NURSING SERVICE IN
HOSPITALS / NURSING
Nursing is a vital aspect of health care & needs to be
properly organized. A nurse is in frequent contact with
the patients & hence her/his role in restoring health &
confidence of the patient is of utmost importance, the
quality of nursing care & the management of the
nursing staff, reflect an image of the hospitals.
Nursing service administration is a complex of
elements in interaction. It results in output of clients
whose health is unavoidably deteriorating, maintained,
or improved through input of personnel & material
resources used in an orderly process of nursing
Administration is the direction, coordination and
control of many persons to achieve some purpose or
Herbert.A.Simon points out, In its broadest sense,
administration can be defined the activities of groups
cooperating to accomplish common goal.
Administration has to do with getting things done;
with the accomplishment of defined objectives – Luther
General administration when applied to nursing
service is nursing service administration.
PHILOSOPHY OF NURSING
SERVICE IN HOSPITAL
The department of nursing service
of hospital recognizes and appreciates
the object of the hospital & acknowledge
that the primary purpose of nursing is to
provide the highest quality of nursing
care service that is possible in assisting
the patient with meeting his daily living
needs wherever he is located along the
In brief, nursing department of the
hospital is to administer high-quality,
cost-effective care to patients & families,
provide health promotion programmes
to all people, maintain a supportive
environment for education of the
professional nurses & promote career
development of nursing employees with
It believes that life & health are primary goods of the nursing service
division of the hospital
It believes that each person is unique & has intrinsic worth, so is
deserving of respect, without regard to such individual characteristics as
sex, age, colour, nationality, religious conviction & socio-economic
It believes that illness, injury & its significance are perceived by the
individual as a threat to autonomy, independence, identity & existence.
It believes that the experiences associated with normal maturation do not
prepare a person for the adaptations needed to cope with illness & illness
It believes that nursing consists of providing or assisting a patient to
perform those functions that he or she would perform independently ,if
better informed or more able.
It believes that persons drawn to nursing have concern for others
welfare, a belief in personal efficiency & desire to actively engage fate.
It believes that nursing interventions are most effective when they are
directed toward the patient’s health goals, based on research evidence,
individualized to meet the patient’s needs and circumstances &
coordinated with care by other health team members.
It believes that high quality of nursing care can best be provided by a
mixture of professional and non professional personnel who are
organized into self directed work teams.
It believes that to ensure continuous improvement of nursing care quality,
the role of professional nurse must include responsibility of nursing
research and nursing education, as well as for patient and family care.
It believes that when jobs for nursing personnel are designed to ensure
employee autonomy and self-actualization, patient care quality, patient
satisfaction and employee satisfaction are maximized.
OBJECTIVES OF NURSING
SERVICE IN HOSPITAL
Management of Nursing Care & Services
Education, Training and Staff Development
Nursing Research &
Community Health Programmes
CATEGORIES OF NURSING
PERSONNEL IN HOSPITAL
In government setup, the categories of nursing
Nursing Superintendent Grade I
ORGANIZATION OF NURSING
SERVICE UNIT IN HOSPITAL
Nursing service refers to the coordinating
responsibility of the nurse who, in addition to giving
nursing care, also works with members of allied
disciplines such as dietetics, medico-social service,
pharmacy & various others in providing a
comprehensive programme of patient care.
In a hospital , many variable factors influence the
number of nurses needed in a ward in order to
render high quality of nursing care.
The factors include
The type of service, ie; medical, surgical, obstetrics &
gynaecology, pediatrics etc.
The acuteness of the service & the rate of turn over of patients according
to the degree or period of illness.
The experience of the nurses who are to give the patient care.
The number of non-nurses who involved in the patient care, the quality of
their work, their stability in service.
The amount and quality of teaching which proceeds the assignment of
personnel to the service as well as that gives as in-service preparation.
The amount & quality of supervision & ward teaching.
The method of appointment of the medical staff.
Affiliation of the hospital with medical college / nursing colleges / school.
The plan of the ward – floor plan.
The physical facilities.
The amount, type & location of equipment & supplies.
The number of hours in the working week of nurses & other ward
personnel & the flexibility in hours.
The morale of the worker
Methods of performing nursing procedures.
The time required for hospital routines, ie; record keeping and reporting.
The method of assignment.
The standards of nursing care.
FACTORS INFLUENCING WARD
Ward Management is one of the pre
requisites for good nursing care. There
are many factors involved in good ward
management, which the nurse manager
need to understand thoroughly for the
good management of the ward.
Knowledge of the ward
Planning the schedule of the ward
Starting the work on time
Establishment of ward routines
Use of democratic method in establishing ward policy
Orientation of new personnel
Orientation of hospital
Orientation of ward
Maintenance of suitable environment
Providing supplies and equipments in a hospital
Clear cut specific orders for medical therapy and nursing
Maintenance of high morale among all members of the staff
Establishment of good working relationship
Assigning duties and responsibility
MODES OF NURSING CARE /
PATTERNS OF NURSING CARE
A pattern of nursing care is that system used for the delivery
of nursing care to patient / clients. The method selected for
assignment of nursing staff to patients directly relates to the
staffing pattern adopted by the health facility. In nursing
service 4 basic patterns exist.
Case Method / Total Patient Care
ROLE OF NURSE
CHIEF, NURSING SERVICE OR
An organization of nursing service which provides for effective
functioning of all nursing service personnel.
Appropriate numbers & categories of personnel to meet nursing
Promotion of the personal & professional growth of all nursing
Utilizing sound personnel management practices in administering
the nursing service.
Planning budgetary requests for nursing service and participating in
planning for supplies and equipments which affects nursing service
Establishing channels of communication and means for reporting nursing
Interrelating nursing service activities with all other hospital services
Conducting continuous review and analysis of nursing service
HEAD NURSE AS
The administrative responsibilities of a head nurse are
primarily concerned with activities which ensure good patient
care & make the ward run smoothly. They include the
planning of patient care & responsibility for clear, complete,
up to date orders which lessen mistakes, & for well organized
reports between all groups so that patients are safeguarded,
time is saved & nervous tension is kept to a minimum.
Another administrative function of head nurse is to delegate
duties and responsibilities according to the qualification &
ROLE OF STAFF NURSE IN
Individualized nursing care to patients
Supervising the nursing care given to the patients assigned
to her team.
Promote the development and self realization of team
Serving as a leader of the nursing care team.
Serving as a member of the nursing care team.
Appropriately utilizing supplies and equipments.
Maintaining effective communication.
Interrelating patient care activities with the administration of
the unit nursing service, the total nursing service and other
Participating in the appraisal of the effectiveness of the
administration of nursing service.
Administration is a combination of purpose & means of
achievement of that purpose. Nursing service administration
results in out put of patient whose health is unavoidably
deteriorating, maintained or improved through input of
personnel & material resources used in an orderly process of
nursing service. Management is the process of getting work
done through others. Nursing management is the process of
working, through nursing personnel to provide care, cure &
comfort to groups of patients. The nurse
managers/supervisors task is to plan, organize, direct &
control available financial, material & human resources in
order to provide effective, economic care to groups of
Deepa Merin Kuriakose,
3rd Semester MSc Nursing
Govt. College Of Nursing, Kottayam