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Of every ten children in the world, one child is born with impairment or
acquires it early in life. Such a child may be partially or totally blind or deaf
& dumb, mentally retarded, physically limited or have a learning problem.
All such children need special help, timely treatment, education & training
to overcome difficulties created by their impairment.

Pathological conditions caused by diseased (or accidents or congenital

malformations) but give little or no information·s on their consequences,
such consequences may be long lasting & irreversible. They may lead to
difficulties with the normal functions of everyday life or limit the possibility
of sharing the social activities of the family & community.

Rehabilitation is an integral part of medical care. It is defined by WHO ´as

the combined & coordinated use of medical, social, educational & vocational
measures for training or retraining, the individual to the highest possible
level of functional ability & at the disabled to achieve social integration.µ

Rehabilitation includes thus all measure aimed at reducing the impact of

disabling & conditions causing handicap. It also aimed at enabling the
disabled & handicapped to be an accepted member of the society.
Rehabilitation medicine has emerged in recent years as a medical specialty.
It involves discipline such as physical medicine or physiotherapy,
occupational therapy, speech therapy, audiology psychology education &
training, social work, vocational guidance & placement services.

The purpose of rehabilitation is to make people productive people out of the

non productivity. Rehabilitation needs enthusiastic cooperation from
different segments of society as well as expertise, equipment, funds not
readily available for this purpose even in an affluent society. It is further
recognized that interventions at earlier stage are more feasible, will yield
results & are less demanding of scare resources.

Rehabilitation nursing is one of the branches of the nursing profession. This

kind of nursing is basically the care of patients who are recuperating from
injury or any kind of illness. Patients who opt for the rehabilitation nursing
are already cured of the immediate cause of their illness, and just need
support and care so that they can get back to their normal working lifestyle
at the earliest. There are several rehabilitation centers that cater to such
patients. Also, there are several hospitals that offer rehabilitation centers to
the patients.
To become a rehabilitation nurse, you would have to undergo training and
gain a degree in rehabilitation nursing. This training gives you all the
nursing skills that you would want to become a good at the job. Once you
have the basic training required, you should undergo advanced training and
a board certification, so that you increase your chances of getting employed
and in the same view ensure that you get the right kind of job that you are
looking for.

With board certification, you might also get an opportunity to lead a team of
nurses on an everyday basis. If a person is interested in a career in
rehabilitation nursing, the first step that they should take is to attend
nursing school. While at nursing school, they should keep their focus on
the aspects of rehabilitation during their training to become a nurse.

The tasks of a rehabilitation nurse are simple, and are related to the day to
day care of a patient. The basic tasks include cleaning of the wounds, or
assisting patients with their bodily functions, or even administering
medicines under supervision. Other aspects that the rehabilitation nurse
may look after are the charting of the patient, and keeping an eye on
whether their condition is enhancing or deteriorating.

Since rehabilitation nursing is required by individuals who have undergone

a severe medical condition and require to be nursed back to health, the
nurse's services may be required for accident patients, surgery patients, or
patients who have lost the ability to perform any task that they would on a
day to day basis. Therefore, the rehabilitation nurse's profile is vast and
varied and the training is quite exhaustive.

Rehabilitation nursing is not only about trying to get a person nursed back
to health, it is also about training the person so that he or she can
understand their abilities and disabilities and make the best out of life. For
example, if a person is confined to the wheelchair after an accident, the
rehabilitation nurse will make it a point to tell them how to use the
wheelchair and move around. Basically, the rehabilitation nurse also acts
as a person who gives the patient a comfort level when they are going
through a difficult time in their life. Patient education is also an important
part of the rehabilitation nurse's profile.

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providing equal opportunities and non discrimination in the area of
education, employment and in the society at large. It therefore
 includes not only the training but also intervention in the general
systems of the society, modification in the environment and
promotion and protection of human rights.
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Rehabilitation can be identified as a whole process of managing disability,

with the aim to enable individuals, their families and care givers to adjust
and cope with their change in circumstances. It must be based on on-going
assessment, planning and evaluation and involve partnership between the
individual, their social network and the health and social care team.

