are

Prepared by:
M.Vijayarani.Bsc.(N).R.N.R.M
ROLE OF NURSE FAMILY AND PATIENT IN ADULT PATIENT CARE
INTRODUCTION:
The word NURSE originated from the Latin word NUTRIX meaning TO
NOURISH. Nurse assumes a number of roles when they provide care to client.
The roles required at a specific time depend on the needs of the client and
aspects of the particular environment.
DEFINITION:
1) According to Virgiena Handerson (one of the first modern nurse) " The unique
function of the nurse is to assist the individual, sick, or well, in the performance
of those activities contributing to health or its recovery (or to peaceful
deatyh0that he would perform unaided if he had the necessary strength, will or
knowledge, and to do this in such a way as to help him gain independence as
rapidly as possible".
2) The International council of nurses published a full definition in 1987,followed
by shorter, more succinct version in 2002,"Nursing encompasses autonomous and
collaborative care of individual of all ages, families, groups and communities, sick
or well and in all settings. Nursing includes the promotion of health, prevention of
illness and the care of ill, disabled and dying people. Advocacy, promotion of a
safe environment, research, participation in shaping health policy and in patient
and health systems management, and education are also key nursing roles.
DEFINITION OF ADULT HEALTH NURSE:
A Nurse who has received additional education and training in the primary health
care of adults.
MEANING OF ADULT NURSING:
Adult nursing involves caring for adults, both sick and well, not only ion the
hospital environment but also in the community setting. An inherent part of the
role of an adult nurse is the promotion of health through education, the
prevention of disease, and the care, substance and rehabilitation of adults
undergoing diagnostic and therapeutic regimens. Clearly the role of the nurse
helping and caring for adults is both challenging and diverse.
GOALS OF ADULT HEALTH NURSING:

Determines responses to health problems, level of wellness, and needs for

assistance.
Provides physical care, emotional care, teaching, guidance and counseling.
Interventions aimed at assisting the client to meet own needs.
AIMS OF NURSING IN ADULT PATIENT CARE:

To promote health

To prevent illness

To restore health

To facilitate coping with disability or death.

To meet these aims the nurse uses knowledge, skills and critical thinking to give
care in a variety of the traditional and expanding nursing roles. To provide
knowledgeable care the nurse uses cognitive, technical, inter personal, and
ethical, legal competencies essential to nurse in practice.
GENERAL DISCRIPTION OF ADULT HEALTH NURSE:
Adult nurses provide medical care to and support the recovery of patients
suffering from acute and long-term illness, diseases such as diabetes or arthritis
or those requiring surgery.
They focus on the needs of the patient rather than the illness or condition.
They promote good health and well being through the education.
Adult nurses plan and carryout case within a multidisciplinary team but are curing
a specific disease, although treatment skills that promote physical healing are
important to care givers.
The adult nurse addresses the holistic health care needs of the client including
measures to restore emotional, spiritual, and social well being.
The nurse helps the client and family to set goals and meet those goals a minimal
cost of time and energy.
The role as a caregiver is the role of nurse.
Gaining the trust and confidence of each patient is an important role of nurses.
In all the cases nurses needs to establish a good relationship with the patient and
their relatives.

Duties of nurses include the following

Preparing care plans

Implementing plans through tasks such as preparing patients for surgeries,

wound treatment and monitoring pulse, blood pressure and temperature.

Observing and recording the conditions of patient.

Checking and recording the conditions of patients.

Setting up drips and blood transfusion.

Assisting with tests and evaluating.

Carrying out routine investigations.

Responding quickly to emergencies.

Organizing staff and workloads.

Teaching skills to student and junior nurses.

Maintaining patient records.

Making ethical decisions related to current and confidentiality.

ROLE OF NURSE IN ADULT PATIENT CARE:

ROLE:
A role is a set of expected behaviors associated with an individual status or
position, which includes behaviors, rights and responsibilities.
Nurses often carry out several roles concurrently, not exclusively of one another.
The contemporary nurse functions in the interrelated roles of caregiver, clinical
and ethical decision maker, protector and client advocate, rehabilitator, comforter,
communicator, and teacher.
1) CARE GIVER:
As a caregiver, the nurse helps the client regain health through the healing
process. Healing is more than just the main point of contact for patients.
Adult nurses who work mainly in the hospitals have traditionally included those
activities that assist the clients dignity.
The required nursing actions may involve full care for the completely dependent
client, partial care for the partially dependent client, and supportive educative
care to assist clients in their highest possible level of health and wellness.

