PDF Overview of Rehabilitation - Jones & Bartlett Learning

PART I General Concepts and Principles of Rehabilitation Nursing

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CHAPTER 1

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Kristen L. Mauk

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LEARNING OBJECTIVES

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? State three common goals of rehabilitation across disciplines.

? Describe significant historical events in the development of rehabilitation as a specialty in nursing

and medicine.

? Jones & Bartlett Learnin? g,DLiscLuCss major concepts of rehabi?litaJtioonn. es & Bartlett Learning, LLC NOT FOR SALE OR DISTR?IBRUecToIgOniNze the scope of practice NofOthTe rFehOabRilitSatAionLnEurOseR. DISTRIBUTION

? Identify 16 basic competencies of rehabilitation nursing.

KEY CONCEPTS AND TERMS

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Nurses (ARN)

Holistic care

Self-care

Certification

Interdisciplinary team

Certified registered

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This is an exciting time to be in the specialty of reha- spinal cord injury, neurological disorders, and chronic

bilitation and rehabilitation nursing. Many new devel- illnesses from a variety of causes who need rehabilitative

opments within the discipline make this a challenging care. The purpose of this text is to provide the reader with

? Jones & BaanrdtdleestitraLbeleafrienldiningw, hLicLhCto work. When one consid?ersJonaesso&lidBfoaurntdleattitoLnaelabranckingrgo,uLndLCabout rehabilitation

NOT FOR SAthLeEprOeseRntDcoInSfTlicRtsIBcoUntTinIOuinNg in Iraq and AfghanisNtaOn T FaOndRtoSsAetLfoErtOh RtheDnIeSceTsRsaIrBy UknToIwOleNdge to meet basic

coupled with the existing number of aging veterans, the competencies in rehabilitation nursing.

area of rehabilitation should be booming, and indeed

there are never-before-seen injuries and effects of war PHILOSOPHY

to challenge the i?nteJrodnisecispl&inaBryartetlaemtt. PLoelyatrrnauinmga, LLC

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has emerged as a sNigOniTficFanOt sRpeSciAalLtyEarOeaRwiDthIiSnTreRhaIB- UTRIOehNabilitation is founded NonOtTheFpOremRisSeAthLaEt aOll iRndDi-ISTRIBUT

bilitation, and the benefits of these services extend to viduals have inherent worth and have the right to be

the civilian population as well. Technological advances experts in their own health care (Gender, 1998). Each

in prosthetics for those with multiple limb amputations person is viewed as a unique, comprehensive, holistic

continue to push the limits of current knowledge in

b?iomJoedniceasl e&ngBinaeerrtilnegt.tTLheedaervnaisntagti,ngLeLfCfects of catasNtrOopThicFOwoRrldSeAvLenEts OsuRchDaIsStTheR2I0B1U0 TeaIrOthNquake in

being. Rehabilitation nurses, and the rest of the team, are

responsib?le Jfoor npreosvid&inBg athretleedtutcLateioanrannidntgra, iLniLnCg to equip theNpOerTsonFOwiRth SthAe LneEedOedRknDoIwSleTdRgeIBanUdTsIkOillNs

Haiti, the tsunami in Indonesia, or Hurricane Katrina in to maximize self-care.

New Orleans suggest that there is a worldwide need for

The philosophy of rehabilitation is distinctly differ-

rehabilitation to help those with life-changing injuries ent from acute care. In acute care the patient's survival

? Jones & BtaorletalerntttoLleivaerangaining. T, hLeLreCare also the individuals s?eenJoniessa &priBmaarrytlfeotctuLs.eNaurrnseisnpgr,ovLiLdeCcare provision that NOT FOR SAdLaiEly OinRheDalItShcTaRreIBfacUilTitIieOs Nwith stroke, brain injuNryO, T FiOnvRolvSesApLerEforOmRingDaIcStiTviRtieIBs oUf dTaIiOlyNliving for persons,

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2

CHAPTER 1 / Overview of Rehabilitation

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persons

to

be

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TABLE 1.1

SALE OR

Examples of

DISTRIBUTION

Conditions That May Benefit

from

able to perform activities of daily living for themselves. Rehabilitation

Promoting self-care is key to rehabilitation.

