1. NURSES & PRACTICE
Syed Amin Tabish
FRCP (London), FRCP (Edin), FACP, FAMS, MHA (AIIMS)
Postdoctoral Fellowship, University of Bristol (UK)

2. Nursing Services
 Nursing profession is considered
a caring profession
 Nursing care is defined as the
care of the patient with regard to
nursing needs
 with the ever increasing
dimension of medical sciences
quantitatively and qualitatively
nursing care is becoming more
and more complex with its
management services.

3. Total health
Includes all of the following aspects:
 Physical Health
 Social health. A sense of
responsibility for the health and
welfare of others.
 Mental health. A mind that
grows, reasons, and adjusts to life
situations.
 Emotional health. Feelings and
actions that bring one satisfaction.
 Spiritual health. Inner peace and
security in one's spiritual faith.

4. Maslow’s Hierarchy of Needs

5. Nursing Service
 Nursing service is the part of the
total health organization which
aims at satisfying the nursing needs
of the patients/community.
 The nurse works with the members
of allied disciples such as
dietetics, medical social
service, pharmacy etc. in supplying
a comprehensive program of
patient care in the hospital.

6. Nursing Services
 WHO defines the nursing
services as the part of the
total health organization
which aims to satisfy major
objective of the nursing
services
 to provide prevention of
disease and promotion
of health.

7. Health Service System
Tertiary
Secondary Care
Primary Care
Self
Care, Self
Reliance
Primary Health Care
University/Regional
Hospital
Provincial/General
Hospital
Health
Center, PCU, Com.
Hospital
Village, CPHC

8. OBJECTIVE OF NURSING IN WARD
 Maximum comfort and happiness by
way of pleasant surroundings.
 Qualitative/comprehensive care to the
patient.
 Care based on the patient’s needs.
 Accurate assessment of illness.
 Adequate material resources at all
times.
 Health education to the patient and
attendants.
 Managerial skills as and when
required.
 Privacy at all levels.

9. Entire nursing process
 ASSESSMENT- not only initial but
integral ongoing component of the
whole nursing process.
 PLANNIG AND IMPLEMENTATION- in
this the nurse formulates and
implements the care.
 EVALUATION- decides whether the
action taken has met the identified
needs or not. This is the final step of
care. Also, review of the whole care
plan. Without this no quality care or
comprehensive care is possible to
provide.


10. PLANNING NURSING SERVICES
 Number and type of patient
 Number of beds and type of ward
 The services required.
 Procedures/techniques necessary
for care.
 Number and type of personal needed
to perform care effectively.
 Physical facilities.
 Provisional of equipment and
supplies.

11. Problems
 Lack of adequate training
 Problem of personnel
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management
Inadequate number of nursing
staff
Lack of motivation
Poor role model
Non-nursing activities
No research scope
Professional risk/hazards

12. Scope of Nursing Practice
 Nurses provide care for 3 types of clients:
 • Individuals
• Families
• Communities
Areas of Nursing Practice
 PROMOTING HEALTH & WELLNESS
 Wellness is a state of well-being. It means
 engaging in attitudes and behavior that
enhance the quality of life and maximize
personal potential.
 Health promotion is a behavior motivated by
 the desire to increase well-being and
actualize human health potential

13. Standards of Care
 Standards of practice are
guidelines used to determine what
a nurse should or should not do.
 Standards may be defined as “ a
benchmark of achievement which is
based on a desired level of
excellence”.
 Standards of care (SOC’s) measure
the degree of excellence in nursing
care and describe a competent
level of nursing care.

14. The standards of practice shall:
1. Be considered as the
baseline for quality nursing
care
2. Be developed in relation to
the law governing nursing
practice
3. Apply to the registered
nurse practicing in any setting
4. Govern the practice of the
licensee at all levels of
practice

15. Nursing standards are important
1. Outline what the profession
expects of its members
2. Promote, guide, and direct
professional nursing practice
important for self-assessment
and evaluation of practicing nurses
3. Aid in developing a better
understanding and response for the
various and complementary roles
that nurses have

16. Nurses & Practice
 The nurse carries personal
responsibility and
accountability for nursing
practice, and for maintaining
competence by continual
learning.
 The nurse maintains a standard
of personal health such that the
ability to provide care is not
compromised.

