Nursing is one of the most rewarding and fulfilling career choices that one can make, where practical creativity is rooted in the higher education system that nurtures a spirit of enquiry, in an environment where achievements are acknowledged and rewarded.
Nurses focus on the needs of the individual rather than on illness or conditions. They help individuals and their families to live more comfortable lives by providing care, advice and counselling.
Modern nursing care is varied and diverse depending on the area of practice for each individual nurse. Generally, the nurse is assigned to an individual or group of patients and works as an autonomous professional within a multidisciplinary team which may include for example other nurses, doctors, physiotherapists, dieticians, medical social workers. Student nurses develop their clinical skills under the direction of clinical nursing staff who are supported by a Clinical Practice Coordinator to ensure that the learning outcomes for each student are identified and achieved.
Irrespective of the practice area the nurse continuously and systematically assesses, plans, implements and evaluates patient-centred care throughout the day. This involves using her knowledge-base for practice in nursing, the biological, psychological and social sciences. Decisions about nursing care are based on nursing research that is developing continuously from the practice of nursing and nurse researchers.
Assessment is carried out to identify problems and concerns by communicating with the patient and other members of the healthcare team, by observing the patient’s health status, by carrying out tests such as taking the patient’s temperature, respiratory rate and heart rate and measuring their blood glucose levels and so forth. Then the patient’s needs are then prioritised.
Planning is the process whereby the nurse, in consultation with the patient to gain their understanding and co-operation, decides the best ways of meeting their needs such as relieving pain, explaining tests and treatments, the aims of the proposed care.
Implementation involves the actual delivery of care to address the patient’s needs. This requires interpersonal and communication skills to help the patient achieve a speedy recovery. Evaluation of the care given is undertaken to determine the effectiveness of the care delivered and this is undertaken in cooperation with the patient and his relatives. It is a very personalised service.
The provision of essential care is a highly complex task relying on effective co-ordination of numerous essential services. At its most basic level it entails ensuring patients are fed, washed, toileted, wounds are cared for, pain is relieved, have sufficient sleep and rest in an environment encompassing cleanliness, heating, lighting, ventilation and so forth. Having the psychomotor skills to undertake these and more complex procedures is secondary to the ability to combine the psychological data with the particular responses of the individual patient. Nursing occurs 24 hours seven days a week, 365 days a year. Currently there are 39 hours in a nurse’s working week, which may involve day duty or night duty in most hospital units. Others are day units or five-day units.
Meeting the psychological and emotional needs is dependent on having strategies to help patients cope with a range of psychological and emotional states and feelings such as anxiety, stress, despair, anger and confusion. To achieve this, the nurse develops and fosters a partnership in the delivery of care through the ability to relate, understand, sympathise and empathise with each patient. She respects the patient’s wishes and accepts their choices. The time to build up such a relationship is the most important element of making it effective. The nurse has to weigh up this issue against the time available particularly in relation to the needs of other patients.
The role of the nurse in providing information and education is important in helping people understand their health status, ways of optomising their lives, decide on treatment options where appropriate and how best to manage their specific situations. The information giving and education role therefore empowers the patient to become self-reliant and self-determined in controlling of her own health.
Nursing is often considered the cornerstone that maintains the different aspects of the health service together. Linking with other healthcare workers is important in providing an agreed multidisciplinary approach to ensure the best possible care and avoid confusion for the patient. The nurse also communicates with the patient’s family and keeps them informed of the patient’s progress unless specifically requested not to do so by the patient. In preparation for discharge of a patient from hospital it is sometimes necessary to communicate with personnel such as the liaison public health nurse and medical social workers in the community to ensure continuity of care when the patient goes home.
The nurse maintains written records of the whole nursing process from assessment to evaluation. All the nurse’s observations, care given, the outcomes of care and patients’ responses are noted. These nursing records contribute towards the continuity of care and also are important from a legal perspective.
A nurse’s day can be both physically and mentally demanding but the realisation that her work creates a real difference to the lives of patients and their families are what make nursing a fulfilling and rewarding profession.