Spinal cord injury

The process of rehabilitation is best undertaken with

the coordinated and de?libJeoranteeasssi&staBncaerotlfeatntiLnteeradrins-ing, LStLroCke

ciplinary team of experNtsOwThoFeOacRh bSrinAgLspEecOifRic kDnoISwTl-RIBUTrTauIOmaNtic brain injury

edge and skills to the rehabilitation program for each Multiple sclerosis

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patient or client. Such a healthcare team may consist of Guillain-Barr? syndrome

a variety of team members including physicians, nurses, Polytrauma

tohrethrao?ptiissJttsso,, snporecoissatlh&weotBirsktase,rrsta,lnecdatstveLomceaaatniroanngeainrlsgc, on,uuLntrLsietClioornsi,sttso, nameNaOfeTw.FTOheRcliSenAt LfuEncOtioRnsDaIsSthTeRceIBntUerToIfOthNe in-

terdisciplinary team (see Chapter 5), which is composed of knowledgeable specialists who work together, share common goals, and collaborate to help clients reach their

Amputation ? Jones & Bartlett Learning, LLC Disfiguring buNrnOs T FOR SALE OR DISTRIBUTION

Parkinson's disease

Functional debility

Joint replacement

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DEFINITIONS OF REHABILITATION

Muscular dystrophy

Chronic obstructive pulmonary diseases

Rehabilitation is a process of adaptation or recovery

Polio

through which or functionally

alniminitdini?vgidcJuooanlndsieutisfofne&r,iwnBgheafrtrohtmelreattetdmiLspaeobarlairnrngying,

LCeLrtCain

types

of

cancer

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or irreversible, participNatOesTtoFrOegRainSmAaLxiEmaOl fRunDctIiSonT,RIBUATlzhIOeimNer's disease and other deNmOenTtiaFs OR SALE OR DISTRIBUT

independence, and restoration. Rehabilitation "refers

to services and programs designed to assist individuals

who have experienced a trauma or illness that results the client. These include promoting self-care, maximiz-

in im?paJiromnenetsth&atBcraearttelseattloLses aofrnfuinncgti,onLL(pChysical, psychNolOogTicFalO, soRciSalA, oLr EvocOatRionDaIl)S" T(RRemIBsUbuTrgIO&NCar-

son, 2006, p. 579). The National Cancer Institute (2007)

ing independe?ncJeo, mnaeisnta&inBinagratnledtrtesLtoerainrgnfiunngc,tioLnL, C preventing coNmOplTicaFtiOonRs, aSnAd LenEcoOurRagDinIgSaTdaRpItBatiUonT.ION

Table 1.2 lists the common goals of the rehabilitation

defined rehabilitation as "a process to restore mental team. The client's achievement of these is measured by

and/or physical abilities lost to injury or disease, in order considering outcomes based on the care planning of the

to function in a normal or near-normal way" (p. 1). For interdisciplinary team, as discussed in Chapter 5.

? Jones &somBea, rthtlies tmt aLyebaeranliinfeglo,nLgLpCrocess. For others, reha- ? Jones & Bartlett Learning, LLC

NOT FORbiSlitAatLioEn iOs Rof sDhIoSrtTdRuIrBatUionT.IFOoNr example, a gymnast NOT FOR SALE OR DISTRIBUTION

may injure her arm and need 3 months of rehabilitation TABLE 1.2 Common Goals of the Rehabilitation Team

to resume her former activity with full range of motion. Foster self-care, self-sufficiency

But for an individual diagnosed with a severe stroke or a

Encourage maximal independence level

war veteran with head ?traJumona,ethse&rehBabairlittlaetitotnLmeaayrbneing, LMLainCtain function

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ccoonntdiintiuoonusst,hevatenmlaifyelboeNnigmO. TpTarboFlveeO1d.R1wpiSrtohAvrieLdheEasbeOixliaRtmatipDolneISs. oTf RIBUPrTevIOenNt complications

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Restore optimum function

GOALS

Promote maximum potential Emphasize abilities

Altho?ugJhognoeasls &areBmaurttuleatlltyLeestaabrlnisihnegd,fLorLeCach in- Promote ada?ptaJtioonnes & Bartlett Learning, LLC

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underlying principles that guide the development of the

Maintain dignity

plan of care. Habel stated that "rehabilitation goals are

Reeducate

the desired outcomes for each rehabilitation client" (1993,

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team, although similar goals for

Assist with community reintegration/reentry

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History

3

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NOT FOR SALEInOaRddDitiIoSnTtoRIhBelUpiTngIOthNe client set goals in eNacOh T FOR SALE OR DISTRIBUTION

needed discipline, interdisciplinary team members also

Nightingale saved "more lives in the Crimean War than the

meet regularly and establish realistic goals and objec-

entire British medical department, using hygiene and rehabilitation principles practiced by the ancient Romans."

