Role of Registered Nurse
Throughout this investigation I will be contrasting two different job roles, these roles being a Registered Nurse and a Domiciliary Care Worker. The reason for choosing these practitioners is that I believe this can help me further my interest in counselling. I believe a Registered Nurse can help me as the practitioner take into consideration different client’s disabilities and also recognises where the input of a counsellor may take place. I will be gaining useful information whilst also learning about what this practitioner entails and how their job works within the health and social care settings.
I believe a Domiciliary Care Worker could help me as it is their role to meet client’s needs, the care worker will also decide when it is time to involve specialist help, for example the care worker could recognise when a client may need professional help from a counsellor.
Both these practitioners can help my interest as they provide a guideline to the social care settings and how clients should be treated within the different care settings.
For both the Domiciliary Care Worker and Registered Nurse I will be carrying out certain research, this research will include the following sub-headings;
* Employment conditions
Registered Nurses can work in the statutory, (commonly known as the public sector) or the private sector. These sectors could be a nurse working within the NHS hospital, which is statutory and a private sector, some hospitals can be run privately, for example St. Josephs which is situated in Newport. Whereas working within a nursing home is a private sector. Funding for Registered Nurses usually comes from the NHS trust; however this is then controlled by the local health board who establish various amounts of money to different practitioners in different health and social care settings.
There are however different types of funding for different aspects of the work, for example there may be different funding for a nurse based in a school, the nurse will then be funded by the school’s budget, this will differ from the type of funding given to a nurse based in a hospital. The NHS trusts funding however is provided for by taxations; people who pay taxes will actually be funding the NHS trust and supplying their wages, for example people who are receiving private hospital care are paying for this, therefore the hospital is making a profit by charging the service users, these are also backed up with insurance schemes to help cover charges, an example of this is ‘BUPA care.’ However in earlier years schemes like these have had to be funded by the NHS, this was to meet the targets which have been set.
A registered nurse asses the needs and problems of patients, keeping care plans and preserving medical records. A registered nurse can work within several different care settings; the four main branches in which the nurse is likely to specialise in;
1. Adult Nursing
2. Children Nursing
3. Mental Health Nursing
4. Learning Disability Nursing
The nurse also provides care to individuals, families and also clients within the community. Nurses are there to promote good health and prevent illnesses. The registered nurse works widely within care settings, nurses work within a group and also working independently, however most nurses are based within the hospital, this then means more group work is promoted. As a Nurse works widely within the care setting they also work alongside different practitioners, these practitioners include;
* Social Worker, as the client may have support from social workers.
* Dietician, as clients may need help with certain diet routines.
* Physiotherapist, as the nurse would assist the client with a Physio Therapist and also recognise whether the client would require this treatment.
* G.P, the nurse will prescribe relevant drugs for the G.P to distribute to the client, if based in medical center.
* Special doctors, E.g. Paediatrician, there to specialise in the care of children
* Care assistant
* Doctors, who works alongside nurses to improve the health of the service user
Each practitioner is valuable to the role of a nurse, and also very important to the client’s health. As working in such a big establishment a lot of team work is used, a nurse will be working closely with a number of practitioners using a lot of skills, such as communication and problem solving to work effectively as a team. Teamwork for nurses is vital as nurse’s work with specialist doctors.
Local and political Factors
The Welsh Assembly Government provides support to local authorities throughout Wales, and also works closely with these authorities. Twenty two local authorities within the Wales area hold ï¿½4 billion of public expenses; this is over one third of the Welsh budget in total. Many wards in hospitals are being forced to be shut down; this is due to the shortage of many nurses, doctors and other practitioners.
There has recently been an outbreak of a winter vomiting disease; this has also led towards shutting down. Recently it has been known that a lot of hospital wards have been closing due to this disease, ‘Several wards at Bridgend’s Princess of Wales Hospital and Neath Port Talbot Hospital have also been hit recently.’ Tuesday 3rd March 2009, BBC News. (http://wales.gov.uk/topics/localgovernment/?lang=en) There is not enough money allocated to NHS to train the high number of nurses needed within Britain, however in the past the UK has employed a number of nurses from the Philippines, this on the other hand was to fill the gap, as not enough people within the UK are graduating as nurses there is a gap to fill, this is then filled by people who come to the UK from the Philippines.
