Rehabilitation nursing in home care

A randomized sample of 83 members of the Association of Rehabilitation Nurses' (ARN's) Home Health Special Interest Group (SIG) responded to a survey in 1998 and 1999 to determine the role intensity of rehabilitation nurses in home care. An instrument was developed that was based on role descriptions formulated by ARN. Significant differences in the roles were reported for caregiver, case manager, counselor, family-client educator, advocate, administrator, student/staff educator, and researcher. Rewards of home nursing included one-to-one interaction with clients, teaching opportunities, promotion of function, nurse autonomy, and seeing rehabilitation results. Difficulties included poor interdisciplinary coordination, budget restrictions, lack of understanding of rehabilitation nursing, and inadequate home aides. Differences between inpatient and home rehabilitation nursing included less equipment and resources and increased levels of responsibility in the home. Barriers for the transition to home rehabilitation nursing included interdisciplinary team communication, reimbursement standards and documentation, time management, autonomous nursing roles, and separation from help or emergency services.