Changing Role of Nursing in Modern Health Care

Dr.T.V.Rao MD
A Nurse is a health care professional who is engaged in the practice
of nursing. Nurses are men and women who are responsible (along
with other health care professionals) for the treatment, safety and
recovery of acutely or chronically ill or injured people, health
maintenance of the healthy, and treatment of life-threatening
emergencies in a wide range of health care settings. Throughout the
21st century, the role of nurse has evolved significantly. With
improved health literacy people are living longer than ever before.
Currently, the average Indian life expectancy rate has increased; and
with greater longevity comes more complex health concerns. This
makes providing the best care more challenging and means it is even
more important to be well educated. Nurses work in a variety of
settings, including the hospital, the classroom, the community health
department, the business sector, home health care, and the
laboratory. Although each nursing role carries different
responsibilities, the primary goal of a professional nurse remains the
same: to be the client's advocate, interpreter of social issues and
provide optimal care on the basis of evidence obtained through
constant clinical care and research. India has made great
improvements in health care with development of Modern Hospitals
with multispecialty care. The major part of the care is imparted by
qualified nurses, and technical staff under guidance of ever busy
Doctors who face complex problems including raise in expectations
of reducing the morbidity and mortality. As the nations hospitals
face increasing demands to participate in a wide range of quality
improvement activities, the role and influence of nurses in these
efforts is also increasing, Yet hospitals confront challenges with
regard to nursing involvement, including: scarcity of nursing
resources; and in view of social and economic demands they migrate
frequently and makes difficulty engaging nurses at all levelsfrom
bedside to management; growing demands to participate in more,
often duplicative, quality improvement activities; the burdensome
nature of data collection, medical documentation and reporting; and
shortcomings of traditional nursing education in preparing nurses for
their evolving role in todays contemporary hospital setting. In the
last two decades India has produced many Nurses from public and
private sector, and lack of skilled teaching staff many times,
compromised with shortage of teaching staff as rapid expansion has
created many teaching without any modern skills. However with
production of newer generation of nursing professionals. We should
not forget because nurses are the key caregivers in hospitals, they
can significantly influence the quality of care provided and,
ultimately, treatment and patient outcomes. In the Indian system of
Medicine, nursing continues to be subordinate to doctors unlike US
where they play a Major role in patient care, many times equals
Doctor in responsibility and skills. I wish to share my experience in a
British hospital in Africa when I was in a hurry to enter to operating
table and scrubbed my hands in hurry, the British nurse told me to
wash my hand once again before operating, I felt bad as it is not
possible in India to face such a situation, as nursing commanding
Doctors. However I felt bad for the moment and realised the most
important aspect in sepsis reduction continues to be hand washing in
spite of the best skills we have, I have seen many competent nurses
in todays Hospitals in India and abroad. And Indian Nurses are
credited as best, never underestimate the power of Malayali Nurses
changed the definition of nursing reaching to great heights and given
great helping hand in all critical care of the patients both rich and
poor alike. With the transformation of the healthcare system well
underway, care coordination is now being highlighted by hospitals,
health systems, and insurers as a key tool in improving patient health
and satisfaction and controlling healthcare costs. Nurses response is
what took you so long?! Without nurses, much of the public
health interventions essential to improving the health of individuals,
families, and populations would not be possible on a large scale
(Savage and Kub 2009, p.2847). Today community nursing is gaining
importance with increasing longevity and raise of economic costs
many patients wish to be nursed with a trained nursing staff at their
residences. The scarcity of nurses is a major challenge for hospitals
and community because it impacts not only their ability to provide
nursing coverage for patient care, but also to provide adequate
nursing resources for other key activities, such as quality
improvement. With proliferation of Medical and Nursing colleges, we
have started producing volume of students and young professionals
however what is important to the society and every patient remain is
how skilled are our nursing professionals, what has to be improved
for making for better reputation of Nursing as many are employed
not only in least equipped hospitals but in High tech hospitals, and
most advanced centres in Developed Nations. We should remember
we need to improve the quality of nursing education. As nursing
students are the future members of the nursing profession, and for
the profession to continue to advance, nursing research must be part
of the foundation of comprehensive, evidence-based clinical
practice. This may only occur with increased exposure to nursing
research. Therefore, it is critical that the future members of the
nursing profession be exposed to, develop an appreciation for, and
become more involved in nursing research, and thus incorporate its
outcomes into the delivery of optimal professional nursing practice. I
wish India needs to work on many fronts for the growing demand for
skilled nurses, Baccalaureate programs in the United States prepare
students for entry-level nursing positions. The focus is to care for
individuals throughout the human life span. Knowledge is acquired
from textbooks, classroom and Web-based instruction, simulation,
and clinical experiences. The goal of all programs is for students to
graduate as safe, entry-level professionals, having received a well-
rounded exposure to the nursing field. All upcoming Nursing
institution in particular, mushrooming private sector, can survive
only if the quality care is increases as Poor education and a lack of
sufficient knowledge can lead to mistakes that are costly for people's
health, burden of Medico legal litigations improved knowledge is an
essential tool for prevention of errors and providing higher quality
care. As todays employment need in Medical profession is of
improvement of quality. We all should strive to be better skilled in
discharging with effective skills, another key component of a hospital
culture conducive to quality improvement is encouraging individual
ownership and accountability for patient safety and quality,
according to respondents. I am one of strong supporter for
introducing the Nursing Informatics to all our Nursing students to
make them the most competent and as par with many Nurses
qualified in Developed countries or even better. All is possible with
determination and dedication, sincerity. It is the real expectation of
all our patients. In time of crisis just remember the Lady with a
LAMP
Dr.T.V.Rao MD Professor and HOD of Microbiology, Travancore medical
College, Kollam Kerala