Rehabilitation Nurse: "The power in taking care of people is remembering that diseases/complications/illnesses affect people very differently."

A rehabilitation nurse is a nursing professional that helps patients suffering from disabling injuries or illnesses live relatively normal and independent lives. Rehabilitation nursing professionals help the patients to recognize their abilities and limitations in order to reach their full potential. Rehabilitation nurses are must be extremely supportive and encouraging. They often help patients to feel empowered and by giving them hope, they can help their patients to extent ostensibly impossible goals. Working as a rehabilitation nurse is one of the most rewarding nursing careers. As a rehabilitation nurse you will frequently get to witness patients to impulse past their own limits and overcome exceptional odds. Because Rehabilitation Nurses will typically work with the same patients on a regular basis, they will also get the chance to establish relationships with patients and their loved ones. Rehabilitation Nurses are not only a caregiver, they will also often be perceived as a friend and source of support during tough times. Rehabilitation nurses help chronically injured patients reach their full potential by following plans of care instilled by physical therapist, neurologist, speech therapists, psychologist and other specialist. The goal of rehabilitation nurses is to help patients become independent by reaching small-term as well as long-term goals.

General Responsibilities of the Rehabilitation Nurse

·         Rehabilitation Nurses possesses the specialized knowledge and clinical skills necessary to provide care for people with physical disability and chronic illness

·         Coordinates educational activities and uses appropriate resources to develop and implement an individualized teaching and discharge plan with clients and their families

·         Performs hands-on nursing care by utilizing the nursing process to achieve quality outcomes for clients

·         Provides direction and supervision of ancillary nursing personnel, demonstrates professional judgment, uses problem solving techniques and time-management principles, and delegates appropriately

·         Coordinates nursing care activities in collaboration with other members of the interdisciplinary rehabilitation team to facilitate achievement of overall goals

·         Coordinates a holistic approach to meeting patient's medical, vocational, educational, and environmental needs

·         Demonstrates effective oral and written communication skills to develop a rapport with clients, their families, and health team members and to ensure the fulfilment of requirements for legal documentation and reimbursement

·         Acts as a resource and a role model for nursing staff and students and participates in activities such as nursing committees and professional organizations that promote the improvement of nursing care and the advancement of professional rehabilitation nursing

·         Encourages others to become CRRN certified, obtain advance degrees, participate on committees, and/or join professional organizations

·         Facilitates community education regarding acceptance of people with disabilities

Rehabilitation Nurses can treat:

·         Amputation

·         Brain injury

·         Burns

·         ALS

·         Cancer

·         Cardiovascular

·         Cerebral palsey

·         Guillain-Barre syndrome

·         Parkinson's disease

·         Major joint replacements

·         Multiple sclerosis

·         Organ transplant

·         Pulmonary disease

·         Spinal cord injury

·         Stroke

Types of Rehabilitation Nursing Careers:

• Neurological: Registered nurses who work as a neurological rehabilitation nurse care for patients who've experience injuries of the nervous system. This includes patients who’ve experienced infections such as meningitis or encephalitis. They also care for patients who experience frequent headaches, seizures, neuralgia and other problems concerning the nervous system. Neurological rehabilitation nurse may work in specialty clinics, skilled nursing care facilities or on neurological units in hospitals.

• Drug and Alcohol: A drug and alcohol rehabilitation nurse help and support patients who have addiction problems change their lives. They teach them positive ways to stay sober to prevent relapsing. Drug rehabilitation nurses monitor patients who are going through withdrawal and teach patients coping skills needed to succeed in life. This nurse may work in rehab clinics, in a doctor’s office or in a hospital drug rehabilitation unit.

• Orthopaedic: Orthopaedic rehabilitation nurses must become expert in caring for patients who are in casts as a result of fractures. They monitor their neurologic status and monitor therapies such as continuous motion therapy (CMT). Hip fractures are very prevalent in the United States with the elderly population and account for many patients on an orthopaedic rehabilitation unit. Orthopaedic nurses work in rehab units in a hospital, skilled nursing and long-term care facilities.

