The process of providing care for a patient who is suffering from a chronic illness, serious injury or disability involves a variety of professionals working together with physicians as a team. Each professional has specific training for a special role in the treatment or rehabilitation process. Most of them have some education in psychology. We’ve already seen how health psychologists can play a role. Let’s look at some careers outside of psychology and the training they require in the United States.
Nurses and Physician Assistants
There are two overall categories of nurses registered nurses (RNs) and licensed practical nurses (LPNs). RNs work in hospitals, community health clinics, physicians’ offices, and industrial settings. They assess and record patients’ symptoms and progress, conduct tests, administer medications, assist in rehabilitation, provide instructions for self-treatment, and instruct patients and their Families in ways to improve or maintain their health. RNs often deal with mental and emotional aspects of the patient as well. All RNs throughout the United States must be licensed to practice, have graduated from an approved training program in nursing, and have passed a national examination. RN training programs vary in structure and length; college and university programs take 4 or 5 years and lead to a baccalaureate degree. LPNs work in hospitals, clinics, physicians’ offices, and patients’ homes.
They perform nursing activities that require less training than those performed by RNs. For example, they take and record temperatures and blood pressures, administer certain medications, change dressings, assist physicians or RNs, and help patients with personal hygiene. Like RNs. all LPNs in the United States must be licensed to practice, have graduated from an approved practical nursing program, and have passed a national examination. Training programs for LPNs take about a year to complete and are offered through various types of institutions, such as trade and vocational schools, community and junior colleges, and hospitals.
Physicians’ assistants and nurse practitioners
Usually work closely with medical doctors, performing routine tasks that physicians ordinarily did in the past, such as examining patients with symptoms that do not appear serious and explaining treatment details (AANP, 2000; AAPA, 2000). Training involves a program of about 2 years of study; admission often requires that applicants have a relevant bachelors degree, such as in nursing, and prior health care experience.
Dietitians study and apply knowledge about food and its effect on the body. They do this in a variety of settings, such as hospitals, clinics, nursing homes, colleges, and schools. Some dietitians are administrators other work directly with patients in assessing nutritional needs, implementing and evaluating dietary plans and instructing patients and their families on ways to adhere to needed diets after discharge from the hospital. Some dietitians work for social service agencies in the community, where they counsel people on nutritional practices to help maintain health and speed recovery when they are ill.
Becoming a dietitian requires a bachelor’s or masters degree specializing in nutrition sciences or institutional management. To become a Registered Dietitian, the Individual must complete a supervised internship and pass an exam.
Many patients need help in restoring functional movement to parts of their body and relieving pain. If they have suffered a disabling injury or disease, treatment may be needed to prevent or limit permanent disability. Physical therapists plan and apply treatment for these goals in rehabilitation (APTA. 2000). To plan the treatment, physical therapists review the patient’s records and perform tests or measure- merits of muscle strength, motor coordination, endurance, and range of motion of the injured body part. Treatment is designed to increase the strength and function of the injured part and aid in the patient’s adaptation to have reduced physical abilities, which may be quite drastic. People who have suffered severe strokes are sometimes left partially paralyzed, for instance.
The most universal technique used in physical therapy involves exercise, generally requiring little effort initially and becoming more and more challenging. Another technique involves electrical stimulation to move paralyzed muscles or reduce pain. Physical therapists also give instructions for carrying out everyday tasks, such as tying shoelaces or cooking meals. If the patient needs to use adaptive devices, such as crutches or prosthesis (replacement limb), the therapist provides training. All physical therapists throughout the United States must have a degree or certificate from an approved training program and be licensed by passing an exam. A bachelor’s degree has been the minimum educational requirement to enter the profession, but a master’s degree in physical therapy will be the minimum as of January 2002.
Occupational therapists help physically, mentally, and emotionally disabled individuals gain skills needed for daily activities in a work setting, at school, in the community, and at home. Their patients are often people who had these skills at one time, but lost them because of a spinal cord injury or a disease. These professionals usually specialize in working with a particular age group, such as the elderly, and a type of disability physical, for example. Based on the patient’s age and the type and degree of disability, a program of educational, vocational, and recreational activities is designed and implemented. The program for a child, for instance, might involve academic tasks and crafts; for an adult, it might involve typing, driving a vehicle, and using hand and power tools.
Occupational therapists in the United States must have a degree or certificate from an approved training program and be licensed by passing an exam. Training requires completing a baccalaureate program plus either a certificate program or a master’s degree in occupational therapy.
The field of social work is quite broad. Probably most social workers are employed in mental health programs, but many others work in hospitals, nursing homes, rehabilitation centers, and public health programs. When working with people who are physically ill or disabled, social workers help patients and their families make psychological and social adjustments to the illness and obtain needed community services, including income maintenance. Thus, social workers may arrange for needed nursing care at home after a patient leaves the hospital or refer a patient for vocational counseling and occupational therapy if the illness or disability requires a career change. These professionals are usually called medical social workers. Training requires a bachelor’s degree in a social science field, usually social work, but often a degree in psychology or sociology is sufficient. Most states mandate some form of licensing or certification.