Home > RNJ > 2009 > May/June > Editorial: Setting Our Course

Editorial: Setting Our Course
Elaine Tilka Miller, DNS RN CRRN FAHA FAAN

Rehabilitation nurses are fortunate to practice in a specialty area with a bright future and great potential to further expand patients’ quality of life and functional outcomes. Although predicting the future is always difficult, the benefit of such an exercise is that it allows us to consider viable practice possibilities. Let us examine where rehabilitation nursing is today. Rehabilitation nursing

  • is a major practice specialty within the healthcare delivery system
  • has its own distinct and expanding body of science and literature
  • possesses an excellent, well-established certification program
  • is viewed as a vital part of the continuum of care by other healthcare professionals (HCPs)
  • enhances the functional capability and quality of life of patients and families.

Some significant trends are emerging in our practice. First, the depth and breadth of rehabilitation nursing is becoming more substantial and is anticipated to accelerate. Expanding technology and treatment advances continue to increase survival rates of individuals with chronic or previously deadly conditions. In addition, the aging of our population has markedly augmented the need for rehabilitation services to cultivate optimal health and quality of life.

Second, because healthcare organizations, health policy makers, and consumers are concerned with reducing hospital lengths of stay and managing costs, it will become more important to begin rehabilitation care when patients are initially admitted to acute care settings. As a result, the demand for improved coordination of acute and rehabilitation care services will become a higher priority. However, this change will require rehabilitation nurses to have well-developed practice performance standards to evaluate the contribution of their care to both the short- and long-term patient/family outcomes ranging from acute care to community-based situations.

Third, globalization and interconnectivity of our world through technology and transportation will affect our practice in substantial ways. Telemedicine, for instance, will become more commonplace and increase the likelihood of greater diversity in patients, families, and HCPs. The problems associated with limited resources (e.g., manpower, financial support, equipment, HCPs’ expertise) that affect achieving quality care outcomes are also anticipated.

Finally, there is a growing emphasis on maintaining the wellness of all patients across the lifespan. In particular, patients increasingly recognize that as changes occur with aging, there will be greater demands for more targeted, cost-effective, and scientifically supported interventions to promote well being, maximize patients’ physical and cognitive functional capacity, and improve quality of life. Advocacy—an important aspect of our present practice—will become even more crucial as we address the multifocal needs of our patients and their families.

As we ponder the future, Rehabilitation Nursing must remain an important voice of leadership, a source of up-to-date information, and a place where questions may be raised and answered. In addition, it is pivotal that the journal be viewed as an essential resource for making data-based decisions pertaining to rehabilitation nursing practice. There are several tangible ways this journal can stay in touch with its members and the changing dimensions of our practice.

  • Recognize that no single approach to preparing and responding to the future is correct. There are many different paths.
  • Encourage creativity to advance rehabilitation nursing to the next level, whatever that may be, in the next 10–20 years.
  • Emphasize the importance of advocacy that blends evidence and quality care outcomes and indicators.
  • Empower ARN’s membership to be responsive to the issues and concerns that affect their patients, families, and other HCPs.
  • Emphasize the essential and unique aspects of rehabilitation nurses. We should not be timid or complacent when marketing our skills.
  • Encourage ARN members to share their expertise, expand their professional horizons and skills, and improve their ability to professionally interact with other HCPs and consumers.
  • Voice the important and necessary questions to advance our practice. For instance, what is the unique and important contribution of rehabilitation nursing?
  • Remain informed on global issues that affect rehabilitation nursing practice and share these issues with colleagues in scholarly articles.
  • Remain aware of the changing demographics of the patients we serve and how these characteristics affect our practice.

Although the future of rehabilitation nursing practice and health care is somewhat uncertain, this is an exceptionally creative and exciting time to explore new possibilities and be a rehabilitation nurse. The challenges confronting rehabilitation are great, but so are the opportunities.