Reimagine Rehabilitation Nursing: My Asks of You

In her August President's Message, ARN President Dr. Patricia Quigley revisits past months' calls for ARN member participation and introduces a new opportunity for rehab nurses to contribute: Reimagining the rehabilitation nursing specialty by "disrupting—for the better—long-standing practices that leave nurses under-developed, under-utilized, and under-appreciated."

Close gatherings of family and friends, full smiles without masks, greetings that allow hugs and handshakes. We never imagined a time, let alone a prolonged time, when these actions would be void in our lives. When absent, we hoped and imagined their return—a return to a more normal life. Now we are living in this "new normal", and our lives have changed in some ways as a result of living through the COVID-19 pandemic.

We are more thankful, check on neighbors more, offer help to others more, and even at times smile with our eyes above a mask. In the mist of imagining our recovery and restoration, we have been invited to reimagine our daily lives, interactions, working conditions, practice, and reliance on technology.

"Reimagine" has reached such a level of prominence following the pandemic that this word has generated a newness for our future. 

Throughout my monthly President's Messages, I have asked of you, though you may not realize how much I have asked.

In December, after a very exciting and successful Virtual REACH Conference that exceeded all expectations with amazement and acceptance, I asked you to give the gift of ARN membership for the holiday season, asking you to celebrate the palpable joy of ARN's community, the pride of rehabilitation nurses, and the thanksgiving of holidays.

To start the new year in 2021, I, like other healthcare leaders, reflected on the unknown impact and future long haul of the pandemic—and invited you to start publishing your stories. I asked of you to assemble your writing team, review the resources ARN provides, and start writing! Rehabilitation Nursing Journal (RNJ) is waiting for your submission, with hopes to have a dedicated RNJ filled with your publications.

For February, after highlighting the first global analysis of the current and future needs of rehabilitation (Cieza et al., 2020), I emphasized the researchers' concerns about the declining professional resources to provide rehabilitation services and importance of function (change in function) as a priority for rehabilitation. Their findings have significant implications for ARN's scope of influence to scaleup rehabilitation nursing services. I asked you to consider adding a new screening that focuses onchanges in function since one's last healthcare visit that has affected the individual's abilities in their daily lives.

In March, I reported to you about the opportunity I had to showcase ARN's journeyin creating our Competency Model for Professional Rehabilitation Nursing, a competency model (CM) for professional rehabilitation nursing that sets us apart. My report was to the American Nurses Association (ANA) and organizational affiliates. I asked of you to fully integrate your CM into your organization's practice and share with others your program tools and successes. We serve together to further integrate/enhance rehabilitation nursing concepts, principles, competencies, and practices within and across roles and settings of care.

Spring in April, and the stress of the pandemic on nurses around the world, consumed my attention on the needs of our aging nurse workforce. I asked you to share with us the workflow, practice, and environmental changes your organization made to support the return of retired nurses. Let's learn together and take the lead on our very special population: retired nurses who responded to the call.

Colleagues, I was not done. I never am. I continue to ask of you …

May brought such extraordinary celebrations of nurses. The world's Nurses Week turned again into Nurses Month. Older nurses of all ages returned to work, but the toll of the pandemic was great—nurses caring for nurses' stress, sorrow, resilience, courage, and dominance. I asked of you to expand the recognition of your colleagues. Honor nurse heroes, innovators, and leaders. We have extraordinary rehabilitation nurses in ARN who deserve so much recognition.

Vaccinations were launched and spared lives, and families were planning gatherings and vacations in June. Summer arrived and so did positive markers of restoration of life and lifestyles. As I reflected on what makes June special, I asked you to do something special for yourself—and find something about June to celebrate. I hope you did.

I have such compassion for older adults and remain steadfast in my commitment to promoting their function and independence without waiver. While new, chronic, urgent, and emergent disease states are managed, fall risks and falls are not. New morbidity and mortality data was released by the Centers for Disease Control and Prevention. I was urgent in my quest for you to plan ahead and join me in protecting the most vulnerable—older adults. In July, I asked that you gather your colleagues and start planning to reach out within your community and plan outreach for Fall Prevention Awareness Week, with an emphasis on protecting our older and vulnerable populations from injury.

Colleagues, I still am asking of you, acknowledging that our worlds are rich with opportunities to shape our future and the future health and well-being of others—to be different.

Reimagination is about imagining doing something you've already been doing, but in a new, different way. 

Today, in celebration of the month of August, I am asking you to not just imagine, but to reimagine rehabilitation nursing.

As a rehabilitation nurse, what are you dreaming about changing or redesigning? We were forced through the pandemic, which created unexpected, unimagined, and unwelcomed changes. Yet, we called upon our collective wisdom, expertise, and courage and learned from each day, from each other. We survived, coped, learned, aspired, inspired, and excelled. Now we are in the position to look back, consider how much we did not know and how much we have learned. We can draw upon our lessons learned to reimagine and create new innovations. The time is rich in opportunity for discovery.

Guided by ARN Executive Director Gayle Irvin, Association Management Center leadership, and consultants, our Board of Directors has been challenging itself to reimagine ARN's structures, processes, and programs to achieve leading best practice positions and outcomes. While cherishing ARN's past, we are excited about the work of our Engagement Task Force—seeking your insight, recommendations, and ideas to reimagine ARN.

As I reflect on the great work that we are doing, I learned about reimagined clinical practices and other nursing organizations' strategic actions to reimagine nurses' roles, practice, and influence while attending ANA's Organizational Affiliates meeting.

For example, the American Organization for Nursing Leadership disseminated a complimentary webinar from Lehigh Valley Health Network (Reimagine Care Team, Patient, and Family Communication). They reimagined patient, family, and staff communication systems to meet needs during the pandemic. They developed and used a mobile app to send secure text messages, photos, and video updates about patients' loved ones to create more meaningful human connections and interactions for families and friends in waiting rooms or at home. ANA's President Ernest Grant informed all members and organizational affiliates about a new national initiative to Reimagine Nursing. ANA will be awarding grants through the American Nurses Foundation, "disrupting—for the better—long-standing practices that leave nurses under-developed, under-utilized, and under-appreciated." They will fund 11 program grants through a donation from Kaiser Permanente that focuses on three moves that will fundamentally change education, regulation, and practice of nursing—changes to prepare practice-ready graduates, digitally enable nursing practice, and direct-reimbursement nursing models. These future initiatives are anticipated with excitement.

Let's share. Let's celebrate what is possible. I ask you to reimagine rehabilitation nursing. For me, maybe my time has come! My very first publication was in RNJ (Quigley, 1981), when I designed and proposed the first model for billing for rehabilitation nursing services, thinking that if the healthcare industry could bill for physical, occupational, and speech therapy, it should bill for rehabilitation nursing services, too.

I so look forward to hearing back from you! 

Patricia A. Quigley, PhD ARNP CRRN FAAN FAANP FARN

President, Association of Rehabilitation Nurses

References

American Nurses Foundation. Reimagining Nursing Initiative. https://www.nursingworld.org/foundation/programs/rninitiative/. Accessed July 3, 2021.

American Organization of Nursing Leadership. Reimagine Care Team, Patient and Family Communication. https://www.aonl.org/education/webinars/reimagine-care-team. Accessed July 3, 2021.

Cieza, A., Causey, K., Kamenov, K., Hanson, S., Chatterji, S., & Vos, T. (2020). Global estimates of the need for rehabilitation based on the global burden of disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 396(10267), p. 2006-2017.

Quigley, P. (1981). Nursing evaluation in rehabilitation. Rehabilitation Nursing, 6(6), p. 12-14.