 Caregiver encompasses the physical, psychosocial, developmental, and cultural

and spiritual levels.
The nursing process provides nurses with a framework for providing care.
A nurse may provide care directly or delegate it to other caregivers.
2) CLINICAL DECISION MAKER:
To provide effective care, the nurse uses critical thinking skills throughout the
nursing process.
Before understanding any nursing action, wheather it is assessing the clients
condition, giving care, or evaluating the results of the care, the nurse plans the
action by deciding the best approach for each client. The nurse makes these
decisions alone or in collaboration with the client and family.
3) ADVOCATE:
Adult nurse also assist clients in exercising their rights and help them speak up
for themselves. The promotion of human or legal rights and serving of care of all
patients based on the belief that patients have the rights to make informed
decisions about their own health and lives.
A client advocate acts to protect the client.
The nurse may also defend clients rights in a general way by speaking out
against policies or actions that might endanger clients well being or conflict with
their rights.
4) PROTECTOR:
As a protector the nurse helps to maintain a safe environment for the client from
possible adverse effects of diagnostic or treatment measures. Confirming that a
client doesnt have an allergy to a medicine and providing immunization against
disease in a community based practice are examples of the nurses protective.
5) COMMUNICATOR:
The role of communicator is central to all other nursing roles.
Nursing involves communication with clients and families, other nurses and
health care professionals, resourse persons, and the community.
Without clear communication it is impossible to give care effectively, make
decisions with clients and families, protect with clients from threats to well being,
coordinate and manage client care, assist client in rehabilitation, offer comfort or
teach.
In the role of communicator nurses identify clients problems and then
communicate these verbally or in writing to other members of the health team.

 The nurse must be able to communicate clearly and accurately in order for a
clients health care needs to be met.

6) COMFORTER:
The role of comforter, caring for the client as a person, is a traditional and
historical one in nursing and has continued to be important, as nurses have
assumed new roles.
Because nursing care must be directed to the whole person rather than simply
the body, comfort and emotional support often help give the client strength to
recover.
While carrying out nursing activities, nurses can provide comfort by
demonstrating care for the client as an individual with unique feelings and needs.
As comforter, nurses should help the client reach therapeutic goals rather than
encourage emotional or physical independence.
7) TEACHER:
As a teacher nurse must helps clients learn about their health and the health
care procedures they need to perform to restore or maintain their health.
The nurse assess the clients learning needs and readiness to learn, sets specific
learning goals in conjunction with the client, enacts teaching strategies and
measures learning.
As teacher, the client, the nurse explains to clients concepts and facts about
health, demonstrates procedures such as self-care activities, determines that the
client fully understands reinforces learning or client behaviour, and evaluates
progress in learning.
It involves providing emotional, intellectual and psychological support.
The nurse counsels primarily healthy individuals with normal adjustment
difficulties and focus on helping the person develops new attitudes, feelings and
behaviour by encouraging the client to look at alternative behaviour, recognize
the choices, and develop a sense of control.
9) CHANGE AGENT:
Nurses who function in the role of change agent recognize the change is a
complex process.
The change agent is proactive (take the initiative to make things happen) rather
than reactive (responding to after they have happened).

 The nurse acts as a change agent when assisting others, that is a client, to make
modifications in their own behaviour.
Nurses also often act to changes in a system, such as clinical care, if it is not
helping a client return to health.

10) LEADER:
The assertive, self-confident practice of nursing when providing care, effective
change, and functioning with groups.
A leader influences others to work together to accomplish a specific goal.
The leader role can be employed at different levels: individual, client, family, and
groups of clients, colleagues or community.
The nurse criticizes the leadership process in a variety of circumstances: when
assisting a single patient and or family to make changes in their health related
behaviour.
When assisting groups or communities to alter their health practices, and when
assisting groups of nurses or other health care professionals to affect the actions
of patients, groups of patients, communities with regard to the achievement of
desirable health behaviors.
11) REHABILITATION:
Rehabilitation is the process by which individuals return to maximum levels of
functioning after illness, accidents, or other disabling events, frequently clients
experience physical or emotional impairments that change their lives and the
nurse help-s them adapt as fully possible.
Rehabilitation and restorative care activities range from teaching clients to walk
with crutches to helping clients cope with lifestyles often associated with chronic
illness.
12) MANAGER:

The term manager in this discussion means the person who co-ordinates
human and material resources in providing care to clients,.human
resources include
Client
The nurse
The family or significant others
Professional colleagues
Support groups

 Research groups
Material resources include equipment and supplies.

