Nursing theories – role of a nurse

Nurses are angels who bear the pain and sufferings of human beings. They ought to be very much responsible for the fast recovery of the patients whom they are taking care of. Nurses consider ‘patients’ as illness and ‘caring’ or ‘nursing’ as the tasks to be done. They are supposed to offer their life for this gracious service. Nurses are synonyms of care. They generally possess several qualities and abilities, and are supposed to play various challenging roles in healthcare. Role of a nurse will be as complex as life itself and involves various tough and painstaking tasks.

Nurses provide valuable therapeutic care and treatment and are supposed to be extreme careful and dutiful. Whatever they do whether it is a diagnostic service, health assessment tests, medication, injections, they are supposed to be extremely vigilant and alert. Their duties include clinical data management and other resource management also. Nurses do home visits and related support services to patients. Nurses coordinate patient services by networking with different services. Moreover they integrate service delivery. Nurses do patient advocacy and communicate information, advice and feedback between patients and services. Nurses properly manage the clinical environment and maintain a hygienic, infection-free surrounding. They do participate in awareness giving programs, classes, community development programs, health education classes, health seminars, immunisation camps and so forth. They perform health screening, patient education, outreach services and other services. Nurses help hospitals to bring about a better human and material resource management. They build a practice base, optimize the usage of professional resources, and maximize financial efficiency also. All this makes us think how efficient and watchful nurses must as what they deal with nothing but human life. As far as healthcare professionals are concerned a single mistake they do may become the mistake of their life which can bring about the decline of their personal as well as professional life. So this high risk nature of the profession demands the professionals to be cautious and extra attentive during their job hours.

Health care professionals have a legal duty of care which dictates that they will provide a standard of care that within reason will prevent client from coming to harm or damage through careless act, or from omission to act, by the health care professional. Cases of negligence have occurred and have resulted in nurses and doctors being sued for this reason when they have failed to adhere to these acts.

The ethics incorporated into good nursing practice are more important than knowledge of the law; practicing ethically saves the effort of trying to know all the laws. The ethical principles of non-maleficence born out of ‘Hippocratic Oath’ or ‘do no harm’, ‘avoid harm’, and ‘prevent harm’ is tied to the nurses duty to protect patient’s safety. People who work in medical profession should be very careful and must never allow themselves to be under alcohol during her duty hours. No matter whatever problems they face or how much strain they undergo, they should be always with hundred percent sense and care. Healthcare professionals who deal with human life have no excuse for the mistakes they do during treatment and medication. Nurses work on tough situations.

A knowledge of the law as an adjunct to a primary area of activity such as nursing requires that a nurse has a full understanding of what the law is, where it comes from and how the system operates. The role of professional of nursing has progressive within the past few years that such an understanding is essential if nurses are to be able to extract from seemingly complex system sufficient practical information to be of benefit in their professional activities.

Contributions of nurses will differ according to the type of their service and the type of organizations they serve. Nurses working in operation theatres, emergency units and intensive care units will have tough and more responsible roles compared to other nurses who work in general wards. Nature of the services will vary according to the nature of the patients. Nurses serving children’s hospitals will have different roles from nurses serving in normal hospitals. Nursing staff who contribute their services to old people will have entirely different tasks. Nursing staff working in mental health care institutions will have different set of responsibilities and roles. Tasks may also differ according to the departments where nurses are placed.

Professional nurses should be able to exhibit all the standards and practices of nursing care. They must be proficient and well experienced in all the aspects of patient care. They must be in a position to explore all the phases of various practice settings and other elements of nursing. Professional nurses must be good in decision-making so that they can effectively manage their duties at their work places. In order to properly coordinate between the fellow staff and also to perfectly accomplish their own duties, a professional nurse must display outstanding decision making qualities. Decisions are made according to the roles of each staff and according to their duty timings and expertise. These decisions should be guided by their competency level, job description and license. Professional nurses will have their jobs allocated according to the excellence and competence they exhibit, meeting the demands and requirements of patients. Work load allocation also should be according to the guidance of the seniors and according to the prevailing regulations and followings of that particular organization (hospital). Effective communication is also indispensable for a professional nurse. Good communication of the nursing staff is very mandatory for good patient management. Professional nurses should be able to effectively convey their instructions (doctor’s instructions) to patients so that patients can cooperate with them. Nurses also should be capable to bring out the demands and status of patients from their mouth (opinion of the patient) by properly communicating with them. Nurses should take the initiative for the careful and timely planning of patient’s activities by effectual interdepartmental communication and coordination. Appropriate and timely assistance to doctors and proper managing of the resources are the other important duties of professional nurses. Superior staff should ensure that subordinate nurses are offering their service to a satisfactory level, and are fulfilling their responsibilities with respect to the scope of license and other regulations and rules of the institution. Services of professional nurses should wrap up a sense of authority, responsibility and accountability. The service of a professional nurse should embrace factors like care, sincerity, responsibility, punctuality. Proper grasping of the situation and creative interventions of professional nurses has redefined the meaning of nursing care. Professional nurses should have undergone enough real situations and should exhibit marginally acceptable performance. Nurses require special skills like attentiveness and observatory power to comprehend the physical as well as mental status of the patient.

Patricia Benner studied how a nurse can develop from a novice stage to an expert stage. Pat Benner’s From novice to expert: Excellence and power in clinical nursing practice is a great text for nursing theory leaners. Benner explained how the true experiences of a nurse (clinical knowledge, a combination of theoretical and practical knowledge) can unveil and create knowledge. The study explained different domains of nursing practice including the helping role, the teaching or training (coaching) role, patient-monitoring role, management and decision making roles, monitoring and managing therapeutic interventions, routines and treatments, and so forth. According to Benner, “...adequate description of practical knowledge is essential to development and extension of nursing theory (Benner, 1984).”

