Postgraduate Specialization Degree in Rehabilitation Nursing

-To identify the nursing care needs for patients with traumatic neurological conditions, systematically making use of suitable assessment tools for each clinical situation;
-To draw up nursing diagnostics, based on identified changes, and produce the respective individual written care plan for those receiving direct care, and suitably specifying priorities;
-To carry out nursing actions and evaluate the results;
-To teach, instruct, train and advocate for the adoption of adaptive strategies;
-To intervene from the definition of diagnoses to therapeutic actions, along with the family, important family members and the social surroundings.

1-Functional assessment of the person/family/community
2-Neurological Exam
3-ASIA Evaluation in the LM;
4-Therapeutic positioning (use of various decubitus including ventral decubitus);
5-Joint movements and therapeutic exercises in bed:
-Muscle strengthening;
-Selective stretching and shortenings;
-Therapeutic massage;
6-Balance training;
7-Gradual raising to the inclined plane dealing with orthostatic hypotension;
8-Transfers;
9-Wheelchair exercises and gait training;
10-Dressing and undressing practice (elastic stockings, clothing, etc., in Spinal Cord Injuries);
11-Bowel and bladder training;
12-Teaching users and the reference members of the family – movement, transfers, feeding, bladder (self-catheterisation) and intestinal self-control, sexuality, risk prevention, etc.;
13-Spinal fixation surgery observation (if appropriate);
14-Placing of spinal stabilising orthoses;

-For objective 1, including objective 5, besides using suitable instruments for diagnostic evaluation in a systematic manner, students should carry out a functional evaluation of the person/family/community, neurological examination and an ASIA evaluation in the LM;
-For objective 3, in accordance with objective 2, programming should be made for the therapeutic positioning, joint movement/exercises in bed (muscular strengthening, selective strengthening and shortenings), balance training and progressive raising, wheelchair exercises and gait training and training in dressing/undressing and bowel and bladder training;
-For objective 4, the teaching, instruction and training should mainly be aimed at the most suitable responses to the nursing diagnoses related to movement, transfers, food, bladder (self-catheterisation) and intestinal self-control, sexuality, risk prevention, and bowel and bladder elimination.

Clinical teaching is based on a tutorial teaching model, presupposing the student, tutoring nurse and the teacher.
As such, supervision and evaluation of this clinical teaching is the responsibility of the teaching staff of the School, counting on the cooperation of the tutoring nurses specialised in rehabilitation nursing. However, these procedures should be based on the reflection and discussion of clinical practices, from diagnostic (neurological) evaluation to planning rehabilitation nursing care, carrying out the planned programme and evaluation of the results/health gains.
At the end of the clinical teaching, the trainee will carry out a critical learning reflection which will be considered/discussed with all those involved in the training process.
Evaluation is continuous, and there will be a qualitative evaluation made at the end of each block, in accordance with the clinical teaching evaluation sheet, which forms an integral part of the clinical teaching orientation guide.

In accordance with what was mentioned above, the teacher, working with the tutoring nurse, plans and produces learning and clinical supervision strategies involving the students, who should play an active role in defining their learning. These individuals should meet with the student three times during the learning process:
-Firstly, at the start of the clinical teaching, with the purpose of providing clarification to the student regarding the learning objectives, the resources and possibilities afforded by the clinical context and methods and strategies to guide, supervise and assess.
-Secondly, roughly halfway through the clinical teaching, with the aim of identifying difficulties or constraints in the teaching-learning process and accordingly define strategies to be implemented until the end of this learning period, with this essentially having a training purpose.
-The last meeting should be carried out at the end of the clinical teaching in order to evaluate the critical learning.

A bibliografia principal deve corresponder à bibliografia referenciada na unidade curricular de “Enfermagem de Reabilitação em Neurotraumatologia”, mais especificamente:
AMERICAN SPINAL INJURY ASSOCIATION – International Standards for Neurological Classifications of Spinal Cord Injury (revised), Chicago: American Spinal Injury Association (2000).
HOEMAN, Shirley P. et al - Enfermagem de Reabilitação: Aplicação e Processo. 2ª ed. Loures: Lusociência, 2000.
ORDEM DOS ENFERMEIROS – Guia de Boa Prática de Cuidados de Enfermagem à Pessoa com Traumatismo Vértebro-Medular – Cadernos OE, Série I, nº2, 2009.