The nurse manages the nursing care of individuals, families and

communities.

Managing requires knowledge about organizational structure and

dynamics, authority and accountability, leadership, change theory,
advocacy, delegation, and supervision and evaluation.

13) CASE MANAGER:

As a care manager, the nurse coordinates the activities of other members of

the health care team, such as nutritionist and physical therapists, when
managing a group of clients care.

In addition, nurse must also manage their own time and the resource of the
practice settings.

As managers, nurses coordinate and delegate care responsibilities and

supervise other health care workers.

14) TEAM MEMBER:

A vital role of the nurse is that of the nurse is that of team members. The
nurse doesnt function in isolation but rather work with other members of
the health care team.

Collaboration requires the nurse to use effective interpersonal skills and

promotes continuity of care.

15) RESOURSE PERSON:

The nurse function as a recourse person by providing skilled intervention

and information.

Identifying recourses and making referrals as needed also fall under the
auspices of this role.

Nurses must consider the client strength as well as availability of

resources, including physical, intellectual, economic, social, and
environmental factors.

16) RESEARCH CONSIDERATION:

Nurses often use research to improve client care .In a clinical area, nurses needs
to

Have some awareness of the process and language of research.

Be sensitive to issues related to protecting the rights of human subjects.

Participate in the identification of significant researchable consumer of

research findings.

Be a discriminating consumer of research findings.

17) EXPANDED CAREIER ROLE:

Nurses are fulfilling expanded career roles, such as those of nurse practioners,
clinical nurse specialist. Nurse midwife, nurse educator, nurse researcher, and
anesthetist, all of which wallow greater independence and autonomy.
18) ROLE IN DIFFERENT HEALTH CARE SETTINGS:
Although many nurses are direct care providers, others role include manager of
other members of the health care team providing patient care , administrator
,nurse practitioner ,clinical nurse specialist, patient educator ,in service and
researcher .Nurses play different roles in different centers like.

Primary care centers

Ambulatory care centers and clinics

Home health care

Long term care facilities specialized care centers and settings

Day care centers

Mental health canters rural health centers

Industry

Homeless shelters

Rehabilitation centers

Healthcare services for care givers and end of life care.

Respice care

Hospice care

Health care agencies (voluntary agencies)

Eg, alcoholic Anonymous

Cancer and support groups

Parish nursing

Government agencies.

ROLE OF FAMILY IN ADULT PATIENT CARE:

A person illness affects not only the person who is ill but also the family or
significant others.
Acute illness may place sudden demands on family. The family should be able to
cope with the changes that occur in the family include the following:

Role changes

Task reassignment and increased demands on time.

Increased stress due to anxiety about the illness

Financial problems

Loneliness as result of separation and pending loss.

Changes in social custom.

The family should have a basic understanding of the disease, its treatment and
personal care.
Families should be able to cope using the known and behaviors to help them to
manage and adapt to the problem.
The family plays an important role in both the development and management of
disease condition.

Doubts and issues or misconceptions related to the disease should be clarified

with the health care professionals.
Family should know the importance of affection and love etc during illness.
The families if offers remedies and advice, it will take over those roles that the
person is no longer capable of and it will provide the care necessary until
recovery or for long term support.
Emotional support from family and friends are essential.
Family members are expected to assist patient in difficulties.
A willing member of the family can be allowed to assist with aspects of
nursing care is comforting to the patient as well as to the relatives.
The family is expected to provide a supporting environment for the patient.
The family should understand the need for the assistance and help the patient.
The family should try to fix in support of the ill member, meal preparation and
chauffeuring the children around varied work schedules.
Family influences the lives of one another.
The family structure, functioning, and relative position in the society significantly
influence the health and ability to respond to health problems.
The family structure, functioning, and relative position in the society significantly
influence the health and ability to respond to health problems.
In some cases, the terminally ill may be taken home and the family becomes
responsible for his care until death occurs.
Family members are important to chronically ill clients. They may help the
management of the chronic illness. This collaboration should be initiated under
the direction of the health care team at diagnosis to prevent difficulties later.
Families are an important factor in the clients response to health problem and in
the ability to cope.
Families are not only being kept abreast of the therapeutic plan, but also actively
participate in the planning and implementation of the care.
Family experiences a crisis or a crisis-producing event, they attempt to gather
their recourses to deal with the demands created by the situation.
Too many visitors may tire the patients and the relatives and families should
understand it.

