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Extended and expanded role of nurses
DEFINITION OF NURSING
 “Nursing encompasses autonomous and
 collaborative care of individuals of all
 ages, families, groups and communities sick or well
 and in all settings. Nursing includes promotion of
 health, prevention of illness and the care of
 ill, disabled and dying people.
 Advocacy, promotion of a safe
 environment, research, participation in shaping
 health policy and in patient and health systems
 management, and education are also key nursing
 roles.” (International council of nurses, 2002)
QUALITIES OF A PROFESSIONAL
NURSE
 N- Nobility, knowledge.
 U- Usefulness, understanding
 R- Righteousness, responsibility.
 S- Simplicity, sympathy.
 E- Efficiency, equanimity
SCOPE OF NURSING
ROLE OF NURSES
 Care giver
 Decision maker
 Client protector and advocate
 Manager and coordinator
 Communicator
ROLE OF NURSES
 Educator
 Counselor
 Collaborator
 Rehabilitator
 Comforter
EXPANDED ROLE OF NURSES
  DEFINITION

         “The functions of a nurse that are not
 specified in the traditional limits of nursing
 practice legislation.”
EXPANDED ROLE OF NURSES
1.Advanced practice nurses

   Clinical Nurse Specialists
   Certified nurse midwife
   Certified registered nurse
    anesthetist.
   Nurse practitioners
JOBS OF NURSE PRACTITIONER
 Diagnosing, treating, evaluating and
  managing a/c and c/c illness and disease.
 Obtaining medical histories and conducting
  physical examinations.
 Ordering, performing and interpreting
  diagnostic studies.
 Prescribing drugs for a/c and c/c diseases.
 Providing prenatal care and family planning
  services
JOBS OF NURSE PRACTITIONER
                       Cont..
 Providing well child care including
  screening and immunisations.
 Performing or assisting in minor surgeries
  and procedures.
 Counselling and education of patients on
  health behaviours, self care skills and
  treatment options.
EXPANDED ROLE OF NURSES
2. Nurse educator
PROFESSIONAL ROLES OF NURSE
  EDUCATOR
 Education
 Clinical supervision
 Role model and mentor
 Continuing education
 Research
EXPANDED ROLE OF NURSES
3. Nurse administrator
4. Nurse researcher
 The nurse researcher investigates
  problems to improve nursing care and to
  further define and expand the scope of
  nursing practice. The nurse researcher may
  be employed in an academic
  setting, hospital or an independent
  professional or community service agency..
EXPANDED ROLES
 A nurse researcher assists with collecting
  data in the field of health and medical care.
  The nurse may review the data and provide
  information on the results. The researcher
  plays a significant role in helping doctors
  and scientists understand the complications
  of medical conditions.
5. Nurse authors
ROLE OF NURSE IN DIFFERENT
PRACTICE SETTINGS
1. Hospitals
2. Skilled nursing facilities
3. Restorative care facilities
4. Home care
HOME HEALTH CARE SERVICES
 Wound care
 Respiratory care
 Elimination
 Nutrition
 Rehabilitation
 Medications
 Intravenous therapy
 Laboratory studies
ROLE OF NURSE IN DIFFERENT
PRACTICE SETTINGS
5. Rehabilitation
6. Community based practice settings
 Community health centers
 Schools
 Occupational health settings
 Hospice and palliative care nursing
 Parish nursing
 Telehealth nursing
SCHOOL NURSE
 School nurses need a working knowledge of
  human growth and development.
 Need counselling skills.
 Keep records of children required
  immunisation.
 Work with teachers to improve the health
  concepts into the curriculum.
 Conduct vision and hearing screens.
 Focus on preventive aspect of child health
PARISH NURSING
   Providing meals for families in crisis or
    when returning home after
    hospitalisation.
   Organising prayer circles.

   Volunteering in community acquired
    immunodeficiency syndrome care
    groups.
   Holding regular grief support groups
LEVELS OF PREVENTION
 Primary prevention
o      health promotion’
o      environmental protection
o      specific protection against disease or
  injury
 Secondary prevention
 Tertiary prevention
JOB DESCRIPTION
 STAFF NURSE
    Direct patient care
 Carry out the procedures of admission and discharge
    of the patient.
   Maintains personal hygiene and comforts of the
    patient.
   Attends to the personal needs of the patient and feeds
    the helpless patient.
   Implements and maintains ward policies and routines.
   Co-ordinates patient care with other team members.
   Administration of medication.
STAFF NURSE
 Assisting doctors in various medical and surgical
  diagnostic procedures.
 Performing simple diagnostic procedures like
  urinanalysis, haemoglobin percentage etc..
 Recording of vital signs.
