All About Nursing Care...

Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings.

Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life.

Nursing practice is the actual provision of nursing care. In providing care, nurses implement the nursing care plan using the nursing process. This is based on a specific nursing theory which is selected in consideration of the care setting and the population served. 

In providing nursing care, the nurse uses both nursing theory and best practices derived from nursing research. The nursing process is made up of five steps:-

1. Evaluate 
2. Implement 
3. Plan
4. Diagnose
5. Assess

Nurses are able to use this process from the American Nurses Association to determine the best care they can provide for the patient. There are many other diverse nursing theories as well.

Early History

The first known documents that mention nursing as a profession were written in approximately 300 AD. In this period, the Roman Empire endeavored to build a hospital in each town that was under its rule, leading to a high requirement for nurses to provide medical care alongside the doctors.

The profession of nursing became considerably more prominent in Europe in the middle ages, due to the drive for medical care from the Catholic church. In this period, there were many advancements and innovations that took place, which eventually went on to form the base of modern nursing, as we know it.

The first Spanish hospital was built in the late 500s to early 600s in Merida, Spain, with the intent to care for sick individuals regardless of ethnic origin or religion. Several others were created in the following centuries but their upkeep was neglected until Emperor Charlemagne began to restore them and update the supplies and equipment in the 800s.

Throughout the 10th and 11th centuries, the nursing profession expanded due to changes in rulings in Europe. Hospitals began to be included as part of monasteries and other religious places and the nurses provided a range of medical care services, as was required, even beyond traditional healthcare. This all-encompassing model gained popularity and continues to be responsible for the wide range of duties a nurse is responsible for today.

At the beginning of the 17th century, nursing as a profession was rare due to various reasons, such as the closing of monasteries that housed the hospitals. However, in some regions of Europe where the Catholic church remained in power, the hospitals remained and nurses retained their role.

History of Nursing 

Florence Nightingale was a nurse who tended to injured soldiers in the Crimean War in the 1850s and played a significant role in changing the nature of the nursing profession in the 19th century.

During this time, the role of nurses continued to expand due to the need for their presence on the front lines of wars, where poor hygiene standards often led to fatal infections in injuries. Nightingale campaigned for improved hygiene standards in the hospital attending the wounded soldiers, which drastically reduced the number of deaths from infections.

The profession of nursing was pushed further forward in 1860 with the opening of the very first nursing school in London. This was the beginning of many other schools for new nurses so that they received appropriate training and education before they began to practice on the field.

However, the need for nurses expanded with the world wars in the twentieth century, and many nurses were required to begin providing care without adequate training. Since this time, education institutions for nurses have continued to expand.

The profession has also branched out into various specializations with further education in particular fields of nursing care, such as pediatrics or oncology.

Types of Nursing Specialties:-

1. Registered Nurse (RN)

Registered nurses (RNs) provide and coordinate patient care and educate patients and the public about various health conditions.

Registered nurses work in hospitals, physician’s offices, home healthcare services, and nursing care facilities. Others work in outpatient clinics and schools.

Registered nurses usually take one of three education paths: a bachelor’s degree in nursing, an associate’s degree in nursing, or a diploma from an approved nursing program. Registered nurses must be licensed.

A registered nurse (RN) is a nurse who has graduated or successfully passed a nursing program from a recognized nursing school and met the requirements outlined by a country, state, province, or similar government-authorized licensing body to obtain a nursing license.

2. Cardiac Nurse

Cardiac nursing is a nursing specialty that works with patients who suffer from various conditions of the cardiovascular system. Cardiac nurses help treat conditions such as unstable angina, cardiomyopathy, coronary artery disease, congestive heart failure, myocardial infarction, and cardiac dysrhythmia under the direction of a cardiologist.

Cardiac nurses perform postoperative care on a surgical unit, stress test evaluations, cardiac monitoring, vascular monitoring, and health assessments.

Cardiac nurses work in many different environments, including coronary care units (CCU), cardiac catheterization, intensive care units (ICU), operating theatres, cardiac rehabilitation centers, clinical research, cardiac surgery wards, cardiovascular intensive care units (CVICU), and cardiac medical wards.

3. Certified Registered Nurse Anesthetist (CRNA)

A CRNA (certified registered nurse anesthetist or just “nurse anesthetist”) is an advanced practice registered nurse (APRN) who administers anesthesia and other medications. They also take care of and monitor people who receive or are recovering from anesthesia.

Anesthesia is a medical treatment that keeps you from feeling pain during procedures or surgery. Different types of anesthesia work in different ways. Some anesthetic medications numb certain parts of your body, while other medications work on your brain to induce sleep.

