At 47, I was a healthy, outgoing and fun-loving person, enjoying a busy work life and active social circle. My husband and I had raised two daughters, and were at the point in our lives when we felt we could begin to take more time to enjoy the important things in life.

On a Saturday night in February, we entertained friends for dinner and retired late. I woke at 3 a.m. with a headache, more painful than any I had previously experienced. I managed to get to the bathroom, a tiny room on the main floor of our small but carefully renovated two storey home. There I lost consciousness. What followed is remembered in an almost dreamlike manner. Becoming a patient for the first time in my life, first in an acute care hospital, later in a longterm rehabilitation centre was my reality for the following 9 months. I learned I had had a cerebrovascular accident...a stroke. In those few minutes, I lost my independence, my health, my lifestyle. I entered an unfamiliar, but what I came to know to be, respectful, knowledgeable and supportive environment.

After an initial few weeks in an acute care hospital, I was visited by two clinicians from the rehab centre where I would be transferred for longer term care. They listened to my story and before leaving, gave me a DVD which they called "An Introduction to Health Caring at the Regional Rehabilitation Centre: A patient's perspective". That evening I watched the movie with my husband and learned many things that would happen in the coming weeks and months. For me, the highlights included a virtual tour of a patient room and the rehab unit with its many therapy rooms and facilities. I remember hearing about the role of the physiotherapist, pharmacist, pastoral care, discharge care planner and numerous other people. My husband paid particular attention to the visiting hours, possible weekend arrangements, and the medical interventions. We were both surprised and somewhat confused by the insistence that the patient is a member of the ‘care team' and is expected to participate, to their best ability, in meetings and decisions being made about their care. It sounded like a tiring prospect, but one that was welcoming and clear.

Re-engaging in my everyday activities while at the Regional Centre required the assistance of strangers, but was approached by professionals who seemed to understand my perspective and who provided expertise which was tempered by gentle questioning and careful listening. Though busy, each member of my ‘care team' took the time to approach me to introduce themselves and explain in simple yet accurate terms their role in the treatment team and process. They called this their scope of practice. They reassured me that they had expertise to offer within their own realm of practice for which they were responsible and accountable. Some of their work was done autonomously but they relied on one another and on the patient and family to determine how best to deliver care. Cooperation among team members, including the patient was crucial. Goals were written in the first person, from the patient's point of view and the care plan was then attached to each goal. The care plan made sense to me. Initially I was nervous about writing goals but after discussion with my husband and daughters, I was able to decide what was most important to me for a particular day and later I helped the team to determine weekly and then monthly goals. I learned that I could ask any member of the team about these goals, the care plan and progress, but could also listen to the team's perceptions at the weekly care meeting. Here, I could ask questions, raise concerns and provide my personal perspective. It became evident to me that communication was important to the team.

Though feeling unwell, exhausted and at times confused, I remember attending a short part of the initial ‘care team conference' - they called it the "meet and greet" and explained that this brief time was meant to reaffirm a concept that the DVD had introduced...that I was a member of the care team and as such, would be consulted about decisions relating to my care. Permission was sought to involve my family as well. Although there were many faces around the table that day, one person took charge of leading me through the maze of meeting new people and met with me again the next day to begin asking and suggesting what my initial goals might look like. Her name was Fay and she explained that she would be my ‘care manager' for my time in hospital and that her job was to ensure a clear liaison between me, my family and the care team. She would check in with me on a regular basis and would coordinate the care plan and the team. She explained as well that I may come to feel more comfortable sharing my perceptions with another member of the team and encouraged me to convey any concerns to her via another team member or directly. It was also explained that a few of the team members were away that day, attending a professional development workshop. "We are constantly learning" she said. Lifelong learning is an expectation here and everyone needs time to update their skills and to reflect about their work. With my permission, my goals were posted on a whiteboard at the end of my bed along with the name of the nurse on shift at that time. Appointments, tests, and important events of the day were posted there. At the bedside table, a large print booklet was clearly visible. A quick glance was all it took to see that it contained many of the topics covered on the DVD but also included answers to other specific questions like: "When will I be discharged?" and "What is occupational therapy?" My husband agreed to read the booklet from cover to cover so that he could understand and help me with any concerns.

