REHABILITATION CLINICALS

During Rehabilitation clinicals, you will teach patients and their families how to manage illnesses or injuries, explain post-treatment home care needs, self-administration of medication and some physical therapy. Some of you may go on and work to promote general health by educating the public on warning signs and symptoms of disease. RNs also might run general health screening or immunization clinics, blood drives, and public seminars on various conditions.

Registered Nurses specialize in working with one or more body systems such as cardiology, gynecology dermatology, liver, transplant, and neurology. Nurses may also specialize in a well-defined population, such as geriatrics and some registered nurses may combine specialties; for example, pediatric oncology nurses deal with children and adolescents who have cancer. The opportunities for specialization in registered nursing are broad and are often determined on the job.

Nursing school will prepare students for different specializations by exposing them to these different populations. Rehabilitation centers provide outpatient and inpatient rehabilitation to patients who have suffered brain injuries, stroke, pain and spinal cord injuries. During rehab clinicals you will be prepared to work as a Registered Nurse in a rehabilitation facility. Clinicals will teach you, how to teach patients, about psychological and physical care. Care plans based on medication regimen and patient diagnosis will be made by you, the nurse. Depending on what particular floor you work on, you may care for patients that are paralyzed from car accidents or suffering from brain injury due to an infection.

During rehabilitation clinicals you will get a lot of experience with the following:

A. Insertion of Foley catheters

You must definitely know the female anatomy and how to practice sterile technique. A good demonstration on Foley insertion can be found on You tube.(1)

B. Wound care

Patient education and sterile technique are also important with wound care.

Here are examples of You tube videos describing a Dressing Change(2) and Wound Debridement. (3)

C. Care Plans

Care plans for paralyzed patients are very important in a rehabilitation facility. Teaching and understanding risk factors will enhance patient care.

The is an example of part of a teaching plan for a young man paralyzed in a car accident who wasn’t wearing his seatbelt.

The learning objective for the affective domain is that the patient will be able to identify two risk factors of a sedentary lifestyle. The objective of the psychomotor doman is the patient should be able to list three ways to improve upper body strength. D.W. is physically but not emotionally ready to learn. His lack of participation in physical therapy and amount of information he can tolerate right now may inhibit learning. He is still a young man and has great upper body strength which can assist him with the activities in daily living.

The professor will teach during a lecture and handouts will be given. The risk factors for a sedentary lifestyle are a reduction in being able for the client to dress, bath and complete activities of daily living. A list of key indicators will be written out for the client to see what activities he should be doing on his own as a paraplegic. Due to the client’s socioeconomic status there are inexpensive ways to improve upper body strength. Intensive exercise regimens may contribute to preservation of arm bone mass in spinal cord injuries with participation in physical activity of more than 60 min per week. The client can use weights with Velcro straps to fit around their wrists while at home. Another is to strap a weight to the wheelchair when at home, this will make harder to push the wheelchair, but will build the shoulders up.

References

1) Foley Catheter Insertion Female. (2008). You Tube. Retrieved from: http://http://www.youtube.com/watch?v=zfujybxPTRY&feature=PlayList&p=270974B24753078D&playnext_from=PL&playnext=1&index=78

2) Post Care Patient Education Wound Care. (2009). You Tube. Retrieved from: http://www.youtube.com/watch?v=fdMsJJWSIT8

3) Debridement of an Infected Diabetic Foot Wound. (2010). You Tube. Retrieved from: http://www.youtube.com/watch?v=L3KCOGxWpwQ