tives that team members can address together. A team

goal is one in whic?h tJwoonorems o&reBdiascritplleinttesLpearatricnipinatge,, LLC

Christine Mumma, e?arlyJAoRNnleeadser&andBauathrotrl(1e98t7t, pL. 5e) arning, LL

liismmituetdu,arellayliestsitca,baNlnisdOhmeTdeFawsOuitrhRabtlShee.AApLnaEteixeOnamtR, palnDedoISfiasTtteRiamImBe UTIONAlthough early recordNs OofTthFeOuRse oSfAsuLcEh eOxiRst,DitISTRIBUT

goal related to patient safety might be the following: Mr. was not until the world wars ensued that significant

Smith will lock his wheelchair brakes 100% of the time gains were made in the field of rehabilitation. This first

ws?eiethtJhcoautneisetfirssomp&atsitBeanfaftrbotyrliedeitnstctehLdaer(gMaer.rnF. rSionmmgitt,hhLaisnLgdCohail,soanceticoanns

occurred through the armed forces, with rehabilitation

services n?ot gJeonnerealsly&beiBngaarvtlaeiltatblLeetoacrinviilniagns,.LInLfCact,

aNreOthTe fFocOuRs), hSaAs aLdEefOinRiteDtimISeTliRmIiBt (UbyTdIiOscNharge), is the increaNseOd nTumFObeRr ofSdAisaLbEledOveRterDanISs rTetRurIBniUngTfrIoOmN

measurable (100% of the time), and includes interventions battle provided the impetus for medical advancement

or reminders from a variety of team members working and federal legislation. Before this time, the need for

with the client throughout the day. This is the type of goal rehabilitation was not nearly as great. One can see that

?NOJTonFeOsR&SBAtwpahrLheroEitgtclerheaeOmtsitnsRdctLoaiDvewniaadIeSrvurdanaTllduiRnseatstIgaieBrf,dfeUduLmrToLeinuImCOtgcbwoNemerseekpslryfootveriaedmaeccuhoppndafaettireeesnntac.be?NsoiuOntJTonFaweOsamsRa&WwjoSaorBrAr.ilandLfrWlEtuleaeOnrtctIRepLroDeensaIetSnrhntTeeidRdnetIgvhBee,lUoULpTnLmiICtOeendNtSotfatreeshwabitihlitmataionny

causalities but little hope of rehabilitation for injured

HISTORY

soldiers. However, in 1917 the American Red Cross Institute for Crippled and Disabled men was created in the

The development?of Jreohnabeislita&tioBnaprrtilnectitplLeseoacrcnuirnregd, LLUCnited States to provide voc?atiJoonanletrsain&inBg faortwleotutnLdeedarning, LL

over a number of yNeaOrsTinFhOisRtorSy,AbuLtErehOabRiliDtaItSioTnRwIaBs UTmIOilNitary personnel. SeveraNl fOedTeraFlOasRweSllAasLiEndOiviRduDalISTRIBUT

not recognized as a specialty until much later. As early as state laws were passed in an attempt to help the disabled,

thousands of years ago, an Egyptian physician recorded but nothing was done on a wide scale.

his observations of a patient with a spinal cord injury,

After World War I, the life expectancy of a spinal

d?escJroibninegsa&disBloacrateledtvteLrteebarraninintghe, LneLcCk, paralysis, aNndOuTrinFaOryRinScoAntLinEenOceR(MDaIrStiTn,RHIoBltU, &THIOicNks, 1981).

The earliest record of crutches appeared on an Egyptian

cftriooornmd?wtihansejus?NgereeOtndJyepTporaeansltFlieyoeOnfsmtcRowi&nnaSidsmBAilteiaizLsorsenEtdtlhw.eOaHetnrtoRe1wLhyaDeiegraadIhrSr,.RnMaTuniRosndkrIg,trBaea,lhUipLtayibToLirnIlCaOietteeaNsr-

tomb in 2380 b.c. (Mumma, 1987). During 300 to 400 b.c., in rehabilitation medicine, recounted that the care for

Hippocrates, known as the Father of Medicine, stated that those with spinal cord injuries was poor. The founder of

"exercise strengthens and inactivity wastes," recording the Rehabilitation Institute of Chicago recounted that

? Jones & BtahretulesettofLaeratirfinciianlgli,mLbLs iCn a patient with amputat?ionJoniensth&eseBdaarytsleatpteLrseonarwnitihngsp,inLaLl cCord injury or stroke

