Stroke Rehabilitation Certification Program - Research Paper Example

? Stroke Rehabilitation Certification Program including Education and Core Competencies Required for All Certified Rehab Registered Nurses (CRRN). Name: Institution: Abstract A stroke, also known as cerebrovascular accident is the quick loss of function(s) of the brain as a result of the impediment of the general supply of blood flow to the brain. It can cause a permanent damage to the function (s) affected or even result in death. Its symptoms start sudden depending on the part of the brain affected, and it is important for early recognition in order to minimize or prevent the damage it causes. There are two kinds of stroke with the most common one being ischemic stroke. This stroke is caused by clotting of blood, which in turn prevents blood flow through an artery or vein to the brain. When discovered early, this kind of stroke is treated by a drug that dissolves obstructing cots in the artery. Hemorrhagic stroke is the second common type of stroke. It is less common, and is caused by rupturing of a blood vessel in the brain thereby spilling to the surrounding tissue. As a result of the spillage, brain cells in the area die due to the lack of oxygen and nutrients required for them to function. The most common stroke risk factors are high blood pressure, heart disease, carotid artery disease, cigarette smoking diabetes and excessive consumption of alcohol. Its symptoms include numbness especially on one side of the body, confusion (either talking or listening), a severe headache, and dizziness, as well as, lose of balance. This paper will examine the role rehabilitation nurses’ play in caring for stroke patients, how certification for the program is awarded as well as the core competencies required. The paper will also look at the impact by CNS, aspects of spheres of influence and synergy model. Introduction Stroke rehabilitation is the process within which patients suffering from stroke are treated in order for them to be able to continue with their daily life. Its main goal is to assist patients relearn the skills that were lost when stroke affected them. But the rate at which one relearns these skills varies according to the person affected. Stroke rehabilitation includes therapy to regain communication disorders such as listening, writing and comprehension. It also involves patients undergoing excises in order for them to regain their muscle strength. Once patients gain their muscle strengths, this is usually accompanied by mobility training which usually includes patients being taught how to use walking aids. In some instances, the use of electrical stimulation is involved in order to arouse weakened muscles so as they can contract (Chick et al., 2004). Stroke rehabilitation should begin once a patient has discovered what he/she is suffering from. This is aimed at stabilizing the patient’s medical condition. On the other hand, the duration of stroke rehabilitation depends on the recovery of the patients as most stroke survivors require more time. In essence, a rehabilitation center is supposed to ensure that a patient in a position to do better and became independent especially through enabling the patient to tolerate the changes that have emerged on their brain and body due to the stroke. This makes them be able to adjust more to living within their home, with family or even the entire community (Lindley, 2008). Need for Stroke Rehabilitation Program Stroke rehabilitation is aimed at helping stroke survivors reach high levels of independence and try to restore their productivity (Massaro, 2006). A rehabilitation program begins immediately a person is confirmed to be suffering from stroke. They offer the program even after a patient is released from the hospital as per the flexibility of an individual. Rehabilitation does not necessarily cure the stroke, but it helps survivors achieve greatest achievable long term outcomes. On the other hand, rehabilitation will largely depend on the damage that has been caused to the brain. Of most important is to ensure that survivors are in a position of preventing themselves from future stroke, and that the teams of professionals in the rehab are in a position of helping you work out the exercises as per survivor’s condition by advising them on the type of exercise, diet and other packages associated to this (Massaro,2006). Rehabilitation assists survivors to re learn the skills forgotten after a stroke. This will include, for example, survivors being taught how to coordinate movements in order to walk. It also teaches survivors on new ways of accomplishing tasks. If for example one side of the body is paralyzed, then they will be taught on ways of accomplishing tasks using the other side of the body which is active (Lindley, 2008). Needless to mention, survivors’ have a higher chance of taking back their abilities at the beginning of the therapy after suffering from the stroke. The Role of Certified Rehabilitation Registered Nurses in Caring for Stroke Patients Nurses work as paramedics in the pre-hospital stage of a patient suffering from stroke. They accomplish the above task by supervising and educating the nursing staff. This includes educating patients on routine healthcare and how the other nurses should contribute to the therapeutic goals that are set for each patient. The rehab nurse also gives counseling services. They also provide encouragement to patients on how to deal with the conditions that they may get into. This is aimed at stabilizing breathing and circulation of blood (Kesten, 2000). The nurses also provide oxygen to patients as well as ensuring that the blood glucose level is right. In addition, the nurses provide a holistic and complete care of stroke patients including relieving pain. For example, the nurses help survivors effecting personal care issues such as taking a shower. The rehabilitation nurse also works hand in hand with the survivors in overcoming risk factors that can lead to another stroke (Chick et al., 2004). Stroke Rehabilitation Certification Program Stroke rehabilitation certification is voluntary and is based on meeting eligibility and doing an examination that one is expected to pass. The society and the nursing profession raised concerns over the accountability for specialty practice and it is against this background that the certification program for rehabilitation nurses was introduced in 1984 with the main aim of ensuring that there was adequate accountability in the profession. The certification can be obtained from the Rehabilitation Nursing