly used in health settings. Positive wellbeing is associated with improved health, longevity, and healthy lifestyle behaviours. However, challenges exist in both defining and measuring wellbeing. Wellbeing has been explored in community and acute-care settings, but less so in subacute and rehabilitation settings where patients frequently stay longer and many experience vulnerabilities including older age, disability, poor health or functioning, or social isolation. Little is understood about what wellbeing means, and factors impacting wellbeing, for patients on subacute and rehabilitation wards.

Study design and methods Qualitative descriptive methodology guided data collection and analysis. Semi-structured interviews were undertaken with 153 inpatients on six wards across three tertiary facilities in the Southern Adelaide Local Health Network. Interview data were analysed, involving in-depth examination and discussion to determine themes regarding the experience of wellbeing for inpatients.

Results Ten key themes emerged around patient wellbeing. A predominant focus of patients’ conversations formed the first three themes: 1) control, dignity, independence; 2) getting better, getting out; and 3) being engaged, amused and distracted. Remaining themes related to various impacts on patient wellbeing including mood and mindset; interacting with others; food; environment; and sleep/rest.

Conclusion Listening to patients and exploring wellbeing from their perspective provided valuable insight into what impacts wellbeing while in subacute care. The overarching themes could be addressed through a range of initiatives to enhance wellbeing and overall health outcomes.

In 2020, a close friend’s traumatic brain injury transformed my understanding of rehabilitation nursing and resilience. As an experienced midwife and Associate Nurse Unit Manager navigating late pregnancy, parenting and pandemic restrictions, I was unprepared for the emotional and behavioural changes that followed her injury. Becoming part of her informal care team exposed me to the vulnerability, uncertainty and grief that families experience during prolonged rehabilitation.

During her six-week inpatient admission, rehabilitation nurses became our anchor. Through thoughtful communication, emotional preparation and consistent compassionate care, they supported not only her recovery but also our capacity to cope. Their practice extended beyond clinical expertise to relational continuity, psychological safety and dignified family-centred care.

This experience deepened my appreciation of rehabilitation nursing as a specialty defined by sustained emotional labour, adaptability and long-term therapeutic relationships. The fluctuating journey of patient recovery mirrors the way nurses build and rebuild their own resilience. Yet nursing culture often promotes a ‘heroic’ narrative of limitless endurance, overlooking the relational and organisational foundations required to sustain wellbeing.

Resilience is not an individual trait but a shared, dynamic capacity shaped by team connection, compassionate leadership and supportive workplace cultures. Promoting wellbeing in rehabilitation nursing requires moving beyond stoicism towards self-kindness, peer support  and organisational accountability. Caring for those who care is essential to maintaining a safe, compassionate and sustainable rehabilitation workforce.

Rehabilitation nursing research has largely been reported from a gender-neutral or female perspective. While the grounded theory, ‘Finding a safe way’, explains male nurse practice in this specialty, its original participants’ sexual identity was not explored, leaving its relevance to gay and/or bisexual male nurses unknown. This study aimed to explore how identifying as a gay or bisexual man might influence nursing practice in rehabilitation. It was an ethics-approved case study using online semi-structured interviews with a purposive sample of self-identified gay male nurses, recruited via the Australasian Rehabilitation Nurses’ Association. Thematic analysis was employed. The participants were over 50 years old with a combined 33 years of experience. The data confirmed the applicability of the theory to nurses who identify as gay. Both participants reported experiencing workplace homophobia and managed their sexual identity by either selectively disclosing (being open) or deflecting (being closeted) to ensure their safety and effective patient care. Managing sexual identity added significant complexity to their practice, driven by a culturally and socially heteronormative environment. Rehabilitation provided a unique context to explore the experiences of gay male nurses. The findings from this study begin to offer a theorised understanding about gay male nurse practice in rehabilitation.