WHAT IS NURSING? WHAT DOES A NURSE DO?

I remember very well the time i decided to join nursing school, the number of people who asked, "why don't you go to medical school?" dismayed me. It was very clear many people are unaware of exactly what  nurses do. I think that it's important that a Registered Nurse is identifiable and for Nurses to lift their heads up and even put RN before their names. I believe that when the public can identify nurses, they will be one step closer to understanding that nursing is a unique profession with its own responsibilities that needs exceptional skills.

WHAT IS NURSING
Nursing in our beautiful country, Kenya, has several challenges one of them though minor is that many people don't know who is a nurse? and what exactly do nurses do? and i strongly believe that the way we present before our patients carry big points towards them respecting us and understanding what our roles. I will start by describing what nursing is, who is a nurse and what do nurses do?


Nursing includes a range of specialties and definition that vary in different countries. in general  a nurse is someone who has formally been educated and highly trained to  care for the sick or disabled. nursing includes several fields of medicine, including the prevention of disease, caring for and monitoring as well as advising pregnant mothers e.t.c.

according to the International Council of Nurses (ICN);

• Nursing encompasses autonomous and collaborative care of clients of all ages, families, groups and communities, sick or well and in all wetting.
• Nursing includes the promotion of health, prevention of illness and the care of ill, disabled and dying clients
• Nursing involves advocacy of client's rights, promotion of a safe environment, doing research, participating in shaping health policy, in-patient and health systems management and education i.e. always progress your knowledge and skills and to educate their clients. This are some of the key roles of a nurse.

other organization describe nursing or highlights the duty of a nurse  as to assist individual in doing activities that contribute to health, recovery, or peaceful or respected death. this activities are those that the patient would perform if they had the strength, will, or knowledge needed.
Nurses strive to achieve the best possible quality of life for their patients regardless of disease or disability by utilizing clinical judgement to protect, promote and optimize health, prevent illness and injury, alleviate suffering and advocating good health  care for individuals, families, communities and populations.

WHAT DOES A NURSE DO?
These are some of the issues many people are faced with since most if not all don't understand what a nurse does. A nurse is a health care profession who is focused on caring for individuals, families and communities ensuring that they attain, maintain and/or recover to optimal health and functioning. In the past nurses were known as the "handmaiden" for doctors. However , much has changed since the mid 1800 and since  the  mid 1950s. Nurses are skilled profession with separate distinct professional function from physicians.

Physicians still write orders but nurses are expected to know when an order, a medication, a dosage e.t.c. is wrong and to be able to effectively communicate to a physician the reasons the nurse cannot follow the order as given. For example, there are big differences in the amount of medication given by mouth, versus by injection, versus by intravenous. A nurse has the legal responsibility to know it's wrong of a doctor mistakenly orders a dose higher than medically  advisable to give


Physicians still write orders. But, nurses are expected to know when an order, a medication, a dosage, etc., is wrong and to be able to effectively communicate to a physician the reasons the nurse cannot follow the order as given. For example, there are big differences in the amount of medication given by mouth, versus by injection, versus by intravenous. A nurse has the legal responsibility to know it's wrong if a doctor mistakenly orders a dose higher than medically advisable to give by a particular route of administration.


Nurses are capable of assessing, planning, implementing, and evaluating care independently of physicians, and they provide support from basic triage to emergency surgery.

Nurses may practice:

• clinics
• cruise ships
• hospice facilities
• hospitals
• industry (occupational health settings)
• long-term care facilities
• military facilities
• pharmaceutical companies (for example, as researchers)
• physician offices
• private homes
• retirement homes
• schools
• schools
• camps

Some nurses may also advise and work as consultants in the the healthcare,legal or insurance sectors. Nurses can work full- or part-time, and many work on a per Diem basis or as traveling nurses or as we call it locum.
Back to what Nurses actually do. Basically a nurse is supposed to see the restoration of normal physiology in the clients they are taking care of, how you ask- human normal physiology comprises of ;

1. Respiration - Involves ensuring that your client is perfusing to the recommended reference values. is the breathing normal or abnormal.The dangers of hyperventilating and hypo ventilation. Circulation is an important component of perfusion and it should be normal, if not a nurse must work toward returning all these irregularities back to normal using the several skills acquired during their training. a nurse should be able to note any changes concerning respiration and circulation and articulating its occurrence with other systems in the body.
2. Nutrition - this is a very important component that many patient don't put into consideration. The body immunity depends on good nutrition thus ensuring your client is well fed speeds up recovery. using scientifically proven ways or as i like calling it evidence based practice certain feeds are recommended for client in certain conditions. Nutrition also provide the patient with the energy to do other important physiological functions such as respiration. Ensuring you client is well fed is one of the keys to quick recovery. Nutrition also involves the digestive system i.e. is the system able to digest the given food to components needed by the body and this involves also the liver since sometime as nurse we opt not to use the normal alimentary canal to deliver our feeds due some scientifically proven reasons.
3. Excretion - This one is a must know for all nurses and it includes defecation, micturation, sweating in others words all the processes that lead to excretion of  unwanted substance from the body. The most vital here is micturation as it assess the the renal function. Your client must remove urine 1-2 L per day. When your patient is on oral feeds ensure that they are defacating . Other organs like the lungs also help to remove these harmful waste like carbon dioxide from the body. most organ involved in excretion help to maintain a balance in the body, this process is called homeostasis.
4. Movement - this involves the muscle especially in long stay clients since  a nurse should help them return to their activity of daily living thus their muscle movement must always be checked. Involving a physiotherapist and an occupational therapist to assist in these long stay clients is helpful.
5. Reproductive - the reproductive functions and area your clients must be respected and injuries to this area may lead to very serious psychological problems.
6. Sensitivity - this now speaks of the nervous system
7. Growth - applies mostly to children where growth is very important and should be monitored 

