UNIT I

Extended Role of Nurse

PREPARED BY:
Sapana Dahal
M.Sc. Nursing 1st Year
Community Health Nursing
 CONTENTS
Introduction
Need of extended role of nurses
Extended role of nurses in various settings
 OBJECTIVES
At the end of the session participants will
be able to :
Explain the extended role of nurses
 Introduction
Nurses play vital role at the forefront of
health care battles and their contribution
have always made significant differences
in improving health care quality.

 Role of nurses has been extended and

expanded with the changing trends.
 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.
 Extended Role of Nurse
Extended role is a procedure that is not
covered in basic training and for which
further training is required.(Rowden,1987)

Extended role includes services to people

and community.
 Extended Role of Nurse(Conti..)
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.
(Birch H,2001)
 Importance

•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.
 Why is extended role felt??

To meet the changing health care needs of the

people, extended role of nurse is very essential.
 Extended Roles
1. School Health Nurse
2. Public Health Nurse
3. Occupational Health Nurse
4. Home Care Nurse
5. Nurse Researcher
6. Nurse Epidemiologist
7. Palliative /Hospice Care Nurse
 Extended Roles(Conti..)
8. Nurse Anesthesist
9. Rehabilitation Nursing
10. Tele Nurse
11. Military Nurse
 Extended Roles(Conti..)
1.School Health Nurse
 1.School Health Nurse (Conti..)

It is a specialized practice of nursing which

protects and promotes student health,facilitates
optimal development and advances academic
success.(National Association of School Nurses)
 1.School Health Nurse (Conti..)
A gap analysis was used to examine the scope of
school nursing practice in the United StatesAn
investigator-developed 39-item self-assessment
survey of scope of school nursing practice was
modified from an existing validated tool,
organized around the five principles of the
National Association of School Nurses’
Framework: Standards of Practice, Quality
Improvement, Care Coordination,
Community/Public Health, and Leadership and
also explored barriers to practice.
 1.School Health Nurse (Conti..)

The survey was completed by 3,108 practicing school

nurses. Gaps were identified for all principles and were
greatest for Quality Improvement and Community/Public
Health practice. All practice items were rated more
important than the ability to practice that item (p < .001).
Self-identified barriers including workload,
school/district expectations, and state regulations
accounted for significant variances in practice across four
of five principles (p < .05, p < .001). Recommendations
include support for population-focused evidence–based
school nursing practice.( Davis D et al, 2019)
 1.School Health Nurse(Conti..)
 The MoHP brought a provision for “One Health
Worker per School Policy" in 2017,and started
its implementation at private schools of Nepal.
 The province 3 government has launched “One
School,One Nurse”programme in all 13 districts
of the province for the first time.
 In the first phase, the Social Development
Ministry has appointed 19 nurses in 19
government schools.
 1.School Health Nurse(Conti..)
This programme has been launched with
the objective of providing emergency
medical services to the students and
counsel female students on reproductive
health and sex education.
2.Public Health Nurse
 2.Public Health Nurse(Conti..)
American Public Health Association
defines public health nursing as “the
practice of promoting and protecting the
health of populations using knowledge
from nursing, social and public health
sciences.
 2.Public Health Nurse(Conti..)
They focus on public health, health
promotion,disease and injury prevention,
health protection,health surveillance,
population health assessment and
emergency preparedness and response.
 3.Occupational Health Nurse
Occupational health is the subfield of
environmental health which deals with
workplace safety and health.
Occupational health nurse deliver program
and services that develop and maintain
healthy and safe workplace environment.
3.Occupational Health Nurse(Conti..)
GON has enforced the concept of
Occupational safety through Labor Act
1992.
There is a provision of appointing nursing
and medical staff when the employed
workers are 500 or more in number.
It is the new concept even to the oldest
industries of Nepal.
4. Home Care Nurse
 4.Home Care Nurse(Conti..)
It is a speciality in which nurses provide
multidimensional home care to patients of
all ages typically in the form of follow-up
treatment post discharge from hospital.
 5. Nurse Researcher
They are the highly trained nurses who study
various aspects of health, illness and health
care and conduct scientific research into
various aspects of health.

They work in hospitals, research

organizations, universities and government
agencies.
 6. Nurse Epidemiologist
Also called as Infection Control Nurse.
The nurse monitors standards and
procedures for the control and prevention
of infectious diseases and other conditions
of public health significance including
nosocomial infections.
 7.Hospice Care Nurse
Hospice nurses promote quality of life for
patients and families facing serious illness
by combining science and art of
professional nursing care.(Hospice and
Palliative Nurses Association,2011)
8.Nurse Anesthesist
 9.Rehabilitation Nurse
• Is a person who specialises in helping people
with disabilities and chronic illness to attain
optimal function, health and adapt to an
altered lifestyle.
• They assist patients in their move towards
independence by settling realistic goals and
treatment plans.
10. Tele Nurse
 10. Tele Nurse(Conti…)
It refers to the use of information
technology in the provision of nursing
services whenever physical distance exists
between patients and nurses.
 11.Military Nurse
• It is also called as army nurse or armed service
nurse.
• It provides care to military personnel.
• Many nurses are attracted towards military
nurses nowadays due to attractive salaries ,
security benefits, personal development,
continuing education, promotions etc.
Summary
 References
1.Dhimal M, Chalise B, Jahan I,et al.,
School Based Health Workers in
Nepal:Supporting Evidence Based Decision
Making. Kathmandu, Nepal Health
Research Council and GiZ; 2018
2.Birch H. The extended role of the nurse
—Opportunity or threat?. Human fertility.
2001 Jan 1;4(3):138-44.
 References (Conti..)
3.Bodenheimer T, Bauer L. Rethinking the
primary care workforce—an expanded role for
nurses. N Engl J Med. 2016 Sep
15;375(11):1015-7.
4.Davis D, Maughan ED, White KA, Slota M.
School Nursing for the 21st Century:
Assessing Scope of Practice in the Current
Workforce. J Sch Nurs. 2021 Oct;37(5):374-
386.doi:10.1177/1059840519880605.Epub
2019 Oct 13. PMID: 31607213.
 References (Conti..)
5.Stanhope M, Lancaster J. Public health
nursing e-book: Population-centered health
care in the community. Elsevier Health
Sciences; 2019 Aug 18.