At rehabilitation centers, the rehabilitation process is different for every

patient. Just as no two people are exactly alike, no two brain injuries are
exactly alike. Rehabilitation programs are individualized, catering to each
person's unique needs.

The person with an injury or disability and his or her family should are
always the most important members of the treatment team. Cultural,
religious, social and economic backgrounds are also taken into
consideration when planning a person's rehabilitation program.

The goal of rehabilitation team is to help people regain the most

independent level of functioning possible. Rehabilitation channels the
body's natural healing abilities and the brain's relearning processes so an
individual may recover as quickly and efficiently as possible.

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The rehabilitation process typically involves a range of essential disciplines
such as a Specialist Consultant, Physiotherapists, Occupational Therapists,
Specialist Rehabilitation Nurses/Nurse Consultant, Doctors, Psychologists,
Speech and Language Therapists, Psychiatrists, and Pain physicians. The
effective rehabilitation is dependent on this group of people functioning as a
team, engaged in collaborative goal planning, focusing on the disabled
person and their family.

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The focus of rehabilitation is upon the patient·s needs and goals in order to
deliver an effective quality service to patients we are aiming to help. We
strive to provide effective rehabilitation services based upon the following
principles:

 m Rehabilitation should begin during the initial contact with the patient
  m Restoring the patient to independent or to regain his pre illness/ pre
disability level of function in as short a time as possible
 m Maximizing independence within the limits of the disability
 m Realize goals based on individual patient assessment & to guide the
rehabilitation programmed.
 m He must be an active participant.
 m The activities of daily living are facilitated.
 m The individual with a disability is encouraged to wear his own clothing
enhances self esteem & dignity.
 m Motivates the patient & helps him to attain social independence.
 m Focus is on the needs of groups of people with specifies conditions.
 m ‘very patient has a right to the rehabilitation services.
 m Providing interdisciplinary assessment in the acute setting to provide
specialist support and advice to prevent secondary complications
developing.
 m Staffed by a team of specialist professionals who work as a co-
coordinated interdisciplinary team to enable people to transfer skills
acquired during therapy sessions to their daily living activities. The
team is currently working towards an interdisciplinary approach. In
rehabilitation this approach is shown not only to be effective, but cost
effective in reducing the need for long term care.
 m Delivering well planned, goal orientated rehabilitation programmers to
the appropriate intensity for the person concerned, whilst supporting
their family and caregivers to contribute to the rehabilitation process.


 
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‘thical issues are of concern to all nurses. Rehabilitation nurses, in
particular, encounter challenging ethical situations in the settings in which
they practice. Nurses provide care to promote the health and well-being of
individuals; this implies interactions among people, and it implies the
seeking of what is good and of what leads to health and welfare.

´‘thicsµ is a formal decision-making process, used to determine the

rightness of conduct. ´Moralsµ refer to the rules and principles of right
conduct (Blais, et al.). The ethical standard for the profession of nursing is
established in the a
 
  



(American Nurses Association, 2001)

‘thical dilemmas are created when a choice must be made between difficult
alternatives or when important principles conflict. Nurses practicing in the
specialty of rehabilitation are confronted with numerous ethical dilemmas.
Members of the Association of Rehabilitation Nurses (ARN) have identified
several ethical issues that are of concern to those practicing rehabilitation
nursing, including the following:
 1.m Patients· rights, including the rights of minors. (Minors are capable of
understanding the decisions made in their name by their parents. If a
minor was not involved in the decision-making process and does not
agree with his or her parents· decision, the minor may have no
recourse regarding that decision, which leads to an ethical and legal
conflict.)
2.m The use of restraints
3.m Do-not-resuscitate orders
4.m Advanced directives, which imply nursing intervention and
responsibility regarding living wills and durable power of attorney
5.m Management of clients who are disposed to self-destructive behaviors
or suicidal gestures
6.m Issues related to healthcare reform and changes in how healthcare is
allocated and delivered including, but not limited to:

