Question?

askater · Dec 7, 1999

I've never worked on a rehab unit. I've sent a lot of patients to rehab. (stroke, M.V.A's, post-surgical patients to rehab) Physical therapy is their focus. The hospital I used to work at had a Rehab Unit. They had kitchen area and a car. They worked on making the patient as mobile and independent as possible.

I never worked in a nursing home either. I volunteered in a nursing home though. There were a lot more confused, dependent patients at the nursing home I volunteered at. More so than the rehab unit at my old hospital.

I feel rehab nursing is a speciality. They work hard getting the patients mobile and independent.

Well this posting probably didn't help you. I hope some nursing home and rehab nurses can help you.

askater · Dec 7, 1999

I've never worked on a rehab unit. I've sent a lot of patients to rehab. (stroke, M.V.A's, post-surgical patients to rehab) Physical therapy is their focus. The hospital I used to work at had a Rehab Unit. They had kitchen area and a car. They worked on making the patient as mobile and independent as possible.

I never worked in a nursing home either. I volunteered in a nursing home though. There were a lot more confused, dependent patients at the nursing home I volunteered at. More so than the rehab unit at my old hospital.

I feel rehab nursing is a speciality. They work hard getting the patients mobile and independent.

Well this posting probably didn't help you. I hope some nursing home and rehab nurses can help you.

mn nurse · Dec 8, 1999

Whoever told you Rehab nursing isn't a specialty obviously wasn't a rehab nurse!

Rehab is a MULTIDISCIPLINARY team approach to restoring maximal function and independence to people with loss of function due to illness or injury. It's about what the patient CAN do, not what they can't. It starts with discharge planning and everything is geared to meeting the functional goals necessary to achieve the discharge plan.

Much of rehab nursing is done with your hands in your pockets. You spend 30 minutes cueing someone how to put his shirt on, rather than 1 minute doing it for him. In between cues, you encourage him for his efforts and try to help him through his frustration. This approach is taken with ADLs, mobility, toileting, med management, cooking, cleaning, financial management, etc. Every aspect of life is addressed; if it isn't independence isn't realistic, another way must be found and implemented.

Acute rehab requires a minimum of 3 hours of therapy daily, and the patients are seen by a physician specializing in physical medicine and rehabilitation daily. These units have stoves, washing machines, cars (to practice transfers), etc. One I know of even has a putting green! Usually the patients with long term deficits, like strokes, cord injuries, etc. receive counseling for adjustment to their disability as part of their program.

Nursing homes provide a variety of services to residents, from care of the advanced Alzheimers patient, to those who have minimal needs for supervision and/or assistance with ADLs. Many are not confused and are quite independent! There are games, trips, entertainment; the key is that these people are "residents", not "patients", and the goal is to make it as "home-like" as possible. Nursing homes do offer therapy, but it's not as intensive as acute rehab.

Some nursing homes have "short-stay" or subacute units that are geared to people who are planning discharge home or to a less restrictive environment. These units are similar to acute rehab in philosophy, but are not as intense in their therapy requirements, the patients are not seen by physicians daily, and usually don't have the resources for counseling by specialists in disability adjustment.

Sorry this is so long, but I hope it helps.

[This message has been edited by mn nurse (edited December 07, 1999).]

ecb · Dec 11, 1999

I DO work in a nursing home, I have worked in a few in the past year and a half. The people/residents we have admitted for rehab get rehab, a few sessions each day as well as specialised activeties. Their days are full and the tend to have a good NH experience.

The therapists in the long term care settings I have been in will actually ask the off shift nurses for input on the care and goals of these residents. We can also slip them a note (if the nurse is so inclined and not burned out) to make a suggestion to change therapy in some way (subtle or Not)

I try to take an active role in the therapy of residents under my care (the ones with rehab potential) but the care of the "Real" nursing home residents can really get in the way

hope this helps

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*** May we all have the serenity to accept what we cannot change, and the determination to change what we cannot accept. ***