Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Chapter 26 Contemporary Nursing Roles and Career Opportunities

2 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Professional Nursing Roles   Care provider   Assessing clients, planning therapeutic interventions, coordinating and evaluating care   Caring: central to nursing interventions   Educator and counselor   Teaching health promotion and health maintenance   Increasingly important in the changing health care environment

3 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Professional Nursing Roles (Cont’d)   Advocate   Promoting what is best for the client   Protecting the client’s rights   Change agent   Identifying client and health care delivery problems   Assessing motivation and capacity for change   Determining and exploring alternatives and assessing cost-effective resources   Leading the change process

4 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Professional Nursing Roles (Cont’d)   Leader and manager   Improving the health status and potential of individuals, families, and communities   Enhancing effectiveness and level of satisfaction among colleagues   Managing multiple resources in a health care facility   Raising citizens’ and legislators’ attitudes toward and expectations of the nursing profession and the health care system

5 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Professional Nursing Roles (Cont’d)   Researcher   Leading nursing research: nurses prepared at the doctoral and postdoctoral levels   Participating in research: nurses prepared at the master’s, baccalaureate, and associate’s degree levels

6 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Professional Nursing Roles (Cont’d)   Coordinator of the interprofessional team   Coordinating practice relationships among several health care disciplines to bond, interact, and unite toward common goals of patient care   Using successful health care team models with concepts related to interdisciplinary health care such as pain management, nutritional support, skin care, rehabilitation, mental health, hospice, discharge planning, and patient education

7 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Team Members Nurse (RN) Chaplain or pastoral representative Dietitian (RD or LD) Occupational therapist (OT) Pharmacist (RPh or PharmD) Physical therapist (PT) Physician (MD or DO) Physician assistant (PA) Respiratory therapist (RT) Social worker Speech/language pathologist (SLP)

8 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   RN demographics (Division of Nursing, Bureau of Health Professions, National Sample Survey, 2004)   Approximately 3 million RNs in the United States   Approximately 60% of RNs employed full time   Average age: 46.8 years Nurses Today: Who Are They and What Are They Doing?

9 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Nurses Today: Who Are They and What Are They Doing? (Cont’d)   Number of male RNs increased from 5.4% in 1996 to 5.7% in 2004   Approximately 81.8% of RNs are white/non-Hispanic   In 2004, nurses reported their highest degree as: 17% diploma 33.7% associate’s degree 34.2% baccalaureate degree 13% master’s or doctoral degree

10 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Hospital Opportunities   Infection control: assess incidence of infection and conduct comprehensive review to ensure prompt and accurate treatment, so that it is not passed to other patients; determine source and onset of infection   Quality management: assess compliance of the institution with established standards; ensure that patient services are consistent with standards through chart review and ongoing interaction with staff

11 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Variations on Traditional Roles in Nursing   Hospice nurse   Informatics nurse specialist (NI)   Occupational health nurse   Quality manager   Case manager   Flight nurse   Telephone triage nurse   Forensic nurse   School nurse   Travel nurse   Parish nurse   Nurse educator

12 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Home care: as patients shift from hospital to ambulatory care and home care, the role of the community health nurse has evolved beyond the traditional public health nurse concept   Dobutamine administration   Chemotherapy   Radiography or telemetry   Uterine monitoring Nontraditional Roles in Nursing

13 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Nurse Educator   Minimum of master’s degree in the specialty area in which they teach   Must be competent in clinical practice at advanced generalist or specialist level   Expectations of the role include teaching, scholarship, and service to the community

14 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Clinical Nurse Leader (CNL)   New role   Prepared as a master’s generalist   Oversees the care of a distinct group of patients in any setting   Actively provides direct patient care in complex situations   Evaluates patient outcomes   Puts evidence-based practice into action

15 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Advanced Practice Nursing   Nurse practitioner   Assesses and manages nursing and medical problems; emphasis on disease prevention and health promotion; job responsibilities include taking patient histories, conducting physical examinations, and ordering, performing, and interpreting diagnostic tests; prescribing pharmacologic agents, treatments, and therapies for the management of patient conditions

16 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Advanced Practice Nursing (Cont’d)   Clinical nurse specialist   Possesses clinical expertise in a defined area of nursing practice for a selected patient population or clinical setting; functions as an expert clinician, educator, consultant, researcher, and administrator

17 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Advanced Practice Nursing (Cont’d)   Certified registered nurse anesthetist   Provides anesthesia and anesthesia-related care on request, assignment, or referral by a patient’s physician, most often to facilitate diagnostic, therapeutic, or surgical procedures

18 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Advanced Practice Nursing (Cont’d)   Certified nurse-midwife   Manages women’s health care, focusing particularly on pregnancy, childbirth, postpartum care, care of the newborn, and the family planning and gynecologic needs of women

19 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Nurse Administrator/Executive   Unites the leadership perspective of professional nursing with various aspects of business and health administration; focuses on administration of health care systems for purpose of delivering services to groups of patients

20 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Doctor of Nursing Practice (DNP)   Expert in advanced nursing practice who has an earned clinically focused doctorate in nursing   In 2004, the American Association of Critical- Care Nurses (AACN) published a DNP position statement calling for transformational change in nursing education, recommending nurses practicing at the highest level should receive doctoral degrees

21 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. What About the Future?   Diversity   Challenge   Unparalleled opportunities for new roles