There are many other factors a nurse must put in to consideration such the environment according to nightingale should be clean with fresh air, no noises, and proper lighting and the patient must be taken care of in all aspects i.e psychological care, spiritual care, biophysiological care e.t.c. Nurse do a lot more, they make the medicine the doctor has prescribed to work best for the client, they prevent the doctor from overdosing or underdosing their clients Nurses are advocates of the patients rights to proper health. They are the reason you are admitted to the hospital so that they can ensure your full recovery.These is just to mention but a few, there are many other things nurse do that if I am to put in to writing will take me pages and pages.




Something that many people forget even the clients and the relatives is that Nurse are not angels, they are humans full of emotions just like any other human being and these emotions can burst anytime, yes it is not appropriate if it bursts when at work but most of us Nurses really try to avoid  these. People forget that Nurses have families that are looking up to them for support but they have sacrificed their time to fully care for the clients. Nursing is a very high stress job and one can easily breakdown. I usually say that here in Kenya the level of nursing is as high as any other place in the world, but the environment and nature of the job makes us easy predators to stress breakdown and negative emotions not forgetting Nurses are not paid well enough to forget the problem they have at home or rather to separate the problem they have at home from job. when they are at work and the are thinking on where next they will get the cash to solve this problem and that problem at home completely distracts their attention at the work place, one just want to finish what they are doing quickly and go somewhere else to look for money.



The media also should be able to bring out what exactly is on the ground for the people to see, before they take medical malpractice as an agenda to fight on each day. In our hospitals there few if no supplies, e.g a scenario where you are supposed to be dressing a wound  aseptically but even the bd pack itself doesn't all the things it need so you will have to use  your head and use what you have and still maintain aseptic status and if the field is compromised you have to continue using the bd packs as they ain't enough or you may be using the only and the last one available. Am not against telling kenyans the truth about some negligence in our hospitals but first exhaust all your possibilities before publishing a story. get the story from both parties. I CONDEMN ACTS OF MEDICAL NEGLIGENCE BY HEALTH CARE WORKERS AND I DO NOT IN WHATSOEVER WAY SUPPORT IT. If some one is professionally incompetent they should be uprooted from the system.

PARTICIPATING IN SCIENTIFIC CONFERENCE

International conference should be instructive and lots of fun but it can also be alarming and lonely. For nursing career development it now almost essential that you participate in scientific conferences. Most school of Nursing don't emphasize on how to make the most of the opportunity as part of its curriculum. Today we gonna talk about how you can organize yourself and make the experience scientifically productive and enjoyable. In essence you should travel, see places, meet new people, make friends and identify one or two ideas that you can apply in your work or research.

There are many reasons why you must participate in international conferences most of which are very obvious, such as, eduction. as Nurses we must be in constant pursuit for knowledge. various issues change with time (medical-legal issues, ethics issues, new technology, better ways of approach to care e.t.c.).

Here are some of the major reasons why you should participate:

1. Education - update your knowledge. we learn from other, we learn from our mistake, we learn from other peoples mistakes. listening to other peoples work and listening to their brilliant ideas and sharing what you have to offer is one of the ways you can update your knowledge fast. Scientific materials presented at the conference may be a couple of years ahead of the journals and  five years ahead of text books.
2. Inspiration - Hear new ideas and meet professional leaders. Networking especially on intellectual basis can make your career move to the next level.
3. Evaluation - scientific conference can help you review your own work and plan for the future
4. Presentation -  after conducting a research results must be analyzed and presented somewhere. you can use the journal but a scientific conference is the most effective way of making a great impact since big name and world leaders in medical science attend these conferences, those are the people you need to hear what you have and if they are interested in your work, your career grows.
5. Recreation -  don't forget you supposed to have fun while you are there, relax and enjoy the company and culture around the meeting.

There are many other objectives but the five are the major ones. Participation in a conference need thorough preparation because you don't want to be disappointed with yourself. You must know the focus of the meeting, always double check and see if your work  is in line with the focus of the conference. 

One last thing, a conference should be a healthy mixture of the social and the scientific, and should provide stimulation and renewal, but if you have the choice of a large international conferences and a small on focused on your area of interest, always go for the small one. also you must know that international conference can be addictive.