Roles and Functions of a Professional Nurse

Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all setting. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. With these nurses work in a large variety of specialties where they work independently and as part of a team to assess, plan, implement and evaluate care.

These nursing practices have been influenced by the nursing leaders in the past. Among the few of them were Clara Barton, Lavinia Dock, Lillian Wald, Margaret Sanger, Florence Nightingale and Virginia Henderson. Florence Nightingale, often considered as the first theorist, earned her title as “The Lady of Lamp” and was the Founder of Nursing while Virginia Henderson is considered as the “First Modern Nurse”.

In this paper, we are going to discuss what is nursing, nurses’ roles and functions and the two visionary leaders and their contributions to nursing.

Nursing and its Definition.

According to Virginia Henderson, “the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge”.

She emphasized that nurses should be concerned on both healthy and ill individuals and interacts with clients even when recovery may not be feasible. She also mentioned that nurses may act as a client advocate and should provide education about the client’s health condition and nursing activities to be performed to improve client’s health condition.

The nurses’ goal is to assist the sick and healthy individual to gain independence as rapidly as possible in performing nursing activities. Moreover, nurses can either be a substitutive (work for the person) to the fully dependent patient, supplementary (helping the person) to the partially-able patient and complementary (working with the person) to the able patient.

Roles and Functions of a Professional Nurse.

Nurses are expected to perform a variety of roles in health care institutions whenever care is provided to the clients. They maybe carried out simultaneously depending on the need of the client in a particular situation and case.

1. Caregiver.  As a caregiver, nurses are expected to assist the client’s physical, psychological, developmental, cultural and spiritual needs. It involves a full care to a completely dependent client, partial care for the partially dependent client and supportive-educative care, in order to attain the highest possible level of health and wellness.
2. Communicator. Communication is very important in nursing roles. It is vital to establish nurse-client relationship. Nurses who communicate effectively get better information about the client’s problem either from the client itself or from his family. With better information nurses will be able to identify and implement better interventions and or nursing care that promotes fast recovery, health and wellness. 
3. Teacher. Being a teacher is an important role for a nurse. It is her duty to give health education to the clients, families and community. However, the nurse must be able to assess the knowledge level, learning needs and readiness of the clients, families and community to give appropriate and necessary health care education they need to restore and maintain their health. 
4. Client Advocate. A nurse may act as an advocator. An advocator is the one who expresses and defends the cause of another or acts as representative. Some people who are ill maybe too weak to do on his own and or even to know hi rights to health care. In this instance, the nurse may convey is client’s wish like change of physician, change of food, upgrade his room or even to refuse a particular type of treatment. 
5. Counselor.  A nurse may act as a Counselor. She provides emotional, intellectual and psychological support. She helps a client to recognize with stressful psychological or social problems, to develop and improved interpersonal relationship and to promote personal growth.
6. Change Agent.  As a change agent, oftentimes a nurse change or modify nursing care plan based on her assessment on the client’s health condition. This change and modification will only happen when the intervention/s does not help and improve a client’s health.
7. Leader.  Nurse often assumes the role of leader. Not all nurses have the ability and capacity to become a leader. As a leader it allows you to participate in and guide teams that assess the effectiveness of care, implement-based practices, and construct process improvement strategies. You may hold a variety of positions like shift team leader, ward in-charge, board of directors, etc.
8. Manager. As a Manager, a nurse has the authority, power, and responsibility for planning, organizing, coordinating and directing work of others. She is responsible for setting goals, make decisions, and solve problems that the organization may encounter. It is also her responsibility to supervise and evaluate the performance of
9. her subordinates. The manager always ensures that nursing care for individuals, families and communities are met.
10. Case Manager.  In some hospitals, a case manager is a primary nurse who provides direct care to the client or family e.g. case manager for diabetic client, she has the responsibility to give health education, measure the effectiveness of the nursing care plan and monitor the outcomes of intervention whether effective or not.
11. Research Consumer. Nurses often do research to improve nursing care, define and expand nursing knowledge.

Biography and Contribution of Florence Nightingale and Virginia Henderson in Nursing.

Florence Nightingale (1820 - 1910)

She was the younger daughter of William Edward Nightingale of Embley Park, Hampshire, and Lea Hurst, Derbyshire, was born at Florence on the 15th of May 1820, and named after that city, but her childhood was spent in England, chiefly in Derbyshire. 

Born to a comfortable family, Florence Nightingale was educated by governesses and then by her father, with her older sister, Panthenope. She was familiar with the Greek and Latin classical languages, and modern languages of French, German, and Italian. She also studied history, grammar, philosophy and mathematics.

By 1844, over parental objections, Florence Nightingale chose a different path than the social life and marriage expected of her by her parents -- she chose to work in nursing, which was then not quite a respectable profession for women. She went to Kaiserwerth, Prussia in 1847, where she received 3 months training in nursing. In 1853 she studied in Paris with Sisters of Charity, after which she return to England to assume the position of superintendent of London's Institution for the Care of Sick Gentlewomen.

