Role Paper
Introduction
Healthcare is not a static field. As healthcare changes, so do the responsibilities and roles of the registered nurse (RN). Certain aspects of nursing vary slightly between facilities, but a few key roles remain the same. These five roles of the RN include, but are not limited to: teacher, advocate, leader, colleague, and expert. These roles are interrelated and each is an intrinsic piece in the practically undefinable nursing role of caregiver (Taylor, 2011, p. 455). The topic of overtime—voluntary or mandatory—is a current issue in nursing. This paper will discuss the different functions of the roles, the practice issues of overtime, the proposed solution and how the nurse will function in this proposed solution.
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Roles of the Nurse Caregiver Registered nurses are one piece that composes an entire team of caregivers. RNs provide care for persons that are sick or injured, as well as preventative care for the well. The role of the nurse as a caregiver is to combine both the art and science of nursing to meet their patient’s needs (Taylor, 2011, p. 9). This role is the primary role of the nurse and includes assessing, diagnosing, planning, implementing, and evaluating. Caring for the patient is not treated as just another task to accomplish for the day; nurses care for and about their patients. Teacher As a registered nurse, it is typically not assumed that teaching would fall under that job title, yet the opportunity and need for teaching occurs daily.
Research indicates that educated patients have better health and suffer less complications than those lacking in teaching (Taylor, 2011, p. 459). The nurse is a professional and as such, will develop good rapport with their patients. Throughout the care of the patient, the nurse-patient relationship becomes one built on trust. With this mutual trust, RNs have the power to influence the patient’s health in a positive way. The nurse plans strategies for this patient to meet health goals and implement these strategies through patient teaching. With a better understanding of their health, patients will be more capable of making informed decisions, speaking up for and involving themselves in their …show more content…
care. Advocate The nurse has the most face-to-face time with the patients. The relationship between nurse and patient can be a very intimate and involved one ultimately built on trust. This special relationship opens the door for communication and allows the nurse to gain a better understanding of their patient (Zerwekh, 2012). Sometimes, if the patient is incapable of doing so for themselves, the RN must advocate for the patient’s health. Advocating for the patient involves stepping in and speaking up for them and making critical decisions that maintain the patient’s well-being. This act of decision making and intervening for the patient can only be accomplished by an expert nurse who is sure of their skills and is unafraid to manage their patient’s care. Leader Whether or not their job title includes “manager”, “supervisor”, or “charge nurse”, the nurse is leader. As an advocate to the patient, the nurse makes constant decisions on how best to help the patient and manage their care. This leadership throughout the patient’s hospital course involves colleagues and other members of the caregiver team. The RN collaborates with healthcare professionals to promote the best patient outcomes—leading other departments of the healthcare team by advocating on behalf of the patient. The nurse’s communication among caregivers and leadership therein, are necessary competencies necessary in maintaining a patient focus in the system of care (Zerwekh, 2012). Colleague The nurse is one piece in the healthcare team. Healthcare teams consists of many members such as doctors, social workers, X-ray technologists, unlicensed assistive personnel, as well as other nurses. The most important component of this role is good communication between colleagues. Though many people contribute to this team, the nurse’s role is distinguished as someone who holds “unique patient knowledge” and therefore are highly involved in collaboration with the healthcare team (Taylor, 2011, p. 293). Expert Nurses embody the role of expert when caring for their patients. Careful patient assessments are performed constantly by the registered nurse. Using findings from the assessments, the nurse interprets the patient’s condition and can then communicate this information to the health care providers. Without the nurse’s expertise and knowledge base, the declining condition of the patient might go unnoticed and their needs therefore, would not be met. Becoming an expert nurse takes time and much practice—expertise can present in various ways such as, researcher, teacher, practitioner, or leader (Zerwekh, 2012). Practice Issue in Nursing A current practice issue in nursing is, simply put, overworking of nurses.
