THE ROLE OF NURSES IN TERTIARY HOSPITAL PRESENTED BY SALEH AHMED SCHOOL OF MIDWIFERY, BAUCHI On 30th may 2012
INTRODUCTION• Tertiary hospital is the highest level of health care in Nigeria. The promotive, preventive, restorative and alleviative caring roles of nurses in this hospital remain vital in provision of appropriate, effective, efficient, acceptable and scientific quality care. In teaching hospital, these roles are provided by well trained professional nurses with cognate experience and advanced knowledge and skills. In consonant with the objectives of teaching hospital, they are responsible for teaching colleagues and students as they perform their duties. Yes, the teaching role is prominent and desirous. This invariably makes nurses in teaching hospital unique and special.
Hospital• The word hospital is derived from Latin word “Hospice” or French word Hospitale; All meant to take care of or treat clients very well• Hospital is an institution in which sick or injured persons are treated
The supposed hospital• A supposed hospital has• Suitably located, constructed, and organized institution• Staff to provide quality health care to people• Functioning facilities for medical care and training of staff and students• Team approach care system
Requirement for good hospital care• It is called the 7 A’s and 3 C’s,• Availability – available at anytime to people• Adequacy – sufficient to meet the need of people and community• Accessibility – easily affordable & reachable• Acceptability – acceptable to all people• Appropriateness- care are selected based on nature of health problem/illness/sickness• Assessability- can be readily evaluated• Accountability- accept responsibility or to account for ones actions
-• Completeness – provide complete care( preventive, promotive, diagnostic, rehabilitative)• Comprehensiveness- care is provided for all types of health problems• Continuity- continuous coordinated care among heath care providers without disruption.
Classification of hospital• There are various criteria for classifying hospital but classification based on objectives is adopted for this paper• Based on objectives, hospital can be classified into three categoriesa) teaching-cum research hospitalb) General hospital for treatment of common diseases and conditionsc) Specialized hospital for specific diseases and conditions e.g. orthopedic hospital
Tertiary hospital• This is a type of hospital that provides highly specialized medical care that involves advanced and complex procedures and treatments performed by medical specialists ( e.g. Doctor, Nurses, pharmacists, medical scientists etc)• Tertiary hospital provides tertiary care.
-• Tertiary care- this is the third level of care which is specialized consultative health care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital• Teaching hospital is one examples of tertiary hospital
-• A teaching hospital is a hospital that provides clinical education and training to future and current doctors, nurses, and other health professionals, in addition to delivering medical care to patients. They are generally affiliated with medical schools or universities (hence the alternative term university hospital), and may be owned by a university or may form part of a wider regional or national health system
-• thus teaching hospital is composed of personnel of advanced knowledge with cognate experience in their professional field. They all have the expected qualifications and attributes to teach and train.
The nurse• A Nurse - In a wider perspective, a nurse is a trained health practitioner with sound scientific knowledge and technical skills to effectively respond and solve health –illness problems of both the healthy and sick individual. The Nurse, practices the art of caring by utilizing the “3Hs”: Heart (affection, love& feeling), Hand (psychomotor –skills} and Head (cognitive –knowledge)
-• A nurse is a person trained in scientific basis in nursing, meeting certain prescribed standards of education and clinical competence to provide services that are essential to or helpful in the promotion, maintenance and restoration of health and wellbeing. The competency of the great nurse is seen through the technical skill, human skill (interpersonal relationship) and conceptual skills (ability to see picture of being a part of a team).
Roles of a nurse in tertiary hospital• The rudiment role of a nurse is caring.• Thus, The heart of nursing is caring.• The roles of nurses in providing the optimum and scientific caring in respective of the types of the hospital are as follows:
-• 1. Caregiver/ Care provider – the traditional and most essential role. The nurse functions as nurturer, comforter, and provider “mothering actions” of the nurse: - i.e. provides direct care and promotes comfort of client.• The activities to achieve this, involves knowledge and sensitivity to what matters and what is important to clients and showing concern for client welfare and acceptance of the client as a person
-• 2. Teacher – provides information and helps for the client to learn or acquire new knowledge and technical skills, encourages compliance with prescribed therapy, promotes healthy lifestyle, interprets information to the client
-• 3. Counselor- helps client to recognize and cope with stressful psychologic or social problems;• to develop an improve interpersonal relationships and to promote personal growth,• provides emotional, intellectual to and psychological support,• focuses on helping a client to develop new attitudes, feelings and behaviors rather than promoting intellectual growth,• encourages the client to look at alternative behaviors recognize the choices and develop a sense of control.
-• 4. Change agent- initiate changes or assist clients to make modifications in themselves or in the system of care.• 5. Client advocate- involves concern for and actions on behalf of the client to bring about a change, promotes what is best for the client, ensuring that the client’s needs are met and protecting the client’s right, provides explanation in clients language and support clients decisions.
-• 6. Manager – makes decisions,• coordinates activities of others,• allocates resources,• evaluates care and personnel,• Plans and gives direction,• develops staff and monitors operations,• gives the rewards fairly and represents both staff and administrations as needed.
-• 7. Researcher – participates in identifying significant researchable problems,• participates in scientific investigation and must be a consumer of research findings,• must be aware of the research process, & language of research,• be sensitive to issues related to protecting the rights of human subjects.
Modified roles of a Nurse in teaching hospital• 1 Clinical Specialists:. She/he provides expert care to individuals, participates in educating health care professionals and ancillary, acts as a clinical consultant and participates in research.• 2. Nurse Practitioner: She/he is skilled at making nursing assessments, counseling, teaching students and colleagues and treating minor and self- limiting illness.
-• 3. A role model- a nurse who is competent, proficient, morally upright, socially and academically outstanding, worthy of emulation by many people.• How punctual, committed &dedicate are you?• How do you dress?• How do you interact & communicate with other?• How do you perform the nursing activities?• Answer to these questions makes you a role model
-• 4. Teacher/Educator- A nurse usually with advanced knowledge and skills of teaching,• who works in clinical or educational settings,• He teaches theoretical knowledge & clinical skills to students and colleagues and conduct research.
-• 5. Nurse administrator- a nurse who functions at various levels of management in health settings;• responsible for the management and administration of resources and personnel involved in giving patient care.• He/she is willing and desirous to impart managerial skills to his/her subordinates
-• 6. Researcher – A researcher to the core.• Who always identifies major problems affecting nurses, nursing practices and services in the unit he works and the hospital.• who conducts research, documents and publishes them.• A nurse willing and ever ready to assist student and colleagues to conduct research
Conclusion• To be very effective and efficient as a nurse in a tertiary hospital like ATBUTH you should have requisite qualification and advanced knowledge. The need for in service and continuous education is a must and a yardstick for promotion, placement, and professionalism.• The hospital as a teaching hospital should in all its activities put teaching as the ultimate in order to keep to its laudable objectives
-• In this teaching hospital, Nurses shall be driven by the desire• to teach and train nurses• To conduct research and implement research findings• To render scientific and technological nursing care• To uplift the profession and• To exhibit profound professionalism in all their practice and services.
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