EXENTENDED AND EXPANDED ROLE OF NURSE

EXENTENDED AND EXPANDED ROLE OF NURSE

Traditionally, the role of the nurses was to provide care and comforts as they carried out specific nursing function, but changes in nursing of the day have expanded the role to include increased emphasis on health promotion and illness-prevention, as well as concern for the client as a whole.
DEFINITION OF NURSING
The word nurse originated from the Latin word nutrix, meaning, “to nourish”. Most definitions of the nurse and nursing describe the nurse as a person who nourishes, fosters, and protects who is prepared to take care of sick, injured and the aged people. With the expanding roles and functions of the nurse in today’s society, any one definition is too limited.
The International Council of nurses published a full definition of nursing in 1987,followed by this shorter, more succinct version in 2002:
Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health prevention of illness, and the care of ill, disabled, and the dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and inpatient and health systems, management, and education are also key nursing roles.
From the above definition the four broad aims of nursing are:
• To promote health
• To prevent illness
• To restore health
• To facilitate coping with the disability or death.
To meet these aims, the nurse uses knowledge, skills, and critical thinking to give care in a variety of traditional and expanding nursing roles.
ROLES AND FUNCTIONS
 Caregiver
 The primary role of caregiver is the primary role of the nurse.
 As caregiver, the nurse helps the client regain health through the healing process.
Healing is more than just curing the specific disease, although treatment skills that promote physical healing are more important to caregivers.
The provision of care to patients that combines both the art and the science of nursing in meeting all the aspect of well being (physical, mental, sociocultural etc.)
As a caregiver the nurse also integrates the roles of communicator, teacher, counselor to promote wellness through activities that prevent illness, restore health, and facilitate coping with disability/death.
 Communicator
 The role of a communicator is central to all nursing roles and activities.
 Nursing involves communication with clients, their families, other nurses, and other healthcare professionals.
It is impossible to give care, make decisions with clients and families protects clients from threats to well being, coordinate and manage client care, assist in rehabilitation, offer comfort etc, unless we establish an effective communication.
This is helpful in wide variety of settings; also it’s a critical factor, the quality of communication to meet the needs of the client.
 Educator / teacher
As an educator the nurse explains the facts and concepts about the health, demonstrates procedures, reinforces learning or client behavior evaluates client progress in learning.
 This can be planned (planned health education) or unplanned and informal (e.g. answering client’s doubts on health issues.)
While doing this the nurse must see that she use methods that matches the client’s capabilities, needs, incorporates other resources such as the family, in the teaching plan.
 Manager
Coordinates the activities of other members of the health team such as nutritionist, physical therapist etc both for individual and the group of clients and use critical decision in the clients health demands.
 As a clinical decision maker, the nurse use critical thinking skills throughout the nursing process to provide effective care.
 These decisions are made alone by nurse, also, in collaboration with client/family/other health care provider.
 Advocate
In the role of client advocate, protection of human or legal rights and the securing of care for all clients based on the belief that client have the right to make informed decisions about their own health and lives.
 During such times the nurse keeps in mind the client’s religion, culture.
 Leader
 The assertive, self-confident practice of nursing when providing care, effecting change, and functioning with groups.
 Counselor
The use of therapeutic interpersonal communication skills to provide information, makes appropriate referrals, and facilitates the patient’s problem-solving and decision-making skills.

 Researcher
 The participation in or conduct of research to increase knowledge in nursing and improve patient care.
 Career Development
Innovations in health care, expanding health systems and practice settings, and the increasing needs of client have been a stimulus for new nursing roles.
Today nurses need to commit t life long learning and career development in order provide clients with the state-of-the art care they need.
 These roles are specific employment positions or paths.
1. Clinician
 Most nurses enter the profession with the goal of providing direct client care.
2. Advanced Practice Nurse (APN)
 Most independent functioning nurse
Has a master’s degree in nursing, advanced education in pharmacology and physical assessment, certification and expertise in a specialized area of practice (ANA, 1996)
May work in primary, acute, or restorative care settings can work as clinician, educator, case manager, consultant, researcher with in his/her area of practice
 Plans and improves the quality of care for the client and the family.
3. Clincal Nurse Specialist (CNS)
 An APN with nursing expertise in a specialized area of practice and may work in any practice setting.
 Traditionally, CNS has most practice often in the hospital setting
 She may specialize in a specific disease-DM, Cancer etc.
4. Nurse practitioner
 Provides care in out patient, ambulatory, and community-based settings
 Provide care for complex and more a holistic approach
 Able to establish a collaborative provider-client relationship.
Others include Family Nurse Practitioner, Pediatric Nurse Practitioner, Women’s health Nurse Practitioner, Acute care Nurse Practitioner, Geriatric Nurse Practitioner.
5. Certified nurse-midwife (CNM)
 An RN who is also educated in midwifery and is certified by the American College of Nurse-Midwives.
Care includes practice of Nurse-Midwifery, independent care for women in normal pregnancy, labor, and delivery, as well as care of the newborn; also includes gynecological such as Pap smears, family planning services and treatment of minor vaginal infections.
 CNM practices with the health care agency that provides medical consultation, collaborative management, and referral.
6. Nurse Educator Works in Schools of nursing, staff development dept. of healthcare agencies (provide orientation programme, safety training etc), client education dept(teach the disabled/ill and their families about care to provide at home.).Need experience in clinical practice to provide with practical skills and theoretical knowledge.
 A faculty member teaches student to become professional nurses.
 Require Graduate degree in nursing and an additional education in the educational process
 Many hold doctorate/ advanced degree in nursing, education, administration etc.
7. Nurse Administrator
 Manages client care and the delivery of specific nursing services with in a health care agency.
 Positions like charge nurse, or assistant nurse manager
 Experience and additional education lead to a middle-management position, such as nurse-manager of a particular unit.
8. Nurse Researcher
 Investigates problems to improve nursing care and to further define and expand the scope of nursing practice.
 May be employed in an academic setting, hospital, or independent professional/community service agency.
 Minimum educational requirement-doctoral degree, with master’s in nursing.
9. Community health nurse /public health nurse
 Functions within the community and serves the health needs of his / her assigned portion of the public.
 His/ her goal is to improve community health by identifying people who are at risk for illness, disability, or death.
Several other categories are also, that sometimes overlap the above ones.
CONCLUSION
With increase educational opportunities for nurse, the growth of nursing as a profession, and the greater concern for job enrichment, the nursing profession offers expanded roles and different kinds of career opportunities such as nurse practitioner, nurse educator etc.