Rehab Nurses Play Many Roles:

·         Administrator

·         Clinical nurse leader

·         Clinical nurse specialist

·         Consultant

·         Nurse practitioner

Rehab Nurses Practice across the Post-Acute Care Continuum:

·         Community hospitals

·         Freestanding rehabilitation facilities

·         Home health agencies

·         Hospitals (inpatient & outpatient rehab units)

·         Insurance and HMOs

·         Long-term acute care

·         Private practice

·         Skilled nursing with rehabilitation

·         Sub-acute facilities

·         Universities and teaching hospitals

Objectives of Rehabilitation Nursing

There are 4 broad objectives of rehabilitation nursing:

·         a. To restore affected abilities to the highest possible level of function.

·         b. To prevent further disability/ handicap.

·         c. To protect the person abilities.

·         d. To assist the person / patient to use his or her abilities

Principles of Rehabilitation:

·         Rehabilitation should begin during the initial contact with the patient.

·         Restoring the patient to independent or to regain his pre-illness/pre-disability level of function in as short a time as possible

·         Maximising independence within the limits of the disability.

·         He must be an active participant.

EMERGENCY NURSE: I have been spit on; Bitten, Slapped and Beaten-But always I win at the end.

Emergency Nursing is a nursing specialty in which nurse’s care for patients in the emergency or critical phase of their illness or injury. While this is common to many nursing specialties, the key difference is that an emergency nurse is skilled at dealing with people in the phase when a diagnosis has not yet been made and the cause of the problem is not known. Emergency nurses also deal with non-emergent populations that present with non-life threatening issues as well. Patients that present to the Emergency Department may range from birth to geriatric. The term emergency is used for those patients who require immediate action to prevent further detoriations or stabilizing the condition till the availability of the services close to the patients. The nurse as a team member plays significant role in the early assessment, intervention either in the form of care or transferring the patient safely to the health services.

Common Nursing Emergencies

·         Choking

·         Bleeding

·         Seizures

·         Difficulty breathing.

·         Fainting.

·         Chest pain or pressure.

·         Uncontrolled bleeding.

·         Coughing or vomiting blood.

·         Sudden severe pain.

·         Poisoning.

·         Major injuries, such as broken bones.

Role of Emergency Nurses:

In addition to addressing these true emergencies emergency nurses increasingly care for people who are unwilling or unable to get primary medical care elsewhere and come to emergency departments for help. Besides heart attacks, strokes, gunshot wounds and car accidents, emergency nurses also tend to patients with acute alcohol and/or drug intoxication, psychiatric and behavioural problems and those who have been raped. They must be adept at working with patients of many different backgrounds, cultures, religions, ages and types of disabilities. Emergency nurses must also have a good working knowledge of the many legal issues impacting health care such as consent, handling of evidence, mandatory reporting of child and elder abuse and involuntary psychiatric holds.

In their role as patient educators, they must have a thorough knowledge of anatomy, physiology, pharmacology and psychology and be able to communicate effectively with patients and their families. An emergency nurse is typically assigned to triage patients as they arrive in the emergency department and as such are the first professional patients see. Therefore, the emergency nurse must be skilled at rapid, accurate physical examination, early recognition of life-threatening conditions. In some cases, emergency nurses may order certain tests and medications following collaborative practice guidelines or standing orders set out by the hospital's emergency physician staff.

Key Responsibilities of an Emergency Room Nurse

·         Triage

·         Taking vital signs

·         Administering medicine

·         Providing treatment

·         Monitoring patients

·         Charting

·         Discharge

Emergency Nursing Education

Education and best practices about women's health issues during disasters is needed on relevant topics including the following:

·         Delivery of care in low resource settings,

·         Issues with special implications in disasters (e.g., infectious disease and violence against women in shelters),

·         Triage and appropriate care of perinatal/neonatal populations in disasters,

·         Altered basic life sustaining requirements for the pregnant woman and her foetus (e.g., adequate rest/sleep, clean water, hygiene, nutrition, and safe bathroom facilities),

·         The psychological burden for women and children in disasters, especially issues related to separation from their significant others,

·         Long‐term mental health needs,

·         Nutrition for pregnant and postpartum women and infants, and

The importance of access to contraception in shelters.

