The role and scope of nursing in modern healthcare systems has grown considerably over the past decades. Nurses have always provided high quality healthcare to patients but their scope of duties and potential for specialization in different fields of care is now far broader than it has ever been. The common misconception is that nurses are simply present in healthcare to measure a patient’s vital signs and administer some medications and treatments. In today’s world of medicine, they can also serve as educators for both patients and other healthcare professionals as well as providing wider support for relatives and society in general. In this article some of the key roles of will be discussed and though it is not an exhaustive list it serves to clarify some misconceptions about their true scope of practice.
Nurses can change medical practice
Historically there have been nurses who used their deep clinical skills and intelligence to actually change medical practice. One prime example of this is the work of Florence Nightingale who may be one of the most famous nurses in all of history. Florence Nightingale worked as a trainer and manager of Nurses during the Crimean war in Constantinople. Here she noted that hygiene and sanitation levels in hospitals treating wounded soldiers was of exceptionally poor standard. As a result of this the mortality rate of injured soldiers was exceptionally high (at around 42%) due to hospital acquired infection. Florence worked exceptionally hard to introduce higher standards of hygiene and sanitation in the hospital such as routine handwashing (which was not commonplace at this time in hospitals) and the basics of what we now term infection control. As a direct result of her interventions the mortality rate was slashed to 2% amongst the injured soldiers. Today Florence Nightingale is known as one of the founders of modern nursing and her strict hygiene regimes live on in hospitals around the world.
Nurses are educators
Modern nurses play a vital role in educating patients and their families on an immense variety of healthcare issues. A nurse needs to have a deep understanding of the health needs and requirements of a varied patient group and is instrumental in producing tailored care plans when patients are both in and discharged from hospital. These care plans are based on medical evidence and form a complete roadmap to ensure that the patient’s healthcare and social needs are met and continue to be when they are discharged from a medical facility. A nurse will often be called upon to educate family members on what the patient needs to do on discharge from hospital to ensure that their recoveries continue, and this may include a detailed description of the medications they need to take and why these are being used. Writing a comprehensive care plan for a patient with significant health needs is quite a challenge and it must be communicated in a way that can be understood by a wide range of patients and relatives who may have varied levels of education and comprehension.
Administering a wide range of medications
Nurses are required to administer a wide variety of medicines as part of their varied roles. In addition to the administration, they will be required to know any potential side effects from these drugs and what to do if the patient experiences such adverse reactions. Nurses must also be aware of the many routes in which medications and drugs can be delivered, from orally to subcutaneously to intravenously and should be competent in all these forms of administration. As an example, a nurse may be caring for a patient who has an advanced form of dementia and as a result suffers from dysphagia (difficulties in swallowing). As well as being involved in the administration of specific dementia medication such as cholinesterase inhibitors which helps with the brains memory and judgement they may also be required to administer thickening agents such as SimplyThick Easy Mix to the patients food and drinks to allow them to swallow these more easily.
Noticing patient changes
One of the key skills that any nurse must have is the ability to recognize changes in a patient’s condition quickly and communicate these effectively to other medical staff. Not all changes to a patient’s condition will be highly visible and this is also where a nurse’s communication skills come in. During nursing assessments, a nurse will be able to determine from both visible observations and the responses of the patient if something is wrong, then must take remedial action or escalate the issue to senior medical staff. In the cases of providing nursing care to young infants, there may not be the capacity for verbal communication from the patient so nursing staff must keep a keen eye on changes during examination and medication administration in terms of the patient’s reactions.
Keeping up to date with medical advances
As a final point, all nurses, regardless of their roles or specializations must keep abreast of changes in medical practice and advancements in medical treatments and procedures. A registered nurse may be required to keep an ongoing record of some of the care and treatments provided to patients to evidence that they are demonstrating current and best practices in nursing and in some countries, this may be required to ensure their ongoing registration with professional bodies.
