After patients have progressed to their maximum potential or during a transitional timeframe before going home, some on the caseload are seen by restorative nursing. This is strictly a nursing program in my facility, with suggested input from therapy but ultimately the decisions are made by nurses. Decisions such as range of motion, exercise progression and how long they are on their caseload are all made by nursing.
I recently designed a program for a gentleman and later learned that the activity was not taking place because to get the patient where they needed to be was "too difficult." I have a problem with this because I feel if I am able to transfer a patient every other person should be able to do it too. Transfers have nothing to do with strength - it is a skill based on technique everyone in health care should have. And if they don't, they are in the wrong profession. Imagine if I said my job was "too difficult" and decided I didn't want to do it. I doubt I would still have one after that. (There I go ranting again about transfers).
I try to explain as best as I can what I want done with patients after they are discharged from therapy. I encourage patients to ask questions about it and let me know if they are not getting what they need out of any program we are doing. After a patient or family spends so much money on co-pays and other equipment needed to make a transition from facility to home easier, I would like to see them continue making progress with nursing. I do not want patients to just accept an exercise program because it fills in their day. Ideally I would like to see the patient have a larger goal in mind, like going home.
Before endorsing patients for the RNA program, I will need to do more training with the nurses and patients to ensure everyone is successful and on the same page about where the patient is progressing to. This may take some time but I think it will be well worth it.