Wants to go into rehab nursing

mom and nurse · Jun 21, 2006

Pros: Getting to work with and really know the patients and their families. Being able to watch them improve. Watching my patient come in on a stretcher and walk (or roll in a wheelchair) out of the facility with a new perspective on their disability. Watching an amputee learning to use a new prosthetic leg (or prosthetic arm). Watching a stroke victim learn to communicate again. It's a little psych, a little orthopedics, a little med/surg rolled into one. Celebrating small victories....such as watching a patient go from requiring continuous feeds to bolus feedings through a peg tube, to mechanical soft diet, on her way back to a regular diet again.

Cons: If you are into the fast action of an ER then rehab is a lot slower pace (most days its a slower pace.....) The patient load at our facility is 6 or 7 to one nurse on days (which is good compared with some places). Patients family members tend to be edgy due to stress. If you are into really intense critical care like chest tubes and PCA pumps you might not see these in rehab. (though as we try to comply with the 60% of the 75% rule it appears the patients we are getting are sicker than they used to be and we are seeing more patients with trachs, more patients requiring restraints, more patients with peg tubes, more patients with Brain Injury and stroke, etc.

Rehab is a rewarding field. More about rehab nursing at http://www.rehabnurse.org and for a definition of what rehab nurses do you can go to http://www.rehabnurse.org/about/definition Hope this helps. :)

cathy54 · Jun 22, 2006

Thanks. It really sounds like what I want. I have worked LTC and some acute care. I have a lot to learn and am willing to do so. This sounds like what I want.

takenbyjoy · Jun 26, 2006

Mom and nurse has it right. I've been in rehab in various positions since 1983 :Melody: ..... Rehab nurses work with all ages of patients. We currently have patients from age 18 to 90+. We get a variety of diagnoses: CVAs, TBIs, SCIs, orthopedic pts including multiple trauma, amputees, and other neurological diagnoses. Rehab nursing can be very rewarding for all the reasons that Mom and Nurse stated. It is physical, maybe more so than other areas of nursing, because our patients get up and have to be in therapy for at least 3 hours a day. Our therapists help alot with that, but ultimately, it is nursing staff (licensed and unlicensed staff) that are transferring patients in and out of bed all day long, off the potty chair, etc. The right training and equipment make all the difference in the world. Our acuity levels have changed dramatically over the last several years, so we do have patients that are "sicker" in rehab than we had in years past. Overall, I think it is still a great area of nursing in which to practice. If you haven't accepted a job yet, I would recommend that you ask to shadow a nurse for day to see exactly how they function in that specific facility. Hope this helps and good luck!

jjjoy, LPN · Jul 19, 2006

Maybe I should consider rehab as well...

I definitely prefer environments where I have a chance to get to know the patients. In med-surg, just as I feel that I'm getting to know who's who and what's going on with them (2-3 days), they are transferred/discharged or at the very least assigned to another nurse and I never know what happens to them.

Also, I like work environments where staff interact and share ideas. On most med-surg units, everyone is too busy juggling their own patients to really interact much. Understandably, the focus is on what needs to be done now; but I'm always curious to know what happens next and how everyone's different contributions work together for the patient.

I did some agency work at an AIDS hospice and enjoyed it more than the hospital environment. I remember coming in one day after a few weeks, knowing who was who, wondering how they were doing and looking forward to starting the day. It was easy to get in touch withand communicate with the facility's medical staff as they weren't in and out of surgery or juggling a full outpatient practice. I couldn't get hired there because they would only hire RNs as charge nurse and I'm not comfortable with that - I'm re-entry with little clinical experience, worse off than a new grad! The only reason I got to work there at all was that it was the holiday season. It was a nice place to work, well-staffed and resourced, so once the holidays were over, they weren't desperate enough to make a place for me.

I tried LTC, too. Passing meds to 30 patients in under 2hrs doesn't much allow for getting to know the patients/residents and seeing the whole picture of their care. Being the unit RN responsible for addressing changes in patient status of somewhere between 60-90 patients... it's overwhelming to me. I probably could manage if I had to, but it's not a job I'd take by choice.

I definitely enjoy teaching. In med-surg there is some teaching but the poor patients are having a lot to deal with and they're only there a short time, so there's not the opportunity for a more indepth chance to assess their learning needs and styles and to tailor information to suit them.

I'd worry about the physical aspect of the job. In general, I hope more places can take advantage of the new lift technologies.

Any rehab nurses out there have any feedback on the realities of rehab nursing and the pros and cons of it given my preferences and style?

Thanks!

mom and nurse · Jul 19, 2006

Any rehab nurses out there have any feedback on the realities of rehab nursing and the pros and cons of it given my preferences and style?
Thanks!

There is lifting involved in rehab. Many of the nurses have attended sessions to learn how to lift patients properly and how much lifting you need to do may depend on the facility.

One thing I failed to mention is that some of our doctors are onsite. They are physiatrists (doctors of physical medicine...specialists in rehabilitation) and it is easier to contact them since their offices are downstairs. Also the doctor, nurse, occupational, physical and speech therapists and case manager have "team conferences" in which we discuss (Doctor first, nurse second, then the therapists) how the patient is doing according to the various disciplines and areas they (and their family) need to work on before discharge (discharge planning), supports that may be needed for the family, etc. I think we relate differently to our doctors than the nurses and doctors working on a med/surg unit. (There is an emphasis on a "team" approach).

One of the joys of rehab is having patients come back to see the people who worked with them and to show how much they have improved (we have an outpatient facility downstairs so many come upstairs to tell us hello after they have been discharged from the inpatient hospital). Also around the holidays former patients come by to see us.

Perhaps there is a rehab facility near you that will let you shadow a nurse so you can see what rehabilitation nurses do at the facility you consider working at.....

takenbyjoy · Sep 11, 2006

JJJoy....you sound like a rehab nurse...... :yeah: . While our patients are not staying as long as they used to (when I first started in rehab, SCI patients could stay up to 3 months!!!! :monkeydance: ), we do get to know them and their families/sig. others pretty well. As far as the physical side of rehab nursing: if you work with a good team (e.g., OT, PT, CNAs), you all help each other. Many facilities are going to "no lift" protocols and there should always be the appropriate equipment to transfer patient. My experience in rehab is that usually, rehab staff are better prepared to deal with the physical aspect of nursing that other specialties.