What Does an Advanced Practice Rehabilitation Nurse Do?

The Association of Rehabilitation Nurses (ARN) endorses the role of the advanced practice nurse, or APRN, as defined and described by the American Nurses Association in Nursing: A Social Policy Statement:

• "The advanced practice registered nurse works with individuals, families, groups, and communities to assess health needs; develop diagnoses; plan, implement and manage care; and evaluate outcomes of care. Within their specialty areas, advanced practice registered nurses may also plan and advocate care that promotes health and prevents disease and disability; direct care or manage systems of care for complex patient/family/community populations; manage acute and chronic Illness, and prescribe, administer, and evaluate pharmacological treatment regimes. In addition, advanced practice nurses serve as mentors, consultants, and educators of nurses in basic practice. They conduct research to expand the knowledge base." (p.16)

The Institute of Medicine believes that "Nurses should practice to the full extent of their education and training." (p. 4). The Advisory Board Company© recognizes that in order to meet the rigor of healthcare value, managing complex patients across populations with high demands there must be "Top-of-License Nursing Practice."

The ARN Standards and Scope of Rehabilitation Nursing Practice defines advanced practice rehabilitation nursing as:

"Preparation for advanced practice in rehabilitation nursing requires a graduate degree in nursing, preferably with a concentration in rehabilitation nursing concepts. APRNs integrate clinical practice, education, research, leadership, and consultation, all of which require intraprofessional and interprofessional collaboration. Advanced practice level nurses in rehabilitation nursing possess and demonstrate advanced levels of expertise in providing, directing, managing, and influencing the care of rehabilitation patients.

The rehabilitation APRN provides clinical expertise in supporting the functions of other nurses and healthcare providers in a variety of settings. A nurse functioning in the advanced practice role may be a clinical nurse specialist or nurse practitioner. APRN certification may be dependent on title protection and federal and state mandates." (p.12)

Roles and Duties of the Advanced Practice Rehabilitation Nurse

Advanced practice rehabilitation nurses may function in a variety of roles including nurse practitioners, clinical nurse specialists, case managers, administrators, educators, researchers, staff nurses, and consultants; and in health care settings throughout the continuum of care.

Direct Care Provider

• Independently manages patients with complex rehabilitation needs
• Serves as clinical expert regarding rehabilitation nursing
• Serves as a clinical expert in complex clinical nursing situations
• Acts as a resource for crisis intervention
• Assesses the appropriateness of admission and delivery of services
• Provides discharge planning
• Collaborates with the interdisciplinary team
• Promotes client/family adaptation to lifestyle changes
• Recognizes opportunities to implement new cost effective technologies for patients with disability and/or chronic illness
• Evaluates outcomes for the complex client in relation to life-long function and health management

Educator

• Provides education to clients, families, and communities
• Performs staff orientation
• Guides individual staff development
• Provides continuing education programming
• Acts as a mentor to nurses and students

Consultant

• Performs case finding
• Provides case management
• Serves as a liaison with third-party payers
• Serves as a resource and a process consultant to staff
• Evaluates and coordinates the interdisciplinary care program
• Serves as a client advocate
• Performs marketing and community relations activities
• Implements programs to enhance staff recruitment and retention
• Functions as a liaison with other community health professionals
• Works with individuals, communities, and populations to set goals for reducing risk, promoting health, and preventing disability
• Development of clinical guidelines, policies and procedures

Researcher

• Communicates relevant research results to staff
• Guides the development of research-based nursing practice
• Contributes to or conducts research activities
• Incorporates relevant research findings into practice
• Collaborates with the interprofessional team to develop new technologies to improve client outcomes
• Directs the data evaluation process to promote optimal rehabilitation outcomes

Manager

• Selects, evaluates, and guides the development of staff
• Establishes operational policies and procedures
• Collects program data to evaluate the client and family care transition experience for the purpose of program management and improvement
• Initiates, monitors and ensures the safety of the environment and the quality of services delivered to establish organizational efficacy

Advanced practice rehabilitation nurses may function in a variety of roles including nurse practitioners, clinical nurse specialists, case managers, administrators, educators, researchers, staff nurses, and consultants.

The Association of Rehabilitation Nurses believes that the role of the advanced practice rehabilitation nurse is a valuable asset within rehabilitation practice and is essential for the continued growth and expansion of rehabilitation nursing as a specialty. In every setting in which the advanced practice rehabilitation nurse functions, he or she acts as a role model for rehabilitation nurses. The value of the advanced practice rehabilitation nurse can be measured by the improved cost effectiveness of patient care, increased nursing staff clinical knowledge and skill, reduced frequency of complications for the rehabilitation patient, increased quality of nursing care, development of new knowledge and innovations, and savings on expenses resulting from the availability of a resident expert for consultation services. The Association of Rehabilitation Nurses encourages the development and expansion of the specialty of rehabilitation nursing through further promotion and utilization of the advanced practice rehabilitation nurse.

References

American Nurses Association (2010). Nursing's Social Policy Statement: The Essence of the Profession. Silver Spring, MD.

Association of Rehabilitation Nurses (2014). ARN Competency Model for Professional Rehabilitation Nursing. Chicago, IL.

Association of Rehabilitation Nurses (2014). Standards & Scope of Rehabilitation Nursing Practice, (6th ed.). Chicago, IL.

Institute of Medicine. Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing (2011). The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press.

The Advisory Board Company. (2013). Achieving Top of License Nursing Practice: Best Practices for Elevating the Impact of the Frontline Nurse. Retrieved from http://www.advisory.com/research/nursing-executive-center/studies/2013/achieving-top-of-license-nursing-practice 

This role description was originally developed by the Advanced Practice Nurses Special Interest Group of the Association of Rehabilitation Nurses in 2002. Subsequent revisions were made in 2011, 2015.