CARING

The most unique characteristics

of nursing as a profession is
that, it is a CARING profession
ROLES & FUNCTIONS
OF A PROFESSIONAL
NURSE
 CARE PROVIDER
The nurse supports the client by
attitudes & actions that show concern
for client welfare & acceptance of the
client as a person. The nurse is
primarily concerned with the client’s
needs
Communicator/Helper

The nurse communicates with

clients, support person and
colleagues to facilitate all
nursing actions
 Teacher
The nurse provides health
teaching to effect behavior
change which focuses on
acquiring new knowledge or
technical skills.
 Counselor
The nurse help the client to recognize
and cope with stressful psychological
or social problems, to develop
improved personal relationships and
to promote personal growth.
 Client Advocate
The nurse promotes what is best
for the client, ensures that the
client’s needs are met, and
protects the client’s right.
 Change Agent
The Nurse initiates changes and
assists the client make the
modification in the lifestyle to
promote health.
 Leader
The Nurse through the process
of interpersonal influence helps
the client make decisions in
establishing and achieving goals
to improve his well-being
 Manager
The nurse plans, give directions,
develop staff, monitors
operations, give rewards fairly,
and represents both staff
members and administration as
needed
 Researcher
The nurse participate in scientific
investigation and uses research
findings in practice.
 Case Manager
The nurse coordinates the
activities of other members of
the health care team, such as
nutritionist and physical
therapist, when managing a
group of client’s care
 Collaborator
The nurse works in a combined effort
with all those involved in care delivery
for a mutually acceptable plan to be
obtained that will achieve common
goals. The nurse initiates nursing
actions within the health team.
OVERVIEW OF THE
PROFESSIONAL
NURSING PRACTICE
Level of Proficiency according
to Patricia Benner

NOVICE
• A beginning nursing student or
any nurse entering a situation
which he or she has had no
previous experience.
Advance Beginner

• The Advanced beginner can

demonstrate marginally
acceptable performance.
 Competent
• Competence is reflected by the
nurse who has been on the same
job for 2-3 years and consciously
and deliberately plans nursing
care in terms of long-range goals.
 Proficient
• The proficient nurse
perceives situations as a whole
rather than in terms of aspects
and manages nursing care
rather than performing tasks.
 Expert
• The expert nurse no longer
relies on rules or guidelines
to connect understanding of a
situation to an appropriate
action.
TYPES OF NURSING
INTERVENTIONS
 DEPENDENT OR PHYSICIAN
INTIATED INTERVENTIONS
• Are based on the physician’s
response to a medical diagnosis.
The nurse intervenes by carrying
out physician’s written orders, but
requires nursing judgement or
decision making
 INDEPENDENT OR NURSE
INITIATED INTERVENTIONS
•Are autonomous actions based on
scientific rationale that is executed
to benefit the client in a predicted
way related to the nursing
diagnosis and client-centered
goals
 INTERDEPENDENT
INTERVENTIONS

•Are actions based on needs

of the patient. Collaboration
with the different members
health team
SCOPE OF NURSING

•Nurses provide care for

three types of clients:
individual, families, and
communities
PROMOTING HEALTH
AND WELLNESS
Wellness is a process that
engages in activities &
behaviors that enhance
quality of life and maximize
personal potential
PREVENTING ILLNESS

The goal of illness prevention

programs is to maintain optimal
health by preventing disease.
Nursing activities include
immunization, prenatal & infant
care, & prevention of STD
 RESTORING HEALTH
Restoring health focuses on the
ill client, and it extends from
early detection of disease
through helping the client
during the recovery period.
•Providing direct care to the ill
person, such as administering
medications, baths, & specific
procedures & treatments
•Performing diagnostic &
Assessment procedures, such as
measuring blood pressure &
examining feces for occult blood
•Consulting with other
healthcare professionals about
client problems
A Patient’s Bill of
Rights
1. The patient has the right to considerate
& respectful care

2. The patient has the right to obtain from

his doctor complete current information
about his diagnosis, treatment &
prognosis in terms the patient can be
reasonably expected to understand
3. The patient has the right to receive
from his doctor information necessary
to give informed consent prior to the
start of any procedure or treatment

4. The patient has the right to refuse

treatment to the extent permitted by
law and to informed of the medical
consequences of his action.
5. The patient has the right to every
consideration of his privacy
concerning his own medical care
program
6.The patient has the right to expect
that all communications and
records pertaining his care
should be treated as confidential
7. The patient has the right to expect
that within its capacity, hospital
must take reasonable response to
the request of a patient for services.
8. The patient has the right to obtain
information as to any relationship of
his hospital to other health care and
educational institutions in so far as
his care is concerned.
9. The patient has the right to be
advised if the hospital proposes
to engage in or perform human
experimentation affecting his
care or treatment
10. The patient has the right to
examine and receive an
explanation of his bill, regardless
of source of payment.
11. The patient has the right to know
what hospital rules and
regulation apply to his conduct as
a patient
 NURSING CODE OF
ETHICS
A CODE OF ETHICS is formal
statement of a group’s ideals &
values. It is a set of ethical principles
that (a) is shared by members of the
group (b) reflects their moral
judgements overtime, and (c) serves
as standards for their professional
 CONFIDENTIALITY

The principle of confidentiality

requires that information about
a client be kept private.
LEGAL ROLES OF NURSES
PROVIDER OF SERVICE – The
nurse is expected to provide
safe & competent care so that
harm (physical, psychologic or
material) to the recipient of the
service is prevented
 LIABILITY