Nurses sometimes confront various ethical issues in their profession. For example while dealing with Asian patients, cultural and spirituality interferes in healthcare decision-making. Healthcare professionals should carefully deal with their patients as it requires much cultural consideration. Cultural consideration must be given while dealing with patients who have an entirely different view of healthcare and medication. Healthcare professional should establish a good relationship with patients and hurt not their religious and ethical beliefs while helping them recover from their sick state. Ignorance of the healthcare professions about the cultural and religious practices of the other parts of world (for example, eastern countries) interferes with communication with patients, resulting in culturally irrelevant services or misinterpretation of side effects of folk medicines. For example Asian people’s lack of familiarity with American culture can make health care services geographically and economically inaccessible and can cause Southeast Asians to be ignorant of available services or how to access them. In such cases a basic familiarity about the Eastern medicine would help the healthcare professionals better understand the approaches that would suit the Asians. The healthcare professionals of Western countries are therefore supposed to be well aware of the belief and culture of the Asian patients. Healthcare professionals should establish a good relationship with their patients and must be completely cooperative in helping the patient recover. They should be abstract in thought and speech and must have good understanding ability to comprehend the sentiments of the patient. Belief clash and misunderstanding may arise in dealing with patients of Asian countries. Healthcare professionals must practice empathy and should develop an unusually strong desire to contribute to the welfare of my patients. They can develop good relationship with patients and can enjoy helping them

The problems associated with the hospitalization and care of Asian patients can be solved by establishing a realm of communication and interaction between the Asian patients and healthcare workers. Healthcare workers should try learning more foreign languages so that they can successfully manage their foreign patients. Healthcare professionals should give due attention to their Asian patients and try to understand their culture and practices. Establishing good relationship would improve the communication. Gaining basics of Asian languages would be of great help to Western healthcare professionals. Cultural diversity and spirituality does make big problems when patients of Asian origin are given treatment in a Western environment. Healthcare professions should have strong empathic abilities so that they can become aware of the patient’s emotions or intentions so easily. Certain patient’s religious perceptions put the healthcare professionals in real dilemma. Heath care professionals should try to understand the difficult feelings and thoughts of their Asian patients. They need to listen carefully to the patient without judging them. Treatment strategies must be based on the cultural and religious stand of the people. Healthcare professional should seriously consider the way the patients interpret their beliefs and culture. The approach of the healthcare professional should go hand in with the belief set of the patient. He can however break off all the irrational, non-positive and irrational concepts and beliefs and abolish all sorts of negative thinking. This should be done in such a way that the religious and cultural feelings of the patient (Asian) are not hurt.

Caring patients in the hospital is a challenging task to the healthcare professional as it involves clashes related to the cultural and religious beliefs of the patients. The professional should comprehend the evidence and truths regarding their religious and cultural beliefs and proceed with the treatment in the best way. Ignoring the feelings of the Asian client and making him absorb the Western mode of treatment is not easy. The healthcare professional should carefully deal with the overlapping of Western treatment methods and the Asian healthcare methods. Providing treatment to the hospitalized Asian patients is practically difficult for healthcare professional as the Western values and beliefs get confused with beliefs and values of the patient. Establishing a proper communicate base between the healthcare professional and the Asian patient is believed to solve the religious and cultural dilemmas executed in the treatment.

A proficient nurse can comprehend the situation properly and can act accordingly to the demands and requirements of the patients. An experienced nurse will have proper knowledge about all possible events that can be expected at a particular situation. They can take prompt action or can modify the plans in order to give the best results. He/she can identify all unusualness of the situation and can foresee all effects prior to the applications. Nurses should have an excellent holistic understanding of the situation in order to offer the best patient care. An expert nurse will have a better intuitive grasp of the situation and can directly move into the needful action rather than considering other unwanted diagnoses and situations. Analytic ability is also essential for a good nurse to deal with every strange situation where they do not have previous experience.

What is patient-centered care? An exploration of ‘patient centered nursing care’ done by Titchen, a Social Scientist, could very well explain a nurse’s role. According to the study, the essence of patient-centered nursing will establish a relationship that would help the patient to address the patient's personal experience of sickness or health. Being in that fellowship, a nurse can offer a special companionship, help and medical assistance, which can transform the patient.

Nursing psychology - A nurse can assist the patient in bringing him out of his negative mentality or pessimistic attitude. Nurses can offer advices and words of solace to patients, refreshing their confidence and bringing out thoughts of hope which can heal a major portion of the sickness. A proper counsellor can rescue an addict from his addiction. A nurse (nurse cum counsellor) can help people come out of various addictions like alcoholism, smoking and drug intake. A nurse can assist him by providing an environment that will help him come out from the hold of addiction. Nurse can convince the addict about the ill effects of addictions. He/she can offer both therapeutic and advice healing services which can take out the person from the horrible pit of addiction. A nurse’s role can be better defined as a facilitating or supporting role that can assist a patient to attain a higher level of consciousness. The art and science of nursing is all about the ‘care’ that a nurse can offer to a patient. Nurses require special skills like attentiveness and observatory power to comprehend the physical as well as mental status of the patient. According to Benner, nurses should offer a care-based service to patients rather than a cure-based service (Benner et al. 1996). A nurse who develops a care fellowship with a patient helps him to bring out the hidden healing which is already inside him.