For I use the term care as in looking

For the assignment, I will critically
define the role of an adult nurse. Within the assignment I will explore; the
role of the nurse within the field of adult practice, how health and social
care policy, legislation, ethical issues and professional regulation influence
current nursing practice, and how research and evidence-based practice can be
applied to nursing care and clinical decision making.

Whilst focusing on the 3 main topics
above, I will also ensure the assignment meets the learning theory outcomes. I will
achieve this by; identifying the key issues within the evolving profession of
nursing, and explaining the role of the nurse and the influence of policy,
legislation and professional regulation on current nursing practice within all
care sectors. For this assignment I will also discuss key ethical issues that
that can relate to both professional practice and nursing research.

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The structure of this assignment will
focus mainly on the framework of the 6Cs that underpin Compassion in Practice
but will take ideas from the 4 Themes of The Code for nurses and midwives, and
the 8 Principles of Nursing Practice.

What
is a nurse?

A ‘nurse’ can be defined as a variety
of different things. It all depends on how you look at it. To me, a nurse is a
person who is willing to go the extra mile for a patient, a person who will do
their utmost to ensure that they are given the best care possible. I use the
term care as in looking after someone when they are unwell or unable to look
after themselves, alongside the physical care they are given there is also
emotional support. This could be in a number of different ways such as someone
to lean on when they receive terrible news. But not only is a nurse there to
support with the bad news, they can also be the bearer of good news.

In 2015, Kristina Eriksen of Rasmussen
College released a blog post on the School of Nursing website stating that a
nurse is not ‘Just a Nurse’. She commented saying “Just a nurse? There’s no
such thing”. She believes that there are 8 reasons a nurse isn’t just a nurse. Their
role includes being; an advocate, a bridge builder, a chemical catalyst, a
confidant, a counsellor, an educator, an interpreter, and most importantly a friend.
(Eriksen, 2015) 1

In my opinion, Rasmussen College
perfectly summed up exactly what is expected of someone who aspires to be a
nurse. It is near to impossible to summarise exactly what is a nurse. This is due
to the fact that there is so much expected of them. It is constantly changing,
people are getting new ideas and old ideas are disregarded. Wanting to know
what a nurse is requires constant re-examination and the ability to adapt to
the imagination of what is to come.  

Florence Nightingale said –

“The elements
of nursing are all but unknown”. (Nightingale, 1859) 2

This was taken from her Notes on Nursing: What it is
and What it is Not book published in 1859. She wrote this book
with the intention of giving hints to the people who were the givers of care
and what she believed nursing to be. Nightingale stated that the book itself is
not meant to be book of teaching for one’s self but rather a guide as to help
in the teaching of others. Because nursing has progressed over the years, the
book hasn’t recently been used in the teaching of nursing. In the 1974 edition,
Joan Quixley stated within her introduction –

“The book was the first of its kind ever to be written. It appeared
at a time when the simple rules of health were only beginning to be known, when
its topics were of vital importance not only for the well-being and recovery of
patients, when hospitals were riddled with infection, when nurses were still
mainly regarded as ignorant, uneducated persons. The book has, inevitably, its
place in the history of nursing, for it was written by the founder of modern
nursing”. (Quixley, 1974) 3

In my opinion, even though the teaching of
nursing has changed throughout the years the principles stay the same. The
teaching of nursing must progress with the times. The practice of nursing from
years ago would not be accepted today, but on the other hand, we would not be
where we are today with patient care, culture, responsibilities, and training –
without it.

What
is the Role of a Nurse?    

With all the changes in healthcare over
the years, a nurse has a number of roles that they must perform, however the
role of the nurse has expanded. As the role of a carer, the nurse must provide
a variety of different care. This includes physical needs, which can range from
complete care, to helping a patient with illness prevention. A nurse must also
address the cultural, developmental, psychological, spiritual needs of the
patient.

Another role the nurse must undertake
is being a communicator. Any barriers to effective communication can prevent
the healing process. It is the nurses role to communicate between the patient
and family members as well as the other health care staff. It is also crucial
for the nurse to ensure written communication is carried out, this could be
patient notes or handover documents. It is essential that nurses have good
communication as it will ensure the patient feels at ease.

