CARRIERS IN THE FIELD OF NURSING IN REHABILITATION AND HEALTH ACTIVITIES are graduate nurses, medical technicians with the close cooperation of nurses who provide nursing care in accordance with their competencies. All employees in the field of nursing in rehabilitation and health activities are included in the narrower interdisciplinary nursing care  team and the wider rehabilitation team.

During the absence of therapists of various professions, all profiles of nursing in rehabilitation and health activities must know the basic problems of patients in the field of physiotherapy, occupational therapy, speech therapy, psychology, social field and respiratory physiotherapy.

The work is focused primarily on the functioning of the patient, and the goal is maximum independence. This cannot be achieved without teaching with an explanation that is tailored to the patient and understandable to him. Difficulty is reflected in a holistic, partner approach, regardless of the anticipated final functional state of the patient. It is crucial that the patient has the opportunity to co-decide, as he is an equal member of the team.

The work in the field of nursing in rehabilitation and spa activities is specific and widespread and occupies all levels of health care. It requires both physical and mental effort. It requires a lot of confidence in yourself, in your abilities, knowledge and skills, with a constant desire to improve, including communication, and especially in the field of constantly improving rehabilitation technology, which allows better health care and later independent life of the user.

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KNOWLEDGE AND ACTIVITIES OF NURSING WHICH THE NURSE IN THE FIELD OF REHABILITATION AND HEALTH ACTIVITIES MUST ACQUIRE AND KNOW

Prevention of ulcers due to pressure and contractures, prevention of falls and other injuries, prevention of edema of affected limbs, care for regular use of prescribed therapy, care for proper, balanced and individualized diet, proper hydration, care for regular urination and stool, prevention of venous thrombosis , neurological deficits, respiratory problems (airway aspiration), cardiovascular problems (orthostatic hypotension, autonomic dysreflexia).
Nursing care in the field of rehabilitation and spa activities is based on the so-called psycho-socio-eco model, and in the process we are constantly focused on solving the patient's problems and problems.

 

ADDITIONAL KNOWLEDGE AND TASKS TO BE KNOWN BY A NURSE IN THE FIELD OF REHABILITATION AND HEALTH ACTIVITIES

1. University Rehabilitation Institute of the Republic of Slovenia URI Soča as tertiary level institutions and health resorts in the Republic of Slovenia represent a learning base for the development of nursing staff at secondary, undergraduate and postgraduate levels, therefore staff employed in nursing in rehabilitation and spa activities :

- higher level of knowledge in various health and medical fields (surgery, internal medicine, neurology, traumatology, oncology, pediatrics, algology (); it is necessary to ensure constant interclinical education;

- in the pedagogical field, the subject of nursing in rehabilitation at health faculties has already been formed (eg ZF UL, FAZB, ...);

- clinical and pedagogical work with high school and medical students, mentoring various works (seminar papers, diploma theses, qualitative and quantitative research, writing articles, ...); with these actions we ensure clinicality in the tertiary rehabilitation and health resort institution; at the tertiary level of health care to ensure the title of university institute all profiles and thus nurses work in scientific research, preparation and writing of professional articles and actively participate in lectures at various congresses, symposia, workshops, working groups and sections;

- coordination, guidance, direct work in clinical practice in terms of clinical exercises of pupils and students (domestic and foreign);

- development, opportunities and possibilities for scientific research work in nursing in the field of rehabilitation and spa activities;

- Nurses are also performers of exercises of the Faculty of Medicine entitled Contact with the patient in the office and currently, depending on the epidemiological situation, also through audio-video conferences;

- active participation in the Section of Nurses and Medical Technicians in Rehabilitation and Spa Activities ; we represented a fifth of all members of the section, and in the last two decades, colleagues from URI-Soča have been presidents and vice-presidents and members of the section's expert committee, as well as colleagues from the spa business;

- together with the Section of Nurses and Medical Technicians in Rehabilitation and Spa Activities and the Chamber-Association, we are providers of theoretical and practical training for graduate nurses and graduate nurses in the following areas :

• Urinary disorders (1x annual training for the acquisition of special knowledge in the field of nursing care for patients with urinary disorders. Training includes 100 hours, of which 50 hours of theoretical content and 50 hours of practical training).

• Nursing care of a neurological patient (1x per year according to the program of the Chamber-Association).

- A registered nurse and a registered nurse are also involved in:

• team for work with the baclofen pump (participates in the insertion of the baclofen pump, in the implantation of the baclofen pump in the operating room,  when filling baclofen with a doctor  in the spasticity clinic, testing before inserting the baclofen pump in the ward and handling the system),

• team in the internal medicine clinic (vascular ultrasound, stress testing),

• team in the urodynamic laboratory,

• a team in a chronic pain management clinic.

