Clinical Skills and Nursing Roles - Coursework Example

Clinical Skills and Nursing Roles I. Introduction The tremendous advancement in technology and medical science contributed a lot in the evolution of the nursing profession and the roles that nurse’s play (McCreaddie 2001). As medical science evolved, nurses are faced with increasing number of tasks from communication, technical, clinical and even administrative. As the roles that nurses play increases1, the Nursing and Midwifery Council (NMC) issued the Code of Professional Conduct ( NMC, 2002) which provided guidance on the scope of a nurses practice and the degree of integrity entailed. According to the Code, a nurse must “practise competently, you must possess the knowledge, skills and abilities required for lawful, safe and effective practice without direct supervision. You must acknowledge the limits of your professional competence and only undertake practice and accept responsibilities for those activities in which you are competent.(NMC 2002) 2 Nurses contribute much to the treatment and recovery of the patient. The attitudes and skills of nurses towards their patients are essential determinants not only to the fast recovery of the patients but also to the efficiency with which the members of the medical team delivers services to the patients. The many roles that a highly skilled nurse play in the care of the patient as well as a member of the medical team would help so much in making the patients confident and comfortable, thereby easing off the burden form the shoulders of the members of the medical team. To understand better the roles that nurse play, let us discuss these roles briefly. II. Six Nursing Roles Nurses are required to “practice and accept responsibilities for those activities in which you are competent”(NMC 2002). Most of the roles that nurses play in their profession are so closely related to each other that they are often seen as part and parcel of the whole health care service. a. Nurse as Caregiver A very noble role of nurses is that of a caregiver to the patients. Often times, caregivers are “family members, friends or neighbors”3 who care for their sick or disabled loved ones. This role is also innate in the nursing profession. A nurse, by the nature of his/her profession is “guardians” of the sick plays the role of a caregiver by helping identify, prevent, or treat an illness or disability. In patient care, playing the role of a caregiver is very important. Caring for the patients and catering to their needs is part of the nurse’s commitment to promote the well being of the patient and is part of his/her ethical duty to provide comfort and compassion to the patient. b. As a Team Player One of the biggest roles of a nurse in the practice of his/her profession is being a member of a team. Health service often requires a number of health care practitioners to work closely together and it is essential that rapport, trust and confident should be present among members of the team. As a member of the medical team, the nurse should take part in the progress of the patient management scheme. It is extremely pertinent that nurses work closely with the rest of the team and gain full understanding of what the patients are going through. As a support system to the rest of the team, the nurse is required to be on the alert always in providing complimentary services to other medical practitioners. It is extremely difficult to give maximum “benefit to the patient without a team approach. And that includes the nurses, the medical oncologist, the radiotherapist, and the physiotherapist. Its a real team approach if we want to make anything come out of the treatments that we offer to these patients.”4 c. The Nurse as Communicator A critical role of a nurse is being a communicator. As part of the support system to the patient, a nurse must communicate to the patient in a manner that is not alarming nor inspiring false hopes, the status of the management of his/her illness. Many times in the course of patient management, the message of the doctor would sink-in after the doctor has left the patient and it now falls on the nurse to help the patient come to terms with the status of his/her illness. This would often put the communications skills of the nurse to the test in terms of how he/she will explain to the patient in a manner, which will facilitate acceptance and encourage the patient to pursue further medical treatment, which has the viability of curing his/her disease. As a good communicator, the initial contact with the patient would often cement the bonds between the nurse and the patient with the common understanding of the illness. A personal relationship will them be established where the patient identifies the nurse “as someone who has designated time to spend” (McCreaddie 2001) with him/her. The role of the nurse will now therefore evolve into being the patient’s chaperone and protector. d. The Nurse as Chaperone A critical role of the nurse is that of a chaperone and protector of the patient. “When the chaperone is a nurse or another member of the health care team, they can act as advocate for the patient helping to explain what will happen during the examination or procedure, and the reasons why” (Royal College of Nursing 2006). As chaperone during examination or procedure, the nurse can assess the patient in understanding what is going on by explaining to them fully and in a language they can understanding more easily. Being familiar with the medical parlance, the nurse can easily assess if the patient really understood what he/she had just been told. The presence of the nurse during examinations and procedures will reassure the patient and will serve as “safeguard against unnecessary discomfort, pain, humiliation and intimidation” (RCN 2006). It cannot be denied that there are many patients who feel intimidated in the presence of a physician and will feel compelled to subject themselves to any suggestions by the physician. By having somebody with them who knows the process and could explain to