Too Smart for Rehab Nursing

Specialties Rehabilitation

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I am too smart for Rehab Nursing.

This is what I hear whenever I tell people that I enjoy working in acute rehab and that when I am done with nursing school this Fall I think I am going to stick around on the rehab floor. I am a Nurse Tech who has worked on this floor for about a year. I am an A student who gets rave reviews from my clinical instructors. "Work in cardiac!" I hear often, "Go to progressive care!" "Rehab?!? You're too smart for rehab, you'll get BORED"

Bored?!? Have these people ever been on a rehab floor? They seem to think all we do is give pain meds and take teetering old ladies to the bathroom. Rehab combines med/surg nursing with a great deal of psych nursing and ortho nursing AND neuro nursing AND oncology nursing! We get all sorts of people on this floor! You have to be ready for anything.

Also, I enjoy the patients. I like getting to know them and their families and there is no greater joy than watching the patient that was not able to even move his/her legs on arrival finally stand up and take a few steps for the first time. Rehab nursing is about being a cheerleader some days and a drill sergeant the next. You have to use tough love sometimes. . .but also know when to just hug a patient and let them cry. We also laugh a lot on my floor.

Yes, there is a TON of paperwork for the nurses (I hear them cursing FIMs every day). Yes, it is physically hard. Yes, there are a lot of pain meds. No, there isn't the constant excitement of Trauma nursing or ICU. But there is magic and fulfillment and some days you truly do feel like a guardian angel.

Does anyone else love working in rehab and hate the comments about how boring it is and how a "smart nurse" shouldn't work there? Because some days I start to doubt myself and I start to think that maybe I should go to a med/surg or tele floor when I graduate -- I am afraid of being pigeon-holed forever as a "rehab nurse" But would that be the worst thing in the world?

Shame on anyone for "ranking" any aspect of nursing! A school nurse is "low" until it is your child hurt at school and needs immediate attention. An LTC nurse is "low" until it is your parent or loved on with Alzheimers and they dont recognize you anymore and there is a medical issue...you are to close to be objective. A psych nure is "low" until its your teen in trouble with drugs or depression.......Did anyone sail through all areas of the NCLEX and nursing school and think these areas were foolish or a breeze? ALL areas of nursing require a set of skills that are unique and until us nurses acknowledge it among ourselves we all look like fools! Be proud of your profession and stand up for all areas! I LOVE rehab nursing. I have spent 5 years in oncology, 12 in cardiac step down and 2 in med/surg. REhab tops all of them. There is GREAT satisfaction to seeing pts fianlly walk out on their own or move a limb or speak and swallow on their own. Familys can be a real challenge as some pts are with you for weeks. It is easy to treat and shove the pt on to another facility.....esp when dressing changes dont occur or showers or you put a cath in and pull it prior to discharge to save yourself work. Cant tell you how many times I have seen that! WE ALL WORK at or jobs

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Specializes in Rehab, Med Surg, Home Care.

I spent the first years of my career in a free-standing sub-acute rehab hospital. We got virtually everything I later saw in med/surg. Only real difference is now having an OR, Cath lab, CT,MRI etc on site so there was a longer time gap between when docs ordered tests and when the pts went to have them in Rehab. I too was "guilted" into feeling that I needed to do some REAL nursing by the comments I kept hearing when I told people I did Rehab nursing. Let me tell you when I did move I was totally prepared in the REAL nursing aspects; assessment, communication with patients and families, critical thinking, plus I had already seen PICC's, central lines, TPN, CAPD, codes, every kind of wound treatment including wound vacs in Rehab. The biggest change for me in going to "acute" nursing was different paperwork, different equipment, and never having the same patient for long enough to see the positive effects of my work with them. I do like med/surg for one of the same reasons I loved Rehab-we saw just about everything and it required me to use ALL my skills- but I don't for a minute feel it is more challenging!

