Rehab Nursing: Interview with Nicole Alarcon, RN

My Specialty

Rehab Nursing: Interview with Nicole Alarcon, RN

Helping patients regain physical mobility after a serious injury

By Keith Carlson, RN, BSN, CPC, NC-BC
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Tell us the story of your nursing career.
I began my nursing career working at a skilled nursing facility in Corona. I worked there for about six months. One of my supervisors at the nursing facility told me of a part-time LVN position opening up at Corona Regional Hospital in the acute rehab department. I naturally jumped at the chance to work for a hospital. I applied immediately, was scheduled for an interview and I got the job! I felt like my career as a nurse was truly getting started.

I worked at Corona Regional for about three years, obtaining a great deal of valuable knowledge about rehab and its processes. The experience I gained there helped me to land a job at Casa Colina, a long-time career goal of mine. At Casa Colina, I was able to work full time at a remarkable facility and that felt great. It didn’t take long for me to decide it was time to pursue my dreams of becoming a registered nurse. I returned to school, earned my degree and now work as an RN, doing something I’ve been passionate about for most of my life.

How did you come to the specialty of rehab nursing?
Rehab nursing was a field I entered by chance. It’s something that I continue to do because I love the work. I’m constantly amazed at what we are able to achieve with many of our patients.

What does your work entail on a day-to-day basis?
I work the night shift. Like at most places, I receive and give report on patients, working alongside LVNs and CNAs within a team nursing structure. It’s the job of the entire team to ensure our patients receive the best care.

Night shift is when we receive most of our admissions. We perform the majority of our patient care with the help of our CNAs. I’m responsible for dispensing medications and providing wound care. During a patient’s stay, we nurses are in contact with the patient’s primary doctor, their physical medicine doctor and other providers involved in the case.

What do you love about your work? What lights you up about it?
Our patients come to us from acute hospitals with limitations related to a disease process, recent surgery or acute injury. I love being a witness as patients gain renewed independence and a feeling of personal accomplishment. It makes me feel good that we can make this miracle happen based on the contributions of many team members and the efforts of the patients and their families.

What are some of the challenges of your work?
Personally, the greatest challenge is seeing some of our younger patients come to us with a spinal cord injury or a traumatic brain injury. While it’s hard on the patients, it’s also very difficult for their families to deal with the challenges they’re facing. There are also permanent changes in function that these patients will be facing for years to come.

Can you share what populations you work with?
Our patient population varies from children as young as 14 to elders over 90.

What special certifications or trainings are required or recommended?
To work as a rehab nurse, it’s recommended to take your CRRN exam and become a certified rehabilitation registered nurse. It’s also essential to be trained on FIM [Functional Independence Measure] scoring. Our patients are scored using this system from the day of admission until discharge. This type of scoring allows everyone on the team to track the patient’s progress.

Another recommendation is transfer training. We do a lot of lifting and transferring of our patients from bed to wheelchair, wheelchair to restroom, etc. This type of training is critical and will save you and your patients from avoidable injury.

How has technology impacted your nursing specialty?
Most of the technological advances have taken place in our therapy department. For the nurses, we’re in the process of implementing our new EMR system, which will help us increase efficiency in patient care. We also use Pyxis [automated medication management] to ensure patient safety when dispensing medications.

What would you recommend to nurses who may be interested in this specialty?
Rehab nursing is a very rewarding specialty with many high points, but it can also have some low ones if a patient doesn’t do well. It involves a great deal of physical labor and patient/family education.

A nurse coming into this specialty should be ready for the emotional and physical toll it can take on you. You need to be empathic, but you also need to understand that the patient and their family members must actively participate in patient care. Rehab is the stepping stone to going home and the medical team is responsible for making sure patients are taught how to be independent and take part in the management of their own care.  

Keith Carlson, RN, BSN, NC-BC, has worked as a nurse since 1996 and has maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students.

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