Roles of Nurses PDF

‫بسم اهلل الرحمن الرحیم‬ Roles of nurses Roles of nurses Roles of nurses  Working areas of the nursing group ▪ Clinical nurse specialist ▪ anesthetist nurse ▪ midwife Nurse ▪ teacher nurse ▪ researcher nurse ▪ Nurse manager Organizational framework of the nursing profession...

‫بسم اهلل الرحمن الرحیم‬ Roles of nurses Roles of nurses Roles of nurses  Working areas of the nursing group ▪ Clinical nurse specialist ▪ anesthetist nurse ▪ midwife Nurse ▪ teacher nurse ▪ researcher nurse ▪ Nurse manager Organizational framework of the nursing profession ✓ Deputy Health and Nursing Department of the Ministry of Health and Medicine ✓ Matron ✓ Supervisor (clinical/educational/health promotion/infection) ✓ Headnurse ✓ Clinical nures  Work areas of clinical nurses Medical surgical wards Orthopedic Neurosurgery ENT Oncology Urology Work areas of clinical nurses Maternity wards❖ Kid wards❖ )NICU(❖ Neonate intensive care unit Work areas of clinical nurses Emergency wards ❖ Cardiac care unit :)CCU( ❖ Intensive care unit :)ICU( ❖ Operation rooms ❖  Work areas of clinical nurses Angiography D Dialysis D  Assessment Assessing is the systematic and continues collection, analysis, validation and communication of patient data, or information.  Family and significant others patient Source of data Nursing and other health care Patient records  Source of data Patient: The patient is the primary and usually the best source of information. Family and significant others: Family members, friends, and caregivers are specifically helpful sources of data when the patient is a child or has limited capacity to share information with the nurse. Patient record: Records prepared by different members of the health care team provide information essential to comprehensive nursing care. Nursing and other health care: To obtain a comprehensive patient database, it may be necessary to consult the nursing and related literature on specific health problems.  interview Physical assessment Methods of data collection consultation Laboratory tests inspection Physical auscultation assessment percussion palpation Physical assessment: a physical assessment may be carried out before, during, or after the health history, depending on a patient s physical and emotional status and the immediate priorities of the situation. The purpose of the physical assessment is to identify those aspects of a patient s physical, ,psychological, and emotional state that indicate a need for nursing care.  Sign Type of data symptom  objective data VS subjective data objective data collection. the process in which data relating to the client's problem are obtained through direct physical examination, including observation, palpation, percussion, and auscultation, and by laboratory analyses and radiological and other studies. Compare subjective data collection. subjective data collection. the process in which data relating to the patient's problem are elicited from a patient or a patient's family. The data are retrieved from the patient's description of an event rather than from a physical examination, which provides objective data.  Components of medical history 1. biographic information 2. cc: chief complain 3. Client expectations c 4. PI: present illness 5. P.M.H: past medical history 6. P.S.H: past surgical history 7. P.D.H: past drug history 8. F.H: family history 9. E.F.H: enviroment factor history.10psychosocial history.11spiritual history  chief complain ✓ Pain ✓ Weakness ✓ faint History of Present Illness (HPI). Obtaining an accurate history is the critical first step in determining the etiology of a patient's problem a past medical history is the total sum of a patient's health status prior to the presenting problem. A family tree, or pedigree chart, is a chart representing family relationships in a conventional tree structure. The more detailed family trees used in medicine and social work are known as genograms. Spiritual history: concerning the spirit" (especially in religious aspects)  diagnosis Nursing diagnoses: Identify the patient s nursing problems ❑Identify the defining characteristics of the nursing problems. ❑State nursing diagnoses concisely and precisely. ❑Collaborative problems: ❑Identify potential problems or complications that require collaborative interventions. ❑Identify health care members with whom collaboration is essential.  diagnosis After the completion of the health history and the physical assessment, nurse organize, analyze, synthesize, and summarize the data collected and determine the patient s need for nursing care. Nursing diagnoses: the first taxonomy created in nursing, have fostered autonomy and accountability in nursing and have helped to delineate the scope of practice. NANDA: (North American Nursing Diagnosis Association) is the official organization responsible for developing the taxonomy of nursing diagnoses and formulating nursing diagnoses that are acceptable for study. Nursing diagnoses represent actual or potential health problems that can be managed by independent nursing actions. It is important to remember that nursing diagnoses are not medical diagnoses; they yare not medical treatments prescribed by the physician, and they are not diagnostic studies. In fact they are succinct statement in terms of specific patients problem that guide nurses in the development of the plan of nursing care. In writing nursing diagnosis, problem and etiology of it are identified. For example: ✓ Activity intolerance related to weakness and fatigue ✓ Ineffective peripheral tissue perfusion related to decreased hemoglobin ✓ Imbalanced nutrition less than body requirements related to fatigue and inadequate intake of essential nutrients.  planning The planning component of the nursing process involves the following steps: 1. Assessing priorities to the nursing diagnoses and collaborative problems 2. Specifying expected outcomes 3. Specifying the immediate, intermediate, and long-term goals of nursing action 4. Identifying specific nursing interventions appropriate for attaining the outcomes 5. Identifying interdependent interventions 6. Documenting the nursing diagnoses, collaborative problems, expected outcomes, nursing goals, and nursing interventions on the plan of nursing care 7. Communicating to appropriate personnel any assessment data that point to health care needs that can best the met by other members of the health care team  implementation The implementation phase of the nursing process involves carrying out the proposed plan of nursing care. The nurse assumes responsibility for the implementation and coordinates the activities of all those involved on implementation, including the patient and family, and other members of the health care team so that the schedule of activities facilitates the patient s recovery.  implementation 1. Put the plan of nursing care into action 2. Coordinate the activities off the patient, family or significant others, nursing team members, and other health care team members. 3. Record the patient s responses to the nursing actions. Examples of nursing interventions: Assist with hygiene care Promote physical and psychological comfort Facilitate the ingestion of food, fluids, and nutrients Manage the patient s immediate surroundings Provide health education Promote a therapeutic relationship Carry out various therapeutic nursing activities Determination of the patient s responses to the nursing interventions and the extent to which the outcomes have been achieved. Evaluation, the final step of the nursing process, allows the nurse to determine the patient s response to the nursing interventions and the extent to which the objectives have been achieved.  evaluation 1. Collect data 2. Compare the patient s actual outcomes with the expected outcomes. Determine the extent to which the expected outcomes were achieved. 3. Include the patient, family or significant others, nursing team members, and other health care team members in the evaluation. 4. Identify alterations that need to be made in the nursing diagnoses, collaborative problems, goals, nursing interventions, and expected outcomes. 5. Continue all steps of the nursing process: assessment, diagnosis, planning, implementation, and evaluation