Overtime in nursing can be mandatory or voluntary, but either has proven to be problematic. The issue of overtime for nurses is not a new one, but one that is still of high importance needing resolution. The business of healthcare is centered on patient satisfaction. However, without proper treatment of staff, facilities risks improper care of their patients. “Current evidence indicates long work hours can lead to adverse nurse and patient outcomes” (Bae, 2012). Nurses mandated to or dutifully volunteering to stay hours past their shift will suffer from trouble concentrating and poor work performance. These two side effects are all due to lack of sleep and overly long days at work and can lead to dangerous patient situations such as falls with injuries and medication
errors. With length of hospital stays on the rise and number of staff nurses on the decline, it seems the practice issue at hand will not be soon resolved. The easy explanation of this problem is a staffing shortage. Though the root of the problem is well-known, the solution to this problem is still relatively unclear. Asking or requiring staff to fill in the gaps of much-needed extra nurses is unfair and harmful to morale and potentially to patients as well. Lack of staff is like a revolving door: first there are not enough nurses; the stress that high nurse-patient ratios bring leads to more nurses abandoning ship; new nurses are hired but once they catch wind of the unsafe work environment, they move along as well resulting again in not enough nurses. So how does this cycle stop? Proposed Solution Administrators must change this current situation (Bae, 2012). The first step is improving staffing levels. Though some states have banned the use of mandatory overtime, nursing work hours need close monitoring as well. When it comes to overtime, the demand is far greater than the supply. “The ultimate goal of banning mandatory nurse overtime or limiting the total number of hours worked is to prevent nurse fatigue and resulting adverse patient events and nurse injuries,” (Bae, S., 2012). Improving nurses’ working conditions would subsequently benefit the quality of care given to the patients (Bae, 2012). In order to maintain safe and quality care for their patients, nurses and administration must acknowledge the adverse effects of already overworked nurses working overtime. The nurses’ roles in implementing this proposed solution is that of a colleague as well as an advocate. The nurse has to step in and look out for their patients by ensuring they are receiving care from a nurse that is caring for themselves. As the protector and quality care decision-maker for the patient, it is the nurse’s responsibility to intervene in unsafe situations. Perhaps by using good communication skills, a nurse could persuade a fellow RN (who agreed to stay on the floor sixteen hours in a shift) to go home and rest when they are scheduled a twelve hour shift the next day. One voice will not change this tough issue in nursing overnight, but with consistency and communication, nurses can aid in facilitating this proposed solution. Conclusion The job title of registered nurse is a very special one. Nurses have many responsibilities and roles to fulfill such as communicating, assisting fellow healthcare team members, teaching, supervising, and advocating for patients. Adequate patient care is threatened when issues like understaffing or excessive overtime arise. The patient must remain the central focus of healthcare and as such, patients deserve caregivers that are well-rested and at the top of their game. This current practice issue can be combatted by administrative efforts to retain staff, as well as implementing the above mentioned essential nursing roles such as advocating for both patients and coworkers.
Although nurses do not wield the power of doctors in hospital settings, they are still able to effectively compensate for a doctor’s deficits in a variety of ways to assure patient recovery. Nurses meet a patient’s physical needs, which assures comfort and dignity Nurses explain and translate unfamiliar procedures and treatments to patients which makes the patient a partner in his own care and aids in patient compliance. Nurses communicate patient symptoms and concerns to physicians so treatment can be altered if necessary and most importantly, nurses provide emotional support to patients in distress.
Studies show that patients forget at least half of the information explained to them (Tamaru-Lis, 2013, p. 268). In addition, low health literacy correlates with poor disease management, readmissions, and poor compliance to treatments (Eadie, 2014, p. 9). The goal of teach-back, therefore, is to improve recollection and increase health literacy. Nursing practice is aimed towards meeting these goals. Ultimately, nursing practice will improve as nurses are better able to deliver quality care, promote patient safety, and increase patient satisfaction. As a result, patient outcomes are optimized because teach-back minimizes communication errors and encourages participation. Participation allows patients to make appropriate decisions which direct health care professionals to provide patient-centered care.
Over the past several years extended work shifts and overtime has increased among nurses in the hospital setting due to the shortage of nurses. Errors significantly increase and patient safety can be compromised when nurses work past a twelve hour shift or more than 40 hours a week. Hazardous conditions are created when the patient acuity is high, combined with nurse shortages, and a rapid rate of admissions and discharges. Many nurses today are not able to take regularly scheduled breaks due to the patient work load. On units where nurses are allowed to self-schedule, sixteen and twenty-four hour shifts are becoming more common, which does not allow for time to recover between shifts. Currently there are no state or federal regulations that restrict nurses from working excessive hours or mandatory overtime to cover vacancies. This practice by nurses is controversial and potentially dangerous to patients (Rogers, Hwang, Scott, Aiken, & Dinges, 2004). Burnout, job dissatisfaction, and stress could be alleviated if the proper staffing levels are in place with regards to patient care. Studies indicate that the higher the nurse-patient ratio, the worse the outcome will be. Nurse Manager’s need to be aware of the adverse reactions that can occur from nurses working overtime and limits should be established (Ford, 2013).
