Not too long ago, the public’s perception of a nurse was someone who cared for you when you were hospitalized, offered comfort at a time when you most needed it and carried out requests that doctors had made. Doctors were responsible for making clinical decisions, and a nurse was seen as a “handmaiden” who carried out the doctors' requests. Wards were run with military precision. Patients were washed, dressed and beds made (with perfect hospital corners!) by a set time each day. The nursing staff were in fear of the matron who made her rounds to ensure that all was done according to protocol and that you were perfectly turned out in your starched nursing uniform and cap.
How things have changed! Nurse training has evolved, and nurses are taking on extended roles including further study to become Nurse Practitioners or advanced courses in particular specialities. In the US today, according to the American Academy of Nurse Practitioners (AANP) there are 115,000 Nurse Practitioners, and the majority work in primary care.
The Nurse Practitioner's role today includes taking clinical histories, performing physical examinations, ordering tests and interpreting results to rule in or rule out diseases, liaising with members of the multidisciplinary team about the patient and what course of action or treatment should be taken in the patient’s clinical care. These responsibilities are in addition to the core values of nursing which have underpinned the profession for many years:
Nurses are at the frontline with patients and their families 24 hours a day, seven days a week. They are responsible for a specific group of patients and plan their care, detect changes in their conditions and then act on these changes to ensure the appropriate intervention is actioned.
You can walk into a ward or clinic today and see many health professionals taking blood work, prescribing and administering medication, carrying out physical examinations, presenting on ward rounds, breaking bad news to a patient or their family, carrying out procedures involving cannulation, central venous catheters, chest drains and administering emergency medication. These could equally be interventions being carried out by a Doctor or a Nurse.
Happy National Nurses week. Be proud and enjoy how your profession has evolved and continues to evolve. In any one working day remember you are an advocate, colleague, team member, life saver, clinical expert, counsellor, researcher, carer, leader and a friend.
~Mandy Tomlinson, RN, Isabel Quality Assurance Director
See how other nurses have used Isabel. View the Video now: Nurse Practioners Rely on Isabel