CRNAs can work in several different medical settings, including:

• Hospital operating rooms (ORs).
• Postanesthesia recovery rooms (PACU).
• Emergency rooms (ERs).
• Outpatient surgery centers.
• Labor and delivery units.
• Physician’s offices.
• Dentist’s offices.

CRNAs have specific responsibilities, which include:

• Educating people before and after they receive anesthesia for a procedure or surgery.
• Assessing a person’s physical response to anesthesia.
• Identifying possible risks to the person undergoing anesthesia, including allergies to anesthetics and issues related to health conditions they may have, such as asthma or diabetes.
• Providing precise dosages of anesthesia.
• CRNAs work with surgeons, anesthesiologists, dentists, podiatrists, and other healthcare providers to provide anesthesia care to people undergoing all types of procedures. They care for people of all ages, undergoing all types of surgical procedures.

4. Clinical Nurse Specialist (CNS)

A clinical nurse specialist (CNS) is an advanced practice registered nurse who has earned a master’s or doctoral degree in nursing. They use their expertise to assess, diagnose, and treat patients. But their role often extends into other areas, like health care management and research. 

A CNS’s primary role is to provide quality, cost-effective specialty care. They work in a variety of specialties, including:

• Pediatrics
• Women’s Health
• Geriatrics
• Psychiatric health
• Rehabilitation services
• Wound care
• Pain management
• Oncology
• Critical care
• Emergency room services

Clinical nurse specialists may order tests, make some diagnoses, administer basic treatments, and, in some states, prescribe medications. Beyond this, they may provide expertise and support to a team of nurses. They often help create practice changes within an organization and plans that ensure the group is using best practices and providing evidence-based care.

The four primary roles of a clinical nurse specialist are:

• Expert clinician
• Educator
• Researcher
• Consultant

5. Critical Care Nurse

Critical care nursing involves working with doctors and specialists to assess, treat, and monitor critically ill patients while also providing their basic care.

Critical care nursing is the field of nursing with a focus on the utmost care of critically ill or unstable patients following extensive injury, surgery, or life-threatening diseases.

Critical care nurses can be found working in a wide variety of environments and specialties, such as general intensive care units, medical intensive care units, surgical intensive care units, trauma intensive care units, coronary care units, cardiothoracic intensive care units, burns unit, pediatrics, and some trauma center emergency departments. These specialists generally take care of critically ill patients who require mechanical ventilation by way of endotracheal intubation and/or titratable vasoactive intravenous medications.

Critical care nurses are also known as ICU nurses. They treat patients who are acutely ill and unstable requiring more frequent nursing assessments and the utilization of life-sustaining technology and drugs.

6. ER Nurse

An ER nurse is a nurse that works specifically in the emergency room. They treat patients who are facing traumatic or severe, often life-threatening medical conditions.

Also called trauma nurses, and similar to critical care nurses, ER nurses have a demanding and stressful job. They are called to act quickly to treat patients suffering from medical emergencies ranging from car accidents and suicide attempts to strokes and heart attacks. An ER nurse needs to be trained and ready to take decisive action in any number of critical situations.  

An ER nurse’s primary responsibility is to identify medical issues, determine severity, and provide immediate support to minimize negative long-term effects and, if necessary, even sustain life.

While no day is ever the same for nurses in the emergency room, here are some of the typical duties these nurses perform:

• Triage cases in order of urgency and need.
• Work with ER staff to stabilize incoming patients. 
• Set broken bones. 
• Perform tracheotomies and intubations. 
• Give stitches and sutures.
• Start intravenous lines (IVs). 
• Administer medication—as instructed by physicians.
• Create and maintain patient records.
• Transfer stable patients to other wings.

To become an emergency room nurse, you’ll first need to complete a nursing diploma, associate degree, or a bachelor’s degree in nursing (BSN).

7. Family Nurse Practitioner (FNP)

Family nurse practitioners (FNPs) are advanced practice registered nurses (APRNs) who typically work in primary care settings and treat patients of all ages, from infants and teens to adults and seniors. An FNP’s focus is on health and disease prevention. 

A family nurse practitioner has pursued a higher degree of education than a registered nurse (RN), including specialized classroom-based learning and hundreds of hours of clinical training in family practice. FNPs are trained to treat patients across the patient’s lifetime.

FNPs care for patients’ physical and mental health, teach wellness strategies such as nutrition and weight management and offer preventive care, including vaccination. They have the authority to diagnose and treat injuries, as well as conditions ranging from influenza to diabetes.