Is the quality or state of being

legally responsible for one’s
obligations & actions & to make
financial restitution for wrongful
acts.
 STANDARDS OF CARE

It is by which the nurse acts or fails to

act are legally defined by nurse
practice acts & by the rule of
reasonable & prudent professional
with similar preparation& experience
would do in similar circumstances.
 ETHICO – MORAL
PRINCIPLES

Ethics – rules and principles that

guide conducts in terms of
rightness / wrongness of a
decision
 ETHICO – MORAL
PRINCIPLES

Morality – personally held

beliefs, opinions, attitude that
guide our action. Commitment
to informal belief
 ETHICO – MORAL
PRINCIPLES

Beneficence – do good
Requires one to act in ways the
benefit patients.
 ETHICO – MORAL
PRINCIPLES

Non maleficence – do no harm

Requires nurses to act in such a
way to avoid causing harm to
patients.
 ETHICO – MORAL
PRINCIPLES

Confidentiality – treat all informations

gathered during the course of caring
for the patient as confidential. Do not
tell about about pt’s condition to
those who are involved in the care.
 ETHICO – MORAL
PRINCIPLES

Invasion of privacy – protect the

physical privacy of the patient.
 CONSENT

A voluntary act by which a

person agrees to allow someone
else to do something. Should be
in writing.
 LAW

Sum total of rules and

regulations by which society is
governed. Regulate social
conduct in a formal and binding
way.
 TYPES OF LAW

Divine - Human
Public - Civil
 SOURCES OF LAW

1. Constitution – basic law that

defines and limits the power of
the government
 SOURCES OF LAW

2. Statutory law - laws enacted

by the legislative ( congress)
 SOURCES OF LAW

3. Administrative – regulatory
law. Made by people appointed
in the gov’tal administrative
agencies and enforcing the
statutory law.
 Liability of the nurse

NEGLIGENCE - failure of the

nurse to provide care that a
reasonable person would
ordinarily use in a similar
situation.
 Liability of the nurse

Malpractice – behavior of a
professional person, wrongful
act, improper discharge of
duties, failure to meet the
standard of care.
 Liability of the nurse

False imprisonment –
unjustifiable detention of a
person with out legal warrant.
 Liability of the nurse

Fraud – act resulting from a

willful act to deceive.
 Liability of the nurse

Defamation – injury of a
person’s refutation, character
assassination
 Liability of the nurse

2 types of defamation
1. Libel – malicious writing
2. Slander – oral statement,
made in the presence of a 3rd
person
 Incompetency

lack legal qualification or skill to

perform
Ethical responsibility of the
nurse

1. Initiate dialogue concerning

the client’s wishes. Do more
listening than talking.
Ethical responsibility of the
nurse

2. Assess the client’s

understanding of the illness and
available option.
Ethical responsibility of the
nurse

3. Facilitate communication of
the client’s desire to family and
other health care providers.
CONTRACTUAL RELATIONSHIPS

A. INDEPENDENT nurse
Practitioner –Contractual
relationship with the client is
independent
CONTRACTUAL RELATIONSHIPS

B. NURSE EMPLOYED by a Hospital –

Functions with employer-
employee relationship. The nurse
represents & acts for the hospital
& therefore must function within
the policies of the agency
CONTRACTUAL RELATIONSHIPS

B. NURSE EMPLOYED by a Hospital –

Functions with employer-
employee relationship. The nurse
represents & acts for the hospital
& therefore must function within
the policies of the agency
CONTRACTUAL RELATIONSHIPS

(“ Respondeat Superior”-Let the

master answer) – The nurse
may also be held liable as an
individual in case of
appropriate behavior.
 INAPPROPRIATE BEHAVIORS

• Hitting client in any part of the

body
• Assisting in criminal abortion
• Taking drugs from the client’s
supply for personal use
 CITIZEN

• The rights and responsibilities

of the nurse in the role of a
citizen are the same as those
individual under the legal
system
 RIGHTS

• Are the privileges or

fundamental powers to which
an individual is entitled unless
they are revoked by law or
given voluntary. E.g right to
physical safety
 NURSES AND CO-WORKERS

• The nurse sustains a co-

operative relationship with co-
workers in nursing and other
fields
NURSING
EDUCATION
 TYPES OF EDUCATIONAL
PROGRAMS
• Licensed Practical (Vocational)
Nursing Programs
Provided by community colleges,
vocational sachools, hospitals,
or other independent health
agencies.
 Registered Nursing Programs

Diploma, Associate degree &

baccalaureate
Baccalaureate Program- The 4
year diploma programs were
social and natural sciences are
included in the curriculum
Baccalaureate Degree Programs

4 years in length
Degree awarded “BSN”
 Graduate Nursing Education
Offer after BSN
Following Requirements:
a. Applicant must be a registered
nurse
b. Must hold a baccalaureate
degree in nursing
 Graduate Nursing Education

c. The applicant must give

evidence of scholastic ability
Master’s Program – The growth of
university encouraged the dev’t
of graduate study in nursing
*1953
Generally take 1.5 to 2 years to
complete
e. The applicant must have letters
of recommendation from
supervisors, nursing faculty, or
nursing colleagues indicating
the applicant’s ability to do
graduate study.
Doctoral Programs * Doctoral
program in nursing which
award the degrees of doctor of
philosophy (PhD), doctor of
nursing science (DNS or DNSc),
or nursing doctorate (ND)