What followed over the months to come were long hours of assessments, treatments, discussions, meetings - some with individuals, others with a pair or group of the care team to avoid duplication. But there were also quiet moments of reflection - what the nurses called ‘protected time' where visitors were limited, no appointments could be booked, and there was enough quiet time to support a short nap, record some thoughts on paper or ponder the future. Initially, I chose to lie down in my room and simply rest during this time as I felt exhausted and vulnerable. In time, I began to record questions in my journal that was always found on the bedside table. I could leave it open if I wanted to share my questions/reflections with others, or close it for privacy. I would return to this journal many times throughout my hospitalization and beyond as it mapped my journey through the daily words, sentences and thoughts recorded there by me, my family and members of my care team. Questions, answers, ideas, feelings, prayers, messages.

I remember waking in the night sometimes and wondering where I was, fearful of falling out of bed, anxious that any headache meant another stroke. Sometimes I was able to calm myself down and return to sleep. Occasionally, I was fearful and tempted to use the call button. I didn't want to bother anyone, but had been convinced by the care team that they were there to help me and would respond to me as quickly and efficiently as possible. One night I was cold and unable to reach the covers in the night. I pressed the call button and waited some time for a response...when the nurse appeared she immediately apologized for the delay, indicating she was helping another patient to the bathroom, and then asked how she could help. She rearranged the blankets and also provided an extra pillow which could be used to help me position myself so that I had better use of my unaffected arm for movement. She told me it was positive to be assertive mutual trust and respect. and ask for help when I needed it. She said that other members of the team do the same thing and that this is a skill that helps everyone to work better together as people and to approach each other with

While I would not describe this time as a positive period in my life, I did have many fond memories of my hospitalization at the rehabilitation centre. I remember several students from Queen's University working with me, some for only a matter of days, others over a period of several months. At first I considered this an imposition as I had to get to know more people which was tiring, but I came to greatly appreciate these opportunities as I realized I was being productive once again...I was teaching these students about how to treat their future patients...I was shaping their education and actually helping them. It was a good feeling. I often watched members of the team teaching students about their various professional roles. Often, I observed students working together in teams...what a good idea, I thought. "They are learning together now so they can work together better in the future." The ward clerk, who I stopped to speak to daily to ask about one thing or another, told me that this kind of interprofessional placement was expected on the unit and that the team had published an article about it in a medical journal. She pointed out to me that it was posted on the CLU information board in the sun room. When I asked, "So what's a CLU?", the ward clerk smiled and said, "This place and all of the people in it...we're one big happy CLU!"

I ventured into the sun room the next day to read the article "So What's a Collaborative Learning Unit?" and then stayed to attend a meeting that had been organized by the students. They were presenting an Education Module about stroke and how the team works together to improve the patient's function. I had heard most of this before, but I was intrigued by the number of community agencies that were also involved in stroke rehabilitation. I was pleased to receive a brochure from the students listing community services as I thought I might need to pursue a few of these options in future. The students described the link to the community agencies as part of the seamless care strategy of the Centre.

As my recovery progressed, I pondered the idea of what a ‘good patient' meant. I had always assumed this entailed quiet deferral to the expertise of professionals and accepting one's fate without complaint. But as a member of the care team and CLU, I started to see my role in a new light..."I have to speak up and help the team to understand my goals, my challenges, things I know I can do and things I fear I'll never do." This did not stop me from feeling frustrated and frightened but it helped to know that my team cared about my feelings and concerns, and not only welcomed but expected to understand my point of view.

If a professional proceeded to conduct an assessment or intervention that I did not fully understand or that I found difficult, I began asking "why, how, what if, why not?" kinds of questions. Though this did not make the activities easier, it gave me an understanding of their importance and bolstered my determination and even my energy.

After several day visits and a weekend trial visit home, I met with my team for a "discharge conference" and learned that the date was tentatively set for the following week. Fay summarized the team's opinion that I was ready to take this step forward in my recovery and asked if I concurred. I was excited, relieved, and anxious about leaving the security of the rehabilitation centre but was developing confidence in my independence. Knowing that the team had organized specific community supports made this transition much easier. I met the case manager from the Community Care Access Centre and knew that the team had provided this person with updates about my needs and challenges.

On the last day of my hospitalization, I completed a survey with a person who was working with a research project called SEIPCLE. She explained that the project was studying and evaluating a number of local CLUs to understand how they worked and she was interested in the patient/client perspective. The goal of the project was to document the ideal CLU and to use it as a model for other health care facilities to learn from as they developed their own unique CLUs. I was pleased to provide positive feedback, as well as some specific suggestions, in my responses. Once again, I felt I was contributing to the well being of people who would find themselves in my position in the future. It's also a way for me to thank the people who have been involved in sharing my care with me over the past several months. I've learned a lot about the health care system and about myself. This is a good place, but I don't have plans to return anytime soon!