17. Nurses & Practice
 The nurse uses judgment regarding
individual competence when accepting
and delegating responsibility.
 The nurse at all times maintains
standards of personal conduct which
reflect well on the profession and
enhance public confidence.
 The nurse, in providing care, ensures
that use of technology & scientific
advances are compatible with the
safety, dignity and rights of people.

18. Nurses & the Profession
 The nurse assumes the major
role in determining and
implementing acceptable
standards of clinical nursing
practice, management, resea
rch and education.

19. Levels of Care
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Preventive
Primary
Secondary
Tertiary
Restorative
Long-term

20. Health Care Providers
 Physicians
 Nurses
 Physician Assistants
 Specialized Care
Providers
 Technicians/Therapists
 Other Providers

21. Health Care Settings
 Acute Care Facilities
 Short-Term
Specialized Care
Facilities
 Long-Term Care
Facilities
 Ambulatory Care
Sites
 Rural Health Centers

22. Code of
Conduct
Professional
conduct:
standards
for conduct,
performanc
e and ethics
 In caring for patients, you must:
 respect the patient or client as
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an individual
obtain consent before you give
any treatment or care
protect confidential information
co-operate with others in the
team
maintain your professional
knowledge and competence
be trustworthy
act to identify and minimise risk
to patients and clients.
These are the shared values of all
the United Kingdom health
care regulatory bodies.

23. Nursing in the New
Millennium
What has changed?
 who delivers
health care
 what is
provided
 when and where
Patients are
seen

24. Nursing and the Environment
Nursing
interventions are
directed toward
preventing and
minimizing the
effects of
environmental
health problems on
persons of all ages.

25. New Nursing Opportunities
 Advanced
Practice
Nurses
 Entrepreneurs
 Data
Management
 Research

26. Nursing Skills
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Physical Assessment
Safety and Infection Control
Patient Care and Comfort
Basic Care
Medication Administration
Nutrition and Elimination
Oxygenation
Circulatory
Skin Integrity and Wound Care
Immobilization and Support
Special Procedures

27. DFS Approved Curriculum-Unit 10
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28. Vital Signs
 Reflect the function of three
body processes that are
essential for life.
 Regulation of body
temperature
 Heart function
 Breathing
DFS Approved Curriculum-Unit 10
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29. Vital Signs
 Measurement (taken at rest)
 Temperature - measures body
heat
 Pulse - measures heart rate
 Respiration - measures how often
resident inhales and exhales
 Blood Pressure - measures
pressure against walls of arteries
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30. Qualities that make a
person successful
 desire, commitment, resp
onsibility, hard
work, power of
persistence, giving more
than you get, pride of
performance and be
willing to be a student.

31. Goal of Nursing
 Nursing has long been described
as an art and a science.
 As nursing evolved as a
profession, nursing leaders
attempted to define nursing.
Florence Nightingale wrote that
the goal of nursing was “ to put
the patient in the best condition
for nature to act upon him”.

32. Conclusion
 Nurses represent the major
personnel expense in any hospital
and are the most directly
responsible for using supplies for
patients.
 Nurses are in a position to maintain
quality in cost effective care. For
effective patient care and greater
satisfaction of patients, we should
be sensitive and responsive to the
needs of patients.
 We must respect the patient rights.

33. Core Values of Nursing
We must preserve core
values of nursing –
compassion, care, cour
tesy, and empathy.

34. Core Values
 We must also uphold basic
virtues - hard work,
generosity, kindness,
punctuality, tolerance,
perseverance, honesty,
truthfulness, modesty, and
politeness.

35. DFS Approved Curriculum-Unit 10
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