Family nurse practitioners work in partnership with family physicians, physician assistants, and nurses in their practices. 

They may also collaborate with social workers and other healthcare professionals depending on their place of employment.

Roles and Responsibilities of a Family Nurse Practitioner:

• Listening to and recording patient health histories.
• Providing thorough physical exams.
• Diagnosing and treating common acute and chronic health conditions.
• Ordering and interpreting lab and other medical test results.
• Developing treatment plans and prescribing medications and therapies, such as physical therapy.
• Teaching basic health care and offering counseling that encourages healthy lifestyle behaviors.
• Referring patients to other health professionals for more complex health and mental health problems (e.g., sending a patient with a fractured wrist or complex back problems to an orthopedist).

8. Geriatric Nursing

Geriatric nursing refers to the care of elderly patients. In this specialty, healthcare providers focus on issues that affect older individuals, such as Alzheimer’s disease and osteoporosis.

Geriatric nurses work at healthcare facilities like nursing homes, hospitals, hospices, and home healthcare service providers to care for elderly patients, who have a higher risk of developing chronic health conditions and diseases such as osteoporosis, arthritis, congestive heart failure, Alzheimer’s disease, cancer, and diabetes. Geriatric nurses help patients cope with and prevent these types of issues.

Specific responsibilities include the following:

• Administering medications and making adjustments when needed
• Creating and evaluating care plans
• Exercising and massaging patients
• Conducting routine physical and mental exams
• Helping rehabilitate patients after injuries
• Watching for signs of elder abuse
• Giving advice on disease prevention and personal safety tips
• Connecting patients with local resources
• Transporting patients to doctor’s visits and other appointments
• Helping patients with daily needs, such as dressing, bathing, and using the bathroom

9. Perioperative Nurse (Surgical/OR Nurse)

Perioperative nursing is a nursing specialty that works with patients who are having operative or other invasive procedures. Perioperative nurses work closely with surgeons, anaesthesiologists, nurse anesthetists, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, and postoperative care primarily in the operating theatre.

Also known as Operating Room nurses or OR nurses, perioperative nurses are registered nurses (RNs) who work in hospital surgical departments, day-surgery units (also called ambulatory surgery units), clinics, and physician's offices. They help plan, implement, and evaluate the treatment of the surgical patient and may work closely with the patient, family members, and other healthcare professionals.

Duties of a perioperative nurse:

• Provide treatment to patients 
• Perform administrative tasks 
• Monitor patients 
• Provide advice to patients and their families 
• Maintain hospital equipment 

10. Mental Health Nurse

Mental health nursing, also known as psychiatric nursing, is a specialized field of nursing practice that involves the care of individuals with mental health disorders to help them recover and improve their quality of life.

Mental health nurses have advanced knowledge of the assessment, diagnosis, and treatment of psychiatric disorders that help them provide specialized care.

A mental health nurse is responsible for the:

• Assessment and evaluation of the patient’s mental health
• Development of a treatment care plan
• Consultation with other health professionals about the treatment plan
• Provision of care and psychotherapy treatment
• Maintenance of medical records
• Support and education to the patients and their family

11. Nurse Educator

Nurse educators begin their careers as registered nurses (RNs). After receiving an advanced nursing degree, these individuals choose to teach new nurses valuable skills by becoming nurse educators. 

Nurse educators are valuable members of the healthcare committee. They have extensive and comprehensive knowledge of how the healthcare system functions. They also understand the needs of patients and are aware of theories of teaching and learning. 

Nurse educators need to have all of the certifications of a registered nurse, including a Bachelor of Science in Nursing. In addition, they will need two to five years of clinical experience, an understanding of the administrative and organizational considerations that influence caregiving, and an advanced nursing degree. 

Some of the most common responsibilities of a nurse educator include: 

• Teaching clinical skills and patient care
• Instructing hospital research
• Guiding students through clinical rotations 
• Designing and evaluating the program curriculum 
• Researching related topics 
• Maintaining clinical skills and certifications 
• Demonstrating communication and collaboration 
• Following legal and ethical teaching practices 

12. Nurse Manager

A nurse manager is an individual in a medical setting with the decision-making power to influence daily operations. They can advocate for improved patient care by optimizing certain processes that a hospital or healthcare organization fulfills every day.

As a nurse manager, you will make decisions that positively influence how hospitals and clinical organizations perform daily. From nurse scheduling to immediate patient care, you’ll work to provide patients with the best possible care. The role of a nurse manager offers an ideal blend of managerial and patient care responsibilities, where you’ll manage nursing resources without removing yourself completely from patient care floors.

