INTRODUCTION:

Health is considered as fundamental right of individual. To provide the population with broad access to basic health services, nurses have to carry out wide range of functions especially in underserved areas like rural sector, remote regions and urban areas. The transition of health care systems from a disease oriented model to health oriented model is an emerging trend¹. Nursing is the largest of the health care professions and nurses are at the fore front of healthcare battles. Their contributions have always made significant difference for patients. Nurses have seen many changes in their roles. Innovations in health care, expanding health care systems and practice settings and the increasing needs of patients have been as stimulus for new nursing roles².

Dictionary meaning Role:

A role is “the sum total of expected behaviors and the behaviors expected from a person who occupies a particular position and status in a social pattern.”

Definition of Role:

It is defined as set of expected and actual behaviors associated with a position in a social structure is called as Role

VARIOUS ROLES

Traditional Role:

Nurses were concentrating in curative aspect maximum.

Expanded Role:

It is the one that nurse assumes by virtue of education and experiences.

Extended Role:

To reach out to the community and extend the services to the people.

Advantages of Expanded and Extended role of nurse:

1 It provides variety of services for patient of all age groups which may be part of hospital or community.

2 It enhances clinical decision skills.

3 It provides great challenges and opportunities for nurses.

4 It provides expert knowledge and high level of job satisfaction.

5 Published evidences shows that nurse can be as effective as doctors within her expanded role.

Needs for expanding and extending nurses role:

The new health care consumer is a client, who may seek health care at home, at place of work or in any type of health care agency. Expansion of scientific knowledge and application of this knowledge to diagnosis and treatment has led to much advancement. Clients can live a fairly productive life with artificial parameters, organ transplants and radiotherapy. There fore there is need to expand nurses role to face new challenges in providing comprehensive care to patients. Under traditional nursing system, practice area, highly talented nurses were removed from direct patient case by promoting them to administrative posts. Hence there were no experts to address the more complex issues in patient care. Advancement i.e. extended role within hospital and community will help nurses to become expert in patient care and achieving satisfaction. Thus to meet the changing health care needs of the people, extended and expanded role of nurse is very essential³.

Extended Role of a Nurse:

The concept of an extended role means to reach out. The role of a nurse in extended care facility is one that a nurse assumes by virtue of education, type of institution where she is employed and experienced. Nurses are assuming their roles in variety of settings. E.g. Hospital and community⁴

Expanded Role of Nurse in Community:

When long term care is required nurses need to do hard work in various settings

1 Community health nurse involves in care of individuals, families and groups which together constitute the total population.

2 The goal is to help individual to maintain optimal health through health education, prevention of disease, provision of nursing and rehabilitative services.

3 Community health nurse involves in care of individuals, families and groups which together constitute the total population.

EXPANDED ROLE OF NURSE IN COMMUNITY:

Family Nurse Practitioner:

Functions:

1 Assist the past and present physical and psychosocial health status of individual.

2 Provide health promotion, education, care including referral services for complicated cases and the management of certain conditions.

3 Provide family health counseling e.g. family planning, anti-natal care, child development and

interpersonal relationship.

4 Conduct and use research to extend nursing theory and to improve health practices among the community.

5 Manages the cases of upper respiratory tract infections, urinary tract infections, gastric upset, hypertension and crisis situation at home.

School Health Nurse:

School nurse practitioners are well trained under many settings like

1 To handle trauma,

2 Manage acute illness,

3 Do physical assessment,

4 Screen for health problems,

5 Immunization to the children.

6 Provide health education , counseling and participation in curriculum.

Occupational Nurse:

The occupational nurse has a very important role in industrial health programs

Functions:

1 Participate in pre employment, periodic and special examination of the employees

2 Rendering emergency care

3 Conduct classes for training first aid to the workers to assist in emergencies. The occupational nurse has a very important role in industrial health programs

4 Provide counseling and referral services

5 Maintenance of records.

6 Participate in health education programs and research

7 project for desired change

8 Conduct classes for training first aid to the workers to assist in emergencies.

Rehabilitation Nurse:

Rehabilitation is the process by which a person returns to maximal functioning after an illness, accident or other disabling events. Nurse as rehabilitator helps the patient in proper rehabilitation⁵.

Rehabilitation Nurse Functions:

1 Develop a therapeutic and supportive relationship with the patient and family.

2 Work with patient to gain his previous strengths and provide necessary training.

3 Make a plan program to restore disabled person to their greatest physical, psychological, social and economical potential.

Nurse Practitioner:

Functions:

1 Provide health care services to the neglected, remote or underserved areas.

2 Does diagnosis, provide treatment of minor ailments through standing orders

3 Provide a package of preventive, curative and rehabilitative services for promotion, maintenance and restoration of community health.

4 Perform certain laboratory tests e.g. HB estimation

5 Maintain appropriate records.

Nurses Role in National Health Programme at various levels:

1. Nurse Administrator at state level:

· Does high level planning, organizing, coordinating, budgeting and controlling of all activities of national health programs along with other members.

· Communicates National Health Program to all district health nurses

· Conduct training programs for district health nurses.

2. Nurse Manager at district level:

· Implement National Health Programme through supervisor at PHC level

· Arrange training programs for PHC staffs. Nurses Role in National Health Programme at various levels

3. Nurse Supervisor at PHC level:

· Delegation of work among health workers related to implementation of National Health Programme

· Supervision to multi-purpose health worker

· Conduct training programs for MPW community leaders like anganwadi teachers and local leaders

4. Health worker at grass root level:

· Conduct survey.

· Actual implementation of all National Health Programme s in community.

· Provide comprehensive care to community and maintain records.

Palliative / Hospice Care Nurse:

Palliative means an agent which relives but doesn’t care disease.A hospice is a system of family centered care designed to make the terminally ill patient comfortable and to ensure satisfactory lifestyle through the terminal phase of illness. It is provided for cancer patients including cardiac and renal patients⁶.

Functions:

Provide care and support to the patient and family during the terminal phase. Provide pain control and comfort measures.

CONCLUSION:

It is concluded that now a day’s nurses are playing widest role in the field of nursing to serve the general public especially under served and under privileged section of the society. Their contributions have always made significant difference for patients. Nurses have seen many changes in their roles. Innovations in health care, expanding health care systems and practice settings and the increasing needs of patients have been achieved.

REFERENCES:

1. A Publication of Holistic Nursing and Health Society, 9-13 and 25-27.

2. Fundamentals of Nursing Barbara Kozier, Glenora Erb, Andry Berman and Shrilee Snyder 7^th edition page number 92

3. G.N. Prabhakara (2007)Trends, Issues and Management in Nursing,1stedition,Delhi,JaypeePublishersandDistributors(P)Ltd,108-130.

4. Barbara A. Moyer and Ruth A.(2008)Nursing Education Foundations for PractiseExcellence,1st edition, New Delhi, Jaypee Brothers Medical Publishers(p)Ltd.,58-65,300-308.

5. Kay Kittrell Chitty(1997)Professional Nursing, concept and challenges, 2^nd edition, Philadelphia, W.B. Saunders Company, 34-58

6. Trends in Nursing Administration and Education,Volume-2,Jan.-July2008 and July-Dec.2008, A Publication of Holistic Nursing and Health Society, 9-13 and25-27.

Received on 06.02.2015 Modified on 28.02.2015

Int. J. Adv. Nur. Management 3(2): April- June, 2015; Page 161-163