America is facing a growing population of individuals with disability, advanced age, injuries, and chronic disease. Advances in healthcare have enabled people to survive injuries and illness like never before. The Center for Disease Control reported in 2015 that 22% of adults in the US have some type of disability. As this number increases and our population continues to age, the need for professional nurses who possess skills to treat chronic illness and the effects of the illness on function and quality of life has grown significantly. Rehabilitation nurses are rising up to meet this growing need and the specialty field is advancing rapidly.
In my nineteen years of nursing practice, no clinical area has been as rewarding to me as rehabilitation nursing. I have been blessed to witness people who have suffered a stroke regain speech and the ability to walk again. I have seen patients involved in multiple traumas regain function. And I have watched a new amputee take their first steps on a prosthetic limb. These are just a few of the inspirational stories that keep me passionate about physical rehabilitation nursing.
Rehab nursing is the transdisciplinary process of assisting a person with disease-organ impairment, personal functional disability, and societal handicap to reach the fullest physical, social, psychological, vocational, avocational, and educational potential consistent with his or her physiologic or anatomic impairment, environmental limitations, desires, and life plans. Rehab nurses assist individuals with disabilities or chronic disease toward maximal health through health restoration, maintenance, and promotion. This is accomplished by using education and supportive strategies based on rehab philosophy, goals, and concepts.
Rehabilitation can be dated back to the days of ancient Egypt when adaptive aids were developed such as crutches and artificial limbs but its greatest incitement came from consequences of wartime combat. Soldiers survived injuries but were faced with serious disabilities. As a result, some of the first rehabilitation units were in military hospitals. Florence Nightingale applied rehab principles in her 1859 book, Notes on Nursing: What Is It and What It Is Not, documenting that allowing patients to do for themselves was an important intervention- maximizing self determination. Physicians were being trained in the field of rehab medicine by 1946 and in 1964 rehab nursing had developed into an organized nursing specialty (Spasser et al., 2006).
Rehab nursing requires understanding that crosses and integrates knowledge from nursing, medicine, cultural beliefs and traditions, allied health disciplines and psychosocial sciences. It begins with immediate preventative care and moves through stages of accident or illness. It continues through restorative care and involves adaption of the whole being to a new life. Rehab nurses want to restore function and optimize lifestyle choices. The rehab nursing care focuses on assisting the disabled patient in developing self care skills through care, education, and support to the patient and family while managing the needs of medically complicated patients.
Successful rehabilitation requires interaction among many different disciplines. An integrated team of physicians, nurses, physical therapists, respiratory therapist, speech therapists, occupational therapists, case managers, pharmacist, dieticians, and others collaborate to help patients reach their full potential. Rehab covers a wide range of diagnoses ranging from joint replacement surgery, sports/ occupational injuries, stroke, severe spinal cord injury, traumatic brain injury, or progressive conditions such as Multiple Sclerosis.
The rehab nurse functions as a teacher, caregiver, collaborator, and patient advocate. As a teacher, they share information about disease processes and teach techniques to help the patient and their families develop self care skills. As a caregiver, they plan, implement, and evaluate the plan of care for the patient. As a collaborator, they develop goals with the rehab team and collaborate interventions to achieve cost effective care. As a patient advocate, they listen and advocate services to promote quality of life to ensure the patient has maximum success.
The Certified Rehabilitation Nurse (CRRN) credential is a nationally recognized program and is appropriate for nurses who care for patients with all disabling and chronic conditions. The certification is available through the Rehabilitation Nursing Credentialing Board (RNCB). Attaining CRRN certification validates professional standing as an experienced rehab nurse with knowledge in a specialized area of practice. These nurses demonstrate knowledge, experience, and commitment to excellence in complicated care for people with physical disabilities and chronic illness in all specialties and settings of rehab. These nurses have improved patient outcomes and increased patient satisfaction. According to research conducted by American Journal of Nursing (2001), CRRN reported they experience fewer adverse events and errors in patient care. For every 1% increase in CRRNs, study showed a 6% decrease in length of stay (Nelson et al., 2007).
Rehabilitation is an exemplary process of functional improvement. By involving patient, family, community, and healthcare providers, rehab nurses prove that optimal function can be achieved when the uniqueness and wholeness of the individual is recognized (Spasser et al., 2006).
Rehabilitation Nurses work in a variety of roles and settings:
Rehab staff nurse
Rehab nurse liaison
Homecare rehab nurse
Rehab case manager
Gerentological rehab nurse
Rehab nurse educator
Rehab nurse researcher
Rehab nurse manager
Advanced practice rehab nurse
Free standing rehab facilities
Home Health/ Community agency
Private companies/ private practice
Department of Veterans Affairs
Long term care
By Stephanie Morrell, RN, BSN, RN-BC, CRRN
- ARN. Retrieved on June 23, 2016 at www.rehabnurse.org.
- Association of Rehabilitation Nurses. ARN Competency Model for Professional Rehabilitation Nursing. 2014.
- Center for Disease Control. 2015. Press Release Disability Impacts. Retrieved on June 23, 2016 at www.cdc.gov.
- Nelson et al., 2007. Nurse Staffing and Patient Outcomes in Inpatient Rehab Settings. Rehab Nsg, Vol 32, Issue 5, pp 179-202. Sept-Oct 2007.
- Spasser et al., 2006. Mapping the Literature of Rehabilitation Nursing. J Med Libr Assoc. 2006. Apr 94 (2 Suppl): E137-E142