Nursing Role Development

Introduction

The role of nurses has become increasingly diversified as the medical field has evolved over time. Nurses are no longer just assisting doctors and providing quality care to patients. Nurses also must work in a variety of settings other than hospitals. This requires that a nurse must be able to adapt quickly and with ease to these various roles and settings. In order for this to be an efficient process nurses must be trained and provided education about these various roles. These various roles will be described and analyzed in order to develop an understanding of the changes that have undergone in the nursing profession. 

Nurse as researcher

A nurse’s role as researcher has become more vital as academics are developing a basis for the nursing science. Nurses are able to continue their education to get a PhD in nursing education. They would be able to conduct research in order to implement best practice for nursing practice. As in other professions nurses who have worked directly in the field are vital in developing research that would improve the profession. While other researchers may have the scientific knowledge to be able conduct effective studies.  A nurse is able to bring the valuable knowledge that they have gained through their profession in order to guide research towards areas which are lacking or need improvement within the nursing profession.

The role of researcher is also vital for a nurse on a larger scale. The nursing profession has to defend itself as being a hard science rather than just a caretaking person. The nurse’s role as researcher could assist with elevating the profession to the same level of other professions such as doctors. “Nursing science that contributes critical, high impact translational health research can distinguish the profession of nursing, raise our credibility and better position our discipline within the community of science” (Joel, 2009, pg. 61). Nursing could also benefit from the research role through gaining more funding for nursing research which would benefit the whole profession. The nurse as a researcher is crucial for this to occur.

Nurse as collaborator

The nurse also must play the role of collaborator between the various professionals and patients they interact with. According to Daly (2003) the nursing profession has become increasingly more diversified which has resulted in the boundaries between professionals both within and outside of the field of medicine to become blurred. Nurses at time are in the midst of collaborations between multiple professionals and must understand the goals of these professionals. Nurses need to be trained in how to effectively manage these relationships. A successful nurse collaborator must be careful to negotiate the boundaries between these professionals while at the same time ensuring that they achieve the goals required of them.

The nurse must also collaborate within the medical field. As patients expect high quality health care the nurse is often the person they go to get their needs met. “The call for collaboration continues to accelerate, driven by consumer and insurer demands for high quality care at a low cost” (Joel, 2009, pg. 169). A nurse must be able to collaborate with the other team members who work with the patient to ensure that they are knowledgeable about the patients care. The nurse must be able to coordinate the care of the patient especially when she may be the one who hears complaint about the other team members competence. 

Nurse as clinician 

As the nurse has the most contact with a patient she can also be beneficial in playing the role of the clinician. The nurse as a clinician can diagnose her patients as she may see symptoms which the doctor may not be around to notice. Also, patients may feel more comfortable with a nurse rather than doctors, who can be intimidating for patients, and they may be more inclined to discuss symptoms that they did not reveal to the doctor. Through building a rapport with her patients a nurse may also have some insight into the patients’ lives which would improve her ability as a clinician. However, nurses must have the education needed to diagnose effectively as they may not be aware of certain conditions without advanced training.

Nurse clinicians tend to be specialists within a certain field which makes them capable of having the advanced knowledge needed to effectively diagnose. Nurses as clinicians can then go onto develop treatment plans which a patient would be able to follow. Building a rapport with the client helps in the development of treatment plans. As a nurse would understand what a patient is capable of and what would work in treating the patient. Actually, knowing a patient can provide opportunities for nurses which are not present for doctors. According to Bryant-Lukosius (2004), managed care has provided opportunities and challenges for the health care industry. In the case of nurses this is one area in which it has provided opportunities.

Nurse as consumer advocate

This relationship between nurses and patients also place the nurse in a good role to become a consumer advocate for the patients. Nurses are knowledgeable about services that could be beneficial for their patients. They also possess a relationship with their patients which would allow them to take the nurses recommendations into account. Patients are often cautious of medical treatments as they worry about costs, side effects or unnecessary treatments. By having a nurse as an ally in recommending treatments doctors are able to provide services or treatments that could possibly save the lives of their patients. 

