Rehabilitative care: Nursing

Rehabilitative care refers to the management of disabilities and chronic health conditions across the lifespan. It can take place in many settings like an acute care hospital, inpatient rehabilitation center, or at your patient’s home. As a nurse, you’ll collaborate with the interprofessional health care team, including nurses, social workers, case managers, physical therapists, dietitians, speech-language pathologists, and physicians, to support your patient’s functional abilities and prevent complications. 

When caring for your patient in rehabilitative care, your assessments will include physical, functional, psychosocial, vocational, and home safety assessments.  

Begin by completing a physical assessment of your patient’s major body systems with a focus on their current functional abilities. Assess their ability to complete activities of daily living, or ADLs, such as bathing, bowel and bladder elimination, and dressing.  

You’ll also assess their nutritional status, including the presence of chewing or swallowing problems, and their ability to prepare meals. Then, determine their level of mobility, their history of falls, and their need for any assistive devices, such as walkers or canes.  

Also be sure to assess their sensory function, and the use of glasses or hearing aids. During your assessment, note any signs or symptoms that may impact your patient’s ability to participate in rehabilitation, like shortness of breath or uncontrolled pain. 

Next, assess their psychosocial status by determining how they feel about their changes in health and loss of function, sources of stress, and their support system. Look for indications of anxiety or depression, such as loss of appetite or problems with sleep.  

Also, take note of any cultural, spiritual, or religious needs that may impact care. 

If your patient is employed, you’ll also perform a vocational assessment to examine the cognitive and physical demands of your patient’s job. Then, along with the rehabilitation team, you’ll determine if job modifications or adaptive equipment will be needed to help them continue working.  

Lastly, you should perform a home assessment to ensure your patient will be discharged to a safe environment. You’ll examine the accessibility of frequently used rooms, such as the bathroom, bedroom, and kitchen, and determine if any modifications are needed, such as a raised toilet seat, handrails, or brighter lighting. 

Alright, your interventions will be focused on supporting your patient’s functional abilities and preventing complications.  

First, you’ll work with the physical therapist to promote your patient’s mobility with gait training and the use of ambulatory aids. Assist with the prescribed exercises to promote range of motion, balance, and strength and to promote independence and decrease the risk of falls.