New roles in rehabilitation--the implications for nurses and other professionals

The development of rehabilitation and intermediate care services, and roles therein, is part of current UK health policy to meet the demands of the ever-growing older population. One new role is the rehabilitation assistant (RA). This is a generic support worker trained at a basic level in nursing, physiotherapy, occupational therapy and social work who works under the supervision of the referring professionals, to deliver integrated rehabilitation programmes. RAs were introduced in one region in the north-west of England to increase the rehabilitation activity for patients. An empirical qualitative study was recently undertaken to evaluate the impact of the RAs from the perspectives of patients and associated nurses, therapists, managers and the RAs.

Fifty-five semi-structured interviews were used to collect data, which was then inductively analysed into categories and then themes. The categories included variations in role, benefits of role, acceptance and integration of role, difficulties with role, training and retention. This paper focuses on the benefits and difficulties of the role.

It was found that patients, professionals and the RAs expressed great satisfaction with the new role. However, barriers to effective rehabilitation were reported owing to ward routines and organizational systems that interrupted and caused inconsistencies with the rehabilitation care programmes for patients.

If it is agreed that the majority of patients (unless end stage terminally ill, unwilling or unable) could benefit from some degree of rehabilitation, then there is an issue around how such skills could be widely implemented. This paper discusses the barriers to effective rehabilitation, the benefits and drawbacks of looking at new ways of working and the need for a unified approach by all care workers in rehabilitative care.