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RN Registered Nurses take care of people who are sick, injured, convalescent or disabled. They care for patients by assessing, planning, intervention, implementation and evaluation, under general supervision, and in accordance with established practices and philosophy. Registered Nurses work with other professionals to ensure patient care is delivered effectively to achieve desired patient outcomes. The RN must effectively interact with the patient and family members while maintaining the standard of professional nursing. There are many travel assignments and jobs available for the Registered Nurse as the Bureau of Labor Statistics notes that nursing is one of the top 10 occupations with the largest job growth. Where would you like to visit? Work in a great environment and enjoy free time seeing places you have always wanted to visit. Many great opportunities await the Registered Nurse in today’s market!

The Rehabilitation Registered Nurse works with a wide range of patients populations and types, ranging from the patient who just had joint replacement surgery, the patient who has suffered a stroke, those with occupational or sports injuries, and some with severe spinal cord injuries or other chronic, progressive conditions such as multiple sclerosis. The nature and stage of the patient’s condition will guide the goals of rehabilitation, which may be to prevent secondary disability, return patients to their former functioning state, improve the body functions or help the patient adapt to a new way of functioning. The primary goal of Rehabilitation Nursing is to help the patient attain or maintain maximum function. Some rehab patients may be learning to live an altered lifestyle because of increasing disability or permanent injury. The Rehab nurse will help the patient to adapt physically and emotionally to lifestyle changes and teach them new skills and providing them with nursing care.

Skills of the Rehab RN 

Educating patients and helping them with the adjustments necessary to support their health. Educating the patients about disease, injuries and related disabilities as well as self-care skills.

Collaborating with other disciplines such as occupational and physical therapy and reinforcing the teaching of these professionals and coordinating the care of the patient.

Supporting adaptive capabilities

Treating changes in the functional ability and lifestyle of patients dealing with disability, injury and chronic illness

Promoting independence that is achievable for the patient and helping the patient accept their “new normal”

Providing compassionate, holistic and comprehensive end-of-life care for patients with life-limiting conditions

The Rehabilitation RN practices in a variety of settings which may include clinics, hospitals, rehabilitation facilities, long term care facilities and the patient’s home. Rehab RNs also may work for educational institutions, private companies, insurance companies or in private practice. There are also outpatient and specialty rehab facilities providing services ranging from acute to convalescent care.

The daily tasks of the Rehab RN may consist of providing direct care to the patient or supervising the activities of other staff members in order to prevent complications and maintain functions such as the ability to move, eat or perform daily living tasks. A Rehab RN may help the patient exercise, provide proper skin care to aid in prevention of skin breakdown and ensure the patient is property positioned to prevent joints from becoming immobile. Illness and injuries may also cause changes in bowel, bladder or respiratory functions. The Rehab Nurse will teach the patient how to self-manage these conditions if possible. 

The Long Term Care Registered Nurse prescribes, delegates and coordinates the skilled nursing care of patients receiving care in a long term care facility. The working environment for LTC RN can be private homes and health care facilities, convalescent homes, assisted living centers and hospices. RNs plan care for patients with long term needs and supervise the staff providing those needs. Registered Nurses develop patient care plans, implement treatments,monitor patients and provide guidance. Long Term Care RNs provide care in the patient’s home or work in a facility and can also supervise the work on LPNs, home care aides and nursing assistants. The RN monitors vital signs and symptoms of the patient, delivers medication, maintains accurate records and implements other treatments. Aides and assistants can feed, clothe, change linens,  help patients with personal hygiene and monitor patients, under the supervision of the LTC RN. RNs may assume many of these duties in smaller facilities.

Some functions of Long Term Care Registered Nurses

Ensuring all work areas and residents’ rooms are maintained in accordance with safety and sanitation standards.

Ordering medications, equipment and supplies as prescribed.

Preparing and administering medications ordered by the physician in accordance with policies and procedures.

Attending rounds with physicians, nurse practitioners and physician’s assistants.

Assisting with the orientation of new staff to the unit.

Collaborating with the resident’s physician to provide the care, services, treatments and rehabilitation ordered.

Communication with the resident’s physician and/or family members when there is a change in resident’s condition or if any incident occurs involving patient.

Administering professional nursing practice services such as: tube feedings, suction, catheterization, changing of dressings, packs and irrigations as necessary.

Gathering samples of sputum, urine and other specimens for lab tests as ordered.

Continuous observation and monitoring of seriously ill residents.

Being the patient advocate and ensuring that other health care team members are providing care according to the resident’s care plan and personal wishes.

Receiving, transcribing and implementing physician’s orders according to facility procedures.

Accurately completing necessary charting as required and in a timely manner following established charting policies and procedures.

Qualifications of the LTC RN

Communications skills, read, write, speak and understand the English language.

Possesses the ability to make decisions independently when such action is warranted.