Nurses can also be consumer advocates on a macro level. Nurses can be advocates for changes that are needed to ensure effective health care delivery. Nurses may see the challenges that families face in getting services and are able to advocate for changes. “Nurses can also advocate for system changes to remove the barriers. It takes education, sophistication and determination to advocate at both these levels” (Joel, 2009, pg. 261). Nurses must be careful in these roles as the changes may be in conflict with the procedures or policies that exist within their organization. Nurses must be able to provide advocacy while ensuring their employment.

Nurse as Manager of Systems

This experience with macro level advocacy prepares nurses to take on the role of manager of systems. A nurse who manages systems has to be able to incorporate all of the roles discussed earlier and also manage a unit to ensure safe delivery of services. However, a nurse has to take more into account than the patient’s need when managing the system. They must ensure that they are providing cost effective services, have a fully trained staff and are able to achieve the goals of the organization. A nurse who runs a unit has to have the education and skills that are needed to efficiently run their staff and unit.

Nurse managers also face the challenge of having to fix problems within the health care delivery system and problems within the profession of nursing itself. According to Apker (2001) nurses face multiple barriers in that they may lack the structures and resources to provide services effectively. Nurses may also lack the training that is required of the additional role they must take on. Nurse managers have to find ways to address these barriers with the limited resources they have. They must also manage a staff which may not have the required amount of training needed to be able to efficiently provide services. 

Nurse as consultant

A nurse in a consultant role would primarily be found outside of the hospital setting. Nurses as consultants provide health care services in settings where healthcare is not the main priority. Within these settings nurses must be careful to juggle a role as medical professional within a setting where there are other priorities and professionals who may not see healthcare as an urgent need. As nurse consultants are often in the outsider position, they must be diplomatic and ensure that they maintain appropriate boundaries in these settings. However nurses in the community can play a valuable role by providing services and education.

Nurses can be consultants in a variety of community settings. Nurses could be consultants in schools where education is the main focus or in retirement communities where maintaining the quality of life of the elderly is the main focus not necessarily healthcare. “NP as consultant in community health setting is another emerging APN role. Long term care facilities, nursing homes and rehabilitation centers are settings having few APNs or professional nurses. However, these settings often have residents with chronic health needs that go untreated or unnoticed until they become more serious” (Joel, 2009, pg. 32). This example highlights the importance of having nurses as consultants out in the community as not all individuals have quick and easy access to health care services. Also, certain organizations have large vulnerable populations who may require medical assistance right away such as schools or retirement facilities. 

Nurse as change agent

Nurses must also fill the role of being a change agent. In order to be an effective health care entity nurses must be proactive rather than reacting when solving problems. This can be difficult to do within an organization which sticks to policies and procedures and may not have the resources available to enact change. As the front line staff nurses have a glimpse into what is needed for change to occur and what areas change must occur. Nurses have a responsibility to their patients to ensure that they are receiving the needed care and if change is needed to ensure this then they must become the change agent. If nurses do not effectively advocate for their patients change will not occur and services may be ineffective.

Nurses must advocate for change not only for service delivery but also for changes within the profession as well. Nurses are often overworked due to staff shortages and may find themselves the first to be let go if there is a decrease in demand. Nurses must become change agents within the profession to ensure that they are secure in their employment. Also, nurses spend a considerable amount of caring for others. If nurses do not care for themselves, they will not able to sufficiently care for their patients. Nurses have a responsibility to not only patients but also towards fellow nurses to ensure that they are cared for as well. 

Nurses role in improving health care delivery and outcomes

As nurses are the ones who directly participate in health care delivery, they are the ones who are more capable in being able to implement the improvement of healthcare delivery. By incorporating the advocacy, management and change agent roles nurses can efficiently improve the health care delivery within their own organization. However, this would be difficult to translate to a larger scale improvement in healthcare around the country as this would require changes in policy which are above the nursing level. However, nurses are able to advocate for these changes by speaking to policymakers about their experiences and recommendations. This is a responsibility for not only nurses in leadership roles but also in the smaller roles. 