 Collecting and sending of specimens for
  laboratory diagnostic procedures.
 Take rounds with the doctors when called to list
  new orders and see that they are carried out.
STAFF NURSE
 Operation theatre management
 Maintains aseptic environment of the
  operation theatre.
 Autoclaving of
  articles, instruments, gloves, linen etc. required
  for various types of surgery.
 Receives patients from the ward intact for
  surgery.
 Prepares anaesthetic trolley and trolley for
  surgery, according to type and procedures.
STAFF NURSE
 Assist the surgeon and anaesthetist.
 Indenting and procuring surgical
  instruments, drugs, gloves, suturing
  materials and O2, N2,CO2 etc. required for
  operation theatre.
 Maintains records and reports pertaining to
  the operation theatre
STAFF NURSE
      Management of Labour room
 Preparation of expectant mother for asceptic safe
    delivery.
   Conducts normal deliveries and reports.
   Attends and assists doctors in all obstetrical
    emergencies.
   Takes care of newborn and premature babies.
   Maintains records and reports pertaining to labour
    room.
   Indent and procure necessary drugs, supplies, linen
    etc. to labour room.
STAFF NURSE
      Educational function
 Helps in orientation of new staff and students..
 Carries out health teaching for individual or
  group of patients
 Participates in in-service education
  programmes.
 Assists and extends co operation in medical
  and nursing research programme.
SENIOR STAFF NURSE
      Direct patient care
 Ensures proper admission, discharge of patients.
 She/he see that total health needs of his/her
  patients are met.
 Takes nursing rounds with staff and students.
 Makes rounds with doctors, assisting them in
  diagnosis and treatment of patients.
 Co-ordinates patient care with other
  departments
SENIOR STAFF NURSE
     Supervision and administration
 Makes duty and work assignments.
 Indenting and procurement of ward
  supplies and equipments and keeps records.
 Does regular inventory checking.
 Maintains discipline among the personnel
  working in the particular ward.
SENIOR STAFF NURSE
 Reports about any medico legal cases in the
  ward/unit.
 Maintains good public relations in his/her
  ward/unit.
 Ensures that students get desired learning
  experience in the ward/unit.
SENIOR STAFF NURSE
       Educational function
 Organises orientation programmes for new
  staff.
 Conducts ward conferences or meeting.
 Guides in formulation of nursing care plans
  and care studies.
 Helps in medical and nursing research.
 Encourages staff development programmes in
  his/her wards
NURSING SUPERINTENDENT
GRADEII
    Patient care and ward/unit management
 Conducts and attends to the departmental and
  interdepartmental meetings/conferences from
  time to time.
 Makes regular rounds of her department.
 Makes rotation plan for the nursing staff and
  the domestic staff Organises and plans and
  nursing care activities of the department.
GRADEII SUPERINTENDENT
 Plans staffing pattern and other necessary
  requirements of her department..
 Supervises the proper use and care of the
  equipment and supplies in the department.
 Officiates in the absence of Nursing
  Superintendent Gr1.
 Helps ward or unit supervisors to produce their
  ward/unit.
 Organises and plans nursing care activities of the
  department.
GRADEII SUPERINTENDENT
        Educational function
 Arranges classes and clinical teaching of nursing
  students in the department.
 Implements the ward teaching programme and
  clinical experience of the students with the help of
  doctors and nurses.
 Does counselling and guidance of staff and
  students.
 Arranges and conducts staff development
  programmes of his/her department.
GRADEII SUPERINTENDENT
      General
 Escorts Nursing Superintendent Gr 1, Medical
  superintendent, and special visitors for
  hospital rounds.
 Arranges and participates in professional and
  social function of staff and students.
 Acts as a liaison officer between the nursing
  department and other higher hospital
  authorities.
NURSING SUPERINTENDENT
GRADE 1
     Nursing services
 Participates in the formulation of the
  philosophy of the hospital in general and
  those specific to the nursing service.
 Determines goals, aims, objectives and
  policies of the nursing services.
 Interviews and recruits nursing staff.
 Makes regular visits in hospitals and wards.
SUPERINTENDENT GRADE I
 Takes hospital rounds with medical
  superintendent.
 Selects and secures proper equipment
  needed for the hospital
 Prepares duty roster, plans staff leave and
  disburses salary.
 Gives counselling and guidance to the
  subordinate staff.
SUPERINTENDENT GRADE 1
 Maintains discipline among nurses and
  other auxiliary staff.
 Participates in hospital and inter-hospital
  meetings and conferences.
 Investigates complaints and takes necessary
  steps.
 Initiates and participates in nursing
  research
SUPERINTENDENT GRADE 1
    General and office duties
 Maintains necessary records concerning the nursing
  staff, students, confidential reports and health
  records etc.
