Text: Roles and Functions of the Nurse

 

A contemporary nurse possesses knowledge and skills in a variety of areas. In the past, nurses provided care and comfort while they carried out specific nursing functions, but changes in nursing have expanded the roles of nurses to include health promotion, illness prevention, health restoration, and concern for the whole client (see box above).

 

ROLES AND FUNCTIONS OF THE NURSE

 

CARE GIVER

 

The nurse directly helps the client to regain health through the healing process. The nurse addresses the holistic health care of the client, including helping the client and family restore emotional and social well-being.

 

DECISION MAKER

The nurse, before taking any action, interprets available information and decides the best approach for the individual client. These decisions can be made alone, with the client and family, or with other health care professionals.

 

PROTECTOR AND CLIENT ADVOCATE

 

The nurse maintains a safe environment, helps prevent injury, and protects the client from possibleadverse effects related to treatment. The nurse also protects the client's human and legal rights and assists him or her in asserting those rights if the need arises.

 

MANAGER

 

The nurse delegates responsibility, supervises other health care workers, manages the resources of the practice setting, and coordinates activities

 

REHABILITATOR

The nurse assists the client's return to maximal functioning through teaching and helping the client to cope with changes associated with illness or disability

COMFORTER

 

The nurse cares for the client as a person through emotional support. The client needs help in reaching therapeutic goals.

 

COMMUNICATOR

 

The nurse is continually involved in promoting communication among all people affected by the client's' needs. Communication is critical in meeting the needs of clients, families, and communities

 

TEACHER

 

The nurse explains concepts and facts about health care to the client, reinforces learning, and evaluatesprogress. Teaching is individualized and may be formal or inform

Career Roles. Career roles are specific employment positions. Most skills required for the expanded roles of the 1980s and 1990s are taught in baccalaureate nursing programs. These skills are now directed toward the generalist practitioner. The newer requirements for nursing specialization are redefining the term "expanded role" (Mechanic, 1988). Nursing specialties have input into the educational requirements for these roles and career opportunities (see box at left).

One method of redesigning nursing roles has been the focus of differentiated nursing practice. This practice had early design in the educational setting where graduate-expected competencies were based on different types of educational experiences. Differentiated practice is now expanding into clinical practice as new nursing roles incorporate primary nursing and case management principles (Harkness et al., 1992). Broadly defined, differentiated practice structures roles and functions of nurses according to education, experience, and competence, while recognizing the importance of all roles to create a community of professional nursing practice (Koerner, 1992). For example, in such a system there is a clear difference between the responsibilities of a baccalaureate-prepared nurse versus one with an associate's degree.

 

CAREER ROLES

 

NURSE EDUCATOR

Nurse educators work in schools of nursing, staff development departments, and client education departments. They provide educational programs for student nurses and nurses and teach clients about self-care and home care. They usually are required to have graduate nursing education

CLINICAL NURSE SPECIALIST

Clinical nurse specialists work in critical, acute, long-term, and community health care agencies (Figure 1-5). They often specialize in managing specific diseases, and they function as clinicians, educators, managers, consultants, and researchers. They have master's degrees in nursing

 

NURSE PRACTITIONER

 

Nurse practitioners are certified to provide health care to clients, usually in outpatient or community settings. Adult nurse practitioners provide primary care to adults; family nurse practitioners provide primary care for families; pediatric nurse practitioners provide care for infants and children; gerontologynurse practitioners provide care to older adults; and obstetrics-gynecology nurse practitioners provide primary care for women. Most have master's degrees in nursing.

 

CERTIFIED NURSE-MIDWIFE

 

Certified nurse-midwives are certified by the American College of Nurse-Midwives to provide independent care for women during normal pregnancy, labor, and delivery. They practice in conjunction with a health care agency, which provides assistance

 

NURSE ANESTHETIST

Nurse anesthetists are registered nurses who have advanced training in anesthesiology. They provide surgical anesthesia under the supervision of an anesthesiologist and administer anesthetics to clients during minor surgery.

 

NURSE ADMINISTRATOR

 

Nurse administrators manage client care within a health care agency. They may hold middle-level (e.g., head nurse) or upper-level (e.g., director) management positions. They usually have baccalaureate degrees in nursing and may have master's degrees.

NURSE RESEARCHER

Nurse researchers investigate nursing problems to improve care and to define and expand the scope of nursing practice. They may be in academic, independent, or community settings. They must have a graduate degree in nursing. In some settings, a doctoral degree is required

 

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