Running head: NURSING STANDARDS OF PRACTICE

Nursing Standards of Practice

Patricia Beemer
Ferris State University



NURSING STANDARDS OF PRACTICE 2

Abstract
Rehabilitation nursing is very specialized. The Association of Rehabilitation Nurses provides
multiple examples of nursing responsibilities. Many disciplines work as a team to provide
exceptional care for a rehab patient. The process begins upon admission and steadily continues
throughout the length of stay. Close monitoring is very important to make sure an area of need
is not over looked.

Keywords: Rehabilitation Nursing, Functional Independence Measures, Association of
Rehabilitation Nurses













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Rehabilitation Nursing Standards of Practice
The Association of Rehabilitation Nurses defines numerous responsibilities of a staff
nurse to insure a rehabilitation patient is provided every opportunity possible to achieve the
highest level of function possible before discharge. However, it is not only the responsibility of
the staff nurse to complete all things needed for patient care. There are many people involved
during a patient rehabilitation stay and it is idly important that all staff work as a team
throughout the process to make sure all is completed prior to discharge. Rehabilitation nursing
involves many different needs than that of other types of nursing. A staff rehabilitation nurse
will play a part in teaching, caregiving, collaborating, and a patient advocating.
The Association of Rehabilitation Nurses provides a well-defined list of responsibilities
of a rehabilitation staff nurse as follows:
-Possesses the specialized knowledge and clinical skills necessary to provide care for people
with physical disability and chronic illness. (ARN, 2014) As a registered nurse on a spinal cord
rehabilitation unit, I have had additional training necessary to provide optimal care for my
patients. Spinal cord injury requires nurses to obtain knowledge in autonomic dysreflexia,
sexual dysfunction, bladder spasms and bowel programs. There are many other components
when caring for a spinal cord patient; however, these are the areas I have paid particular attention
to.
-Coordinates educational activities and uses appropriate resources to develop and implement an
individualized teaching and discharge plan with clients and their families. (ARN, 2014) Upon
admission of a patient to our rehabilitation hospital I define the needs of not only the patient, but
also the family. Many times, entire family involvement is necessary in order to develop a plan
allowing the patient to discharge home with the family rather than a long term care facility. I
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work with a team including a physiatrist, social worker, occupational therapist, physical
therapist, speech therapist and sometimes a psychologist. After the initial admission assessment,
all evaluate and define needs within their discipline, creating their own care plans. Weekly team
conferences are then held to discuss progress and concerns related to the patients individualized
care plan.
-Performs hands-on nursing care by utilizing the nursing process to achieve quality outcomes
for clients. (ARN, 2014) The nursing process is started upon admission to our hospital. A care
plan is individualized and initiated for each patient. This process has been a struggle for our
facility since the start of our electronic medical records transition. Our hospital has recently
hired a nurse specifically to address issues such as these and provide training to our staff to
insure we are following through with our care plans and nursing process. Our first step is to
provide training to our staff and to hold them accountable to update them every shift. We
typically include three main care plans: knowledge deficit related to self-care, pain and
knowledge deficit related to rehabilitation care. After those are initiated, I then develop more
care plans relating to their need and diagnosis.
-Provides direction and supervision of ancillary nursing personnel, demonstrates professional
judgment uses problem solving techniques and time-management principles, and delegates
appropriately. (ARN, 2014) Within our rehab facility, we have specialized nurse techs trained
specifically to provide tasks such as sterile catheterization, bowel programs, and transfer
techniques in relation to specific needs as outline by our physical therapist. However, as a
registered nurse, it is my responsibility to oversee the nurse tech and make sure they provide
appropriate care to our patients. We have specific routine training and a skills check off for our
nurse techs to complete in order to continue to provide care to our rehabilitation patients.
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-Coordinates nursing care activities in collaboration with other members of the interdisciplinary
rehabilitation team to facilitate achievement of overall goals. (ARN, 2014) During our team
conferences, we define the needs of the patient and the barriers needed to overcome prior to
discharge. These barriers may be defined within nursing or therapy. We review weekly and
provide an update to our interdisciplinary team.
-Demonstrates effective oral and written communication skills to develop a rapport with clients,
their families, and health team members and to ensure the fulfillment of requirements for legal
documentation and reimbursement. (ARN, 2014) In order for our facility to be reimbursed for
services, we need to provide specific documentation. Extensive training is providing to score
accurate Functional Independence Measures (FIM) scores. In order for our nurses and therapist
to be able to care for patients and continue employment, it is a requirement to pass a specific
FIM test yearly. It is pertinent all FIM documentation is accurate starting on admission through
to discharge. Reimbursement for services is based on these measures. A designated team within
our facility provided the training needed and follows documentation from staff on a daily basis to
insure accurate documentation.
-Acts as a resource and a role model for nursing staff and students and participates in activities
such a nursing committees and professional organizations that promote the improvement of
nursing care and the advancement of professional rehabilitation nursing. (ARN, 2014) I have
completed our preceptor program within our facility. It is a requirement for our staff to complete
this program prior to training another nurse or student. This is a class that continues throughout
the year. I meet with all preceptors and review a plan for orientation and discuss any concerns
noticed with previous nurses during orientation. I meet with our nursing educator throughout
this process to individualize the needs of nurses during their orientation.
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-Applies nursing research to clinical practice and participates in nursing research studies.
(ARN, 2014) I am currently involved in reviewing our clinical policies to reflect research
findings according to evidence based practice. Our team involves our medical director, director
of nursing, nurse managers and five staff nurses.
Professional Development Plan
Goals
Throughout my nursing career I have developed many goals, some I have already
achieved and others I will continue to achieve along my journey. Within the next year, my goal
is to complete my training to be a Certified Rehabilitation Registered Nurse and complete the
necessary testing for this certification. I have completed my wound certification course through
the Wound Care Education Institute and set a goal to complete my testing within the next three
months in order to develop a wound team at our facility beginning in June of 2014. I set another
goal to complete my BSN program by the end of 2014.
Action Plan
In order to accomplish the goals I have set for myself and my career, I have developed an
action plan. I have scheduled to attend a training conference in March of 2014 to review
necessary information in preparation for the certification test to become a Certified
Rehabilitation Registered Nurse. Our facility currently hires an independent wound consultant to
oversee our wound patients. I have discussed with her my class for certification and we have
worked together to develop a time for me to follow her as she rounds on her patients. This
opportunity is providing a plethora of knowledge needed to become certified. In order to earn
my BSN by the end of 2014 I need to complete three more classes after this semester. With the
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assistance of my advisor, I have a plan to complete these three classes within the next two
semesters.
Evaluation Plan
I will evaluate my progress in obtaining my certification for a Certified Rehabilitation
Registered Nurse, my BSN and my Wound Care Certification on a regular basis. I will continue
to study and confirm dates of education and training. Ultimately, the goals I have listed will be
reached by the end of 2014 in the form of a degree or certification.
















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Reference
Association of Rehabilitation Nurses. The Rehabilitation Staff . 2014. Retrieved from:
http://www.rehabnurse.org/pubs/role/Role-Rehab-Staff-Nurse.html