By advocating for changes in health care policy nurses would also play a role in improving healthcare outcomes. Through healthcare reform patients may be more likely to pursue preventive care as they would have insurance. Doctors may also be willing to provide treatments which would save the lives of patients without necessarily compromising their resources. Nurses would also be provided with resources to better for their patients. Nurses would also be providing with training and education to improve their effectiveness. All of these changes combined would result in improved healthcare outcomes.

Nurse as leader

A nurse in a leader role must be able to incorporate all of these roles along with effective negotiation skills to be a prepared leader. A nursing leader would be able to communicate effectively in order to be able to effectively negotiate with her superiors. A leader must also demonstrate diplomacy as they may need to be able to negotiate with professionals in multiple fields. Nurses have to maintain appropriate boundaries as they may not be able to express their true feelings about a situation. Nurses must also be able to negotiate within their own nursing ranks as this can be more difficult to do than negotiating with superiors.

When negotiating the nurse at times may need to bring up the skills that she has. Often nurses are taken for granted for the work that they do and may not be appreciated. “The core concepts for the advanced nursing practice role are: autonomy in clinical practice, pioneering professional and clinical leadership, expert practitioner and researcher” (Furlong, 2005, pg. 1066). This statement demonstrates how much nurses accomplish. By being able to understand that the roles they take on and all the tasks they accomplish a nurse may be more confident in how crucial her abilities are to the organization. This knowledge would also improve her confidence during negotiations with superiors for increased resources.

Professional Development

Understanding the roles of a profession at times is not fully completed until after someone enters the profession. However after analyzing the various roles nurses must now undertake an understanding of the profession can be developed before entering into the field. As a researcher I would research new treatments or services to provide to my patient especially when the services may not be available within the organization I work within. As a collaborator I would collaborate with other professionals such as social workers to ensure that my patients were getting the best care that they could receive. As a clinician I would utilize the knowledge I have gained through my education and the experience I have gained through my work with my patients to effectively diagnose them. As a consumer advocate I would ensure that my patients obtained the best possible treatments that were available for them. As a manager of systems I would ensure that my unit was being run with enough resources and competent staff while still staying under the budget requirements. As a consultant I would work with outside community agencies to provide psychoeducation regarding health issues and would provide healthcare services to populations within these agencies. As a change agent I would engage with politicians and community leaders to advocate for change within the healthcare system. In improving healthcare delivery and outcomes I would ensure that the hospital is meeting standards through utilizing quality improvement measures within my nursing unit. I would utilize negotiation skills in becoming an effective leader to ensure that my staff were getting the resources I needed. I would utilize diplomacy and effective communication in order to achieve this goal. Through understanding the various roles of a nurse I would advance my professional development to become a nurse who is as diversified as the healthcare setting in which I work. This would go onto assist my patients, the other nurses around me and also the hospital in which I work.  

References

Apker, J. (2001). Role development in the managed care era: A case of hospital-based nursing. Journal of Applied Communication Research, 29(2), 117-136.

Bryant-Lukosius, D., A. DiCenso, G. Browne, & J. Pinelli. (2004). Advanced practice nursing roles: development, implementation and evaluation. Journal of Advanced Nursing, 48(5), 519-529.

Daly, W. M., & Carnwell, R. (2003). Nursing roles and levels of practice: a framework for differentiating between elementary, specialist and advancing nursing practice. Journal of Clinical Nursing, 12(2), 158-167.

Furlong, E., & Smith, R. (2005). Advanced nursing practice: policy, education and role development. Journal of Clinical Nursing, 14(9), 1059-1066

Joel, L. A. (2009). Advanced practice nursing: Essentials for role development. FA Davis.