`m access to health care and rehabilitation

`m cost containment
`m quality of healthcare
`m determining length of stay
`m defining who meets the criteria for rehabilitation
`m dealing with patients' noncompliance with treatment and
rehabilitation
`m patient and family teaching in preparation for discharge to home
or another level of care
`m discharge to care level with appropriate skills for patients· needs

7.m Confidentiality, security, and privacy related to patient care

8.m Substance abuse
9.m Abused clients
10.m . The nurse/client relationship, e.g., when does it become too
intimate, and when is intimacy between the nurse and the client
appropriate?
Because ethical issues are of great concern for rehabilitation nurses, the
Association of Rehabilitation Nurses developed this position statement

 
The Association of Rehabilitation Nurses supports the 2001 ANA a
 

  


and the American Hospital
Associations
 
(1992) as important guides for ethical
decision making. ARN makes the following additional statements:

1.m The rehabilitation nurse acts as a patient advocate.

2.m The rehabilitation nurse recognizes the importance of patients·
participation in the decision-making process and realizes that
some patients do not and will not value independence and
wellness as much as the rehabilitation professional does.
 3.m The rehabilitation nurse is concerned about the rehabilitation
patient's quality of life as defined by the patient, if technological
advances in healthcare are compromising it. Advanced medical
technology may prolong life but not improve the quality of life.
4.m The rehabilitation nurse is responsible for providing information
or assisting with the collection and interpretation of information
that is necessary to resolve major ethical dilemmas and assist in
the patient's decision-making process.
5.m The rehabilitation nurse stays informed about ethical issues that
might affect rehabilitation patients and is aware of his or her own
values and attitudes.
6.m The rehabilitation nurse delivers care in a nonjudgmental and
nondiscriminatory manner that is sensitive to the patient's
diversity and protects the patient's autonomy, dignity, and
rights.
7.m The rehabilitation nurse supports the American Nurses
Association 1991 position statement on nursing and the Patient
Self-Determination Act.
8.m The rehabilitation nurse bases his or her decisions on the ethical
principles of autonomy, beneficence, justice and nonmaleficence.
9.m The rehabilitation nurse participates in research and realizes that
the benefits of research and human experimentation carry
certain threats to human rights. To protect these rights when
participating in research, the nurse considers the issues of
informed consent, criteria for inclusion and retention of subjects,
training of researchers, research dissemination, ethical
supervision and accountability, and provisions for subjects'
privacy and the confidentiality of results and findings.
10.m The rehabilitation nurse participates in decision-making
regarding allocation of resources used by or for the patient.

Regarding the rights of patients, the Association of Rehabilitation Nurses

holds the following beliefs:

1.m All people have the right to receive rehabilitation services

regardless of their age, race, gender, ethnicity, religion, or
economic status.
2.m All patients have the right to receive full resuscitation, request do
not resuscitate orders, request the discontinuation of life support
measures, or refuse recommended treatment, as long as they
fully understand what they are requesting.
3.m All patients· medications used to improve their ability to
participate in rehabilitation will be accompanied by a defined
plan of care with targeted outcome.
4.m All patients have the right to expect modification to their
environment to promote their safety. If environmental
 modifications prove unsuccessful, patients have the right to
expect that the least restrictive restraint device may be used to
prevent risk from harm. Use of environmental modifications
and/or restraints will be accompanied by a defined plan of care
targeted at restraint reduction outcomes.
Xm All patients have the right to expect the patient education process
to include health information and instruction that is applicable to
the patient·s care needs as well as information needed to make
decisions about discharge plans. These decisions may include
resources for discharge to home or another level of care. m