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Specializes in Neuro/Med-Surg.

I just love everyone's responses and experiences and opinions. Thank you so much! I am feeling happier and better about working in rehab long term. Thanks everyone!

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Lola: im so glad you posted this message, i am a new grad and just accepted a job on the rehab unit. As soon as i got on the unit, the nurses told me that i should move on to other speciality to get more experience. I've heard many times that i should look into working on med-surg and acute care from different nurses. It is easy to be impressionable as a new grad and i find myself getting restless partly because of the advises from well intended veteran nurses.

However, i agree with everything that everyone else said here, so far, i found rehab to be very rewarding, i get different kinds of patient's all the time, i have less support so have i have the oppertunity to develop indepedent critical thinking skills, and get tremendous satisfaction when patients leave this place in better shape when they came. It is a happy and proactive place and most of the time, it puts me in a good mood.

I just started working and as a brand new grad, is it hard to say that i want to settle down, but i will never regret working in rehab for my first job, and it is something that i see myself coming back to. So thanks for starting this post, it gave me a different point of view and a different voice than what i've been hearing.

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I keep reading alot of this non-sense on other threads. I believe that it is all propaganda. ICU, ER, Trauma, etc. areas of nursing are, or so it seems so burned out and synical by/about the system in which they work. That they will put down another NURSES' area of interest and work. It is comparing Apples to Oranges in the same industry. Who's job is harder, who is smarter, who is....Bla, Bla, Bla, The questions: are you happy and are you trying to make a difference and are you making a living ? Very simple concept. JM2C.

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Specializes in NICU, Peds, Med-Surg.

I have to agree with EVERYTHING everyone else has already said.....:yeah:

And I'll add a couple more stories you can tell people who want to cut you down!!!

I admitted a 75-yr.-old lady recently for a "LEFT HIP".....I always SAY their diagnosis in "QUOTES" and my

coworkers laugh because we ALL know they are usually WAY more than "JUST a HIP"......Amen? :smokin:

By the time she was with us for 3 hours, her BP plummeted, pulse getting faster.......

then she became pale and diaphoretic....I was TERRIFIED she was about to code on me!

She also c/o chest pain, so we did an EKG (yea, and WE do our own EKGs if our resp. therapist

is busy!) and when I handed the EKG to the Nurse Practitioner, he was NOT happy....Bad sign!

I'm thinking they are CERTAINLY going to send her back to acute, but nooooo!!!

So, the BP is just getting lower and lower (can you sayyyy.....78/34!!!:mad:)

I'm thinking hypovolemia but also thinking her sugar has GOT to be low....because now we're in

the bathroom and she tells me she feels verrrrrrrrrrry dizzy. I'm thinking I'm going to be

pushing D 10 as soon as hubby tells me she hasn't eaten in three days.............:uhoh21:

Nope, glucose was 263 AND when I tested her urine, she was spilling protein and ketones.....

I go to tell the doctor alllllllllllll this info (and again, we do NOT always have them

around like "acute"). I get orders for NS at 100 cc/hr, plus a unit of blood. WOW, I couldnt

believe what a couple hours of good ole' saline did for this lady!!!:yeah: And, I was SHOCKED

that she in fact did NOT code, and she stayed with us about 2 weeks!!! :lol2: Soooo, anyone

who wants to cut down rehab nurses needs to work a couple shifts with us!

Another story I JUST heard from my friend was that we had a lady with a Pulmonary Embolism......I do NOT

have experience with them, I just ASSUMED she "ship them out" immediately.....too scary

for our sub-acute rehab! NOPE......because of her status (again, I wasn't there to see it,

but her resps, breathing effort, sats, etc were NOT enough to "send her out acute")....she

DID stay at our facility, she got a nice double dose of Lovenox and some other interventions,

and she is now doing very nicely in our BORING rehab facility after her hip replacement....

