2009 Annual Report - Saint Francis Hospital and Medical Center

“Rehab nursing is very different from
acute care nursing,” explains Amy Calvo, R.N.,
C.R.R.N. “In the acute care hospital, patients are
evaluated, treated, stabilized and discharged.
Here, the focus for most patients is on getting
them home and back to their family, work and
everyday life.” This focus, combined with the
more complex medical needs of today’s patients
(the result of ever-shorter acute hospital stays)
means the rehabilitation nurse must play a
variety of roles. As a caregiver, he or she
performs all the functions normally associated
with nursing. “A patient may not be able to do
much on his or her own at first,” says Amy. “So we’re tending to
basics like feeding, toileting, wound care and skin integrity. And
because acute rehab treats the whole person, we’re addressing
psychological and social needs as well.” As the patient progresses,
caregiving incorporates rehabilitation strategies. Every aspect of
daily life, from eating and dressing to taking medication and
transferring from bed to chair, is an opportunity to put skills
learned in therapy to work. It’s also an opportunity for education.
“We do a heavy amount of teaching,” Amy says. “Every patient
has a discharge plan when they come here and that plan most
often involves the family, because patients will need assistance
when they go home. As educators, we help family members
understand the patient’s medical condition and the stages he
or she will go through over time. We also teach them about
medication, wound care and quality of life issues. And we make
sure the patient understands, as much as possible, what he or
she can do in terms of self-care at home.”
As a member of the rehabilitation team, the acute
rehabilitation nurse is part of a coordinated effort to achieve the
best possible outcome for each patient. Nurses attend weekly team
meetings with physiatrists, physician assistants, therapists, case
managers, consultants and other adjunct staff. “We talk about
After two years of rehabilitation nursing
experience, a registered nurse may qualify
to sit for the Rehabilitation Registered
Nurse certification examination
administered by the Association of
Rehabilitation Nursing (ARN). Candidates
who successfully pass this examination
are awarded the Certified Rehabilitation
Registered Nurse (C.R.R.N.) credential.
where the patient is currently,” Amy explains. “And we go over
therapy and nursing goals.” To ensure these goals and other vital
information are communicated to everyone who comes in contact
with the patient, they are posted on a white board in the patient’s
room. The board may indicate, for example, the patient’s level of
mobility, speech and swallowing abilities, and whether he or she
can use a sliding board to transfer from bed to wheelchair. The
therapy schedule is posted as well. While sharing information is
important, patient privacy is safeguarded. “We’re careful with the
type of information we post,” explains Amy. “And what we do
post is all in our own ‘hieroglyphics.’”
Another vital role of acute rehabilitation nursing is the
collaborative relationship with the case manager. Right from
admission, the rehabilitation nurse and the case manager focus
on preparing patients for their return home, often to a new and
different life. Every dimension of this new life is incorporated into
the discharge planning process and the rehabilitation nurse is an
integral member of the planning team.
Equipment unique to acute rehabilitation nursing includes the
Arjo Sara Lift (a standing lift that allows secure transfers); the
Arjo Maxi Move (a mobile passive floor lift); sliding boards for
patients who can bear weight; special reclining chairs for
showering; and a rotating disk, which allows patients to change
direction without moving their feet.
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