Core Competencies Required for All Rehab Registered Nurses - Research Paper Example

? Core Competencies Required for All Rehab Registered Nurses Core Competencies Required for All Rehab Registered Nurses Rehabilitation practices and principles were initiated many years ago; however, the practice became recognized within a considerable span of time, years later after it had been invented. The Egyptian physicians were the first to recognize the practices of rehabilitation about a thousand years ago. The rehabilitation services were mainly offered to the patients with spinal cord injury, paralysis, vertebra dislocations, and urinary incontinences (Mauk, n.d.). Many nurses have been credited for playing significant roles in elevating the rehabilitation concepts. In the year 1854, Florence Nightingale was the significant figure to introduce rehabilitation concepts in England. Notably, during this period, rehabilitation practices reduced mortality rates particularly during the Crimean War. Isabel Adams Hampton introduced the rehabilitation practices and principles in North America between 1860 and 1910. In emphasizing the underlying principles and practices of rehabilitations, Hampton pointed out that it is important to be clean and asepsis throughout the rehabilitation processes in order to reduce chances of secondary infections (Association of Rehabilitation Nurses, n.d.). Therefore, it vital for the rehabilitation nurses to remain clean all through the practice as well as maintaining cleanliness within and about the rehabilitation structures. The hygiene among the key principle of nursing rehabilitation can only be achieved by meeting competency requirements. It should be noted that rehabilitation is the process of recovery or adaptation whereby on a person suffering from functionality or disabling limiting conditions that may be irreversible or temporary, participates to regain maximum independence, functionality, and restoration. Rehabilitation services or programs aims at assisting a person to help from trauma or illness resulting from loss of functions that may include physical, social, psychological, and vocation (Mauk, n.d.). According to the National Cancer Institute (NCI) (2007), rehabilitation is the process that aims at restoring an individual’s mental or physical ability lost from injuries or diseases. Rehabilitation processes may be short lived or may be practiced on an individual for the rest of their lives depending on the extent and nature of injury. Goals of a rehabilitation practices are often defined within the goals that are mutually established within each individual’s practice of rehabilitation (Association of Rehabilitation Nurses, n.d.). Additionally, the underlying practices and principles within each defined rehabilitation process are often guided by the development care plan that is available or developed by a rehab nurse (Committee on the Robert Wood Johnson at el, 2011). In other words, the rehabilitation practices or goals are defined within the desired results for each rehabilitation client. The entire rehabilitation team often share or concentrate on a particular rehab area thereby sharing similar goals for the same client. The most vital purposes of the rehabilitation include maximizing self-dependence, self-care, restoring and maintaining functions, encouraging adaptation, and preventing complications (Mauk, n.d.). There are numerous goals and objectives of undertaking rehabilitation measures; however, a particular practice is often pegged on the desired outcome as per the care planning forwarded by the interdisciplinary team. Competencies and Certification The Basic Rehabilitation Nursing Practices Competencies were published in the 1994 by the ARN. The manual was produced to help in precept or educate, teach, and orientate new nurses on the requirements and principles of rehabilitation. The understanding of the rehabilitation was divided into three stages that cover a total of twelve months (Mauk, n.d.). Each phase has its own training goals and objects towards competency. The first phase incorporates a three months training where the nurse is oriented towards the practice. The second phase involves development on the practice (the next three months of the same year). The competency practices often ensure that the rehab nurses fully understand the essential requirements needed to care for patients during their rehabilitation. Moreover, the teaching or orientation under each phase teaches these nurses the total 89 practices. In the year 2006, ARN established an evidence based practice that focus on the new publication and it aims at common challenging interventions. There are 16 basic competencies, recently updated from the earlier ARN competencies. This update led to the establishment of the ARN- Competencies Assessment Tool (CAT) (Committee on the Robert Wood Johnson et al., 2011). The CAT assessment competencies are web-based tools that are availed at no cost to assist educators and managers to evaluate the rehabilitation knowledge towards staffing nursing rehabilitators. Each of the three competency areas are often evaluated using ten multiple-choice questions. It should be noted that these web ARN-CAT questions were updated in the year 2009. However, no available or reliable statistics that is available for the ARN –CAT (Mauk, n.d.). Certification is an important program since increases the knowledge and makes the nurses to be more positive towards their patients’ outcome. Some landmark studies have revealed that researchers use prospective observation designs in examining the nursing employment or staffing. Notably, the practice often promotes the attitude of the rehab nurses on their patients. Additionally, the relationship between