Roles of the NurseRoles of the Nurse

NUR101 Fall2009Lecture #17K. Burger, MSED, MSN, RN, CNEPPP By:Sharon Niggemeier RN MSN

Roles of the NurseRoles of the Nurse CoordinatorCommunicatorTeacherCounselorManagerLeader

Team playerMotivatorDelegatorCritical thinkerInnovatorResearcherAdvocate

CoordinatorCoordinatorCoordinates and

plans carePiece together

fragmented carePrepares pt. for

dischargeLiaison in health

care team

CommunicatorCommunicatorEstablish rapportEstablish therapeutic (helping)

relationshipBe aware of verbal & nonverbal

communicationAssertive communicator

TeacherTeacherEducate pt. to develop

self-care abilitiesProvide knowledge to

allow pt. to make informed decisions

Demonstrate needed skills

Promote health, prevent illness, restore health & facilitate coping

Teaching-Learner ProcessTeaching-Learner Process

Teaching-planned method to help someone learn

Learning- process by which an individual increases their knowledge or changes their behavior as a result of an experience

Learning DomainsLearning DomainsCognitive learning- acquiring new

knowledgePsychomotor learning- acquiring a

new physical skillAffective learning- acquiring

/changing values, feelings or attitudes

Developmental ConsiderationsDevelopmental Considerations

Children learn through play & experience

Take into account their motor development along with their intellectual development

Adolescents learn through their peers

Take into account their intellectual, developmental, maturity and psychosocial development

Developmental considerationsDevelopmental considerations(androgogy)(androgogy)

Adults- most must believe they need to learn before they are willing to learn

Adults- bring life experiences as resources for learning

Adults- believe learning should be useful immediately (rather than in the future). They Want relevance!

Adults – internally motivated and capable of self-regulation

Developmental ConsiderationsDevelopmental Considerations(older adults)(older adults)

Assess for perceptual impairments– Visual– Auditory– Memory– Longer reaction timesAND ALSO– Generational learning differences

Learning StylesLearning Styles Visual Auditory Tactile Combination Concrete Versus Abstract Active Versus Reflective Right Versus Left Brain Multiple Intelligences

Verbal, Logical, Visual, Body, Musical, Inter or Intrapersonal

Principles of teaching-learningPrinciples of teaching-learning

Communication is importantThorough assessment of pt. learning needs

and factors affecting their learning Include pt. in planningUse varied teaching strategiesUtilize patient’s previous life experiencesUtilize nursing process

Barriers to LearningBarriers to LearningLanguageCognitive levelLack of interestCultural differencesLiteracyHealthStress

Utilizing Nursing ProcessUtilizing Nursing Process

Assessment: Readiness to learn Ability to learn Learning strengths What do they know

already??? Do they WANT to

LEARN?

Analysis: Knowledge deficit

Planning: Who, what, when, where & how.

Determine whether cognitive, psychomotor, or affective goal.Write with an “action verb”

GET CLIENT COMMITMENT

Implementation: Include written, visual and tactile

materials. Select strategy and methods:

Content – Sequence – TimingDemonstration?Discussion?Role Play?

Evaluation: has pt. Learned/goal met? Return Demo

CounselorCounselorAssist and guide pt.

in solving problems or making decisions

Utilize the interpersonal (helping) relationship

Nurse doesn’t tell pt how to solve the problemGuides pt to decisions(self-determination)

Utilize the nursing process

“Could you just listen”

PlansOrganizesDirectsControlsDelegates

ManagerManager

Management ProcessManagement Process

Planning-Identify needs, dev. goalsOrganizing - Identify resources to meet

goalsDirecting- leading others in reaching

goals Control- monitoring ongoing

evaluationsDelegates

DelegationDelegation

The five rights of delegation– Right task– Right person– Right circumstances– Right communication– Right feedback

DelegationDelegation

Nurse who delegates maintains accountability

Only the task is delegated NOT the accountability

Who can you delegate tasks to?

Managers and LeadersManagers and Leaders

ManagersAdministratorsRelies on controlShort term plansEye on bottom

lineDoes things right

LeadersInnovatorsInspires trustLong term plansEye on the

horizonDoes the right

thing

LeaderLeaderHave visions to energize othersMotivates others to achieve goalsEncourages others to do their bestWorks collaborativelyHave wider variety of roles then

managers

Leadership SkillsLeadership Skills Cognitive

Knowledgable

InterpersonalGenuineInspires trust

Ethical/legalIntegrity always

CommunicationOpen

Problem solvingCritical thinker; Out of the boxFlexible

Management Organized

Self-evaluationReflects, adapts, changes

Characteristics of Great Characteristics of Great LeadersLeaders

Intelligence-knowledge, judgment & decisiveness

Personality- confidence, creativity, adaptability, integrity & independent

Abilities- enlist cooperation, diplomacy, social participation & interpersonal skills

A great leader cannot be appointed!

Leadership StylesLeadership Styles

Autocratic- leader has complete control of group

Democratic- shared leadership between leader and group

Laissez-Faire- leader gives group control

Transformational-charismatic leader creates change by empowering group

Situational – leader changes style to fit situation

Increasing Manager/Leader Increasing Manager/Leader SkillsSkills

Self –assessment

Develop skills-computer, cost containment etc.

Think positive

Maintain physical wellness

Psychologically: Strong self

conceptBe confidentKnow strengths

& limitations

PowerPower…to possess power

implies the ability to change the attitudes and behaviors of individual people and groups….

Positive Power = “power with” NOT “power over”

Types of Power:

LegitimateRewardCoerciveReferentExpert

Building PowerBuilding PowerExpand personal resources – rest and reflectPresent a powerful picture – dress, act, speak the partPay the entry fee – stand out; do moreDetermine the powerful in the organization – know

chain of command, names & faces of powerLearn the language/priorities of the organization

Learn mission/vision/prioritiesIncrease professional skills & knowledge

Perform extraordinarily, continuing education

Building PowerBuilding PowerKeep a broad viewBe flexibleDevelop visibility and a voice in the

organizationToot your own hornMaintain a sense of humor Empower others (Marquis & Huston 1998)

ChangeChange

Things ALWAYS CHANGE!!!!Planned change- purposeful effect to bring

changeResistance to change- threatened, lack of

understanding, personality, more workOvercoming resistance to change- leaders

use their skills to overcome resistance to change

CHANGE IS GOOD!!!!!!!!!!!!!!!!!!!!!!!!!

Team PlayerTeam Player

Nurses are part of a teamDon’t work in isolationWho are the other team members?What does being a team player

mean?

MotivatorMotivator

Motivation- Internal impulse that allows one to take action or change behaviors.

Nurses motivate patients to make changes by: having a positive attitude, listening to patient needs, encouraging, rewarding, and devoting time and energy to assist with changes.

Critical ThinkerCritical ThinkerA way of looking at problems other

than the obvious“Thinking outside the box”Looking at the big pictureQuestion why something is being doneAsk, “what if…..”Open to new ideas

InnovatorInnovator

Takes action to make things happenInitiates changeSees a problem and looks for solutions.

Instead of , “Oh well, there’s nothing that can be done about it” the innovator will be proactive.

ResearcherResearcherCollect data to improve nursing

practiceProvides info for evidenced-based

practiceStudies are done on nursing practice,

education & administrationProvides professionalism to nursing

AdvocateAdvocate

Protect and support the pt.Patient representative for ALL pt.AssertivenessPromote self determination

SummarySummary

The role of the nurse is varied and complex

Caring for patients requires that nurses take on different roles at different times

Nurses need to fulfill their varied roles as best as possible by understanding their roles and knowing how to improve in each role