Nurse-Midwives: Changing Health Care for the Better, Midwifery: An Ancient Commitment, A Modern Success Story

Midwives are a certified nurse midwife (CNM) is a licensed health care provider that is trained in both nursing and midwifery. A certified midwife (CM), is also licensed but is trained in midwifery. The professional organization for midwifery in the United States is the American College of Nurse-Midwives. CNMs and CMs are nationally certified by the American Midwifery Certification Board through a national midwifery certification exam.

A women’s health nurse practitioner (WHNP) is an educated and experienced nurse practitioner who focuses on offering primary care services to women of all ages. In order to become a WHNP, nurses must first complete an education as a registered nurse and then go on to advanced studies in order to become a nurse practitioner. It is during these studies that students can choose to specialize in women’s health and go on to complete clinical, hands-on experience with female patients. It is important to note that a women’s health nurse practitioner is different from a certified nurse-midwife (CNM). While CNMs tend to focus on childbearing, from conception to delivery, a WHNP follows the entire lifespan of women’s health and does so most often in a primary care office setting, rather than a hospital or delivery room. Further, while the two paths share some educational similarities, the specializations and post-degree steps will differ: a CNM must now complete an AMCB-accredited, specialized MSN or DNP degree prior to becoming certified as a nurse-midwife, while a WHNP must complete an NCC-accredited, specialized MSN or DNP degree prior to pursuing a license to practice as a nurse practitioner.

CNMs must complete a graduate school program prior to taking the examination.CNMs are licensed through each state’s Board of Nursing or Medical Board. Certification must be kept current! Recertification for competency of practice is completed every 5 years and approved both by the issuing state government of practice and by the American College of Nurse-Midwives. Midwives help women with normal pregnancies and deliveries, with the idea of letting childbirth occur as naturally as possible. Midwives are trained to help women with normal, uncomplicated pregnancies, labor, and deliveries.

The scope of Nurse-Midwifery Practice:

·         Pregnancy, birth, & new-born care

·         Women’s primary care & health promotion

·          Family planning

·         Advanced clinical practice by some,

E.g.:  first assist in surgery – circumcision – colposcopy – ultrasonography

·         Education • Public Health

Current Global Trends

There are currently approximately 5,000 practicing nurse-midwives in the United States, and since 1975the number of nurse-midwives has continued to grow each year. According to the World Health Organization (WHO), there is a critical global shortage of “skilled birth attendants”.

·         34% of the world’s births occur at home without a trained medical professional present.

·         The World Health Organization cites midwifery as a key component of improving global maternal and child health, and seeks to promote the profession on a global scale!

Women’s Health Nurse Practitioner Role Requirements

·         In order to become a WHNP, one must first become a registered nurse (RN) by completing an accredited nursing program at the undergraduate level. From there, students must apply and be accepted to a nurse practitioner program. Some programs will require that students declare a specialization upon application but others will not. Many RNs find it helpful to have some clinical experience as an RN before going on to enroll in an NP program since that can be helpful when it comes to choosing a specialization. Each WHNP program will have its own prerequisites, which may include a certain GPA in undergraduate coursework, letters of recommendation, and graduate school entrance exams.

·         Due to the high demand for nurses around the country, many advanced nursing programs have distance learning options for those who are already employed as RNs. Interested students may be able to pursue a nurse practitioner program with online courses without having to relocate or stop working.

·         Women’s health nurse practitioners do not require certification in all states, but that requirement is becoming increasingly common. The main organization which offers credentials for women’s health nurse practitioners is The National Certification Corporation. Certification requires that nurses sit for a computer-based exam and provide transcripts from an approved nurse practitioner program. Upon successful completion, nurses will be able to claim the Women’s Health Nurse Practitioner-Board Certified credential.

·         Many nurse practitioners also find value in professional organizations, such as Nurse Practitioners in Women’s Health (NPWH), which offers educational and networking opportunities as well as political and research advocacy, as well as the Association of Women’s Health, Obstetric, and Neonatal Nurses(AWHONN).