NOT FOR SA(MLuEmOmRa, 1D9I8S7)T. RIBUTION

NOT FmOigRhtSbAe lLaiEd iOn Ra bDoxISofTsRawIdBuUstTinIOthNe basement of the

Several nurses are credited with playing a significant hospital, given little therapy, and waiting to die.

role in the promotion of rehabilitation concepts. Florence

Nightingale organized professional nursing in England in "They got terrible bed-sores, developed kidney and bladder

1ath8be5le4C.torBiymsiugesnaininfgiWcraeanhrt.a?NlyIbsOiadJlibetToaectlrnFieAoeaOndsseapRmr&thinSseBcHAmipaaLlomrerEtstpl,aeNtOloititntgRyhL(r1taDei8nt6aeIg0Srad?nlTu1eir9Rwni1na0IggBs),ULTLICOpalrmoNbolsetmthsD,era.sHnaodmwsaeimrwdpRitulhysklsa,tpryoioiknneebse.er?N"idn,OrwJehTaoaibtniiFnlitegaOtsfiooRnr&dmSeeaBdAtichain.LIretEt(w1l9ea7O7st, tpR. 4L3D)eaISrnTiRnIgB,ULTL

was one of the leaders in the development of the nursing

profession in North America. In a book on nursing prin-

The Veterans Administration was created after World

ciples and practice, Hampton pointed out to her pupils War I to care for those with service-related disabilities,

t?heJimopnoerstan&ceBofacrltelaentltinLesesaarnndiansgep,sLisLatCall times to but the in?itiJalocnareespr&ovBidaedrtilnetthteLeearalyrn19in40gs,wLaLs cCus-

pNreOveTntFseOcoRndSaAryLinEfeOctRionDs,IsSayTiRngIB"nUo TdeIOpaNrtment of todial, noNt rOehTabFilOitaRtivSe.AHLowEevOerR, siDgnIiSfiTcaRnItBleUgisTlaItOivNe

a nurse's work should appeal more forcibly to her than decisions, such as the Vocational Rehabilitation Act of

the attention to the hygiene of the sick-room. She should 1943, provided funding for training and research with the

thoroughly grasp the general principles which underlie disabled. In addition, the United Nations Rehabilitation

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them

in

the

minu?NtesOtJTonFAteOhsdeRmp&liaSnnBiAsntairLnraEgttilooeOnftctdRarLreeDewfaoItSrrhnweToiiRnnuvIgnBod,lvUeLedmTLaIneCOndtNdoifs4ab4lceoduvnettreireasnisn.

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4

CHAPTER 1 / Overview of Rehabilitation

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NOT FORAsSaArLesEultOofRthDe IdSevTeRloIpBmUenTtIoOf sNulfa drugs and better NOT FTOhRe ASmAerLicEanOARcaDdeImSyToRfIPBhUysTicIaOl MNedicine and

medical treatment, more wounded had survived World Rehabilitation was established in 1938 and the American

War II and the world now had to decide what to do with Board of Physical Medicine and Rehabilitation in 1947.

its disabled. According to Rusk (1977), although there However, if was not until well into the 1950s that reha-

had been many peopl?e cJonocnerensed&wBithartthleetfatteLeofatrhneing,biLliLtaCtion began to be widely ac?ceJptoend eassa&viaBblaermtleedtit- Learning, LL

disabled, there was noNorOgaTniFzeOdRmoSvAemLeEntOtoRprDomISotTeRIBcUalTspIOecNialty. During this timeNboOokTs FwOereRpuSbAlisLhEedObyR DISTRIBUT

their rehabilitation. Fortunately, he persevered in his physicians on the subject, and over the next two decades

belief that there was quality of life beyond disability. several pieces of legislation were enacted, including many

Rusk's philosophy, which he developed and practiced amendments to the Vocational Rehabilitation Act of

dituwrians?gnWoJtooernnldoeuWsgah&rjIuBIs,tawtroatslheteotattlrtLehaeet atbhroendwyin.hHgoel,epLmlLeaaCnd--edthhaist causeNtOo aTnyFoOneRwShAo LwEouOldRlisDteInS, TpiRonIBeeUrinTgIOa Nfield