 Submits annual reports of the nursing service
  departments to Medical superintendent, INC and
  Nurses Registration Council.
 Maintains cordial relations with public and
  voluntary workers.
 Participates in professional and community
  activities.
DIVERSITY IN NURSING
 Forensic nursing
 Telemetry nursing
 Space nursing
 Travel nursing
 Military nursing
Extended and expanded role of nurses

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Extended and expanded role of nurses

  • 2. DEFINITION OF NURSING  “Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities sick or well and in all settings. Nursing includes promotion of health, prevention of illness and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.” (International council of nurses, 2002)
  • 3. QUALITIES OF A PROFESSIONAL NURSE  N- Nobility, knowledge.  U- Usefulness, understanding  R- Righteousness, responsibility.  S- Simplicity, sympathy.  E- Efficiency, equanimity
  • 5. ROLE OF NURSES  Care giver  Decision maker  Client protector and advocate  Manager and coordinator  Communicator
  • 6. ROLE OF NURSES  Educator  Counselor  Collaborator  Rehabilitator  Comforter
  • 7. EXPANDED ROLE OF NURSES DEFINITION “The functions of a nurse that are not specified in the traditional limits of nursing practice legislation.”
  • 8. EXPANDED ROLE OF NURSES 1.Advanced practice nurses  Clinical Nurse Specialists  Certified nurse midwife  Certified registered nurse anesthetist.  Nurse practitioners
  • 9. JOBS OF NURSE PRACTITIONER  Diagnosing, treating, evaluating and managing a/c and c/c illness and disease.  Obtaining medical histories and conducting physical examinations.  Ordering, performing and interpreting diagnostic studies.  Prescribing drugs for a/c and c/c diseases.  Providing prenatal care and family planning services
  • 10. JOBS OF NURSE PRACTITIONER Cont..  Providing well child care including screening and immunisations.  Performing or assisting in minor surgeries and procedures.  Counselling and education of patients on health behaviours, self care skills and treatment options.
  • 11. EXPANDED ROLE OF NURSES 2. Nurse educator PROFESSIONAL ROLES OF NURSE EDUCATOR  Education  Clinical supervision  Role model and mentor  Continuing education  Research
  • 12. EXPANDED ROLE OF NURSES 3. Nurse administrator 4. Nurse researcher  The nurse researcher investigates problems to improve nursing care and to further define and expand the scope of nursing practice. The nurse researcher may be employed in an academic setting, hospital or an independent professional or community service agency..
  • 13. EXPANDED ROLES  A nurse researcher assists with collecting data in the field of health and medical care. The nurse may review the data and provide information on the results. The researcher plays a significant role in helping doctors and scientists understand the complications of medical conditions. 5. Nurse authors
  • 14. ROLE OF NURSE IN DIFFERENT PRACTICE SETTINGS 1. Hospitals 2. Skilled nursing facilities 3. Restorative care facilities 4. Home care
  • 15. HOME HEALTH CARE SERVICES  Wound care  Respiratory care  Elimination  Nutrition  Rehabilitation  Medications  Intravenous therapy  Laboratory studies
  • 16. ROLE OF NURSE IN DIFFERENT PRACTICE SETTINGS 5. Rehabilitation 6. Community based practice settings  Community health centers  Schools  Occupational health settings  Hospice and palliative care nursing  Parish nursing  Telehealth nursing
  • 17. SCHOOL NURSE  School nurses need a working knowledge of human growth and development.  Need counselling skills.  Keep records of children required immunisation.  Work with teachers to improve the health concepts into the curriculum.  Conduct vision and hearing screens.  Focus on preventive aspect of child health
  • 18. PARISH NURSING  Providing meals for families in crisis or when returning home after hospitalisation.  Organising prayer circles.  Volunteering in community acquired immunodeficiency syndrome care groups.  Holding regular grief support groups
  • 19. LEVELS OF PREVENTION  Primary prevention o health promotion’ o environmental protection o specific protection against disease or injury  Secondary prevention  Tertiary prevention
  • 20. JOB DESCRIPTION  STAFF NURSE Direct patient care  Carry out the procedures of admission and discharge of the patient.  Maintains personal hygiene and comforts of the patient.  Attends to the personal needs of the patient and feeds the helpless patient.  Implements and maintains ward policies and routines.  Co-ordinates patient care with other team members.  Administration of medication.
  • 21. STAFF NURSE  Assisting doctors in various medical and surgical diagnostic procedures.  Performing simple diagnostic procedures like urinanalysis, haemoglobin percentage etc..  Recording of vital signs.  Collecting and sending of specimens for laboratory diagnostic procedures.  Take rounds with the doctors when called to list new orders and see that they are carried out.
