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Extended Expanded Role of Nurses
Extended Expanded Role of Nurses
Extended Expanded Role of Nurses
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Ms Asmat Parveen
Islamic University of Science and Technology
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Nurses in every role are impacted. They’re being asked to work in areas of the hospital that
aren’t their normal specialty. They’re providing tele-health consultations. They’re being re-
deployed to learn new skills and take new roles—as safety officers, and taking care of
critically ill patients. They’re making triage plans operational. We’ve had to reallocate our
resources in profound ways, and nurses are innovating and leading in the midst of the crisis.
That shift leaves nurses feeling like they’re abandoning their individual patients. They’re not
able to provide the level of care they’re used to. The gap between what they can do and what
they believe they should do creates moral distress, a sense that they’re compromising their
integrity. They’re very complex. Nurses always have obligations to the patient in front of
them, but the pandemic imposes so many limitations. It might be that nurses can offer
knowledge and skills to relieve patient’s symptoms, or provide options for palliative care or
spiritual support, or simply listen to fears and concerns. At the same time, nurses have to
consider how to benefit more people. This often means making room for sicker patients by
discharging patients who would under other circumstances be admitted. Moment-to-moment
decisions are required on how to use equipment, medications, and resources when there
aren’t enough for everyone. We always begin with patients as our first priority in our
professional ethical framework. That doesn’t mean we don’t have obligations to our own
well-being and families. Nurses are grappling with questions like, “Am I potentially causing
harm to my family by coming home from work every day?” and “How do I balance the needs
of my loved ones with the endless needs of patients?”The stakes are very high, and
unfortunately there are no good answers. Part of being able to find integrity here is accepting
the reality of our current situation and living with uncertainty—acknowledging we’re making
decisions under constrained and difficult circumstances.
2. Shortage of nursing staff: Nurses face tremendous work-related stress, burnout due to
workload, and long working hours due to the acute shortage of trained nursing staff. Long
working hours, overtime and work overload affects the physical and psychological wellbeing
of the nurses. While more than 90% of nurses have MSD (musculoskeletal disorder), 61%
also experienced neck pain sometimes. Most recurring pain area (51%) is leg ache, followed
by knee pain (51%). Similarly, 51% nurses complained of upper and lower back issues, 41%
reported to have taken leave(s) for 1-3 days whereas 7% nurses have taken leaves for 4-6
days in a span of two months to manage the pain, indicating an evident productivity loss to
the organization.
Also 88% of nurses work for 8-10 hours a day along with doing overtime at least twice or
thrice a month. Similarly, 74% of the nurses stand for more than 4-6 hours a day at a stretch,
causing stress on their lower limbs. While 20% of nurses reported performing double-shift
duty at least twice a month, 26% of nurses were requested to work on their off-days twice a
month whereas 10% of nurses were called on duty more than twice a month on their off-days.
4.Safety : Concerns regarding personal safety and security at workplace and in the
community as well as concerns regarding the safety of family members.
5. Meeting Patient Expectations: Patients have very high expectations but because of
budget and staffing cuts during COVID 19, nurses can’t always meet these expectations. This
puts immense strain on nurses who have lots of patients to look after. Hearing their patients
are unhappy with their level of service can affect morale and put nurses under a great amount
of negative stress.
6. Workplace Hazards: Nurses regularly work with needles, sharp tools and heavy
equipment which might be infected during this COVID 19. To help avoid infection and
accidents, all staff should be trained properly and always follow rules and regulations to
ensure they aren't injured, along with their colleagues. Any potential hazards should be dealt
with immediately. For example, wet floors can cause serious accidents. As nurses are busy,
it's easy to forget to check the floor for potential dangers but wearing appropriate footwear
can help reduce the chance of an accident happening. Healthcare shoes with effective slip-
resistant grip are excellent on slippery floors and help you stay on their feet.
Inadequacy in the care rendered may vary from ineffective medical care to non- availability
of doctors, and yet nurses are being blamed. Non-availability of equipments in hospital which
in turns affects the quality of care. Although the responsibility is not necessarily of nurses,
yet nurses are ultimately responsible for patient care environment in their wards.
Conclusion: Nurses have the same obligations to self as to others. Investment in one’s well-
being is not optional, it’s a moral mandate. It’s not only post-traumatic stress but this feeling
in some people that they’re acting against their own consciences in certain actions during the
crisis. The fallout of that is significant moral distress or moral injury, which accumulates over
time. And we can’t wait to take measures to manage that distress. We must begin now. We
want to provide recommendations from frontline nurses to inform our health care system’s
future responses to crises so we are never unprepared in the way we are with COVID-19.
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