1R9e4h3a,btilhiteatAiornc?hAitJcetcotonufrea1s9l 7B&3a.rBTriheaerrstmlAeoctstttosLfige1na9i6fri8nc,ainanntgdp,iteLhcLee C of legislationNpaOssTedFiOn RtheS1A9L90Es OwaRs tDheISATmReIrBicUanTsION

that other doctors refused to accept as legitimate, until with Disabilities Act. This statute mandated employers

rehabilitation services were available to civilians as well to make reasonable accommodation for disabled work-

as military patients. His experiences touched an entire ers, preventing discrimination on the basis of physical

? Jones &natBioanr, talnedtthiLs eexaprenrtiinsegi,nfLluLeCnced care of the disabled ? Jimonpaeirsm&enBt. Taarbtlee1t.t3Lsuemarmnairnizges, mLLajCor historical and

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NOleTgiFslOatiRveShiAghLlEighOtsR. DISTRIBUTION

TABLE 1.3 Selected Ma?jorJHoisntoericsal&andBLaegritslleattitveLHeigahrlinghitnsgRe,laLteLdCto Health Care and Disability? Jones & Bartlett Learning, LL

Year

HighNligOhtT FOR SALE OR DISTRIBUTION

NOT FOR SALE OR DISTRIBUT

1601

Poor Relief Act (England): provided assistance for the poor and disabled.

1854

Florence Nightingale organized professional nursing in England; used hygiene and rehabilitation principles practiced by the ancient Romans.

1873? Jones & FBirsat rscthleoottl oLf neuarsrinnginatgB,elLleLvuCe Hospital in New York. ? Jones & Bartlett Learning, LLC

1883N?1O90T2 FOR SAAwLavEe oOf hRospDitaISls,ThRomIBesU, anTdIOinsNtitutes established for "criNppOleTd cFhiOldrRen.S" ALE OR DISTRIBUTION

1910

Nurse Susan Tracy published "Studies of Invalid Occupation"; the beginning of occupational therapy.

1911

Workers' Compensation Laws enacted.

1914?1918

World War I

? Jones & Bartlett LearAnminergic,anLRLedCCross Institute for Disabled?MeJnoprnoevidsed&voBcaatriotnlealtttraLineinagrfonriinnjgur,yLsoLldCiers. NOT FOR S19A18L?1E938OR DISPTosRt?IWBoUrldTWIOarNI: mortality rate of those wNoOunTdeFd,OpaRrticSulAarLlyEwitOh sRpinDalIcSoTrdRinIjBuriUesT, wIOasNhigh.

Rehabilitation was minimized. Veterans Administration was created to care for those with service-related

disabilities.

1919

First issue of Archives of Physical Medicine and Rehabilitation.

1920

First Civilian Rehabilitation Act passed by Congress (Smith-Fess Act): provided vocational rehabilitation

serv?iceJs.oFinrset csivi&lianBreahratblielittattiLoneparorngrianmgfo,rLmLedC.

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1935

SocNialOSeTcuFritOy ARct SenAacLteEd. OR DISTRIBUTION

NOT FOR SALE OR DISTRIBUT

1938

American Academy of Physical Medicine and Rehabilitation formed.

1939?1945

World War II

1941

Dr. Frank Krusen wrote the first comprehensive book on physical medicine and rehabilitation.

194?2 Jones & SBisaterrtKleentntyLInestaiturtneienstgab, lLishLeCd: Sister Kenny's research led?to Jthoendeevselo&pmBenatrotfltehtetpLroefeassrinoninofg, LLC

NOT FOR SpAhyLsicEal OtheRrapDyIaSndTbRoIoBstUedTsuIOppNort for physiatry as a specNialOty.T FOR SALE OR DISTRIBUTION

1943

Vocational Rehabilitation Act: provided funding for training and research with the disabled (amendments

follow through the 1960s). UN Rehabilitation Administration was formed. Representatives from 44

countries met to plan care for disabled WWII veterans. The number of disabled veterans increased as a

result of the development of sulfa drugs and better medical treatment.

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NOT FOR SALE OR DISTRIBUTION

NOT FOR SALE OR DISTRIBUTION

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History

5

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NOT

FOR

SALTAEBLEO1.R3

DSIeSleTctRedIMBaUjoTr HIiOstoNrical

and

Legislative

NOT FOR

Highlights Related

SALE OR DISTRIBUTION

to Health Care and Disability (Continued)

Year

Highlight

1945?present

1946 1947

Post?World War II : greater number of disabled civilians because of increased industrialization and

?traJnospnoertsati&on Bacacidrtelnetst.t Learning, LLC NHOillT-BuFrtOonRAcSt (AHoLspEitaOl SRurvDeyISanTdRCoIBnsUtruTctIiOonNAct)

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Dr. Howard Rusk brought the first medical rehabilitation services to a U.S. Hospital (Bellevue). The

American Board of Physical Medicine and Rehabilitation was formed. Rehabilitation became a board-

certified specialty.