them in a friendly and comforting manner, undergoing test and procedures will not be as traumatic as going through it alone. Furthermore, the presence of the nurse as chaperon will not only serve the interest of the patient alone but also the physician. In many cases, doctors are unfairly accused of abuses primarily due to the fact that the patient did not understanding the necessity of the test performed on them. Because of misunderstanding, some patients would accuse the doctor of violating their person and humiliating them. The presence of the nurse as witness to the whole examination or procedure would ensure that the physician would not also be put in a difficult situation where he/she would be wrongfully accused of malpractice. e. Role as an educator The nurse role in education is closely related to his/her other roles. As a communicator, the nurse is already doing some aspects of education. Explaining the process to the patient is a form of education where the patient is taught on what is really happening and why things are happening as it is. For instance, by explaining to the patient why he/she needs blood transfusion and the side effects that he/she might have after the transfusion is already part of education. In the field of peer education and formal education, the role of senior nurses as educator is vital.5 Serving as mentor during in-service training and giving inputs to new nurses facilitates sharing of a wealth of experiences, which are useful in the practice of the nursing profession. On the other hand, some nurses have regular teaching commitments in colleges and universities and have developed course modules, which are currently being used by schools. This role of the nurse as formal educator contributes a lot to the advancement of the nursing profession. f. Nurse as a Researcher Research is one of the fields where nurses are also engaged in nowadays. A popular research theme among nurses focused on the experiences through narrative inquiry (Lindsay 2001) in patient care, the possible choices for action in health care and education situations. The role of the nurse as a research is very important to help understand patient behaviour and the responses of health care professionals to the patient. Note that nurses spend more time with the patients than any other health care practitioner and have more time to observe patient and healthcare professional relationships. By having a firm grasp of the day by day relationships of health care professionals and their patients, the nurse as a researcher could very well help point out areas for improvements as well as means and methods of dealing with patients that gets more positive feedbacks. III. Application of Roles of Nurses in the Case Study In our scenario, there are a number of roles, which the nurses could play in order to make Amy and Isobelle understand fully the situation. First, the nurse can play the role of a communicator, where he/she will mediate between Amy, Isobelle and the physician by interpreting the things that the physician tells Amy and Isobelle.6 By discussing fully in a way, which both Isobelle and Amy can easily understand, the nurse can help Amy and Isobelle go through the recovery period with less stress and anxieties. Second, the nurse can play the role of an educator where he/she will explain in details to Amy and Isobelle the nature of Amy’s injuries and how these injuries have affected her motor skills. Furthermore, she can explain further what the physician may have previously discussed, what are the things which need to be done in order to hasten Amy’s recovery. Education is one of the best ways to dispel wrong notions and help the patient overcome her/his fears. Third, as a caregiver, the nurse could demonstrate to Isobelle how to properly care for her mother. Furthermore, the nurse can give recommendations as to what should and should not be done by Isobelle in order to facilitate the recovery of her mother. 7 Fourth, the nurse can play the role of a chaperone when it is time for Amy to undergo examinations. By doing so, the nurse can further assist Amy and Isobelle by providing the doctor a good first hand historical account of Amy’s progress in the hospital. First hand information provided by the nurse will certainly help the doctor in assessing Amy’s condition. IV. Conclusion The roles of nurse in the delivery of health care services have evolved with time. Advancements in medical science and technology have introduced many changes into the roles that a nurse plays. However, there are some constant truths, which never change, in the nursing profession. These truths are deeply imbedded into the nursing culture that however may science and technology change the face of the health care profession these things will not change. The role of the nurse as team member, communicator, educator, chaperone and caregiver are part and parcel of the profession will always hold true in most areas of specialization in the nursing profession. On the other hand, the role of the nurse as a researcher is still relatively new and yet to be explored further. Yet, it can easily be surmised as early as now that the role of a nurse as researcher would surely contribute to the advance of the nursing profession and the whole healthcare sector. Bibliography 1. Changing Role of Nurses in the NHS http://www.allaboutmedicalsales.com/articles_nurse_advisors/nurse_practitioners_nurse_advisors_aj_010604.html last accessed April 18, 2006 2. Coffey, S. & Lindsay, G. (2004) Emerging Professional Issues: Maintaining the dialogue while Managing Confidentiality. CADE/This is IT Pioneers 2004 Conference. York University, ON. 3. Levenson R, Vaughan B. (2000) Developing new roles in practicean evidence based guide. London: Kings Fund 4. Lindsay, G. (2006) Reading Journals: Recovery and Reconstruction of Meaning for Nursing Praxis. Journal of Nursing Education, Syllabus selections: Innovative learning activities, 45(3), page 1 5. Lindsay, G. in collaboration with J.W.S. 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