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NURSES & PRACTICE
Syed Amin TabishFRCP (London), FRCP (Edin), FACP, FAMS, MHA (AIIMS)Postdoctoral Fellowship, University of Bristol (UK)
Nursing Services Nursing profession is considered
a caring profession Nursing care is defined as the
care of the patient with regard to nursing needs
with the ever increasing dimension of medical sciences quantitatively and qualitatively nursing care is becoming more and more complex with its management services.
Total healthIncludes all of the following aspects: Physical Health Social health. A sense of responsibility for
the health and welfare of others. Mental health. A mind that grows,
reasons, and adjusts to life situations. Emotional health. Feelings and actions
that bring one satisfaction. Spiritual health. Inner peace and security
in one's spiritual faith.
Maslow’s Hierarchy of Needs
Nursing Service Nursing service is the part of the total
health organization which aims at satisfying the nursing needs of the patients/community.
The nurse works with the members of allied disciples such as dietetics, medical social service, pharmacy etc. in supplying a comprehensive program of patient care in the hospital.
Nursing Services WHO defines the nursing
services as the part of the total health organization which aims to satisfy major objective of the nursing services
to provide prevention of disease and promotion of health.
Health Service SystemUniversity/Regional Hospital
Provincial/General Hospital
Health Center, PCU, Com. Hospital
Village, CPHCSelf Care, Self Reliance
Tertiary
Secondary Care
Primary Care
Primary Health Care
OBJECTIVE OF NURSING IN WARD Maximum comfort and happiness by way of pleasant surroundings.
Qualitative/comprehensive care to the patient.
Care based on the patient’s needs. Accurate assessment of illness. Adequate material resources at all times. Health education to the patient and
attendants. Managerial skills as and when required. Privacy at all levels.
Entire nursing process ASSESSMENT- not only initial but integral
ongoing component of the whole nursing process.
PLANNIG AND IMPLEMENTATION- in this the nurse formulates and implements the care.
EVALUATION- decides whether the action taken has met the identified needs or not. This is the final step of care. Also, review of the whole care plan. Without this no quality care or comprehensive care is possible to provide.
PLANNING NURSING SERVICES
Number and type of patient Number of beds and type of ward The services required. Procedures/techniques necessary for
care. Number and type of personal needed to
perform care effectively. Physical facilities. Provisional of equipment and supplies.
Problems Lack of adequate training Problem of personnel
management Inadequate number of nursing
staff Lack of motivation Poor role model Non-nursing activities No research scope Professional risk/hazards
Scope of Nursing Practice Nurses provide care for 3 types of clients: • Individuals
• Families• Communities
Areas of Nursing Practice PROMOTING HEALTH & WELLNESS Wellness is a state of well-being. It means engaging in attitudes and behavior that
enhance the quality of life and maximizepersonal potential.
Health promotion is a behavior motivated by the desire to increase well-being and actualize
human health potential
Standards of Care Standards of practice are guidelines used to determine what a nurse should or should not do.
Standards may be defined as “ a benchmark of achievement which is based on a desired level of excellence”.
Standards of care (SOC’s) measure the degree of excellence in nursing care and describe a competent level of nursing care.
The standards of practice shall:
1. Be considered as the baseline for quality nursing care2. Be developed in relation to the law governing nursing practice3. Apply to the registered nurse practicing in any setting4. Govern the practice of the licensee at all levels of practice
Nursing standards are important 1. Outline what the profession expects
of its members2. Promote, guide, and direct professional nursing practice important for self-assessment and evaluation of practicing nurses3. Aid in developing a better understanding and response for the various and complementary roles that nurses have
Nurses & Practice The nurse carries personal
responsibility and accountability for nursing practice, and for maintaining competence by continual learning.
The nurse maintains a standard of personal health such that the ability to provide care is not compromised.
Nurses & Practice The nurse uses judgment regarding
individual competence when accepting and delegating responsibility.
The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence.
The nurse, in providing care, ensures that use of technology & scientific advances are compatible with the safety, dignity and rights of people.
Nurses & the Profession The nurse assumes the major role in determining and implementing acceptable standards of clinical nursing practice, management, research and education.
Levels of Care
Preventive Primary Secondary Tertiary Restorative Long-term
Health Care Providers
Physicians Nurses Physician
Assistants Specialized Care
Providers Technicians/
Therapists Other Providers
Health Care Settings Acute Care
Facilities Short-Term
Specialized Care Facilities
Long-Term Care Facilities
Ambulatory Care Sites
Rural Health Centers
Code of ConductProfessional conduct:standards for conduct,performance and ethics
In caring for patients, you must:
respect the patient or client as an individual
obtain consent before you give any treatment or care
protect confidential information
co-operate with others in the team
maintain your professional knowledge and competence
be trustworthy act to identify and minimise
risk to patients and clients. These are the shared values of
all the United Kingdom health care regulatory bodies.
Nursing in the New MillenniumWhat has
changed? who delivers health care
what is provided
when and where Patients are seen
Nursing and the Environment
Nursing interventions are directed toward preventing and minimizing the effects of environmental health problems on persons of all ages.
New Nursing Opportunities
Advanced Practice Nurses
Entrepreneurs
Data Management
Research
Nursing Skills Physical Assessment · Safety and Infection Control · Patient Care and Comfort · Basic Care · Medication Administration · Nutrition and Elimination · Oxygenation · Circulatory · Skin Integrity and Wound Care · Immobilization and Support · Special Procedures
DFS Approved Curriculum-Unit 10 27
DFS Approved Curriculum-Unit 10 28
Vital Signs Reflect the function of three
body processes that are essential for life. Regulation of body temperature
Heart function Breathing
DFS Approved Curriculum-Unit 10 29
Vital Signs Measurement (taken at rest)
Temperature - measures body heat
Pulse - measures heart rate Respiration - measures how often resident inhales and exhales
Blood Pressure - measures pressure against walls of arteries
Qualities that make a person successful desire, commitment,
responsibility, hard work, power of persistence, giving more than you get, pride of performance and be willing to be a student.
Goal of Nursing Nursing has long been described
as an art and a science. As nursing evolved as a
profession, nursing leaders attempted to define nursing. Florence Nightingale wrote that the goal of nursing was “ to put the patient in the best condition for nature to act upon him”.
Conclusion Nurses represent the major personnel
expense in any hospital and are the most directly responsible for using supplies for patients.
Nurses are in a position to maintain quality in cost effective care. For effective patient care and greater satisfaction of patients, we should be sensitive and responsive to the needs of patients.
We must respect the patient rights.
Core Values of NursingWe must preserve core values of nursing – compassion, care, courtesy, and empathy.
Core ValuesWe must also uphold basic virtues - hard work, generosity, kindness, punctuality, tolerance, perseverance, honesty, truthfulness, modesty, and politeness.
DFS Approved Curriculum-Unit 10 35
