Duties of Registered Nurses

The duties of a registered nurse have evolved from the early days of simple bathing, bed changes, floor mopping and hauling of slop buckets, to prescribing drugs and simple operating procedures. The nurse of today is the first line of defense that a patient has against unsafe medical practices and poor health choices.

Assessment

• The primary duty of every nurse is the assessment of a patient's physical, spiritual and emotional well-being. This basic skill learned in the very first nursing class is the one skill and duty the nurse will use every day with her patients. An assessment will quickly alert the nurse to the patient's current state of health--positive or negative. It is this assessment upon which she will base her care for the next few minutes to days. Typically in an in-patient setting a patient is assessed every few hours. Among the body systems a nurse will assess are: respiratory, circulatory, cardiovascular, integementary (skin) and digestive. A nurse will also assess a patient's spiritual and emotional well-being as part of her care.

Medications

• The secondary duty a nurse has is the administration of medications. Medications will typically be prescribed by a physician unless the nurse has an advanced role, such as a nurse practitioner and some clinical nurse specialists. These nurses are able to use their assessment skills to determine which medication a patient needs and may then write the prescription. For medications prescribed by a physician, a nurse must rely on her assessment as to whether or not the medication is proper, at that time, for the patient to take. Many times a patient's condition is unstable and a medication may not be warranted until the patient's vital signs improve. During those times, the nurse may delay medication administration, or decide not to give the medication altogether. It is always best to call the physician and advise him of the change in the patient's status and to alert the physician that she will not be administering the medication.

Advocate

• One of the most important duties of a registered nurse is one of patient advocacy. The nurse must act on her patient's behalf with other members of the multi-disciplinary team caring for the patient. This may mean the nurse alerts the respiratory team when a patient is having breathing problems. This may also mean acting as the patient's advocate with the doctor if the patient or nurse feels the physician's treatment is unwarranted or dangerous to the patient. A registered nurse must have a strong backbone at times when dealing with physicians and other medical professionals as she takes the proactive lead in advocating for her patient.

Listener

• As technology advancements make the registered nurse's job easier, it is important for the registered nurse to remember that patient care is about nursing the patients and not machines. Frequently a machine may tell the nurse that the patient is stable, yet the patient is telling the nurse they are not. Machines can be wrong and frequently present one picture of the patient, while the patient is presenting another. Listening to what the patient is saying, both verbal and non-verbal, is a very important tool in patient care and one that is frequently forgotten when machines make nursing care more convenient.

Counselor

• A nurse counsels her patients at every meeting, whether an office visit or an in-patient admission to the hospital. Patients look to the registered nurse as an expert in healthcare. This essential duty of the registered nurse may lead her to a simple counseling session on smoking cessation to teaching a newly diagnosed diabetic on how to check their blood sugar. It is common for a nurse to sit down with a patient and go over all new medications, as well as check the old medications for interactions. A registered nurse's counseling duties also do not start and end with the patient. The registered nurse will frequently counsel a patient's family members in order to secure a stable and supportive environment for the patient. Also during times of extreme illness and upset in the family, a nurse will act as a counselor so that decisions for the patient can be made in a calm and informed manner.

Considerations

• For many years nursing has been touted as being both an art and a science. For a nurse to succeed in her career, she must perform all of the above duties as well as practice the art of nursing which is a more subtle tool learned over time. Part of the art is knowing something is wrong when everything appears to be right. The old "gut feeling" is an important part of the nurse's successful and safe practice with hwe patients. A nurse is constantly bombarded with information regarding the patient, but knowing what are the important considerations at the time, is where the '"art of nursing" thrives. The science part of nursing stems from lab values, known pathology of disease and vital signs. All of these values must be interpreted and decisions made for care from them, along with the nurse's sense of what the patient's needs are. When a nurse learns to combine the science of nursing with the art of nursing, it is then she will succeed in carrying out her duties as a registered nurse and be a strong advocate for her patients.