Role and Responsibilities of nurse in medical surgical setting

Introduction 

  • The primary role of nurse is to provide care. Medical surgical nurses provide direct care to adult patients in numerous settings.
  • Medical surgical nursing is the largest group of professional in the field of nursing.
  • Medical surgical settings include hospitals , clinics , home , surgical centres.

Medical surgica setting 

It includes various departments such as -

  1. OPD
  2. IPD
  3. ICU
  4. Home health care
  5. Community health nursing

1. OPD(Out Patient Department)

  • It is defined as a part of hospital with alloted physical facilities , medical and other staffs with regularly scheduled hours to provide care for patients who are not registered as inpatients.
  •  A hospital department where patients receive diagnosis , followup care or treatment but don’t stay overnight.
  • It is first point of contact between a patient and hospital

 Types of OPD

A. Based on type of service

  1. Centralized outpatient service
  2. Decentralised outpatient service

B. Based on type of patient

  1. General outpatient
  2. Emergency outpatient
  3. Referred outpatient

Role of Nurses OPD

  • Nurse provide direct care to patient in the form of medicine and treatment as directed by physician
  • Nurse participate in setting up the care plan for patient and administer , take vital signs and change dressing .
  • In clinics nurse work directly with patient by getting their medical history , monitoring vital signs and performing blood draws.
  • Provide healthcare advises through educating patient and family members.
  • Nurse work with all age groups and with different healthcare and social care needs.
  • Nurse also organises health camp and provide routine and emergency care to camper .

2. IPD – Inpatient Department 

  • An inpatient department is a unit of a hospital or a healthcare facility where patients are admitted for medical condition that require appropriate care and attention.
  • Any patient is admitted for short and long term depending on severity of their diseases.

Function of  IPD

  • To provide the highest possible quality of medical and nursing care for the patients .
  • To provide necessary equipment , essential drugs and all other stores required for patient in an organized manner
  • To furnish most desirable environment substituting as temporary home for patients
  • To provide facilities to meet the needs of the visitors and attendants

 Role of nurse in  IPD

a. Clinical responsibility - Inpatient care nurses ‘ main goal is to improve patients’ quality of life while ensuring they are comfortable. In addition , nurses ensure admissions and discharge of patients.

b.  Managerial responsibility- inpatient nurses’ maintain patient files , update patient statistics and provide reports to doctor and other staff members.


c.  Personnel responsibility -inpatient care nurses consultants engage in staff placements in inpatient department. Coordinating inpatient care services and providing expert advice also falls within their responsibilities.

 d. Research and development responsibility - inpatient care nurse consultants work with other staff members to ensure delivery of proper palliative care.

3. ICU ( INTENSIVE CARE)

  • An ICU also known as an intensive therapy unit where a specialised treatment is given to patient who are acutely unwell and require critical medical care.
  • ICU provide the critical care and life support for ill and injured patient.

Types of  ICU

  1. General
  2. Medical ICU
  3. Surgical ICU
  4. Medical Surgical ICU
  5. Specialised
  6. Neonatal ICU
  7. Special care nursery
  8. Pediatric ICU
  9. Coronary care unit
  10. Cardiac surgery ICU
  11. Neuro surgery ICU
  12. Burn ICU
  13. Trauma ICU

Role of Nurse in  ICU

  • Monitor exact , detailed reports and records of critical ICU patient .
  •  Monitor and record symptoms and changes in patients‘ conditions and inform to physician .
  • Order , interpret and evaluate diagnostics tests to identify and assess patient’s condition .
  • Carefully observe and document patient medical information and vital signs.
  • Consult and coordinate with health care team members about whole patient care plans.
  • Modify patient treatment plans as indicated by patient’s response and conditions.
  • Assist physicians with procedures such as bronchoscopy , endoscopy , etc
  • Critical care nurses may also care for pre and post operative patients when those patients require ICU care
  • Ensuring  properly  storage of equipments and devices after use.
  • Providing  education  and support  to patient family.
  • Acting as patient  Advocate.

4. Home  Health Care

Home health care is the provision of medically, para professional services and equipments to individuals and their families in their place of residence for the purpose of promoting maintaining , or restoring health or of minimising the effects of illness and disability .

 Home healthcare nurses must have -

  • Strong knowledge base
  • Communication principles
  • knowledge of family dynamics

5. Community Health Nursing 

  • Community health nursing is a synthesis of nursing practice and public health practice applied in promoting and preventing the health of population .
  • It is established on recognized needs and functioning within the total health programme.

Role of Community Health Nursing 

  • Provide care to disabled ones
  • Teaching
  • Advocating
  • Maintaining healthy environment
  • Collaborating
  • Preventing and reporting
  • Participate in professional development activities
  • Identifying the need and referring for service
  • Ensuring quality nursing research and engaging in nursing research

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