What Is Rehabilitation Nursing? The Ultimate Guide
According to the World Health Organization (WHO), rehabilitation is an essential aspect of universal health coverage, helping approximately 2.4 billion children, adults, and older people around the world live as independently as possible and participate in different areas of life, such as education, work, and recreation. As is the case with the nursing profession in general, the demand for rehab nursing is expected to increase as people live longer but face more chronic diseases and disabilities.
Are you considering a career in rehab nursing? This ultimate guide covers everything you need to know about rehabilitation nursing to help you decide whether this specialty is right for you.
What Is Rehabilitation Care, and What Does It Mean in Medical Terms?
A medical definition of rehabilitation is “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment.”
Rehabilitation may assist people with eating, moving around, seeing, hearing, thinking, and communicating. Anyone may need rehabilitation at some point in their lives, such as after an illness, injury, or surgery or when functioning has declined with age. In these cases, rehabilitation can help people be as independent as possible and participate in education, work, recreation, and important roles such as childcare.
People often require rehabilitation after the following events:
- Spinal cord injury
- Joint replacement
- Brain injury
- Balance disorders
- Neurological conditions
- Cardiopulmonary conditions
- Parkinson's disease
- Respiratory failure
- Orthopedic conditions
The goal of rehabilitation care is to help patients recover and return to living as independently as possible as soon as possible.
What Does IRF Stand For?
The abbreviation IRF stands for “inpatient rehabilitation facility.” These facilities may be freestanding rehabilitation hospitals or rehabilitation units in acute care hospitals. Regardless of their location, Medicare- or Medicaid-certified IRFs must provide intensive rehabilitation programs, and the patients admitted to these facilities must tolerate three hours of intense rehabilitation services daily.
What Is a Rehabilitation Unit in a Hospital?
Rehabilitation hospitals or rehab units within hospitals offer short-term care to patients recovering from medical procedures, injuries, or other events in order to help patients return home as soon as possible.
To achieve this goal, patients are treated and supervised by physical medicine and rehabilitation (PM&R) physicians, cared for around the clock by rehabilitation nurses, and receive targeted and intensive therapy for three hours every day, five days per week, assisted by physical therapists, occupational therapists, respiratory therapists, and speech-language pathologists. Other professionals working in rehabilitation include social workers, case managers, physician specialists, psychologists/psychiatrists, and dieticians.
To cater to patients’ healthcare needs, rehab hospitals or units have access to other medical specialties, such as the following:
- Neurology for the treatment and care of conditions affecting the nervous system
- Pulmonary care for conditions affecting the lungs
- Cardiology to care for patients with diseases and abnormalities of the heart and blood vessels
- Nephrology for treating conditions that affect the kidneys
Generally, a rehabilitation hospital or unit offers post-acute care. In other words, patients are usually treated in an acute care setting and then transferred to a rehab hospital or unit. However, in some cases, patients may be admitted directly from their homes or other settings.
Can Nurses Work in Physical Therapy?
Rehabilitation nurses may work in any of the following places:
- Inpatient rehabilitation centers
- Outpatient rehabilitation centers
- Long-term care facilities
- Community and home health settings
- Insurance companies
- Private practice
- Industrial health centers
All of these settings offer rehabilitation, including physical therapy. However, nursing and physical therapy are separate professions. Nurses don’t work in physical therapy; instead, they collaborate with physical therapists and other healthcare professionals in the care of patients with rehabilitation needs.
What Is the Role of a Rehabilitation Nurse? Rehab Nursing vs. Physical Therapy
Since nursing implies the use of clinical judgment to provide care that helps people improve, maintain, or recover health, cope with health problems, and improve their overall quality of life, nurses are essential in all phases of rehabilitation: acute, post-acute, and long-term rehabilitation. Furthermore, although rehabilitation requires a multidisciplinary healthcare team, nurses hold a special role in this team since they usually have the most interaction with patients and their families and, therefore, generally have the greatest insight into the personal and contextual factors that can influence a patient’s rehabilitation process. Rehab nurses educate patients and family members; they provide counseling, case management, and advocacy. They may also participate in research that contributes to improved rehabilitation practices.