Certificate Board (RNCB). The Need for the Core Competencies Autonomic Dysreflexia This is a syndrome of imbalanced reflex sympathetic discharge that occurs to patients suffering from spinal cord injury. This condition is associated with sustained or severe hypertension. The condition is a medical emergency and thereby treating it during its early stages can prevent high blood pressure. Therefore, it is the role of nurses to educate patients and their family members on how to prevent it, its signs and on how to manage the life threatening condition (Kesten, 2000). This condition requires special care from both the clinical officers and the patient’s family members. In most cases, this condition worsens when the patient and those taking care of him do not understand ways of managing it. Bowel Function The Bowel also known as the colon is the last part of the digestive tract. This part is tasked with the responsibility of taking food into the body, and there after getting rid of waste products. It also serves to act as a temporary storage for any waste byproducts of the digestion process before the said waste products, are eventually released from the body. Once patients suffer from stroke, it may lead to bowel incontinence. Therefore, the nurses will guide patient on tips on how to improve the bowel function (Chick et al., 2004). Just like in any other condition, it is crucial that the patient and those taking care of him gets to understand various ways they can enhance bowel functioning. Communication Communication is the ability to send or receive and comprehend the message either verbally or nonverbally. As a Clinical specialist, it is vital for good communication to be exercised and listening skills in order to get to understand a stroke patient. In many times, patients suffering from stroke are not able to communicate or are not able to comprehend what is communicated to them because the stroke disrupts their communication system. In this regard, clinical specialists should be in a position to interpret various forms of communication conveyed by the patient (Kesten, 2000). For instance, a patient who is not able to speak could be using gestures to communicate to the clinical specialists. In addition, it is critical that the specialist ensure that his or her points are well understood by the patient. This is paramount especially when directing or instructing the patients on what is required of him In terms of ensuring his safety and health. Impact of Clinical Nurse Specialists Clinical nurse specialists (CNS) can broadly be defined as registered nurses that have advanced their practice in preparation for graduation. They work with other nurses with an aim of improving outcomes on their performance. The CNS has a role of integrating care across the three spheres of influence (Patient, nurse, System). The major task that CNS is tasked with is to ensure improvement on the condition of the patient. CNS practice also empowers nurses to develop caring practices in order to reduce or alleviate patient suffering. Clinical Nurse Specialists are also involved in the treatment of illness zones, promotion of health disease management and prevention. The three spheres, i.e. the patient, the nursing personnel and the system (which is normally concerned about the healthcare system) are interrelated but each sphere has a unique focus. Therefore, Clinical nurse specialists ensure that there is an improvement on the patient’s condition and a continuous improvement in nursing care. They also manage a team of nurses and coordinate any kind of research that is aimed at improving patient care. Clinical Nurse Specialists provide advanced assessment to survivors of stroke. Through the direct monitoring of the patients, they are able to determine whether a patient id developing a positive or negative development towards recovering from stroke (Kesten, 2000). The Synergy Model in Nursing This is a practice intended to match up the needs of patients and their family with those of the nurse (s) attending them. This model has been designed to ensure that the core needs of the patients and their families are the main driving factors that eventually drive and influence what will be the main competencies and characteristics of the nurses attending to the patients (Bornstein, 2009). It is often found that most of the patients being attended to in a hospital tend to share similar experiences and needs with each other. This is despite the fact that the said needs often vary across very wide ranges from illness to health. The more intense the level of affliction or degree of compromise on the patient’s health afforded by the disease, the more the demands made by the patients as pertaining to the attendance of their needs will be found to be complex (Bornstein, 2009). It is especially essential for nurses to ensure that they are able to easily adapt to these varying degrees of competencies so as to be able to sufficiently attend to stroke patients as these are often found to have varying degrees of affliction after suffering from the debilitating effects of a stroke (Bornstein, 2009). This is important as nurses are able to integrate aspects such cultural disparities in the plan of care for the patient. In this way, patient needs are met while the nurse establishes a good working relationship with the patient and their family (Bornstein, 2009). CONCLUSION The type and severity of disability a patient may suffer after a stroke varies greatly. In this regard, post stroke rehabilitation offered by certified Rehabilitation Registered nurses and Clinical Nurse specialist, varies due to the variability of patient needs. Nevertheless, the nurses usually play a crucial role in helping and assisting them on their way to recover from the stroke. The role the nurses play in educating and supporting the stroke patients is vital for the reduction and prevention of possible strokes in future. References Fisher, M. (2009).Stroke: Investigation and management. Edinburgh; New York: Elsevier. Massaro, L. (2006). Stroke care: The guide to JCAHO certification. California. HCpro, Inc. Lindley, K. (2008). Stroke. New York, Oxford University Press. Bornstein, N. (2009). Stroke: Practical guidance for clinicians. New York: Karger. Kesten, K. (2000). The impact of clinical nurse specialists on clinical pathways in the application of evidence-based practices. Journal of Professional Nursing, 26, 1. pp. 42-44. Chick, K. et al., (2004). Enhancing patient education through clinical nurse specialists’ collaboration. Clinical Nurse Specialists, 26, 6. pp. 317-22. Read More