patients and the staffed nurses is often improved the competency certification (Mauk, n.d.). Therefore, certification within the rehabilitation is inversely related to the duration taken by the rehabilitation patients. Specifically, according to a research on the relationship between the duration of stay of patient and certification of nurses, it was revealed that there is a decrease in the duration of stay of patient in the rehabilitation institutions with increased nursing certification (American Association of Cardiovascular & Pulmonary Rehabilitation, 2004). In addition, nurses’ certification within the rehabilitation centers adds confidence and professionalism that elevates the service delivery within the rehabilitation practice. The certified registered rehabilitation nurses (CRRN) is the credential body for certifying the rehabilitation nurses. The CRRN has certified over ten thousand nurses have been certified in the United States. Currently, this body requires that persons who need the certification must take examinations towards the certification (Mauk, n.d.). The examination is quite vital since it an avenue that makes rehabilitation nurses or students to understand and comprehend the vital practices and principles required for the practice. Moreover, the CRRN needs the rehab nurses to have at least two year of experience in a rehabilitation institution before they are certified for the practice (Association of Rehabilitation Nurses, n.d.). This creates a vital understand of knowledge and practices that are required of both the nurse and the patients before they embark on full practice (American Association of Cardiovascular & Pulmonary Rehabilitation, 2004). The two years attachment will also create vital required relationship between the nurse and the patients so that when in practice or after certification the nurse will only need to perfect on the same. The certification is also an avenue that tells both the employer and patients on the nurses’ experience and expertise in the area of their services. Through certification the rehabilitation nurse’s specialty and the degree of effectiveness with that specialty can be evaluated and determined. Further development of practice often evaluates and certifies that the rehab nurses have additional knowledge within the practices (Mauk, n.d.). Certainly, the rehabilitation nurses usually renew their certification after every five year of practice. The renewal and evident practice improvement are often registration through portfolios where the activities in the rehabilitation nursing are highlighted. Notably, the certification provides a way of validating the expertise of the rehabilitation nurses as it highlights the gain in additional knowledge within the areas of expertise of these nurses (American Association of Cardiovascular & Pulmonary Rehabilitation, 2004). Professionally, the certification practices are sure ways of promoting credibility of the rehab nurses with the community thereby promoting the relationship between patients, the community, and the nurses themselves. The association of rehabilitation nurses was founded in the year 1974. The institution was established to address the specialty needs of the nurses. By the year 1976, the ARN become the recognized body within the nursing specialty in united stated (Mauk, n.d.). The first rehabilitation nursing exams was conducted in the year 1984. Numerous nurses have so far been certified by this organization in the United States. It should be noted that many specialties are often certified within ARN and some of them include counselors, physiatrists, life care planners, case managers, and insurance representatives. The rehabilitation concepts often provide ways of considering or categorizing the major factors that influence the rehabilitation concepts and practices. These concepts are often divided into adaptability, chronicity, holistic care, coping, quality of life, and self-care (American Association of Cardiovascular & Pulmonary Rehabilitation, 2004). Despite the wide area of competencies requirements, the entire concepts and practices can be summarized into general competency requirements (Committee on the Robert Wood Johnson et al., 2011). The first competency requirement among the rehabilitation nurses is that they should promote adaptability. The adaptability requires rehab nurses not to only concentrate with recovery of the patients but must also ensure adaptability. The basis of the requirement is that patients often face emotional and physical changes; therefore, they usually experience intensely personal demoralization (Mauk, n.d.). Thus, the rehabilitation professionals must be able to understand their roles despite their enormous contribution to the recovery of the patient. These key competency requirement shall ensure that the rehabilitation nurses have the expertise of supporting and encouraging and being resourceful to the patient (Association of Rehabilitation Nurses, n.d.). Whenever an individual gets ill, all that the health care providers think of is the recovery of the individuals, sometimes they never think of emotional trauma that the person may be undergoing (Fitzpatrick and Ea, 2012). Therefore, it is the responsibility of the rehabilitation nurse to ensure that such patient’s emotional challenges are as well taken care. According to the ARN-CAT denotes that this competency concept shall ensure that the rehabilitation process helps the patient to adopt or adapt to alternating life situations without posing false hope to the recovery process (Mauk, n.d.). Therefore, rehabilitation nurses are required to demonstrate skills that suggest they can add adaptability value to the rehabilitee patients. Emphasize ability: the emphasizing