  • 22. STAFF NURSE  Operation theatre management  Maintains aseptic environment of the operation theatre.  Autoclaving of articles, instruments, gloves, linen etc. required for various types of surgery.  Receives patients from the ward intact for surgery.  Prepares anaesthetic trolley and trolley for surgery, according to type and procedures.
  • 23. STAFF NURSE  Assist the surgeon and anaesthetist.  Indenting and procuring surgical instruments, drugs, gloves, suturing materials and O2, N2,CO2 etc. required for operation theatre.  Maintains records and reports pertaining to the operation theatre
  • 24. STAFF NURSE Management of Labour room  Preparation of expectant mother for asceptic safe delivery.  Conducts normal deliveries and reports.  Attends and assists doctors in all obstetrical emergencies.  Takes care of newborn and premature babies.  Maintains records and reports pertaining to labour room.  Indent and procure necessary drugs, supplies, linen etc. to labour room.
  • 25. STAFF NURSE Educational function  Helps in orientation of new staff and students..  Carries out health teaching for individual or group of patients  Participates in in-service education programmes.  Assists and extends co operation in medical and nursing research programme.
  • 26. SENIOR STAFF NURSE Direct patient care  Ensures proper admission, discharge of patients.  She/he see that total health needs of his/her patients are met.  Takes nursing rounds with staff and students.  Makes rounds with doctors, assisting them in diagnosis and treatment of patients.  Co-ordinates patient care with other departments
  • 27. SENIOR STAFF NURSE Supervision and administration  Makes duty and work assignments.  Indenting and procurement of ward supplies and equipments and keeps records.  Does regular inventory checking.  Maintains discipline among the personnel working in the particular ward.
  • 28. SENIOR STAFF NURSE  Reports about any medico legal cases in the ward/unit.  Maintains good public relations in his/her ward/unit.  Ensures that students get desired learning experience in the ward/unit.
  • 29. SENIOR STAFF NURSE Educational function  Organises orientation programmes for new staff.  Conducts ward conferences or meeting.  Guides in formulation of nursing care plans and care studies.  Helps in medical and nursing research.  Encourages staff development programmes in his/her wards
  • 30. NURSING SUPERINTENDENT GRADEII Patient care and ward/unit management  Conducts and attends to the departmental and interdepartmental meetings/conferences from time to time.  Makes regular rounds of her department.  Makes rotation plan for the nursing staff and the domestic staff Organises and plans and nursing care activities of the department.
  • 31. GRADEII SUPERINTENDENT  Plans staffing pattern and other necessary requirements of her department..  Supervises the proper use and care of the equipment and supplies in the department.  Officiates in the absence of Nursing Superintendent Gr1.  Helps ward or unit supervisors to produce their ward/unit.  Organises and plans nursing care activities of the department.
  • 32. GRADEII SUPERINTENDENT Educational function  Arranges classes and clinical teaching of nursing students in the department.  Implements the ward teaching programme and clinical experience of the students with the help of doctors and nurses.  Does counselling and guidance of staff and students.  Arranges and conducts staff development programmes of his/her department.
  • 33. GRADEII SUPERINTENDENT General  Escorts Nursing Superintendent Gr 1, Medical superintendent, and special visitors for hospital rounds.  Arranges and participates in professional and social function of staff and students.  Acts as a liaison officer between the nursing department and other higher hospital authorities.
  • 34. NURSING SUPERINTENDENT GRADE 1 Nursing services  Participates in the formulation of the philosophy of the hospital in general and those specific to the nursing service.  Determines goals, aims, objectives and policies of the nursing services.  Interviews and recruits nursing staff.  Makes regular visits in hospitals and wards.
  • 35. SUPERINTENDENT GRADE I  Takes hospital rounds with medical superintendent.  Selects and secures proper equipment needed for the hospital  Prepares duty roster, plans staff leave and disburses salary.  Gives counselling and guidance to the subordinate staff.
  • 36. SUPERINTENDENT GRADE 1  Maintains discipline among nurses and other auxiliary staff.  Participates in hospital and inter-hospital meetings and conferences.  Investigates complaints and takes necessary steps.  Initiates and participates in nursing research
  • 37. SUPERINTENDENT GRADE 1 General and office duties  Maintains necessary records concerning the nursing staff, students, confidential reports and health records etc.  Submits annual reports of the nursing service departments to Medical superintendent, INC and Nurses Registration Council.  Maintains cordial relations with public and voluntary workers.  Participates in professional and community activities.
  • 38. DIVERSITY IN NURSING  Forensic nursing  Telemetry nursing  Space nursing  Travel nursing  Military nursing