EXTENDED ROLE OF NURSE

Introduction

Nursing is the largest of all health care professionals.Nurses play vital role at the
forefront of health care battles and their contribution have always made significant
differences in improving health care quality.Traditional role of nurse was focused
on curative aspect.The role of the nurses have always been extended and expanded
with the changing trends.Innovation in health care,expanding health care systems
and practice settings and increasing needs of patient have been stimulus for role
change.

Dictionary meaning of role

It is the sum total of expected behaviors and the behaviors expected from a person
who occupies a particular position and status in a social pattern.

Importance of extended role

 It provides variety of services for the patients of all age group either in
hospital or community.
 It enhances clinical decision skills.
 It expertises knowledge and high level satisfaction of the people.

Needs of Extended nurse’s role

The health care client is the patient,who may seek health care facilities at home, at
place of work or in any type of health care agencies. Expansion of scientific
knowledge and application of this knowledge to diagnosis and treatment has lead
to much advancement. Patients can lead to productive life with artificial
parameters , organ transplants and radiotherapy.Therefore, there is the need to
expand the nurse role to face a new challenges in providing comprehensive care to
patients.Thus, to meet the changing health care needs of the people, extended role
of nurse is very essential.
Extended role of Nurse

The concept of extended role means to reach out. The role of nurse in extended
care facility is one that a nurse assumes by virtue of education,type of institution
where she is employed. Nurses are performing various roles in various settings
such as hospitals and community. Extended role includes services to people and
community. Extended role is a procedure that is not covered in basic training and
for which further training is required.(Rowden,1987)

A literature review has been carried out on the effect of co-managing the pre and
post operative care of patients undergoing cataract surgery that included
assessment of the extended role of the nurse.Possible rationales behind the moves
to encourage nurses to extend the scope of their practice are suggested which
include cost-effectiveness,improved patient care,freezing medical time and
professional status enhancement.( Rose KE, Waterman HA, Tullo AB,1997)

An article was published on ‘The extended role of the nurse — Opportunity or

threat?’ which concluded that nurses from various fields have expanded their roles
to meet the changing needs of patients and the profession. Published evidence
shows that nurses can be as effective as doctors within these expanded roles, but
that there is a danger that gender issues will cloud the debate because of the
assumption that all nurses are female and all doctors are male. This problem is
especially evident when female nurses perform an extended role involving male
patients, although female doctors are in a similar position and work with the same
patients without undue comment. The roles of doctors and nurses should
complement each other, and all practitioners should work for the benefit of patients
in their care, rather than defending traditional roles and hierarchy. There is
confusion surrounding accountability of nurses who work in an extended role
between the medical and the nursing profession, and both the Royal College of
Nursing and the British Medical Association need to clarify the situation. This
article looks at the arguments for and against the extended role of the nurse
specialist and discusses current opinions within the nursing and medical fields. The
article also describes how nurses at Midland Fertility Services have successfully
extended their role to encompass ultrasound-guided oocyte retrieval and surgical
sperm recovery.( Birch H,2001)

Nurse can perform their extended role in the hospital and the community settings.

Extended role of nurse

In Hospital

1.General category

 General Wards
 Medical-surgical wards
 OPD’s and day care

2. Speciality Clinical Nurses

 Intensive Care Unit(ICU)
 Medical
 Surgical
 Neurological
 PICU
 NICU
 Ortho HDU
 Onco ICU
 CTVS ICU
 Critical Care Areas other than ICU
 Emergency and triage
 Cath Lab
 Dialysis
 Endoscopy
 Operating Room

 Specialised Streams
 Infection control measures
 Diabetes Educator
  Pain management nurse

In Community
 Home care nurse
 School health nurse
 Occupational nurse
 Rehabilitation nurse
 Nurse practitioner
 Nurse manager
 Palliative/hospice care nurse
 Nursing researcher
 Geriatric Nurse