1951

Alice Morrissey, RN, wrote the first textbook for rehabilitation nursing.

?195J8ones & BaDrtr.leRutstkLanedacronllaibnogra,toLrsLfCirst published Rehabilitation M?edJicoinne.es & Bartlett Learning, LLC

N19O66T FOR SALMEedOicaRid eDnIaSctTedR. TIhBeUCoTmIOmiNssion on Accreditation andNROehTabFiliOtatRionSFAacLilitEiesOwRas eDstIaSblTishReIdB. UTION

1968

Architectural Barriers Act: set accessibility standards for federal buildings.

1973

Federal Rehabilitation Act: increased awareness of the needs of those with disabilities; influenced

accessibility and employability.

? Jones & Ba1r9t7l4ett LearninAgs,soLciLatCion of Rehabilitation Nurses (?ARJN)ofonrmesed&; rehBaabirlittaletiottn nLuersainrgneimnegrg, eLs LasCa specialty.

NOT FOR SAL19E75OR DISTRAIBRNUJoTuIrOnaNl was first published. NOT FOR SALE OR DISTRIBUTION

1981

ARN publishes Rehabilitation Nursing: Concepts and Practice--A Core Curriculum. Another comprehensive rehabilitation nursing text published.

The ARN Journal was renamed to Rehabilitation Nursing.

1984

?ThJeofinrstecsert&ificBataiorntelexatmt Lfoer raerhnabiinlitgat,ioLnLnuCrses (CRRN) was given ? Jones & Bartlett Learning, LL

1990

NAOmTericFaOnsRwitSh ADiLsaEbiliOtieRs ADct:ImSaTnRdaItBedU"rTeaIsOonNable accommodation" byNemOpTloyFeOrs Rfor SthAosLe wEitOh R DISTRIBUT

disabilities.

1993

Family Leave Act enacted to assist those with caregiver and family responsibilities.

1995

ARN publishes a core curriculum for advanced practice in rehabilitation nursing; the first advanced

? Jones & BarptralectticteLneurasernceirntifgic,atLioLnCexamination in rehabilitation?is oJfofenreedsto&obtBaian rthtleectretdLenetaiarlsnCiRnRgN-,ALLC N2O00T9?pFreOseRntSALTbEhaseiOcCCRRRRNRDN-A.IcSreTdRenItBialUisTteIrOmNinated. All nurses who wisNh tOo cTerFtifOy iRn reShaAbLilitEatiOonRnuDrsiInSgTobRtaIBin UtheTION

In response to the growing number of injured veterans from continuing wars in Iraq and Afghanistan, the VA established four Polytrauma Rehabilitation Centers and 21 Polytrauma Network Sites as well as many other Polytrauma Support Clinic Teams to provide support and rehabilitation to returning soldiers.

? Jones & Ba2r0t1l0ett LearninFgin,aLl ruLleCfor IRF prospective paymen?t syJstoemneimspl&emBenaterdtltehtatt aLffeecatsrnpaiynmge,ntLfoLrCrehabilitation

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The AssociatiNonOoTf RFeOhaRbiSlitAatLioEnONRursDesIS(ATRRNIB) UTION

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was established in 1974 by Susan Novak to address the

BOX 1.1 Web Exploration

need for nurses in this specialty area. In 1976 the ARN Visit the ARN website at . Explore the

was recognized as a specialty nursing organization by the

A?mJeroicnaensN&ursBesaArtslseotctiaLtieonar(nAiRnNg,,2L01L0Ca). The first

resources available through the ARN and examine the

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rNehOabTiliFtaOtioRn nSuArsLinEg jOouRrnDalIwSaTs pRuIbBliUshTedIOinN1975 and

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then a core curriculum in 1981. The first certification

Although the roots of rehabilitation may have been

exam for rehabilitation nurses was given in 1984. As slow to take hold, growth continues to be evident. By the

of 2010 there were about 10,000 certified rehabilitation early 1990s rehabilitation was one of the top specialty

? Jones & BnaurrtsleestitnLtheeaUrnniitnedgS,tLatLesC. See Box 1.1.

? Joncehsoi&cesBoafrmtleedtitcaLlesaturdneinntgs.,CLeLrtCifications now exist

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NOT FOR SALE OR DISTRIBUTION

? Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.

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