Do NP's have a role in inpatient rehab settings?

mom2cka · May 21, 2009

I work in an acute care setting, and we do not utilize NPs, nor do the physiatrists see that as a future need for our unit, but my cousin is an NP who works at Sister Kenney, which has facilities in the Minneapolis/St Paul area. I'm not sure if a CNS-rehab focus would be more appropriate in an acute care setting. If you post this on the rehab board, you may get more responses from rehab nurses who work with the NP/CNS folks in rehab settings.

core0 · May 21, 2009

Hi! I am an RN who is certified in rehab nursing. I love the rehab setting, but I long for more from my career. I am currently looking into possibly pursuing my masters (currently I have an ADN), and becoming a NP. I would love to practice in a rehab setting (possibly a skilled rehab setting or acute rehab). Does anyone have any insight for me?

All of the acute rehabs around here use either NPs or PAs. The ones that I am most familiar with use PAs. They round on the patients every day and make any interventions needed. I am guessing that the NPs doing this are similar. Sub acute and skilled have some very technical rules on how often a physician vs. an NPP need to see the patient but NPs and PAs are common in this setting also.

David Carpenter, PA-C

Advanced Practice Columnist / Guide · May 21, 2009

My first job after graduating from my NP program was at a free-standing Acute Rehabilitation Hospital working under the Department of Physical Medicine and Rehabilitation. The hospital offers In-patient Stroke, Traumatic Brain Injury, Spinal Cord Injury, Orthopedic, Geriatric, and General Physical Medicine and Rehab. Within the hospital building is an out-patient clinic where discharge patients can receive out-patient follow up.

Our role was to round with specific rehab teams in the in-patient setting and manage the patients medically. The teams include the Attending Physiatrist, an Internal Medicine consultant, a PM&R resident, and the Mid-level Provider (we had NP's and PA's doing the same role). Each specialty unit or service (i.e., SCI, TBI, stroke, etc.) had their own team consisting of the clinicians I mentioned. There were opportunities to follow up patients in the clinic with the individual attendings. There were also opportunities to do PM&R consults at referring hospitals which were part of the health system that owned the free-standing acute rehab hospital.

What I loved about the service was the schedule (Mon-Fri, 8AM - 5PM, though sometimes I did stay late when there were admissions who arrived after 4 PM), no on-call or off-shifts (the PM&R residents did that), and the multidisciplinary nature of the setting (we collaborated with PT, OT, SLP, Neuropsychology, Nutrition). What was also great about the specialty was the long-standing relationships with patients and the "happy" outcomes when patients do get to go home. There were some depressing moments such as admitting previously healthy young adults who have became quadriplegic from a traumatic accident. The attendings were great to work with and not one of them had inappropriate temperaments.

What I hated was the pay which was definitely lower than my classmates who were hired in acute care specialties. I now work in Critical Care which was really my preferred setting to work as an NP but I definitely didn't hate my one and a half year stint in PM&R.

lifelong · May 22, 2009

I remember graduating this past November (2008) and being offered an NP position in an inpatient rehab unit. I was doing my final clinical rotation in an ICU and we referred many patients to rehab (some in-house/others SNFs, etc.). Anyway, the inpatient rehab unit had 30 beds, self contained and the position had a hospitalist feel to it. I would work with up to 3 MDs as they rotated every month, and it was a M-F position. I would round on patients, participate in weekly multidisciplinary rounds. Pay was 88K, good benes/perks, etc (I live in Ohio). I didn't take it because Rehab is not my thing, but I think there is clearly a need for NPs in the rehab environment. Hope this helps.

Tracey