The family should actively participate in the health education.

Also family has an important role in prevention of high-risk diseases in the
patient.
Patient family plays a vital role in carrying about restrictions and plans in the
patients.eg.diabetes patients should follow strict sugar free diet.
Discharge plans must include both the patient and family and should be taught
clearly to the item before discharge or transfer.
ROLE OF PATIENT IN ADULT PATIENT CARE:
1. Patient is the good source of information about illness.
2. Patient is not a passive recipient of care he is an active participant.
3. Patient should be cooperative with the treatment.
4. Patient must be given information about his care to make choices or manage
their conditions.
5. Patients are the key player in the decision making in the patient care. Patient
plays a decision maker role with skill in tools of the function.
6. Chronically ill individuals must learn to live with the course of chronic illness.
7. Part of the task also involves developing a personal identity that includes the
chronic illness and life style changes in necessities.
8. Maintaining interpersonal relationships with the health team members.
9. Patients can clarify the misbelieves and doubts regarding the treatment and
procedures with the adult health nurse.
10. Patients cooperation is very important in assessment, planning,
implementation, and evaluation.
11. Patient also participates actively in the patient and family teaching
programmes.
12. Giving consent for surgeries and diagnostic procedures is also an important
role.
13. Patient is expected to move the health team members towards the goals of
potential well-being.

14. With the level of knowledge, skill and confidence patient can develop the selfmanagement capacity so that he could be targeted towards the quality
improvement care.
15. More effective care processes and interventions are to be planned to make
the patients function in expanded role.
SUMMARY:
Thus the comprehensive care of adult patient not only involves the care of nurse
towards the patient but also the participation of patient and family is important
for improvement of the patient towards his potential well being.
REFERENCES:
1. Potter.P.A.Perry.A.G.Fundamentals of nursing- concepts of process and
practice .4th ed. Saint Louis: Mosby.1997. 223 225,484 487.
2. Kozier.B.Erb.G.Berman.A.Burke.k.Fundamentals of nursing concepts,
process and practice.7th ed. Delhi: Pearson 2004.47 50,221 222,229
231,484 485,502 503.
3. Black.J.M.Hawks.J.H.Medical Surgical Nursing - Clinical Treatment for
positive outcomes.7th ed. Phildelphia.:Saunders.2005.vol.1.150 152.
4. Bauer.F.L.The process of planning care. A theoretical Model.1st ed.St.Louis:
Mosby.1972.103 110.
5. Delaune.S.C.Landner.P.K.fundamentals of nursing Standards and
practice.3rd ed. Australia: Thomson-Delmer.2006.266 268.
6. Smeltzer.S.C.Bare Brenda. Textbook of medical surgical nursing .10th ed.
Philadelphia: Lippincott.2004.14 16.
7. Craven.R.F.hirnle.C.J.Fundamentals of nursing human health and
function.5th ed. Philadelphia: Lippincott.2007.1292 1293.
8. Atkinson.L.D.Murray.M.E.fundamentals of nursing nursing process
approach.296 300.
9. Stanhope.Larancarter.J.Foundations of nursing in community oriented
practice.2nd ed. St Lewis: Mosby.346 349.

10. Bond.J.Bond.S.Sociosiology and health care an introduction for nurses and

others health care professional .2nd ed. Churchil livingstone.112.
11. Furest.E.v.Wolff.L.Fundamentals of nursing 3rd. ed. Philadelphia.1964.628
629.
12. Walsh.M.Tindall.BcLINICAL nursing and related services .6th ed. London:
Watson.2002.4 9.
13. http://content.healthaffairs.org/cgi/content/full/hlthaff.var.133/DC2

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Labels: family and patient in adult patient care, Role of nurse

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