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Apologies -- must have sent the wrong file.)

The role of nurses in improvement of health care delivery in medical - surgical units

An increasing number of nurses are working in medical - surgical units and being involved in the care of medical - surgical patients. A National Sample Survey of Registered Nurses in 2000 found that "More than 32% of nurses working in hospitals primarily care for medical/surgical patients ... this translates to more than 230,000 full-time and part-time med/surg nurses nationwide. (Hauser, H.S. 2003)

The perception of the roles of medical-surgical nurses has recently been undergoing a significant change and development. There is still in many quarters a general perception that the medical-surgical nurses see themselves as "non-specialty nurses who spend much of their time putting out fires and gathering equipment." (Grindel, Cecilia. 2004) However, experts state that this view undervalues the function and role of these nurses in promoting health care in the medical -- surgical unit. ( ibid) In a study of the contemporary role of the medical-surgical nurse titled The leadership role of medical-surgical nurses: what is it?, Cecilia Grindel, states that there is a great need for medical-surgical nurses to in fact play a leadership role in medical units. This assessment is based on the degree of expert knowledge and critical thinking skills that these nurses can bring to the health-care situation. (ibid)

The general role and function of the medical - surgical nurse includes the following aspects.

A helping role in the unit.

A teaching and coaching function.

Diagnostic and patient monitoring function.

Administering/monitoring therapeutic interventions.

Managing rapidly changing situations.

Monitoring/Ensuring quality of health care practices.

Organizational and work-role competencies.

(Ashby, Denise A. 1997)

This general list can be extended to present a more comprehensive view of the extensive functions and roles of these nurses in terms of the improvement of health care development. The medical - surgical nurse's role in clinical practice includes aspects such as performing admission histories and physical assessments; ordering lab/diagnostic tests and following up on results; the development of patient care treatment plans: procedural/diagnostic tests; the implementation of clinical protocols in collaboration with physicians; and the arrangement of follow-up home care as needed. (Roberts, Dottie. 2003) The medical - surgical nurse also has an educative role in the Identification of system and quality issues affecting patient care as well as participation in quality improvement initiatives and counseling for patients and staff.

Furthermore, these nurses also act as a resource to the community in relation to health promotion and health - care delivery. The medical-surgical nurse also participates in interdisciplinary rounds and makes referrals as needed in providing continuity of care. ( ibid) In terms of research the nurses are expected to participate in clinical research projects and present scholarly papers/posters at professional conferences. ( ibid)

However, the role of these nurses goes beyond the technical and administrative functions in the unit. " Although ... nurses manage highly technical and complex care situations, it is often the nurse's kind word, gentle touch, calming smile, or silent presence that make a real difference to our patients." (Medical Surgical Unit) Another important aspect that underlines the importance of the role of the medical-surgical nurse is that fact that they are no longer seen merely as the handmaidens of physicians, but as a profession distinct from medicine. "Physicians focus on disease - the manifestation of aberration at the cellular, tissue, or organ level - while nurses focus on illness - the human experience of loss or dysfunction."(Buresh, 1993 p.23)

The roles and functions of medical -- surgical nurses is, as have been mentioned, continually being redefined and developed. This development includes aspects such as error detection and reduction in the units. An example of this error reduction and the way in which nurses can help in this regard is the early recognition of patient problems which can result in positive patient outcomes.

A particularly important role of nurses in acute care settings is identifying subtle changes signaling deterioration in the patient's condition. Nurses, who recognize ominous events early and take corrective action either independently or in consultation with physicians, can prevent further decline in a patient's status and increase the likelihood of a positive health outcome

(Grindel, Cecilia. 2004)

Another area of concern is the calculation of medicine. The medication calculation skills of the…[continue]

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