The exact responsibilities of a nurse manager can include:

• Creating department schedules that identify when nurses and other staff members will work.
• Supervising nursing staff members as they serve patients, address patient conflicts, communicate with family members, and perform all other necessary aspects of their positions.
• Providing patient care through all of the processes required by comprehensive bedside nursing.
• Solving any issues in current clinic operations.
• Collaborating with staff in other departments to ensure that patients receive the best possible care, from intake through release.
• Recruiting and training new nurses.
• Improving the efficiency of all healthcare organization processes.
• Organizing facility records for quick recall and future reference.

13. Nurse Midwife

Nurse midwives provide care to women across the lifespan, including during pregnancy and the postpartum period, and well-woman care and birth control.

Nurse midwives practice in hospitals and private practice medical clinics and may also deliver babies in birthing centers and attend at-home births.

duties and responsibilities of a nurse-midwife:

• Provides professional reproductive and gynecological health care. 
• Works independently or collaboratively with other medical practitioners.
• Promotes the concept of minimal intervention. 
• Provides health surveillance from pregnancy to breastfeeding. 
• Promotes wellness through health education.
• Provides appropriate intervention for any impending health hazard.
• Diagnose and treat ailments. 
• Consult with or refer their patients to specialists when necessary. 
• Provides primary health care services for women throughout their lifespans.
• Fever complications.

14. Nurse Practitioner

A nurse practitioner (NP) is a nurse who has advanced clinical education and training. NPs share many of the same duties as doctors. They perform physical exams, diagnose and treat diseases and other health conditions, and prescribe medication. A nurse practitioner must have a graduate-level degree of education.

NPs provide patient-centered care. They focus on disease prevention, living a healthy lifestyle, and understanding your health concerns. An NP can serve as a primary care provider or as a specialty care provider focusing on a specific group of people. They work in a variety of healthcare settings, including:

• Physicians’ offices.
• Clinics.
• Hospitals.
• Emergency rooms.
• Urgent care sites.
• Nursing homes.
• Colleges.

They may work independently or with doctors to provide a full range of healthcare services. Nurse practitioners:

• Take and record medical histories and symptoms.
• Perform physical examinations.
• Order diagnostic tests, such as laboratory tests or X-rays.
• Analyze test results.
• Diagnose and treat illnesses, diseases, and other health conditions.
• Create patient care plans.
• Prescribe medication.
• Write referrals for specialists.
• Counsel people on how to stay healthy.

15. Nursing Administrator

Nurse administrators supervise nurses and other healthcare team members. They recruit, hire and train nurses. Other responsibilities include building work schedules and conducting performance reviews.

Nurse administrators—sometimes called nurse managers, nurse directors, or chief nursing officers—do not get directly involved with patient care. However, their job duties most assuredly affect patients’ experiences and outcomes. Administrators keep their staff motivated, oversee or provide needed training, and ensure that regulations are met, if not exceeded.

Because they operate in managerial roles, nurse administrators have to have solid business sense, exhibit strong communication skills, and be masterful at time management. In addition, they must possess an extensive medical background and training.

Nurse administrators are responsible for:

• Maintaining the budget and reporting on financial matters.
• Serving as a liaison between nurses and other hospital workers, including executives.
• Establishing policies and procedures and ensuring staff is in compliance.
• Developing a strategic vision for the hospital or department.

16. Oncology Nurse

Oncology nurses are registered nurses who take care of either cancer patients or those with the potential of developing cancer. Oncology nurses work with physicians and other medical professionals to prevent, diagnose, treat, and manage cancer symptoms, as well as provide palliative care. 

Oncology nurses can work in various healthcare settings—essentially anywhere that treats cancer patients.  Some common places oncology nurses work include hospitals, doctor's offices, outpatient care centers, hospices, cancer centers, clinics, and nursing homes.

There is a variety of specializations within the field of oncology nursing. Some common specializations include:

• Pediatric Oncology
• Radiation oncology
• Surgical oncology
• Immunotherapy
• Genetic counseling
• Hematology
• Chemotherapy/infusions
• Gynecological oncology
• Bone marrow transplantation
• Breast oncology  

Oncology nurse responsibilities might include:  

• Monitoring a cancer patient's condition
• Running various tests and evaluations
• Managing symptoms in cancer patients
• Administering medication to cancer patients
• Helping to manage the side effects of treatments, such as chemotherapy 
• Administering chemotherapy and other treatments like infusions 
• Educating patients and their loved ones on a particular type of cancer, treatment options, management plans, and lifestyles adjustments during cancer treatment
• Assessing a cancer patient's mental and emotional needs
• Helping create a plan of action for a cancer patient's care 
• Advocating for cancer patients and their loved ones  
• Recording a patient's health history, monitoring their vital signs, and maintaining clinical documents 
• Caring for cancer patients after surgery 
• Coordinating with other healthcare providers

17. Orthopedic Nurse

Orthopedic nursing is a specialty that focuses on musculoskeletal diseases and disorders.  These orthopedic issues include conditions like arthritis, bone fractures, broken bones, joint replacements, genetic malformations, arthritis, and osteoporosis.