Peplau’s development model of nursing
states that a nurse will adopt one of 6 roles. (Peplau 2005) 5 The
first is a stranger. The nurse may
take on the role of a stranger, the client is greeted in the same way as they
would meet a stranger in real life situation. This provides an accepting atmosphere
that builds trust between the patient and nurse. The second role a nurse may
portray is the role of a teacher.
They will convey knowledge in reference to a need or interest. The third role
they may take on is the resource person. They will provide a specific
piece of information that assists in the understanding of a problem or new
situation. The fourth role a nurse may initiate is a counsellor. They will help to understand and assimilate the meaning
of life changing occurrences, provide guidance, and possible encouragement to
make changes within their lives. The fifth and penultimate role is a surrogate. They will help to define certain
domains of dependence interdependence and independence. They may also act on
behalf of the patient as a counsel. The sixth and last role the nurse may adopt
is a leader. They might help the
patient with accepting responsibility for meeting personal goals.

What
is expected from a nurse?

If feel, there are many aspects that
are expected from a nurse. There are certain things that must be done in a
certain way. A nurse must ensure that a certain level of care is given to a
patient, whilst also caring for 5-8 other patients. Whilst doing their jobs
they have been allocated, they must ensure that the families of the patients
are being kept informed of everything that is happening.

Throughout the day, the job of a nurse
does not decline. Depending on where the nurse is based they will have
different schedules. On a ward the first task a nurse must carry out is
‘handover’. During this, they must get every piece of information that happened
on the shift before. Any information that is supressed could reduce a necessary
level of care. Within a morning shift, after the handover would be medication.
This is an imperative part of the day and some of the medication is what helps
keep the patients alive. If the nurse was to administer the wrong medication,
there would be serious consequences. There is a lot of pressure that comes with
the job of administering medication. Medication management is an important role,
the Nursing and Midwifery Council (NMC) released an article in 2007 (updated in
2010) with the standards that are required of a nurse within this role. They
wrote –

“The administration of medicines is
an important aspect of the professional practice of persons whose names are on
the Council’s register. It is not solely a mechanistic task to be performed in
strict compliance with the written prescription of a medical practitioner (can
now also be an independent and supplementary prescriber). It requires thought
and the exercise of professional judgement…” (NMC, 2010) 6

The
booklet provides the minimum standard by which practice should be managed and
will provide the framework for practice to be moderated.

There are many theories that are the
basis of nursing care models. These are what is expected in nursing care which
are the essential factors, which over time are developed into the nursing
models we use today. (Catledine & Close, 2009) 7

Advocacy

Advocacy can take on many shapes in
nursing. The way it’s used is often in a legitimate way as for someone to represent
another. Within nursing, the term is used to describe a nurse who stands up for
their patient or will represent them when they need help. An advocate will act
accordingly with the patients best interests in mind, they may act as a
patients spokesperson to protect them from harm, always promote the patients
wishes and freedom from suffering, and will only represent the patient when it
is appropriate within their recovery. Most times, being an advocate for the
patient may only be that they are there to ensure patients receive ample pain
medication, checking the patient understands what is happening amidst their
treatment, and providing adequate knowledge so that they may make informed decisions,
whilst supporting those decisions.

Care

The term ‘care’ is used as in a nurses
actions and activities that are performed to benefit and gratify the patient
during recovery. This is all done to lead them to a place of complete
independency. Care can be displayed, not only in the practical side but also
the fundamental side such as bathing, dressing, feeding, grooming, and turning
a patient.

Comfort

Comfort consists of emotional,
environmental, physical, psychological, and social. Comfort can be achieved by
carrying out regular turns within the bed, or being transferred from bed to
chair or vice versa. Whilst these comfort breaks are being carried out, roughly
every 2 hours, a nurse would check the skin for pressure marks. This would also
give the patient the opportunity to raise any concerns or to have a
conversation with someone for peace of mind. During this time any personal care
that needs to be addressed can be carried out, this could include oral care,
remaking the bed, and possibly assisting with eating and drinking. In my
opinion, this is one of the most important parts of the day as it allows the
nurse and patient a chance to get acquainted as they will be within each
other’s company for the next 12 hours. In my experience, during those first 20
minutes, I have managed to understand what my patient is like and how they like
to be treated. I have then followed through with the same level of care
throughout the day, establishing a connection of trust between myself and the
patient.

Compassion

Compassion is such a crucial element
within nursing, it is one of “nursing’s most precious assets” (Schantz, 2007) 8

 

The
6 C’s within nursing

The 6 C’s can be related to what a
nurse is through all aspects. A nurse must be caring, compassionate,
communicational, courageous, committed, and competent. A caring nurse is the
most crucial team member. In most cases a nurse is the first person they are
greeted with on a ward or on home visits. It is important that the patient and
their families are made to feel welcome and safe. Throughout the admission of
the patient or the length of the home visit, the nurse must maintain a certain
level of care, they can’t let it waver or the care the patients receive may be
compromised.

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