She came to prominence during the Crimean War for her pioneering work in nursing, and was dubbed "The Lady with the Lamp" after her habit of making rounds at night to tend injured soldiers. Nightingale laid the foundation stone of professional nursing with the principles summarized in the book Notes on Nursing.  The Nightingale Pledge taken by new nurses was named in her honor, and the annual International Nurses Day is celebrated around the world on her birthday (wikipedia).

In later life Florence Nightingale suffered from poor health and in 1895 went blind. Soon afterwards, the loss of other faculties meant she had to receive full-time nursing. Although a complete invalid she lived another fifteen years before her death in London on 13th August, 1910 (John Simkin).

Her Contributions

Her improvements in improving the standards for the care of war casualties in the Crimean earned her the title “Lady with the Lamp”. Her efforts in reforming hospitals and producing and implementing public health policies also made her an accomplished political nurse: She was the first nurse to exert political pressure on government.

She is recognized as the first nursing’s scientist-theorist for her work on “Notes on Nursing: What It Is and What It Is

Not” and “Notes on Hopitals”. She published these books in 1859 with the support of wealthy friends and John Delane at The Times and was able to raise £59,000 to improve the quality of nursing.

In 1860, she founded the Nightingale School & Home for Nurses at St. Thomas's Hospital. The school served as a model for other training schools. Its graduates traveled to other countries to manage hospitals and institute nurse-training programs. 

She also became involved in the training of nurses for employment in the workhouses that had been established as a result of the 1834 Poor Law Amendment Act.

Virginia Henderson (1897 - 1996)

She was born in Kansas City, Missouri on Nov. 30, 1897, the fifth of eight children of Daniel B. and Lucy Minor (Abbot) Henderson. Her father was an attorney for Native American Indians. Her mother came from the state of Virginia to which Miss Henderson returned for her early schooling. She was educated at the U.S. Army School of Nursing (1921) and Teachers College, Columbia University where she completed her B.S. (1932) and M.A. (1934), then taught from 1934 until 1948.

Virginia Avenel Henderson died on March 19, 1996 at the age of 98. Her ending had the warmth, style, and graciousness of her life. After partaking chocolate cake and ice cream and saying goodbyes to her family and friends, she passed from one dimension to another. Miss Henderson, and she always preferred Miss to Ms., left behind a quantity of work that is the soul of modern nursing.

Her Contributions:

Virginia Henderson has been called the "first lady of nursing" and the "first truly international nurse." Her writing, presentations and her research and contacts with nurses have profoundly affected nursing and impacted the recipients of care by nurses throughout the world. Among them are as follows:

1. She began her career in public health nursing in the Henry Street Settlement and in the visiting nurse service in Washington, D.C.
2. She was the first full-time instructor in nursing in Virginia when she was at Norfolk Protestant Hospital in Norfolk and was active in the Graduate Nurses Association of Virginia. She designed a plan to create district organizations within the state. She was an early advocate for the inclusion of psychiatric nursing in the curriculum and served on a committee to develop such a course at Eastern State Hospital in Williamsburg, Virginia in 1929.
3. During her years at Teachers College, Columbia University, Henderson was an outstanding teacher and drew students from many countries to study with her. Nurses through the United States studied with her without ever leaving their home schools when her revision of Bertha Harmer's Textbook of the Principles and Practice of Nursing became widely use.
4. Other important publications grew out of Henderson's years at Yale University including Nursing Research a Survey and Assessment in collaboration with Leo Simonds. She also directed a twelve-year project entitled Nursing Studies Index, four volumes recognized as an essential reference for many years.
5. Her book, Nature of Nursing, published in 1966 expressed her belief about the essence of nursing and influenced the hearts and minds of those who read it. 
6. At the age of 75, Henderson directed her career to international teaching and speaking. This enabled another generation to reap the benefits of contact with this quintessential nurse of the twentieth century.
7. In 1953, she joined Yale School of Nursing, a particularly fitting association, since the first dean, Annie Warburton Goodrich, had served as her mentor in her early professional years. The Yale years were a time of great productivity.

Conclusion

Florence Nightingale and Virginia Henderson were among the visionary leaders in the past who have greatly influenced the nursing practice and contributed much to the improvement of nursing status worldwide. Though nursing have a lot of definition, yet it all boils down to caring of the clients as a holistic being. Nurses also assume variety of roles and functions such as caregiver, leader, change agents, teacher, manager, case manager, counselor, client advocate, and consumer research.

References

Berman, Audrey, Erb, Glenora Lea, Kozier, Barbara, and Snyder, Shirlee. 2008. Fundamentals of Nursing: Concepts, Process, and Practice. New Jersey: Pearson Education, Inc., 8th Edition, 460 – 483.

John Simkin. Spactus Educational. Retrieved from http://www.spartacus.schoolnet.co.uk

Florence Nightingale. In Wikipedia. Retrieved from http://en.wikipedia.org

Angela Barron McBride. Virginia Henderson. Retrieved from http://www.nursinglibrary.org

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