Although physical therapists (PTs) also work in rehabilitation and share the same ultimate goals as rehab nurses, PTs are primarily movement experts who improve the quality of life of their patients through prescribed exercises, as well as hands-on care and patient education. Physical therapists examine each patient to develop a treatment plan to improve the patient’s ability to move, reduce or manage their pain, restore function, and prevent disability. They help people recover or maintain their independence as nurses do, but they also help people lead active lives and achieve fitness goals.
What Does a Rehab Nurse Do?
Since rehabilitation nurses may work in many different settings, their responsibilities may vary. That said, the following are typical duties of a rehab nurse in most inpatient acute or post-acute rehabilitation nursing settings:
- Providing hands-on nursing care for people with physical disabilities and chronic illnesses to achieve quality outcomes for patients
- Collaborating with other members of the interdisciplinary rehabilitation team to facilitate the achievement of overall goals
- Coordinating a holistic approach to meeting patient's medical, vocational, educational, and environmental needs
- Providing direction and supervision of ancillary nursing personnel, demonstrating professional judgment, using problem-solving techniques and time-management principles, and delegating appropriately
- Demonstrating effective oral and written communication skills, essential for developing a rapport with patients, their families, and health team members and ensuring the fulfillment of requirements for legal documentation and reimbursement
- Coordinating educational activities
- Developing and implementing individualized teaching and discharge plans with patients and their families
- Acting as a resource and a role model for nursing staff and students and participating in activities such as nursing committees and professional organizations that promote the improvement of nursing care and the advancement of professional rehabilitation nursing
- Encouraging others to become certified, obtain advanced degrees, participate on committees, and join professional organizations
- Facilitating community education regarding the acceptance of people with disabilities
- Actively engaging in legislative initiatives affecting the practice of rehabilitation nursing and individual patients
- Applying nursing research to their clinical practice and participating in nursing research studies
How to Become a Rehabilitation Nurse and How Long Does It Take
Rehabilitation nurses are usually registered nurses (RNs) who have either completed a two-year associate’s degree in nursing (ADN) or a four-year bachelor’s of science in nursing (BSN). To become licensed as registered nurses, graduates of these programs must also pass the National Council Licensure Examination (NCLEX).
As is the case with most nursing jobs, rehabilitation nursing positions also require nurses to have Basic Life Support (BLS) certifications.
Rehabilitation Nurse Certification
Although specialty certification is often not required for nursing positions, pursuing certifications makes nurses more competitive and also improves the nursing care and treatment they can offer.
The Association of Rehabilitation Nurses offers the Certified Rehabilitation Registered Nurse (CRRN®) credential for registered nurses with two years of practice as RNs in rehabilitation nursing within the last five years or one year of practice as a registered nurse in rehabilitation nursing and one year of advanced study in nursing within the last five years.
How Much Does a Nurse Make?
There are many factors affecting a rehab nurse’s potential salary. For example, the average salary of an RN is $82,750 per year. However, the average salary of an RN in California is $124,000, and the average salary of an RN in South Dakota is $60,540. Evidently, a rehab nurse’s state of residence significantly affects their potential salary. Another factor that affects rehab nurses’ potential salary is the type of facility that employs them. The following are the average salaries of RNs in different settings that employ rehabilitation nurses:
- Outpatient care centers: $93,070
- General medical and surgical hospitals: $85,020
- Specialty hospitals, except for psychiatric and substance abuse hospitals: $84,800
- Psychiatric and substance abuse hospitals: $80,260
- Home health care services: $78,190
- Offices of physicians: $73,860
- Skilled nursing facilities: $72,260
Additionally, factors such as work experience and certifications significantly influence a rehab nurse’s salary.
What Is Rehab Nursing Like?
If you talk to ten different rehab nurses, you will probably hear ten different descriptions of what this nursing specialty is like. That said, these descriptions can still help you picture a day in the life of a rehab nurse and help you decide if you can picture yourself in that setting as well.
