Hospital Nurse

Job Duties Hospital nurses, the largest group of registered nurses (RNs), administer medical treatments and provide bedside care. They usually work as staff nurses and may sometimes supervise licensed practical nurses or nursing aides. They typically work in one department, such as surgery, maternity, pediatrics, the emergency room, intensive care, or cancer treatment. They are responsible for monitoring the care of patients, from diet to physical activity. They give patients medications under the direction of physicians. They observe patients, carefully assessing and recording their various symptoms, as well as cataloguing their progress. They create nursing care plans and provide instruction to patients regarding how to become more independent. Job Skills Hospital nurses need to have well-developed communication skills, and the ability to observe accurately and make decisions accordingly. They must be willing to work with a team, as well as supervise others. Due to the intense nature of the work, hospital nurses should be emotionally stable and have a sympathetic disposition. .

School Nurse
Job Duties School nurses work in various academic settings, providing primary care to children. Their duties range across a wide spectrum and may include emergency care, illness prevention, health counseling, community and public relations, vision and hearing screening, and health education. They may be responsible for the care of students with advanced medical conditions, providing them with tracheostomy care or tube feeding. They work in either school-based clinics or school campuses. School nurses strive to increase the well-being, success, and achievement of the students they care for. They help encourage positive mental and physical development, health safety, and learning. Job Skills School nurses need to have well-developed communication skills, and the ability to observe accurately and make decisions accordingly. They must be able to work with patients who are sometimes reluctant to cooperate. They must be willing to work with a team, as well as supervise others. Due to the intense nature of the work, school nurses should be emotionally stable and have a sympathetic disposition.

Office Nurse
Job Duties Office nurses provide care to patients in outpatient facilities like physicians' offices, clinics, ambulatory surgical centers, community clinics, workplaces, dialysis centers, pain management centers, and emergency medical centers. They help patients prepare for examinations, and they assist patients during examinations. They administer injections and medications under the direction of physicians. They may assist with minor surgeries. Some office nurses are also responsible for clerical duties, such as record keeping and office management. They work with patients of all ages who have all types of illnesses and injuries. They provide patients with education, pain and case management, and discharge planning. Job Skills Office nurses need to have well-developed communication skills, and the ability to observe accurately and make decisions accordingly. They must be willing to work with a team, as well as supervise others. Due to the intense nature of the work, office nurses should be emotionally stable and have a sympathetic disposition.

Private duty nursing

Private duty nursing is the care of clients by nurses, whether an RN (Registered Nurse) or LPN/LVN (Licensed Practical Nurse). Most nurses who provide private duty care are working one-on-one with individual clients. Sometimes such care is provided in the client's home, or an institution, such as a hospital, nursing home or other such facility.[1] Private duty nursing was a far more widespread practice prior to the introduction (in 1964) of intensive care units where nurses provide care to a limited number of clients in what is usually a more high-tech situation. Many private duty nurses are self-employed or work as contractors. The practice of private duty nursing was in many senses a precursor to a rise (in the 1980s) of wider-scale nurse entrepreneurs. Non-medical care could be provided by the nurse but is most often provided by unlicensed assistive personnel such as nursing assistants, home-health aides, sitters, professional homemakers, or other titles. These caregivers often do minor housekeeping chores for their clients, but they cannot provide skilled nursing care. Private Duty Nursing Services

Patient receives nursing services at home from Registered Nurses (RNs) or Licensed Practical Nurses (LPNs), in accordance with physician orders Patient may receive continuous nursing services beyond the scope of care available from certified home health care agencies (CHHAs) Patient may need only intermittent nursing services which are normally provided by the CHHAs but which are unavailable at the time the patient needs them

Private duty home care agencies are companies that provide home care aides, companion care, homemaker services and may provide nursing services in the client's home or place of residence. "Private duty" means private pay. In other words, no government monies are used for the cost of care. The most common methods for covering the cost of private duty home care is through long term care insurance benefits, out of pocket, or other types of savings arrangements.

Private Duty Nurse Job Description

Private duty nurses provide patient care in the home. Private duty nurses contract with individual patients to provide care in hospitals or the individual's home. The nurse works with a physician to evaluate the health of the patient and administer treatments. Private duty nurses may work with many different clients or just one. The increase in older patients will cause significant growth in the need for private duty nurses, according to the Bureau of Labor Statistics.