To become a nurse and working within the NHS the applicant must hold a degree or diploma in nursing, (which is a pre-registration programme) whilst holding this degree/diploma this then allows you to work with the nursing and midwifery council, also known as the NMC. There are however no minimum requirements to enter a higher education institution (HEI) this is due to the fact that this place of education will set their own criteria, though these are more than likely to be around 5 GCSEs or equivalent at grade C or above in English language or literature and a science subject for a diploma programme and 5 GCSEs plus 2 A levels or equivalent for a degree programme. On top of these entry requirements all students are to be able to demonstrate knowledge of literacy, numeracy and good character.
Depending on the nursing school the nurse has chosen they may need to sit an entry test. These test could either be an SAT or ACT test, the career may also be asked to sit the National League for Nursing Pre-Admission exam. On the outcome of these test results this will then evaluate the Nurses career.
Some trainee nurses may be required to attend interviews with their employees. However this does not apply to all nurses. These interviews will be put into place so the employee can meet the nurses and also get to know a bit more about them and why they may find nursing as a good profession for themselves. On the other hand some employees may not find this appropriate so the nurses will not require an interview.
Due to the aging population of nurses it is currently estimated that by the year 2020 there will be a shortage of nurses; this estimation is around 800,000 nurses. Due to the increasing rise of the population and health conditions, many more health care jobs are needed, therefore the NHS are increasing the amount of health care job vacancies, and this is likely to stay this way for many generations. With currently over 100,000 job vacancies the outlook on the job opportunities within the nursing field looks very promising. The job role of nurses is in high demand and is more than likely to stay the same for some time; therefore more health care settings are willing to work alongside students and staff to ensure that they will become long-term employees of the health team.
Nursing is a very important role within the health care system, hospitals will not be able to function without the help of nurses, and this is a career which most nurses enjoy being a part of. It has been shown that 70% of the public believed that nursing is an active and positive career. The public believe Registered Nurses to be of a high status and very knowledgeable. ‘In my experience ‘specialist’ nurse practitioners are excellent and worth their weight in gold. I have no doubt that the incontinence nurse specialists, leg ulcer nurse specialist; MS nurse specialists and so on do their particular job better than anyone else.’
However the nurses themselves have a different opinion on how they perceive their career, they believe themselves to have a low knowledge and also believe that having the career of a Registered Nurse is not a profession. Whilst the RN’s believe this the public still has very high attributions towards RN’s. Many television programmes portray Nurses as flighty, the general public may come across some images which are meant to be of humour to the public, such things like bedpans or long needles, however these images are harmful and can also be harmful to those who are dependent on the ‘media image,’ for example a person may be dependent on the media and imitate certain issues which appear within the media. (www.google.com/publisperceptiononnursing) It has also recently been discovered that the lack of take up the flu vaccines provided for nurses increased problems, for example flu epidemics.
Nurses get paid according, to which band they are part of with the NHS, this is also known as, or covered by ‘Agenda for Change,’ (AFC) pay scales. This however is the NHS 2000 implications. This system covers all types of health situated careers, with an exception of doctors, dentists and most of the senior managers. Each practitioner is evaluated by their role within the care settings. Nine bands make up the payroll, each practitioner gains the chance to progress to a further wage, and they can do this by gaining more experience and also by developing more advanced qualifications. This wage is also determined on how long you have been working within the care settings. On the other hand school nurses do not work shift patterns therefore their wages will be different from the table below.
Whether working within the statutory or (public sector) the RN’s is eligible to holidays. Since the 1st October 2007 the annual holidays changed, there is now an increase in holidays, this increase will include, from this set date RN’s will be entitled to 4.8 weeks holiday, this then also including bank holidays and public holidays, (24 days if you work a 5 day week.) From the first of April 2009 RN’s will be entitled to 5.6 weeks holiday, this also including bank and public holidays, (28 days if you work a 5 day week.) The amount of time a RN are entitled off for a holiday again depends on the amount of time, (years) the RN has been an employee. Registered Nurses are also entitled to ‘sick days.’ This however is only eligible if the employee is unable to attend their place of work due to an illness, this sick pay is offered to full-time and permanent part-time employees. The full-time employees are entitled to 7.6 hours paid sick leave, this is on the condition that the employee has completed a month of continuous employment and 7.6 hours at the end of each month, this then continuing for a further four months of continuous service.
