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Contemporary Nursing Roles and Career Opportunities


This will lead to the best possible health ... Quality management nurses assess the compliance of the institution with established ... or the operating room. – PowerPoint PPT presentation

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Title: Contemporary Nursing Roles and Career Opportunities

Contemporary Nursing Roles and Career

  • The proliferation
  • of career opportunities for nurses is growing.

Professional Nursing Roles
  • Care provider
  • Educator and counselor
  • Client advocate
  • Change agent
  • Leader and manager
  • Researcher
  • Coordinator of the transdisciplinary health care

Change Agent
  • When nurses first adopted the role of "change
    agent," few individuals visualized to what extent
  • nurses would fulfill this role.
  • nurses have expanded their role as change agents
    in many ways.
  • The profession continues to identify client and
    health care delivery problems, assess their
    motivation and capacity for change, determine
    alternatives, explore possible outcomes of the
    alternatives, and assess cost-effective resources
    in infinite health-related situations.

  • Leader and Manager
  • The leadership role of the professional nurse is
    paramount to the health care system.
  • Nursing leadership varies according to the level
    of application and includes
  • Improving the health status and potential
    of individuals or families.
  • Increasing the effectiveness and level of
    satisfaction among professional colleagues
    providing care.
  • Managing multiple resources in a health
    care facility.
  • Raising citizens' and legislators'
    attitudes toward and expectations of the nursing
    profession and the health care system.

  • Leader and Manager
  • There is little doubt that the management role of
    the nurse has become more important.
  • Nursing management includes planning giving
    direction and monitoring and evaluating.
  • Nursing care of individuals, groups, families,
    and communities.

  • The majority of researchers in nursing are
    prepared at the doctoral and postdoctoral levels,
    an increasing number of clinicians with master's
    degrees are beginning to participate in research
    as part of their advanced practice role.

  • Nurses prepared at the baccalaureate and
    associate degree levels are also participating
    in research.
  • These nurses may be assisting with data
    collection, critiquing research findings, and
    using these findings in practice.
  • More nursing interventions are based on nursing
    research than in the past.

Coordinator of the Transdisciplinary Health
Care Team
  • Transdisciplinary teams consist of collaborative
    practice relationships among several disciplines
    of health care professionals.
  • The disciplines include nursing, medicine,
    pharmacy, nutrition, social work, and other
    allied health professionals such as physical
    therapists, respiratory therapists,occupational
    therapists, and speech therapists.

  • Coordinator of
  • Health CareTeam
  • Transdisciplinary teams are valuable because
    professional members bring their in-depth and
    specialized knowledge and skills to the
    interaction process.
  • A plan of care developed by the
    transdisciplinary team is usually considered a
    valuable health management tool (Van Ess Coeling
    and Cukr, 1998).

Transdisciplinary health care team
  • The term transdisciplinary health care team may
    not be as familiar as the term multidisciplinary
    or interdisciplinary team.
  • Multidisciplinary health care teams consist of
    many disciplines involved in meeting client care
  • Interdisciplinary teams refer to coordination
    between and among disciplines involved in
    providing client care.

Transdisciplinary health care team
  • The more global and inclusive term
    transdisciplinary health care teams can be
    described as including multiple disciplines
    bonding, interacting, and uniting toward common
    goals of client care.
  • The collaborative process involved in
    transdisciplinary health care incorporates the
    definitions of multidisciplinary and
    interdisciplinary health care and, in fact,
    transcends a single health profession to create
    comprehensive work outcomes.

Transdisciplinary health care team
  • Studies that investigate the process of
    transdisciplinary health care teams in action
    report improved quality of care, increased client
    satisfaction, increased nursing satisfaction, and
    reduced hospital cost by decreasing hospital
    length of stay and increasing nursing retention
    (Wasserman, 1997 Baggs, 1989 Baggs et al.,
    1992 Knaus et al., 1986).

Transdisciplinary health care team
  • Successful health care team models that use
    concepts related to transdisciplinary health care
    include pain management, nutritional support,
    skin care, rehabilitation, mental health, and

Transdisciplinary health care team
  • Client education is another area in which
    collaboration and disciplines working together
  • are absolutely essential.
  • Health care professionals must understand one
    another's contributions to client education and
    ensure that the information clients and families
    receive is consistent and complete.
  • This will lead to the best possible health
    outcomes for clients and families.

  • The phrase "a typical nurse" has become a
    misnomer as the profession enters the
    twenty-first century.
  • Nursing roles are so diverse that there literally
    is no typical role or practice setting.

Registered Nurse Demographics
  • Eighty-one percent of these RNs hold active
    licenses and are employed in nursing.
  • Approximately 58.5 of this group are employed
    full time in the profession, with 23.3 of nurses
    working part time.

Registered Nurse Demographics
  • In 2000 the average age of the RN population was
    45.2 years.
  • In 2000 31.7 are under 40 years of age, 18.3
    under 35 years, and 9.1 under 30 years.
  • Some speculate that the increase in the average
    age of RNs may represent the aging society or
    "second-career" nurses, with younger persons may
    be choosing other professions.

Registered Nurse Demographics
  • Although the profession continues to be
    predominantly female, the number of men working
    as RNs significantly increased.
  • The 2000 report indicates that the number of male
    RNs increased to 5.9, up from 5.4 in 1996 data
    (Division of Nursing-Bureau of Health
    Professions, National Sample Survey, 2001).