Job Duties
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The private duty nurse administers medications and treatments and changes dressings for patients in the home. The nurse can also take samples such as blood for diagnostic testing and evaluate the patient's vital signs. A private duty nurse evaluates the condition of the patient and records information in medical records. The information can include the progress of a treatment plan and symptoms the patient experiences while undergoing treatment. The patient's physician uses the information to develop or make changes to the treatment plan. Private duty nurses can perform emergency procedures for patients having a reaction to medication or treatment. The nurse notifies the physician of adverse reactions to treatment and medication. A private duty nurse provides the patient and the patient's family with information on good health habits. The nurse teaches the family how to care for the patient such as administering medications, changing dressings and preparing healthy meals.

Skills
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Private duty nurses must have compassion and a good bedside manner when working with patients. Time management skills are necessary to manage the workload of a private duty nurse. Nursing requires a strong attention to detail and the ability to evaluate a patient's condition.

Home Health Nurse

Job Duties Home health nurses provide medical and health services to patients at their places of residence. They work with both patients and their families, assessing the home environment and determining the needs of patients. They work with many different types of patients, such as people recovering from accidents, child birth, or cancer. They are sometimes responsible for supervising home health aides. After traveling to the patient's home, home health nurses administer medications, monitor patients, and instruct patients on appropriate home care. They may teach, counsel, and demonstrate skills to both patients and their families. They serve as liaisons between patients and other health care workers, such as physicians and hospital staff. Care may be episodic or continuous, and it may involve focus on the psychological wellbeing of the patient. Job Skills Home health nurses need to have well-developed communication skills, and the ability to observe accurately and make decisions accordingly. They need to be able to honor the wishes of their patients. They must be willing to work with a team, as well as supervise others. Due to the intense nature of the work, home health nurses should be emotionally stable and have a sympathetic disposition.

Home Health Care Nursing Information and Overview Home health care is allowing the patient and their family to maintain dignity and independence. According to the National Association for Home Care, there are more than 7 million individuals in the United States in need of home health care nurse services because of acute illness, long term health problems, permanent disability or terminal illness.

Home Health Care Basics Nurses practice in a number of venues: Hospital settings, nursing homes, assisted living centers, and home health care. Home health care nursing is a growing phenomenon as more patients and their families desire to receive care in their homes. The history of home health care stems from Public Health Nursing where public health nurses made home visits to promote health education and provide treatment as part of community outreach programs. Today academic programs train nurses in home care and agencies place home health care nurses with ailing individuals and their families depending on the nurse's experience and qualifications. In many cases there is a shared relationship between the agency and the academic institution. Home Health Care Nurse Job Description Through an array of skills and experience, home health care nurses specialize in the wide range of treatments, emotional support, education of patients who are recovering from illnesses and injury for young children and adults, to women who have experienced recent childbirth, to the elderly who need palliative care for chronic illness. A practicing nurse must have the skills to provide care in a unique setting such as someone's home. The nurse is working with the patient and the family and must understand the communication skills for such dynamics. Rapport is evident in all nursing positions, but working in a patient's own living space needs a different level of skill and understanding. There is autonomous decision making as the nurse is no longer working as a team with other nurses in a structured environment, but is now as a member of the "family" team. The host family has cultural values that are important and are different for every patient and must be treated with extreme sensitivity. Other skills of a home health care nurse include critical thinking, coordination, assessment, communication, and documentation. Home health care nurses also specialize in the care of children with disabilities that requires additional skills such as patience and understanding of the needs of the family. Children are living with disabilities today that would have resulted in mortality just twenty years ago. Genetic disorders, congenital physical impairments, and injury are just a few. Many families are familiar with managing the needs of the child, but still need expert care

that only a home health care nurse can provide. It is important that a home health care nurse is aware of the expertise of the family about the child's condition for proper care of the child. There are many complexities involved, but most important, a positive attitude and positive reinforcement is of utmost importance for the development of the child. Medication coordination between the home health care nurse, doctor, and pharmacist, ensures proper management of the exact science behind giving the patient the correct dose, time of administration, and combinations. Home health care nurses should be familiar with pharmacology and taught in training about different medications used by patients in the clinical setting. Many advanced practicing nurses are familiar with medication regiments. They have completed graduate level programs. Home health care agencies believe that a nurse should have at least one year of clinical experience before entering home health care. Advanced practicing nurses can expedite that training by helping new nurses understand the home health care market and teaching.