ability is a competency requirement that ensures that the rehabilitation nurses encourage their patients so that they do not think of themselves (patients) negatively. In this care, ARN-CAT assessment evaluates the nurse on how they handle the patients particularly how they handle patient’s healthcare experiences (Association of Rehabilitation Nurses, n.d.). In situation where the rehabilitation nurses, concentrates on the patient’s predicament the patient will feel disadvantages, misfortunes thereby prolonging the patients’ recovery. For instance, an amputated limb may not recover as quick as had been anticipated if the rehabilitation nurse concentrates on sympathizing with the victim over his or her condition, or what might have facilitated such situations. The CAT assessment concentrates on how the rehabilitation nurse will handle such conditions. In this context, the rehabilitation professional is required to offer hope and optimistic outlook for the patients so that the patient may have hope for the future regardless of their current medical conditions. Additionally, the nurse should be demonstrating what mechanisms she would use to monitor the progress of the patient. In this situation, the rehabilitation nurse must set mutually agreed goals that are realistic and achievable (Mauk, n.d.). These goals must be short term and long term in nature to allow the patients to participate in the rehabilitation processes. This setting makes the patient to feel as part of the goal; thus, he or she will participate towards accomplishing the same. Their main obstacle will to achieve the goals and objectives of their treatment. The other competency requires a rehabilitation nurses to treat the whole person. The concept herein requires that the patient to be concentrated on as a holistic being in relation to the rehabilitation process. Everyone is a unique person; therefore, should be considered uniquely regardless of the age, gender, race, creed, or any other functional capacity (Mauk, n.d.). Any change in a person is often accompanied by other changes that involve remembering an individual’s past experiences, values, problems, and beliefs. Therefore, the rehabilitation process should ensure that all the experiences and events of a person are fully utilized during the rehabilitation processes. The competencies value examined in this situation concentrates on the nurses’ capacity to utilize the patients’ experiences for their own recovery benefit rather than using the same to remark them (Association of Rehabilitation Nurses, n.d.). The rehabilitation nurses are expected to treat a person but not a disease. Grieving is a core practice or process within the rehabilitation process. This practice is common among those who suffer loss of their loved ones. This practice often targets two sets of people or clients: the actual victim and the persons around the victim. In this context, the ARN-CAT evaluates the care giving ability of the rehabilitation nurses (Mauk, n.d.). The rehabilitation nurses must understand that in the situations of grieving, the ensure family is often affect; therefore, they must all be under appropriate rehabilitation process. Thus, the nurse must be ready to learn and understand the financial, emotional, and spiritual believes of the affected family (Fulton, Lyon & Goudreau, 2010). Grieving competency requirement will enable the student to be ready to learn identify community resources needed for any rehabilitation process towards handling their clients. The competency requirements have highlighted the healthcare professionals with the preventive care measures that are required of a rehabilitation nurses. Rehabilitation is one of the primary health care services provided towards improving the entire life of patients directly. However, there are certain secondary rehabilitation processes that some patients are always subjected. Therefore, it is vital for the rehabilitation-nursing students to identify initial type of the rehabilitation process the client should undergo. Additionally, the competency assessments are critical avenues that ensure that these students develop career competency that will in turn ensure that patients under rehab obtain quality medical and non-medical services in the rehabilitation facilities towards quality life. Different patients’ needs different rehabilitation medications; therefore, the ARN should amplify it assessment tools to incorporate evaluation of the nurses in line with different patients. For instance, the war victims will certainly need difference rehabilitation processes as compared to accident or grieving victims. References American Association of Cardiovascular & Pulmonary Rehabilitation. (2004). Guidelines for cardiac rehabilitation and secondary prevention programs. Champaign, Ill: Human Kinetics. Association of Rehabilitation Nurses. (n.d.). Rehabilitation nursing criteria for determination and documentation of medical necessity in the inpetien rehabilitation facility. Retrieved November 14, 2012, from http://www.rehabnurse.org/pdf/PS-Criteria.pdf Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine., Robert Wood Johnson Foundation., & Institute of Medicine (U.S.). (2011). The future of nursing: Leading change, advancing health. Washington, D.C: National Academies Press. Fitzpatrick, J. J., & Ea, E. E. (2012). 201 careers in nursing. New York, NY: Springer. Fulton, J. S., Lyon, B. L., & Goudreau, K. A. (2010). Foundations of clinical nurse specialist practice. New York: Springer. Mauk, L. K. (n.d.). General concept and principles of rehabilitation nursing: Overview of rehabilitation. NY: Jone & Bartlett Learning. Retrieved November 14, 2012, from http://samples.jbpub.com/9781449634476/80593_ch01_5806.pdf Read More