Advanced Practice in Rehabilitation Nursing
Changes in health care are influencing the conversion of many positions in nursing to advanced practice positions due to the complexity of providing and managing care for clients and families. These changes are creating a shift in demand for increasing numbers of advanced practice nurses in rehabilitation in order to meet the needs of people experiencing chronic illness and disability.
In the future, position titles and responsibilities will continue to change and evolve to meet the needs of society and the healthcare delivery system. Clients with chronic illness and disability will continue to require access to highly skilled rehabilitation professionals for their continued healthcare needs. The Association of Rehabilitation Nurses (ARN) projects that in this increasingly complex environment we will need to increase the number of nurses with advanced skills and practice responsibilities to continue to achieve optimal client outcomes.
For these reasons, the Association of Rehabilitation Nurses recognizes and supports the state boards of nursing as the governing bodies for nursing licensures and specialty certification board regulators with the right and responsibility to define specialization in practice. This statement is consistent with the American Board of Nursing Specialty definition of a nursing specialty. ARN supports advanced practice nurses in the clinical practice of rehabilitation and has developed a scope and standards of practice incorporating both ARN's definition of advanced practice and the American Nurses Association's Nursing's Social Policy Statement (ANA, 2004) regarding advanced practice, as it applies to rehabilitation nursing.
Advanced practice nurses in rehabilitation have a graduate degree in nursing. They conduct comprehensive assessments and demonstrate a high level of autonomy and expert skill in the diagnosis and treatment of complex responses of individuals, families, groups, and communities to actual or potential health problems stemming from an altered functional ability and altered lifestyle resulting from physical disability or chronic illness. They synthesize complex data to formulate decisions and plans that optimize health, promote wellness, manage illness, prevent complications and secondary disabilities, maximize function, and minimize disabilities. Nurses in advanced practice integrate education, research, and consultation into their roles and function in collaborative relationships with nursing peers, the interdisciplinary team, and others who influence the health environment.
Advanced practice nurses in rehabilitation may practice in a wide variety of roles across the healthcare continuum and hold a variety of job titles that incorporate specialization, enhancement, expansion of practice and knowledge, and education at an advanced level (ANA, 2004)
Rehabilitation nurses providing health care in clinical advanced practice roles need to conform to the highest uniform national standards available. Advanced education and advanced certification validate the qualifications and practice competencies of the advanced practice nurse, ensuring that the continued health and safety of the public are protected.
Recently, the issue of regulating advanced practice has become a concern to some agencies. The Association of Rehabilitation Nurses supports the premise that educational requirements, self-regulation, and a standardized certification process that meets uniform national standards would ensure highly competent practitioners and protect the public. Throughout health care, education and advanced certification are considered the mechanisms through which professions regulate themselves. This framework is supported by ARN.
Advanced practice rehabilitation nurses, as defined, may function in a variety of roles and job titles, for example, clinical nurse specialist, nurse practitioner, case manager, unit manager, program manager, rehabilitation coordinator, and/or consultant. They may practice in a variety of settings such as inpatient acute care, acute rehabilitation, subacute rehabilitation, long-term care, home health, ambulatory care, insurance companies, schools of nursing, and private practice.
The definition, scope, and standards of advanced rehabilitation nursing practice enable the advanced practice rehabilitation nurse to function wherever individuals, families, and communities are affected by chronic illness and disability.
American Nurses Association (1995b). Nursing' social policy statement.Washington, DC: Author.Approved May 2004
Approved May1996, reviewed June 2006.
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