There are two ways for a woman nurse, these two ways include, Nurse Dresses and Nurse Tunics. There are three different dressed available to the nurses, the traditional nurse’s dresses are white with contrasting piping, with elbow length arms; this is as the sleeves will not interfere with medical procedures which may be occurring, the next dress is striped and the last is coloured. Nurses do have a choice of a zip up nurse’s dress or stud fastening dresses, however some hospitals may have policies and this choice may not be available to some nurses. There is also the choice of Nurses Tunics, these prove to be comfortable and also practical, these come in a number of different colours and also styles. Other practitioners also wear this uniform, such as a dentist, care workers and all other health care workers. Nurse’s trousers are also available; these come in all different colours to suit the colour of the nurses Tunics, these sizes go from size 8-28. Male nurse’s uniform also include the tunics, however these are darker colours but there is also a choice of white tunics. All nurses are to wear occupational nurse’s shoes, these are high quality leather uppers, this also has a special slip resistant thread pattern sole, and most of these shoes have steel toe caps.
As a nurse is part of the NHS scheme the practitioner automatically becomes a member of the NHS pension scheme. The NHS has however undergone some serious changes; these changes will become valid to practitioners on the 1st April 2008. If the nurse has joined the pension scheme on, or before 31st March 2008 they will become a member of the 1995 section of the NHS pension scheme, but if the practitioner has chosen to join on, or after 1st April 2008, the practitioner will then find themselves a member of the 2008 section of the NHS pension scheme. Members of the 1995 scheme can however have the opportunity to switch their pension plan to the 2008 scheme, this is for a limited period, this is planned to run from autumn 2009 until 30th June 2012. The 2008 scheme provides pensioners with more flexibility, this also provides flexibility around a pensioner’s time to claim their pension this can be very convenient for some people.
Presence of Stressors
A lot of stress can arise from being in the profession of a nurse; the nurse may come across difficult patients who are unwilling to cooperate. Depending on the area in which the nurse works the stress can become lower or can increase, for example A&E may become a more stressful place than the maternity wards. Whilst working within the care settings as a nurse does nurses come across a lot of different patients, these patients may be very abusive towards the nurse, physically and emotionally. Patients may become angry with waiting and be violent towards the nurse who is treating them. Nurses are put under a lot of pressure with the way they handle patients, as there is an increase in the amount of patients needing medical help nurses are working to the best of their ability to provide care that is needed, effectively and efficiently.
Even though nurses are caring for their patients and trying to the best of their ability to treat them this may not be respected by the patients, this can then lead to physical threats, emotional abuse and even violence. From this sort of behaviour a nurse can feel unwanted, this then reduces the self esteem and the nurse is likely to lack in self confidence. Due to the reductions in nursing this proves to be a bad area, if nurses are lacking in these qualities and prefer to opt out of the nursing profession this then means that again there are going to be less qualified nurses graduating. Shift work can become very stressful for the nurse, as a lot of the time the nurses are based in hospitals and have to spend a lot of time working with a variety of different service users this can prove to become difficult and stressful as the nurse does not have enough social time.
Nurses may not be very good at keeping to deadlines and meeting targets, this can also prove to be very stressful, for example if the nurse does not stick to the target to get a service users records in time this can have serious implications, this then putting strain upon the nurse. Some service users do not recover from their illness, which leaves the nurse feeling upset, especially if the nurse has provided care for the service user throughout their time at hospital, and has made a bond with this person. The nurse may become very upset and emotional; this then puts strain on the nurse’s career. Paper work and record keeping can also demonstrate stress within the job role. Paper work can be very demanding and also time consuming; this can be very stressful for the nurse and the deadline may not be met.
Being a nurse is a very satisfying, helping others gives the nurses a lot of self esteem and also builds up confidence, they make patients feel at ease whilst they go through a difficult period in their lives. Nurses are regarded as very hard working member of their community, helping others and being a positive influence on those in need. Nurses take a lot of pride in the work they do, they treat every patient with a lot of respect and are hoped to gain this respect back. This job is very rewarding in the type of work that is put into place, knowing that the nurse has helped someone recover from a serious illness or just been there in their time of need is enough to satisfy the nurse into knowing they have done their job properly and to the best of their ability.