Orthopedic nurses are familiar with traction, casting, mobility devices, and pain management.  

Orthopedic nurses work in hospital units, offices, and outpatient care clinics. They work with a wide age range of patients and care for both men and women. 

An orthopedic nurse spends time encouraging patients to increase their mobility, educates them about how to protect their joint and bone health, and implements strategies to minimize their pain and complications.

18. Pediatric Nurse

Pediatric nursing is a specialization of the nursing profession that focuses on pediatrics and the medical care of children, from infancy to the teenage years. This is an important field because the health of children is distinct from that of adults due to the growth and development that occurs throughout childhood.

Pediatric nurses usually work in a multidisciplinary team with other health professionals to provide the best medical care possible for children. 

Some pediatric nurses also choose to specialize further in a particular field of children’s health, such as anesthetics, oncology, or neurology.

Individuals well suited to a career as a pediatric nurse are likely to have the following traits:

• Cheerful and friendly
• Good communication skills with people of all ages
• Organized and able to follow complex treatment plans
• Works well under pressure
• Patience and willingness to adapt
• Interest and love for children

Pediatric nurses may work in a range of environments, including hospitals, private pediatrician clinics, nursing homes, schools, government agencies, and social services.

19. Public Health Nurse

A public health nurse is a registered nurse (RN) who advocates for positive changes in population health. This exciting career gives nurses the opportunity to work directly within communities to educate people and give them the tools they need to improve their health outcomes.

In general, the responsibilities of public health nurses include:

• Recording and analyzing aggregate medical data
• Evaluating the health of patients and creating treatment plans
• Monitoring patients for any changes in condition
• Delivering top-quality care alongside physicians
• Educating patients about available support services and helping them access care
• Emphasizing primary prevention in order to avoid disease or injury before it occurs
• Working with public health officials to help underserved communities gain access to care
• Developing a relationship with patients and following up to track progress
• Referring patients to other providers as needed
• Assessing health trends in communities
• Managing budgets of public health programs

A principal goal of public health nursing is to address the health disparities within marginalized communities by focusing on the environmental, physical, and social determinants of health.

Where Do Public Health Nurses Work?

• Government organizations
• Nonprofit organizations
• School systems
• Community clinics
• Outpatient clinics

20. Travel Nurse

Travel nursing is a nursing assignment concept that developed in response to the nursing shortage in the United States in the 1970s. This industry supplies nurses who travel to work in temporary nursing positions, mostly in hospitals. 

Travel nurses can also work abroad. Common jobs for travel nurses include:

• Hospitals
• Clinics
• Community health center
• Private practices
• Rehabilitation facilities
• Nursing home

Working as a travel nurse has many perks. Here are some of the benefits of travel nursing:

• Assistance in obtaining passports/work visas (if working internationally)
• Bonuses
• Choice of location
• Competitive pay
• Free housing
• Higher-than-average pay for RNs
• Medical, dental, and vision coverage
• Retirement plans
• Selection of hours/shifts worked
• Travel reimbursement

Some personal characteristics that serve travel nurses on the job include:

• Ability to learn quickly.
• Resilience to persevere in challenging contexts. 
• Flexibility. 
• Comfort with working in new environments.
• A strong support network.

21. Neonatal Nurse 

A neonatal nurse is a nurse that works specifically with newborn babies typically in their first month of life. Most often, neonatal nurses work with infants who face specific challenges right after birth including birth defects, heart problems, prematurity, and more.

Neonatal nursing is one of these subspecialties that allow nurses to be qualified to work with newborn babies and their mothers. Neonatal nurses focus their work on caring for newborns and sometimes focus on premature babies who are in the NICU.

The main work of neonatal nurses is to help mothers during birth and after the birth of their child. They perform traditional nursing duties like checking vital signs and monitoring patients, performing tests on newborn babies, performing neonatal tests throughout a woman’s pregnancy, and helping patients decide on an effective care plan for patients.