In the spring of 1968, I was a junior in a baccalaureate nursing program in a small town in Kansas. One of my courses was a “medical-surgical nursing” clinical course. From the title, you can see we did not have fancy names for courses in those days. The title precisely names what the course involved—working with patients on a combined medical-surgical floor in a community hospital. I was flying through the semester with ease until I had a conference with my instructor. The head nurse of the unit where I was working, Mrs. Isley, had talked with my instructor and complained that I was not doing my work and that I was lazy. I was mystified at what she could be referring to. That week, I had been working with an older female patient who had a stroke that resulted in right hemiplegia and aphasia. The issue, from Mrs. Isley’s perspective, was that, during the patient’s bath, I had helped the patient use a washcloth mitt (anyone remember that?) and guided her right hand to wash her face and her unaffected arm and hand. My laziness was not doing the bath independently but getting the patient involved! The head nurse was not too crazy about my passive range-of-motion exercises with the patient either. I was already a budding rehab nurse at age 20 and did not even know it!
Fast forward to rehabilitation in 2019, the opportunities that patients have for rehabilitation in the majority of the United States are tremendous. However, that is not the case in most of the world. Because of inequities in rehabilitation care, the World Health Organization (WHO) has launched a campaign titled “Rehabilitation 2030: A Call for Action” (WHO, 2019). The campaign was inaugurated when government officials, organizations representing rehabilitation service user groups and providers, funding bodies, international professional organizations, research institutions, nongovernmental organizations from around the world, and the WHO convened at the WHO headquarters in Geneva in February of 2017 (Gimigliano & Negrini, 2017). The aims of the meeting were as follows:
- to draw attention to the increasing unmet needs for rehabilitation,
- to highlight the role of rehabilitation in achieving the sustainable development goals proposed by the United Nations, and
- to call for coordinated and concerted global action toward strengthening rehabilitation in health systems (WHO, 2017).
The history of the WHO and rehabilitation dates from the Declaration of Alma Ata in 1978. The Declaration named promotion, prevention, cure, and rehabilitation as one of four (at that time; now five with the addition of palliative care) health strategies to achieve and maintain health (Stucki, Bickenbach, Gutenbrunner, & Melvin, 2018). Rehabilitation is poised to become the key health strategy of the 21st century (p. 315). What an exciting and energizing time for rehabilitation! There is much work to be done to position rehabilitation for the future. Association of Rehabilitation Nurses (ARN) members, Drs. Michele Cournan and Stephanie Vaughn, will represent rehabilitation nursing on the WHO’s Competency Framework Steering Group. The group is charged with developing a rehabilitation competency framework. Michele and Stephanie are the only nurse members of this prestigious group. Congratulations Michele and Stephanie!
Mrs. Isley, rehabilitation has come a long way since my washcloth mitt.
Pamala D. Larsen, PhD, RN
Gimigliano F., & Negrini S. (2017). The World Health Organization “Rehabilitation 2030: A call for action”
. European Journal of Physical and Rehabilitation Medicine
, 53(2), 155–168.
Stucki G., Bickenbach J., Gutenbrunner C., & Melvin J. (2018). Rehabilitation: The health strategy of the 21st century. Journal of Rehabilitation Medicine
, 50(4), 309–316.