... social life issues. Supporting to these Todd et al. (1993) demonstrated that nurses with 8 hour shifts had a high level of satisfaction than nurses worked for 12 hour shifts. However, contradictory results were found in Stone et al.(2006) study. They reported a significant level of nurse’s satisfaction was revealed with 12-hour shifts than those with 8-hour shifts. Furthermore, in 1996 Golec et al. carried out a study to compare the effect of 8 and 12 hour shifts among ICU nurses. The finding revealed that the nurses with 12-hour shifts demonstrate less social and family disruption than 8-hour shifts. Nevertheless, 12-hour shifts reported more health, and wellbeing complains s than 8-hour shifts. In addition, the study indicated that although 12-hour shifts provide more days off, it appears to be insufficient to dispel the adverse effects on health and wellbeing.
...hological preparation. After a nurse is done working their regular shift being forced to work overtime can out them a greater right of medical mistake in part due to fatigue and tiredness consequently putting the patient at high risk of complications.
It is important to evaluate which learning style your patients prefer in order for them to best understand what needs to be done for the maximum appropriate outcome. Licensed practical nurses are advocates and that’s someone who supports and supplies information to their patients. Advocacy often involves standing up in support of a patient and their rights. This is especially true when patients are not able to protect their own rights. When filling the role of counselor, Licensed Practical Nurses can help patients and families explore ideas and feelings towards healthcare and illness (8 Roles of the LPN). Some patients have a difficult time accepting a disease or its treatment options. As a practical nurse you consult with RN supervisors regarding patient care and assessments. In some settings LPN 's communicate directly to physicians. Communicating information to the proper people assists in increasing the effectiveness of care plans (Role). As practical nurses we are only one part of a patient care team. Other important members include RN 's, CNA 's, physicians, physical/occupational/speech therapists, dietitians, volunteers, and more (8 Roles of the LPN). With such a large team, every member has their own scope of
In the recent past, nursing has come to the forefront as a popular career amongst students across the globe. The demand for nurses has kept increasing gradually over the years. In fact, the number of registered nurses does not meet the demand of the private and public health sector. This phenomenon has resulted in a situation where the available registered nurses have to work extra hours in order to meet the patients’ needs. With this in mind, the issue of nurse fatigue has come up as a common problem in nursing. According to the Canadian Nurses Association (CNA), nurse fatigue is “a feeling of tiredness” that penetrates a persons physical, mental and emotional realms limiting their ability to function normally. Fatigue does not just involve sleepiness as has been assumed before. It involves utter exhaustion that is not easily mitigated through rest. When nurses ignore the signs of fatigue, they risk the development of chronic fatigue and other health problems that may not be easily treated. Additionally, fatigue may cause nurses to lose more time at work as they may have to be away from work for several days to treat it. The issue of nurse fatigue has permeated the nursing profession to the extent of causing errors in the work performed by nurses. Fatigue causes a decrease in a nurse’s ability to make accurate decisions for themselves and their patients. It is therefore important to find ways to curb nurse fatigue such that it is no longer a problem. Nurse fatigue is a danger to the patients, organizations and to the nurses themselves and must be mitigated adequately.
The role of a Registered Nurse cannot be neglected in the provision of quality and safe care to patients and adopt procedures adequate for the condition of the patients because they work at the front line level; moreover, they have direct dealing with patients and integration of personal and professional skills is necessary. Therefore, there are certain attributes that are necessary to be present in a Registered Nurse for accurately performing various tasks. These include; Workload management, leadership qualities, interpersonal skills, control of practice, professional development, effective communication skills and organi zational loyalty (Daly & Carnwell 2003, pp. 158-167). These attributes hold significance in terms of obtaining positive outcome for not only the Registered Nurse but also the organization and the patient. Workload should be managed in such a way that the care process is not affected. Registered Nurse should have leadership qualities to help, motivate and inspire other nurses. Similarly, a Registered nurse should also enable and promote learning opportunities for other nurses. A Registered Nurse has responsibilities towards the subordinates, patients and most importantly to the organization. Effective communication skills can allow Registered nurses to establish a trusting relationship with patients identifying their problems and needs. The code of ethics and principles of practice must be followed and the practice of the nurse should be in the line of the organization’s working principles. The responsibility should be met as accountability factors must be considered significant in healthcare setting (Cornenwett, et al, 2007, pp.122-131; Bradshaw et al 2012, pp.13-14). ...
