AIM OF THE STUDY/PAPER: To identify the contribution of the nurse within the multi-professional rehabilitation team.
The requirement for nurses to work effectively within the multi-professional rehabilitation team is increasingly important with the higher incidence of chronic disease, growing numbers of older people and enhanced survival from major trauma.
A 2-year qualitative investigation was undertaken centred on three contrasting condition case studies (fractured neck of femur, rheumatoid arthritis and stroke). Clients were theoretically sampled, with their 'rehabilitation pathway' through different services providing the window through which the nurse's contribution was explored. Multiple methods and points of data collection were used, including observation, face to face interviews (clients, carers and staff) and record review. To enhance generalisability, a series of national expert workshops were undertaken with four groups: users, carers and carers' organizations; nurses; members of the multi-professional team; and educationalists.
Six interlinked roles for the nurse were identified: assessment, co-ordination and communication, technical and physical care, therapy integration and therapy carry-on, emotional support, and involving the family. Of particular significance is the creation of a supportive environment for rehabilitation to occur. Some nurses undertook aspects of all of these roles at any one time while others were only involved in one or two areas. While nurses expressed a desire to integrate therapy into their care delivery, the actual achievement of this goal was variable.
Key elements of the nurse's contribution within rehabilitation should aim to maximize client choice to enhance independent living in the client's future environment. At a nursing educational policy level the nurse needs to have a full understanding of the principles and models of rehabilitation. At a practice level, the nurse's role must be valued and recognized, by nurses themselves and other team members.