-  Nurses and medical technicians:

• are also actively involved in the implementation of serial plastering, especially in children and adolescents, but occasionally also in elderly patients, after completing the course,

• take a neurological patient nursing course.

- All profiles in the field of nursing in rehabilitation and spa activities pass a course to meet the scale of functional independence of the patient (FIM) .

- All nursing staff was also actively involved and successfully completed training on airway aspiration, various modes of communication, swallowing disorders… and attended a lecture on the treatment of patients with violent behavior.

- The tendency of the institutions is that all nurses in the field of rehabilitation and spa activities receive additional training in many areas, so among other things we actively participate in training in the field of ulcer / wound care and nursing of various stomata (special knowledge in enterostomal therapy), education in the field of nosocomial infections and hand hygiene …

 

2. Education of patients, relatives and personal assistants in performing invasive nursing procedures such as : airway aspirations, toilet tracheal inserts, clean intermittent catheterization, neurogenic bowel training, neurogenic bladder training, treatment and prevention of chronic wounds, as well as continuation, knowledge and handling of respiratory support and non-invasive mechanical ventilation, parenteral feeding methods, post-acute phases of treatment, care and nursing in the home environment. These nursing procedures are discussed by the nurse in rehabilitation and spa activities with the patient, his relatives, caregiver or personal assistant before coming to the institution, during hospitalization and after leaving the hospital. Nursing staff has the role of coordinating, coordinating and implementing all interventions / procedures of nursing in the field of rehabilitation and spa activities .

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3. All nurses in the field of rehabilitation and  Due to the nature of their work (24 hours / day), spa activities take over part of the tasks and interventions of physiotherapy and occupational therapy in all work shifts .

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4. Training of daily activities: Daily activities are all those activities that the patient must master in order to live independently: feeding, dressing, washing, sitting and moving in space. The task of the nurse in the field of nursing in rehabilitation and spa activities is to try to include them in daily activities as soon as possible according to their abilities. Re-learning activities is the domain of the occupational therapist. However, the nurse plays an important role in daily activities. It first focuses on the activities that are most important for the patient's independence (feeding, personal hygiene). Leave the patient to eat alone, protect him appropriately and prepare his food appropriately. However, he must always be nearby and observe the patient. Patients also learn to dress quickly. It is important to choose appropriate clothing. He advises the patient to always dress first the affected side, then healthy. In undressing, the opposite is true. She encourages him to do as much as he can on his own. Collaboration with a physiotherapist and occupational therapist is essential. The nurse continuously monitors and observes the consistency between what the patient says and what he does or does not do. what he does and what he says.

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5. Use of medical devices: With the correct use of appropriate devices, the patient can achieve maximum possible independence in performing basic living needs and movement. The most important conditions that we want to influence with devices are: contractures and rigidity of the joints, muscle atrophy, paresis, plegia, spasticity ... In patients, depending on the underlying disease or. We use the following rehabilitation aids: orthoses, prostheses, wheelchairs, orthopedic shoes and insoles, walking sticks or crutches, stilts, functional electrical stimulators, self-help aids (shower chair, transfer board, sock dressing accessories, custom cutlery… ).

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In the field of rehabilitation and spa activities, the nurse works in all areas, not only as a nursing provider, but also as a consultant, assistant, teacher, liaison among other medical staff, a source of information. In addition to comprehensive care, it also offers the patient emotional support and thus takes care of strengthening his mental health. The nurse plays an active role in carrying out nursing and therapeutic interventions in gaining independence during rehabilitation. In the phase of treatment and rehabilitation, he is an integral member of the medical and rehabilitation team , within which he performs independent nursing care and participates in diagnostic - therapeutic treatment by performing numerous medical  technical interventions.  The purpose of nursing is to provide comprehensive and quality nursing care that is safe for the patient.

The role of the nurse in the rehabilitation and spa activities is very demanding. He can perform nursing tasks independently (nursing activity), interdependently (cooperates with the doctor in diagnostics and therapy) and interdisciplinary (cooperates with physiotherapy and occupational therapy and other members of the rehabilitation team). The basic goal of the orientation is to achieve quality nursing care in all areas. By definition, rehabilitation is an active process through which affected patients (including their relatives, carers or personal assistants) achieve full recovery from injury or illness or, if this is not possible, exercise their optimal physical, mental and social potential and become involved. the most suitable home and social environment.