Public Health Nurse

Job Duties Public health nurses focus on populations instead of just individual patients, although they do work with individual patients a great deal of the time. They typically work for government or private agencies, including schools, health departments, ambulatory care clinics, and retirement communities. They work to improve the overall health of the community in which they work. They plan and implement health-related programs. They teach individuals and groups about health issues like preventative care, nutrition, and childcare. They arrange for immunization clinics, blood pressure testing, cholesterol level testing, and other health screening clinics. They often work closely with teachers, parents, physicians, and community leaders. Their main goal is to work with local governments to correct health problems that face particular communities. Job Skills Public health nurses need to have well-developed communication skills, and the ability to observe accurately and make decisions accordingly. They must be able to work with patients who are sometimes reluctant to cooperate. They need to be able to honor the wishes of their patients. They must be willing to work with a team, as well as supervise others. Due to the intense nature of the work, public health nurses should be emotionally stable and have a sympathetic disposition Community Health Nursing Nurses in this field work in government and private agencies, clinics, and other private settings. They focus on populations, working with individuals, groups, and families to improve the overall health of communities. They educate about health care issues, disease prevention, nutrition, and childcare, and also work with community leaders, teachers, parents, and physicians in community health education.

Public Health nurses care for all the people of their community. Public health nurses monitor the spread of disease, keep vigilant watch for environmental hazards, educate the community on how to care for and treat themselves, and train for community disasters and bioterrorism. Public health nurses advocate not just for the patient, but for the community.

Palliative care
Palliative care (from Latin palliare, to cloak) is a specialized area of healthcare that focuses on relieving and preventing the suffering of patients. Unlike hospice care, palliative medicine is appropriate for patients in all disease stages, including those undergoing treatment for curable illnesses and those living with chronic diseases, as well as patients who are nearing the end of life. Palliative medicine utilizes a multidisciplinary approach to patient care, relying on input from physicians, pharmacists, nurses, chaplains, social workers, psychologists, and other allied health professionals in formulating a plan of care to relieve suffering in all areas of a patient's life. This multidisciplinary approach allows the palliative care team to address physical, emotional, spiritual, and social concerns that arise with advanced illness. Medications and treatments are said to have a palliative effect if they relieve symptoms without having a curative effect on the underlying disease or cause. This can include treating nausea related to chemotherapy or something as simple as morphine to treat a broken leg or aching related to an influenza (flu) infection. Although the concept of palliative care is not new, most physicians have traditionally concentrated on trying to cure patients. Treatments for the alleviation of symptoms were viewed as hazardous and seen as inviting addiction and other unwanted side effects.[1] The focus on a patient's quality of life has increased greatly during the past twenty years. In the United States today, 55% of hospitals with more than 100 beds offer a palliative-care program,[2] and nearly one-fifth of community hospitals have palliative-care programs.[3] A relatively recent development is the concept of a dedicated health care team that is entirely geared toward palliative treatment: a palliative-care team.

Scope of the term

Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illnesses. It is focused on providing patients with relief from the symptoms, pain, and stress of a serious illness whatever the prognosis. The goal is to improve quality of life for both the patient and the family. Palliative care is provided by a team of doctors, nurses, and other specialists who work together with a patient's other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment. A World Health Organization statement[4] describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual." More generally, however, the term "palliative care" may refer to any care that alleviates symptoms, whether or not there is hope of a cure by other means; thus, palliative treatments may be used to alleviate the side effects of curative treatments, such as relieving the nausea associated with chemotherapy. The term "palliative care" is increasingly used with regard to diseases other than cancer such as chronic, progressive pulmonary disorders, renal disease, chronic heart failure, HIV/AIDS, and progressive neurological conditions. In addition, the rapidly growing field of pediatric palliative care has clearly shown the need for services geared specifically for children with serious illness.

Palliative care:

provides relief from pain, shortness of breath, nausea, and other distressing symptoms; affirms life and regards dying as a normal process; intends neither to hasten nor to postpone death; integrates the psychological and spiritual aspects of patient care; offers a support system to help patients live as actively as possible; offers a support system to help the family cope; uses a team approach to address the needs of patients and their families; will enhance quality of life; is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy.

While palliative care may seem to offer a broad range of services, the goals of palliative treatment are concrete: relief from suffering, treatment of pain and other distressing symptoms, psychological and spiritual care, a support system to help the individual live as actively as possible, and a support system to sustain and rehabilitate the individual's family.[5]

Comparison with hospice in the United States

In the United States, hospice services and palliative care programs share similar goals of providing symptom relief and pain management.[6] Non-hospice palliative care is appropriate for anyone with a serious, complex illness, whether they are expected to recover fully, to live with chronic illness for an extended time, or to experience disease progression. In contrast, although hospice care is also palliative, the term hospice applies to care administered in patients with a prognosis of 6 months or less to live. What is Hospice Care? Hospice care is similar to palliative care in that the goals are to alleviate symptoms and improve quality of life. In contrast to palliative care, however, hospice is appropriate when there is a life expectancy of six months or less. When curative treatments are no longer working and/or a patient no longer desires to continue them, hospice becomes the care of choice.