“I work on the code team for a acute rehab center and have my CRRN(Rehab certified) and most of the nurses are second to the therapists and you work around them. You're getting your patients out of bed daily into wheelchairs or assisting them with gait belts. Applying orthotics, getting them dressed, helping them eat and do transfers. Focused on bowl and bladder regulation programs. More minor wound care with some serious wounds on a more rare occasion. Mostly oral route medications. IV meds an IV access even less common.” – Reddit user redhtbassplyr
“I work in a 60 bed rehab acute care hospital that deals mostly with Parkinson’s, hip fx, knee replacements and misc neurological issues/ trauma cases. My patient load is often 8 patients for 12 hrs. Sometimes when staffing is low nurses are put on total cares (CNA and LPN work) with less patients (approx. 5)...some days are so insanely busy that I don’t end up getting all my charting and tasks done until 1-3 hrs after my shift has ended...” – Reddit user mostlymass
Is Rehab Nursing Hard?
All nursing specialties have their particular challenges. Likewise, every nurse has a unique personality. Therefore, it is important for nurses contemplating rehab nursing to ask themselves whether their personality fits with the challenges of this specialty. For example, for this rehab nurse on Reddit, the hardest part of the job was boredom:
“I learned a lot from rehab, but man, did I get bored. The rhythm of medicate, get dressed, cafeteria, premedicate pain meds, lunch, meds, toileting, bowel care, everything just became such a grind.”
For this other rehab nurse working in acute rehab, the greatest challenge was trying to help their patients without generating other health concerns:
“It's a nice hybrid of med/surg & stroke rehab. Our usual patient/nurse ratio was 8:1…We had lots of traumatic brain injuries and new stroke patients who didn't understand that they can't ambulate the same. The most frustrating thing was balancing patient's pain with constipation but I guess that's my small gripe. Remember proper lifting mechanics too!”
Why Choose Rehab Nursing
The pros of a nursing specialty can be as diverse as its cons—it all depends on the eye of the beholder. For some, it is genuinely a specialty they enjoy and want to stay in; for others, it is a good place to get started, learn what they need to learn, and move on.
“For me I think rehab nursing is rewarding because you see patient progress, help patient/family with the transition process and it is (usually) the patient's last hospital stay before they go home. It is a bit physical with the turning and transferring, but you will learn the importance of good body mechanics.” – Reddit user justahobby82
“It's a great place to start as a new grad, but is definitely stressful and demanding. The rehab I worked in had a very high turnover. Put in a year or so, and then move on to where you actually want to be!” – Reddit user sunshine326
What Makes a Good Rehab Nurse: Tips for New Nurses
If you have decided to give rehabilitation nursing a try, this advice from experienced rehab nurses on Reddit will help you succeed in this nursing specialty:
“Advice for succeeding is finding someone who'll take you under their wing as a mentee or friend. Other than that all you have to do is listen, learn and say yes to the opportunities that interest or advance you. The first year is an immense learning curve. So on the days you feel like you know nothing, you very well may not. Ask questions. Keep yourself in and your patients safe. Keep a notebook. The drugs you don't know? Conditions you've never heard of? Procedures you're not familiar with? Acronyms? Write them down. Go home. Look em up. And write them down in another notebook and describe them to the best of your ability.” – Reddit user Gibbygirl
“My best advice is to ask as many questions as you can, and if anyone is upset that you’re asking questions then that’s a red flag to the unit. Try and get as much hands-on practice as you can with a preceptor. Learn and appreciate different specialties. Rehab is definitely a unique place to be and there are a ton of learning opportunities, even if it isn’t your passion you can use it as a stepping stone to get where you want to be!!” – Reddit user livbliv
Final Thoughts on Rehabilitation Nursing
All nursing specialties are essential; they are all in demand; they all have advantages and disadvantages. Ultimately, which specialty you choose should depend on your unique strengths, interests, and personality. Follow your intuition! Does rehab nursing seem right for you? Then go for it! Otherwise, continue exploring other nursing specialties here!