Rehabilitation nursing: invisible and underappreciated therapy

Abstract

A nursing colleague recently spoke of the dismay she felt at a multi-disciplinary meeting where preliminary findings of a study related to time use in neurological rehabilitation were discussed. One researcher reported that ‘too much time was spent in the bathroom’. This time was perceived as inactive, and encroaching on patients' therapy time. The nurse challenged the classification and interpretation as ‘time wasted’, pointing to the likely therapeutic nature of time spent in the bathroom – time spent coaching patients in specific tasks to develop self-care and independence. This is what rehabilitation nurses do; where possible, we don't ‘do for’ (which does speed up bathroom time), but use all opportunities to ‘do with’ or to explain, demonstrate and stand by while our patients slowly ‘do’. Rehabilitation nurses do not see bathroom time as getting patients ready for their group therapy sessions, but rather as one-to-one sessions of therapy in vivo, therapy that is focused and tailored to the achievement of meaningful tasks for individuals.

Nursing practice in stroke rehabilitation: systematic review and meta‐ethnography

“…There was also an assumption that training should be provided in the workplace by therapists (Pound & Ebrahim , Clarke ). Such an approach impacts directly on nurses' capacity to work collaboratively with therapists and also negatively on therapists' expectations of nurses, for example in relation to encouraging and facilitating independence in daily living activities (Kearney & Lever ). Education and training programmes were encouraged, but were not compulsory.…”

“…More recently, organisational and professional factors limiting nurses' contribution to stroke rehabilitation, and preventing collaborative MDT working, have been identified (Barreca & Wilkins , Seneviratne et al . , Kearney & Lever ). Few studies have examined stroke survivors' perspectives on nursing, but in these, stroke survivors frequently described nurses positively, but few identified instances where nurses contributed to their rehabilitation (McDuff , Seacrest ).…”

“…Few studies have examined stroke survivors' perspectives on nursing, but in these, stroke survivors frequently described nurses positively, but few identified instances where nurses contributed to their rehabilitation (McDuff , Seacrest ). Pryor () and Kearney and Lever () argue that nurses' rehabilitation role is largely hidden and often not fully understood or appreciated by other MDT members.…”

Understanding nursing practice in stroke units: a Q-methodological study

“…Nurses represent the largest professional group working with stroke survivors but there is currently limited evidence regarding nurses' involvement in post-stroke rehabilitation [4][5] . N rehabilitation role can be hidden and not fully understood by other MDT members [6][7] . The perspectives of other MDT members, on nurses' practice and contribution in stroke rehabilitation are largely unreported.…”

Examining subacute nurses’ roles in a changing healthcare context

“…Almost every participant in this study stated that they would support more patient rehabilitation if they had time, but that they were often overwhelmed by other duties focused on patient clinical care. Nurses were torn between the responsibilities of a traditional nursing role and the expectations of their work as rehabilitators (Barreca & Wilkins, 2008; Kearney & Lever, 2010; Munce et al, 2017; Neatherlin & Prater, 2003). The observation data also demonstrated a very fast‐paced and busy environment in which nurses struggled to complete the duties expected of them.…”