Patient education is a process of providing patients and their families with information, knowledge and skills that are necessary for the management of their health and illness concerns (Park, 2005). It is the responsibility of nurses to follow the teaching process when providing patient education. They includes assessing the patient educational needs, planning an educational session, implementing the plan, and evaluating the educational process. Obstacles to teaching and learning are those that confront nurses in the educational process. Nurses can find that they don’t have enough time, knowledge, and teaching skills. In addition, patients’ literary level, and environment and personal conditions will affect their ability to learn. Cognitive and humanistic are two learning theories that can help nurses and patients to achieve the goals and benefits of the patient education.
These articles have many similarities when discussing the issue of staffing shortages. For patients, their loved ones and the general population, they don’t understand the ramifications and strain that staffing shortages have on nurses. People expect and deserve complete, competent and safe care when they are patients. These articles bring to light all the struggles that nurses have to deal with. Nurses are fearful that they will make mistakes, will harm patients, and will harm themselves. (Bae, 2012; Erlen, 2001; Martin, 2015) Overtime can be overwhelming and exhausting, which can lead to errors being made. (Bae, 2012; Erlen, 2001) These articles perceive that it may be beneficial for nurses, patients, and healthcare facilities to decrease the nurse-to-patient ratio, however, this option is not always
The health care system of today will be invaluable without the help of well-trained registered professional nurses. According to Wilkinson, Treas, Barnett, Smith (2016) registered nurses in today’s health care have the training required to develop a care plan with other health care workers that is specific for each patient in their care, instead of the same general approach for every patient. This is known as patient centered care because each patient is different from the other and the registered nurse role includes developing a good plan for every patient they care for. In performing such duties, registered nurses tend to create a strong bond with their patients by caring for their patients by all means possible. By caring for their patients, they tend to gain their patients and their families trust. According to Wilkinson et al. (2016) There are many support systems for patients in our communities that have good intentions of assisting sick people and those in need. Most of them are not known by the patient or their families. The registered nurse is the one who is in the position to inform the patient or family about such resources that may be very helpful for them if they are interested. By doing so, the patient knows that the nurse really cares about him/her and that feels very comforting and may help the patient get well
As the nursing career is expected to grow, several job openings are expected in the next ten years. These several job openings will increase job security. Also, their career has flexible schedules. Basically meaning a nurse “can constantly rotate what days he or she works or just set a schedule so he or she may have a four day weekend” (1 Registered). Because nurses manage patients on a daily basis treating and diagnosing, they are rewarded mentally and at times physically. “People are constantly thankful and truly realize the impact of a nurse” (1
Notably, having higher proportions of nurses working shorter shifts—8–9 hours or 10–11 hours—resulted in decreases in patient dissatisfaction” (Stimpfel et al.). This is essentially saying that the longer the shift length, the more negative outcomes result. This study proves that eight to nine-hour shifts are more effective, and should, in turn, be worked more than longer shifts. This is a problem because hospitals are likely to continue to schedule nurses for twelve hours shifts out of
Working in a fast-paced environment and being on their feet can really take a toll on a person. In addition they have to be prepared for anything to happen during their shift. A study of overworked and stressed nurses found that nurses are overworked suffered from physical sickness like type two diabetes (Stress and overworked 2006). For most nurses, their work week consists of more than sixty hours. Working that many hours can double their chances of sicknesses. When they compare the working week hours of nurses who worked the normal 21 to 40 hours with those that work more than 40 or 60 hours a week, they found that in comparison the ones who worked 40 hours or more a week increased the risk by almost 50 percent for type 2 diabetes (Stress and overwork 2006). If nurses were to work their normal work hours without mandatory overtime, then their health would improve.
The majority of our society holds the notion that nurses are no more than trained professionals, working for a doctor, who simply provide medical care for the sick and informed. However, what nursing means to me goes deeper than that belief. Nursing is a profession in which individuals are responsible for not only the care of the sick and infirmed but are also responsible for being a support system and an educator, as well as an advocate for the promotion of optimal care. In today’s society, nurses are an important part of any medical facility’s investment. This paper will address the many different aspects of nursing in which nurse’s act as not only caregivers but also act as, counselors and educators.