Registered Nurse Demographics
  • Changes also are occurring in the educational
    preparation of RNs
  • increasing in the number of nurses graduating
    from associate degree nursing programs and
    baccalaureate-prepared nurses.
  • In 2000 graduates from basic nursing programs
    were 40.3 associate degree, 29.6 baccalaureate
    degree, and 29.3 diploma graduates.
  • In 2000 nurses reported their highest degree as
    22.3 diploma, 34.3 associate degree, 7
    baccalaureate degree, and 10.2 master's or
    doctoral degree (Division of Nursing-Bureau of
    Health Professions, National Sample Survey, 2001).

Registered Nurse Demographics
  • Advanced practice nurses now comprise 7.3 of the
    RN population, up from 6.3 in 1996.
  • Nurse practitioners lead this group in numbers,
    followed by clinical nurse specialists (CNSs),
    nurse anesthetists, and nurse midwives.
  • Nurse practitioners and CNSs make up 80 of the
    advance practice group. (Division of
    Nursing-Bureau of Health Professions, National
    Sample Survey,2001).

Hospital Opportunities
  • In the hospital the nurse in a direct-care role
    provides care for people who are ill and unable
    to provide for themselves.
  • Hospital positions can range from staff nurse to
    administrator and, in a general hospital, entail
    any of the clinical specialties and most of the
    target populations.

Trends in Health Care Delivery Systems
  • From To
  • Acute inpatient care -
    Lifespan care
  • Treating illness -
    Maintaining health
  • Focus on the individual -
    Focus on

  • aggregates/populations
  • Product of care orientation -
    Value of care orientation
  • Number of hospital admissions -
    Number of lives covered

  • (capitation)
  • Managing organizations -
    Managing networks
  • Managing departments -
    Managing markets
  • Coordinating services -
    Documenting quality and

  • outcomes

Trends in Health Care Delivery Systems
  • The clinical setting has been based on
    experiences as a student, the new graduate needs
    to be prepared to have different perceptions in a
    new role.
  • At a minimum, experiences that are highly
    enjoyable on the limited-time basis of a student
    schedule may feel different when the new graduate
    functions in that role full time.
  • It also is good to have a mix of experiences and
    learning opportunities before making a definitive

Trends in Health Care Delivery Systems
  • Nursing within hospitals offers almost endless
    opportunities for diversity.
  • Staff level positions in a hospital can be on
    many different units, and working different
    shifts on those units presents different work
    environments, approaches to work, and priorities
    of client care.

Quality Management
  • The parameters of a position in quality
    management or quality control vary from
    institution to institution, the basic premise is
    to ensure that outcomes in client care services
    are consistent with established standards.
  • Quality management nurses assess the compliance
    of the institution with established standards and
    explore variations from established standards.
  • Chart reviews and ongoing interaction with the
    staff of the agency are integral components of a
    quality management position.

Quality Manager
  • The health care providers to assess opportunities
    for process improvement, implement changes,
    measure outcomes, and then start the improvement
    process over again.
  • Quality management nurses research and describe
    findings and look for opportunities to improve

Quality Manager
  • Quality studies produce critical pathways or
    algorithms defining care and expected client
  • Basic and advanced knowledge of quality
    management tools is essential, although practice
    may vary from setting to setting.
  • In the inpatient setting the quality management
    nurse needs strong clinical skills as might be
    acquired in medical surgical practice, intensive
    care units, or the operating room.

Quality Manager
  • Experience in home care would be an advantage for
    a quality management nurse in that setting.
  • Interpersonal skills are important because to be
    successful this role requires building
    relationships and rapport.
  • The role of quality manager is one that promotes
    improved care for health care recipients in a
    variety of settings.

Case Manager
  • This role has had a rich tradition in community
    and public health nursing, and in acute care.
  • Case managers coordinate resources to achieve
    health care outcomes based on quality, access,
    and cost.
  • The complexity of case management practice is
    obvious in the era of chaotic systems caused in
    which providers, services, and coverage details
    are constantly changing.
  • Case managers identify the best resources at the
    lowest cost to achieve the optimum health outcome
    for the client (Stanhope and Lancaster, 2000).

  • Growth of the nursing profession be prompted by
    technologic advances in client care, which allow
    an increased number of health problems to be
    detected early and managed quickly.
  • Health maintenance organizations, ambulatory
    surgicenters, and church health centers are only
    a few of the places where the public will receive
    their health care.
  • Nursing can be a vital component of the
    "alternative setting" movement that is on the
    forefront of health care reform.

  • Professional nursing services should be viewed as
    a cost-effective way to provide disease
    prevention and health-promotion activities in
    multiple areas of the community, including
    industry, business, and commerce.
  • Wellness and disease prevention, historically
    fundamental to the nursing profession, are now
    becoming more meaningful and revitalized concepts
    within the larger health care system.

  • The nursing profession historically has requested
    a chance to prove its worth in producing
    cost-effective, quality health care.
  • Encouragement for nurses who are interested in
    developing new roles is provided by examples of
    nurses who envisioned and created new roles.
  • Traditional, nontraditional, and advanced
    practice nursing roles offer many exciting
    opportunities for professional growth and