Nursing Scope of Practice
What Is Nursing?
According to the Board of Registered Nursing- Nursing is a unique profession concerned with all variables affecting clients in their environment. Nursing actions are initiated to best retain, attain, and maintain optimal client health or wellness using the three preventions (primary, secondary, tertiary) as interventions to keep the system stable [www.csufresno.edu/ chhs/depts_programs/ nursing/.../what/ - dated on 1/2/2010].
What does Nurse do?
Nurses save and improve lives as front line members of the health care delivery team. They independently assess and monitor patients, and taking a holistic approach, determine what patients need to attain and preserve their health. Nurses then provide care and, if needed, alert other health care professionals to assist. For instance, emergency department nurses triage all incoming patients, deciding which are the sickest and in what order they require the attention of other health care professionals. Thus, nurses coordinate care delivery by physicians, nurse practitioners, social workers, physical therapists and others. Nurses assess whether care is successful. If not, they create a different plan of action.
One of the most important roles of the nurse is to be a patient advocate--to protect the interests of patients when the patients themselves cannot because of illness or inadequate health knowledge.
Nurses are patient's educators, responsible for explaining procedures and treatments. For instance, nurses teach patients and their families how to eat in a healthier way, take medicines, change wound dressings, and use health care equipment.
Nurses empower patients, guiding them toward healthy behaviors and support them in time of need. When patients are able, nurses encourage and teach them how to care for themselves. Nurses provide physical care only when patients cannot do so for themselves. As patients near the end of their lives, nurses provide dignity in death by advocating for sufficient pain medication and the opportunity to die at home to allow them to spend meaningful time with family members in their final days.
Hospital nurses are responsible for discharge planning, deciding together with other health professionals when patients can go home, and helping patients adapt to their conditions and work toward full recovery.
Nurses, especially those working in community settings, work to prevent illness through education and community programs designed to decrease transmittable illnesses, violence, obesity and tobacco use, and provide maternal-child education--to prevent some of the leading health problems of our time.
Some nurses are independent scholars whose work is at the forefront of health care research. Many nurses obtain Master's and Ph.D. degrees in nursing, then work as scholars, educators, health policy makers, managers, advanced practitioners such as Clinical Nurse Specialists or Nurse Practitioners, or sit on Boards of Directors [www.nursingadvocacy.org/faq/what_is_nursing.html on 12/2/2009]. In Bangladesh Registered Nurses (male), nurse-midwives (female), and assistant nurses are usually involved in providing clinical nursing services. The nurses work at different levels of health care system mostly in the hospitals. They work in different positions such as, Nursing Superintendent, Deputy Nursing Superintendent, Nursing Supervisor, Senior Staff Nurse and and Staff Nurse. Nurses work at Government, private, army institutions and N.G.0. There are approximately 28,748 registered nurses in Bangladesh of which 14,594 nurses are working in the government sector. Nearly 13,000 registered nurse-midwives are either unemployed or working in the non-government sector; and about 2000 are working abroad.
The Bangladesh Government has initiated to provide health care services at the doorsteps and institutional health care infrastructure has been extended from national to the union levels where Union sub-centre exists. The sphere of nurses' clinical practice is also expanded from highest to lowest institution namely 10-bedded Rural Health Centre (RHC). At present 14,597 nurse-midwives are in practice and working for different categories of health care institutions providing preventive, curative and rehabilitative care, and educational institutions producing registered nurse-midwives; teachers; administrators; leaders and managers.
Types nurses posts indicates that, nurses of Bangladesh has good scope to practice in clinical areas or educational institute or administration.
1. Scope exists at the Clinical Settings (Curative):
Dhaka Medical College Hospital (1700 beds) | 04 Medical College Hospitals (800-1010 bedded) | 03 Medical College Hospitals (500-650 bedded) | ||
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05 Medical College Hospitals (250 bedded) | 07 Specialized Institute & Hospitals (100-600 bedded) | Pabna Mental Hospital (500 bedded) | ||
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01 Shahid Sohrawardi MCH (375 bedded) | 09 General Hospitals (250 bedded) | 02 General Hospitals (200 bedded) | ||
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01 Infectious Disease Hospital (100 bedded) | 02 General Hospitals (150 bedded) | 03 Chest Clinics & Chest Hospitals (100-150 bedded) | ||
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03 Health Complexes (31 bedded) | 02 Thana Health Complexes (31 bedded) | 03 Leprosy Hospitals (20-80 bedded) | ||
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07 Chest Clinics & Hospitals (20 bedded) | 04 Trauma Hospitals (20 bedded) | 01 Dental Hospital (20 bedded) | ||
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Rural Health Centre (10 bedded) | 01 Airport Health Clinic | 02 Port Health Clinics | ||
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08 Model FP Clinics | 34 TB (Chest) Clinics | |||
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Preventive Areas
Civil Surgeon Offices-64 | ||||
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2. Educational Institutions (Basic and Post Basic):
Nursing College-07 (Each has 100 seats for Basic Program) | Nursing Institutes-01 (With 50 seats for Diploma Program) | College of Nursing-01 (Containing 125 seats for Post-basic Program) | ||
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Nursing College-03 (Each has 125 seats for post-basic Program) | Nursing Institutes-13 (Each has 50 seats for Diploma Program) | Nursing Institutes-29 (Each has 30 seats for Diploma Program) | ||
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3. Administration
Directorate of Nursing Services (HQ) | Divisional Offices-06 | |
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