Health Policy & Advocacy
Inclusion of Rehabilitation Concepts as a Component of Generic Content in BSN Programs
Summary: The Association of Rehabilitation Nurses (ARN) recognizes the need to include basic rehabilitation concepts within the curriculum required of students pursuing a Bachelor of Science Degree in Nursing (BSN).
The current changes in the health care environment have and will continue to alter what should be minimum knowledge required for graduation from an accredited BSN program. The concern is that as patient needs and practice environments for nursing continue to change there is a need for a broader understanding by graduating nurses of the basic principles underlying the specialty practice of rehabilitation.
The purpose of this position statement is to delineate the rationale behind inclusion of basic rehabilitation concepts and interventions into the curriculum of BSN programs.
History of Specialty Practice Education Within Generic Educational Programs
Inclusion of specialty practice education within generic educational programs is not a new concept. Since the inception of the "trained" nurse, the curriculum of such programs has evolved over time to reflect the changes in society and the progress of both medical and nursing practice. As nursing education expanded into institutions of "higher learning", the curriculum began to further evolve. These initial programs generally included the study of medical and surgical techniques as well as post partum care and the care of the newborn. By the early 1930s and 1940s generic RN curriculum included in-hospital delivery, psychiatric nursing, and the new specialty of pediatrics. By the late 1960s most generic BSN programs had also included principles of critical care nursing.
Rehabilitation Concepts - Consistent with General Nursing Beliefs and Trends
Incorporating basic rehabilitation tasks and techniques into nursing education is nothing new. Range of motion activities, bowel and bladder re-training methods, and ambulation techniques have been a cornerstone of most nursing curricula for both fundamental and beginning medical surgical nursing for decades. Nursing textbooks over the last 15 years have discussed that "rehabilitation should begin on the day of admission" to the acute care facility but never define what constitutes rehabilitation nor how to achieve it. There is even less discussion in these same books as to what the nursing response should be for the individual once the acute crisis is over. Even the public health component places an emphasis on crisis management rather than on how to meet the ongoing needs of those with disabilities and chronic illness.
As the technical aspects of maintaining life have improved, individuals are surviving debilitating injuries and disease which they would not have survived even 10 years ago. Survival of these diseases and injuries often leave patients with various levels of limited functioning. Recognizing and supporting the ongoing needs of these individuals needs to be an essential aspect of the continuum of basic nursing practice. The education of the BSN nurse, therefore, needs to go beyond what is now being taught to more clearly describe the role of the nurse in rehabilitating patients.
Rehabilitation is one of a handful of clinical nursing specialties in which the patient is not just a body part, system or a period of time within the life cycle. The basic concepts of rehabilitation reflect a philosophy consistent with the holistic nature of nursing. The commitment is to assist the individual maintain independence beyond hospitalization. The goals for preventing complications; restoring and maximizing function, including self-esteem and life satisfaction; and community re-integration are congruent with the direction of Health Care Management, over and above the notion of medical management of disease. Rehabilitation nursing concepts are the basis for much of what is expected of the nurse practicing in home health care, restorative programs in skilled nursing facilities, care of the developmentally disabled, dementia care, and chronic disease management. It is a specialty which not only acknowledges the need for other disciplines in the acute and chronic management of disabilities and disorders but intensively interacts with these other disciplines to insure that treatment goals are mutually set in collaboration with the patient, family, and significant others, are measurable, and are accomplished.
Benefits to the Profession and the Individual Practitioner
Integrating basic concepts of rehabilitation nursing within the generic BSN program will assist in accomplishing the following:
Approved November 1994
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