I HATE IT when I orient a new nurse, and I'm not kidding----I've had TWO people say this to

me on their FIRST day---"I'm afraid I'll be BORED here"....OMG! I don't say it, but the first

thing I think is "then WHY are you wasting your time applying/ interviewing and working here!!?!!!?":down:

But what cracks me up is that we RUN the entire 12 hours, and I always ask 'em "are ya still afraid you'll be

BORED?" :lol2:

One thing I DO hate is our recent change in paperwork....OMG! We keep saying we are back in the 1950's

and let's put on our white caps and white dresses again. We have to do SERIOUS, DETAILED narrative

charting, and not just on our own notes, but in the admission note---we have to write a longgggggg

paragraph (or two or three) to justify to Medicare why they're in rehab and not a SNF or their own home.

It is RIDICULOUS and since they changed it, we are ALL late, every time.....by an hour or TWO! UGH!:nono:

GOOD LUCK TO YOU AND DON'T LISTEN TO THE NEGATIVE PEOPLE!!!!!!!!! It IS wonderful to see a young

person (he had a major TBI) go from not talking, couldn't swallow, not walking......to a fully functional teenager

many months later.....when I saw him come to visit, I almost cried and I STILL get goosebumps when I tell

people about it. I could NOT believe he was the same person!!!!!!!!!! :redbeathe:bow::p

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Specializes in Emergency Department, Rehabilitation.

Hey Lola, I graduated in December and just started my first RN job at a rehab hospital. I was a PCA in an ER for years and recently in Inpatient Rehab. Anyone who tells you rehab nursing isn't very impressive or looks down on rehab nursing is truly ignorant. Every single medical specialty prescribes rehab for their patients from hips, knees, and spines to cardiac, brain injuries, and major traumas. As more and more procedures are done outside acute care facilities rehab becomes more important to the patient's outcomes.

Karma is something, kiddo. Someday nurses that look down their noses at rehab nurses will be the ones who look to us to ease their pain. Follow your heart and you'll be just fine. Good luck on your final semester!

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Specializes in Legal, Ortho, Rehab.

Wow I didn't know getting someone to their highest level of functioning was looked down upon! After all, we just restore independence and all... :twocents:

No nurse is higher than the other, all of our roles are important.

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Specializes in LTC, Acute Care.

I have been on orientation in acute rehab for 2 days and I have got to admit that I am in love. That is if you can be in love with a particular field.....lol. There hasn't been a dull moment yet. We have IV's and of course CPM. I also work in LTC and to me rehab is the middle ground between med-surg and LTC. I have learned so much in these couple of days and am looking forward to learning more. People have often told me that I "belong" on ICU/CCU but I say to them I'M doing what I love and that's what matters most.

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When you do your rotations in clinical to different specialities you will see why you need to branch out and do other types of nursing. Nurses go to rehab nursing at the end of their careers not the begining.

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Specializes in LTC, Acute Care.
When you do your rotations in clinical to different specialities you will see why you need to branch out and do other types of nursing. Nurses go to rehab nursing at the end of their careers not the begining.

I beg to differ. There is always time to try different specialties and some choose acute rehab, some LTC, some clinic, and some med/surg. I believe in people doing what makes them happy.

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Specializes in Emergency Department, Rehabilitation.
When you do your rotations in clinical to different specialities you will see why you need to branch out and do other types of nursing. Nurses go to rehab nursing at the end of their careers not the begining.

Like I said earlier in this thread, when people make a generalization like this it's naive and probably meant to be insulting. If certain nurses actually spent any significant time in rehab they would see that it encompasses many different disciplines instead of pigeon-holing a nurse into one certain specialty. To be an effective rehab nurse you have to rely on all your skills and you have to be able to do that without the resources many acute care hospitals have the luxury of falling back on.

ALL nursing specialties work hard and exceptional nurses are everywhere. Unfortunately, there are others who feel they make themselves appear better than others when they try to tear other specialties down.

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