Ability to communicate on a personal level with residents, family members, personnel, visitors, government agencies and the general public.

Work well with others and show leadership and supervisory ability.

Knowledge of medical and nursing practices and procedures, and the regulations, laws and guidelines pertaining to long term care.

Maintain a cheerful, patient and enthusiastic disposition and handle difficult residents.

Display a willingness to research and learn about new methods and principles and ways to incorporate them into existing practices to benefit the resident.

Demonstrate Safe and Effective Use of Equipment such as:

CPM

Oxygen wall regulators/portable oxygen

Patient Call System

Electronic thermometer

TPN administration

Foley catheters

Geri chair

Specialty beds

Computer, printer, copier, fax

NG tube/suctioning

Drains

Safety bed alarm system

IV pump

Gait belt

Dinamap

PCA

Crash Cart

Defibrillator

Insulin pump

Lifting equipment

Enteral feeding pump

Anti embolic stockings

The Bureau of Labor Statistics estimates that opportunities for Registered Nurses will grow by about 26% in the few years and many of the jobs will be in Outpatient Clinics.

The RN in the Outpatient Clinic may plan, oversee and coordinate the every day patient and nursing services, including operational and/or administrative duties. Responsibilities of the RN in the Outpatient Clinic setting may include:

Perform routine patient assessment and treatment

Draw blood, check vitals, monitor vitals if required

Implement and document nursing care

Assist physicians during examinations and/or procedures

Administer meds

Coordinate and/or supervise the care of the patients in the clinic

Educate the patients and their families about services provided

Maintain inventory of medical supplies and equipment 

Performs miscellaneous duties assigned

In most cases the patient does not stay overnight in this setting and the RN must make sure that the patient is prepared to continue to recover at home. The Outpatient RN will check symptoms, administer medications and educate the patient and family, including providing written instructions.  

Long Term Acute Care Registered Nurses are bridging the transition from intensive care to home. LTAC patients normally transfer from an intensive care unit and are receiving ventilator assistance. Some patients have large open wounds or other acute problems. The patient may be on inotropic agents and require careful monitoring. Most patients in these units, age 18 and up, have an average stay of 25 days or longer. LTAC RN’s state that one of the most challenging aspects of caring for these patients is the management of multiple, long-term, complex medical conditions, multiple system failures and the patient’s anxiety. LTAC if the final stop when trying to wean patients off a respirator and most patients in these units have been in the hospital for many months by the time they reach this phase. It is a long, hard road for them and some are nearing wit’s end by the time they reach this point in their recovery.

The LTAC RN must spend considerable time with family members in addition to caring for patients. Family members may be frustrated by their loved one’s perceived lack of progress. Some may also have travelled long distances to visit their loved one and can be unfamiliar with Long Term Acute Care.

Critical thinking skills and independence are essential in this setting. Unlike the Intensive Care Unit, the physician on call in not in the unit and therefore the LTAC nurse may work more autonomously than typical in a critical care setting. RN LTAC must be able to manage stress appropriately, make decisions under pressure and manage the anger/fear/hostility and violence of others appropriately. RN’s may be exposed to toxic/caustic chemicals and detergents and extreme hot and cold conditions. Exposure to communicable diseases, blood and/or body fluids and exposure to dust/fumes and gases are also possibilities.

Accurate assessment, reassessment, development and implementation of care plan in a safe, accurate and appropriate manner

Knowledge of specific conditions, disease and treatment therapies for the specific population of the setting

Tracheotomy care

Accurately document records in a timely manner

IV Therapy

Serve as advocate for patient and/or family members regarding decisions affecting the care plan

Wound care and skin care protocols

Ostomy care

Identify the educational needs of the patient and family members and provide the necessary education to meet those needs

Post of care of patient

Assess and evaluate patient’s response to care plan and prioritize and implement appropriate changes to plan

Responsibilities of the Long Term Acute Care Registered Nurse may include:

Appropriate response to an emergency situation.

Staple/suture removal

Chest tube care

Collaborate, assess and coordinate discharge planning needs and readiness for discharge with other health care team members on a timely basis

Always show respect and awareness for the patient and family members as individuals and as a family unit

Provide direct supervision and assistance in evaluation of staff performance

The RN in LTAC settings will stand, sit, walk, perform repetitive tasks and motions, have good manual dexterity, hear alarms/telephone/normal speaking voice, have clarity of vision and be able to distinguish colors.

Demonstrate Safe and Effective Use of Equipment such as:

CPM

Oxygen wall regulators/portable oxygen

Patient Call System

Electronic thermometer

TPN administration

Foley catheters

Geri chair

Specialty beds

Computer, printer, copier, fax

NG tube/suctioning

Drains

Safety bed alarm system

IV pump

Gait belt

Dinamap

PCA

Crash Cart

Defibrillator

Insulin pump

Lifting equipment

Enteral feeding pump

Anti embolic stockings