The role of the nurse on the health care team

The patient is the centre of the nurse's concern
Nurses care for the sick and injured in hospitals, where they work to restore health and alleviate suffering. Many people are sent home from the hospital when they still need nursing care, so nurses often provide care in the home that is very similar to the care they give to patients in the hospital. In clinics and health centres in communities which have few doctors, nurses diagnose and treat common illnesses, prescribe and dispense medications and even perform minor surgery. Nurses are also increasingly working to promote people’s health and to prevent illness in all communities.

There are many roles in nursing. The nurse cares for the patient, carries out procedures ordered by the doctor and, in collaboration with the doctor and other team members, assesses the patient and treats his or her problems. The nurse coordinates the work of others involved in caring for the patient, including the patient's family, who may do a lot of the caring for the patient. The nurse also protects the patient, working to prevent infection and ensure a safe, healthy environment in the hospital. Finally, the nurse teaches the patient and family about health-related matters and promotes patients’ well-being in all situations, speaking for them (advocating), if necessary. The hospital nurse plays many roles on the health care team.

Care for the patient
Nurses care for patients continuously, 24 hours a day. They help patients to do what they would do for themselves if they could. Nurses take care of their patients, making sure that they can breathe properly, seeing that they get enough fluids and enough nourishment, helping them rest and sleep, making sure that they are comfortable, taking care of their need to eliminate wastes from the body, and helping them to avoid the harmful consequences of being immobile, like stiff joints and pressure sores.
The nurse often makes independent decisions about the care the patient needs based on what the nurse knows about that person and the problems that may occur. For example, the nurse may decide that, in order to prevent pressure sores, the patient needs to be turned every two hours. However, the nurse may consult the doctor about this if it is possible that turning the patient might cause some other problem. Thus the nurse uses understanding of medical conditions, as well as knowledge of nursing, in deciding on patient care.
The nurse not only takes care of the patient but also gives comfort and support to the patient and his or her family. When the patient cannot recover, the nurse helps to make sure that the death is peaceful. In caring for the patient, the nurse cares about the patient.
Caring is the very heart of nursing.

Work with the doctor to cure the patient
When a person becomes ill or is injured, generally the doctor assesses the patient, diagnoses the patient's problem and decides on the treatment needed to cure the problem or relieve the patient's symptoms. In the past only the doctor assessed and diagnosed. Today, however, nurses play a large role in evaluating patients and detecting problems. In some rural areas, nurses admit patients to hospital and manage their care, referring only the most critical patients to distant medical centres.
In every hospital nurses carry out many of the treatments prescribed for the patient. For example, the doctor may prescribe surgery or bed rest or a certain therapy. The doctor will perform some of these treatments, such as surgery. It is the nurse who gives most of the treatments. If a patient needs intravenous therapy, usually the nurse sets up the intravenous line and gives the patient the fluids and drugs prescribed. If the patient needs an injection, it is the nurse who gives it. The nurse changes the patient's dressings and monitors the healing of the wound. The nurse gives medication for pain. Many physicians order medication for pain "to be given as needed". They let the nurse decide when to give the medication.
The nurse also monitors the patient's progress to make sure that the recovery has no complications. Because nurses have more frequent contact with patients than other staff, they often find problems before anyone else.

Coordinate the care of the patient
In taking care of patients, the nurse collaborates with other members of the health care team. The nurse works closely with the doctor, as well as with other nurses, physical therapists, and any other professionals involved in the patient's care. In many hospitals today the team members together plan the care of the patient. The nurse is the person who coordinates the work of all the team members and sees that the plan is carried out. For example, the nurse makes sure that the patient's appointments for laboratory investigations are made and kept, sees that treatments are given, and checks to be sure that any needed referrals are made before the patient is discharged.
The nurse also plans and supervises the care given by nursing assistants, checks on the work of housekeeping staff assigned to clean the patient's room, and ensures that the patient gets enough healthy food. The family learns how to give basic care from the nurse, who also helps them where necessary. This includes learning how to use traditional ways of healing with modern health care. The nurse supports the family in giving basic care to their sick loved one. It is the nurse who has the final responsibility for the quality of the care the patient receives during the hospital stay.
In coordinating the work of others, the nurse always keeps the patient at the centre of concern.

Protect the patient
When a person is ill and weak, he or she is more vulnerable to infection and injury. One of the major responsibilities of the nurse is to protect the patient by ensuring that the environment is safe and healthy. In particular, the nurse takes every precaution to prevent the spread of infection from one patient to another. The nurse sees that the patient's room is clean, the patient is clean, water has been boiled or is safe, needles and other materials used for procedures are sterile, soiled materials are kept away from the patient, and needles and other sharp objects are placed in safety containers after use. The nurse washes hands carefully before and after patient care and between patients. The nurse protects the patient’s dignity and tries to save the patient from embarrassment or shame. When the patient’s clothing must be removed, the nurse tries to ensure the patient’s privacy.
The nurse also makes sure that the patient is physically safe, cannot fall out of bed, or fall when trying to walk, or slip on a wet floor. The nurse tries to protect the patient against anything that might be harmful in the environment.

Teach the patient and family
Teaching is a major role of the nurse in restoring health, promoting health and preventing illness. When a person is ill, the nurse demonstrates things the patient can do to help with recovery. For example, nurses teach patients to cough and breathe deeply after surgery to prevent lung complications. They show patients how to walk on crutches. They teach people with diabetes to monitor their blood sugar.
Whenever the nurse works with a patient, the nurse uses the opportunity to teach that person about self-care. Nurses teach both patients and their families about proper diet and nutrition, cleanliness and hygiene, exercise, sleep and rest and all the other aspects of a healthy life. Before the patient leaves the hospital, the nurse teaches the patient and family about care at home. For example, nurses teach family members how to bathe the person or wash his or her hair in bed, and how to feed the person or change dressings. Nurses teach people how to minimize the effects of disability so that they will have the best quality of life.

Advocate for the patient
Nurses are with people during the most critical times of their lives. Nurses are with people when they are born, when they are injured or ill, when they die. People share the most intimate details of their lives with nurses; they undress for nurses, and trust them to perform painful procedures. Nurses are at the bedside of the sick and suffering 24 hours a day. They are there when patients cannot sleep because of pain or fear or loneliness. They are there to feed patients, bathe them, and to support them. Nurses have a long history of caring for the patient and speaking for his or her needs. That is what advocacy is about: supporting the patient, speaking on that person’s behalf, and interceding when necessary. This advocacy is a part of the nurse's caring and a part of the closeness and trust between nurse and patient that gives nursing a very special place in health care.