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EXTENDED AND EXPANDED ROLE OF A NURSE

INTRODUCTION: - Extended care facilities assist client with their
daily activities, provide care when necessary and co-ordinate
rehabilitation service.
Definition:- Extended role of nurse is an activity concerned with the
patient either in hospital or community that are appropriate for
delegation by doctors to nurses.
EXTENDED ROLE OF NURSE
 Care giver
 Manager
 Advocator &protector
 Counsellor
 Nurse educators
 Communicator
 Rehabilitator
 Collaborator
 School health nurse
 Occupational health nurses
 Parish nurses
 Public health nurses
 Home care nurses
 Rehabilitation nurses
 Office nurses
 Nurse epidemiologists
 critical nurses
 Nurse administrators
 Nurse practitioners
 Nurse midwife
 Community health nurses
 Occupational health nurse
 Psychiatric nurses
 Medical surgical nurse
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1) CARE GIVER- Care giving role is primary role of nurse. The nurse
adds the holistic care needs of the client, including measures to restore
emotional, spiritual & social wellbeing.
2)MANAGER -The nurse coordinates the activities of team members
and manage the task.
3)PROTECTOR AND ADVOCATOR - As protector, nurse helps to
maintain a safe environment for the client and take steps to prevent
injury and protect client from possible adverse effects of diagnostic or
treatment measures. Conforming that a client does not have an allergy
to a medication and providing immunization.
4)COUNCELLOR- The role of a counsellor, nurse helps to explore
feelings and attitude about wellness &illness with patients and their
families.It involves providing emotional, intellectual and
psychological support. Counselling requires therapeutic
communication skills.
5)COMMUNICATOR- The role of communicator is central to all u

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Nursing roles and activities.

-Nursing involves communication with client, families, other nurses
and health care professional and he community.
-Quality of communication is critical factor in meeting the needs of
individual, families and communities.
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-The nursing interventions planned and implemented for each client

and should document them on client record this type of
communication need to be clear and relevant.
6)REHABILITATOR-Rehabilitation is the process by which
individual returns to maximum level of functioning after illness,
accidents or other disability events.
-Usually client experiences physical or emotional impairment that
changes their lives and nurse helps them to adapt as fully as possible
by using her knowledge and skills.
Functions
-Move towards independence
-Work as part of multidisciplinary team
-Coordinate patient care prevent complication
-Patient education and counselling
7)COLLABORATOR-Many professions make up the team involved in
the care of each client.
-Besides nurse, their also can be physical therapist, occupational
therapist, social workers and nutrients.
-The nurse collaborates with other team members when providing
care to client.
8)SCHOOL HEALTH NURSE-School nursing is a specialized practice
of professional nursing that facilitates the wellbeing, academic
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success and lifelong achievement of students.

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Functions
 Direct care giver- The school nurse is expected to give
immediate nursing care to the ill or injured child or the school
staff members
 Case finder- the school health nurse identifies as early as
possible children at risk for physical, behavioural, social or
academic problems.
 Case manager- help to coordinate the health care for
children, with any health problem.
 Consultant- provide professional information about changes
in school environment and their impact on the health of
children
 Health educator- the nurse provides health education
regarding proper nutrition or safety information, personal
hygiene to children and also to their parents
9)Occupational health nurse;-Occupational and environmental
health nursing is the specially practice that provides for the delivery
health and safety programmes and service to the workers and
community group. Practice focus on ;-
- Promotion of health
-Restoration of health
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- Prevention of illness
- Protection from hazards
Functions
 Direct nursing care- this care involved primary, secondary and
tertiary prevention with nursing intervention from assessment.e.g.
physical assessment, screening.
10)PARISH NURSE- Parish nurse is the most commonly used term for
the professional advanced nurse practice role for the gathering in
churches, temples or mosques.A parish nurse specialist who
encourages physical and spiritual health. A parish nurse is a registered
nurse with specialized knowledge who is called to ministry and
affirmed by a faith community to promote health, healing and
wholeness
FUNCTIONS–
-Provide a spiritual care:spiritual care is the core of parish nurse
practice and central to the healing process.
- Health counsellor: health counsellor explain health risk appraisal,
plan for health their life style, provide support and guidance related
acute and chronic, actual and potential health problems.
-Health advocate:- as an advocate, parish nurse guides persons
successfully for problem solving and care options.
-Health educator: as an educator, serves to gain knowledge in order to
make best choices for maintaining health, lowering health risk,
preventing illness and managing diseases' already present.
11)PUBLIC HEALTH NURSE

 It is a registered nurse specially trained in community health

 Public health nurses work within the communities and focus on
different areas to improve the overall health of the people within that
community.
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functions
 Health advocate-as an advocate, public health nurse collects,
monitors & analyse data and discuss with the client which
services are needed.
 Care manager-public health nurses uses the nursing process of
assessing, planning, implementing, & evaluating outcome to
meet client’s needs.
 Health educator-as an educator the public health nurse
identifies community needs & develop and implement activities
aimed at changing behaviour.
 Communicable disease control-public health nursing skills are
necessary for education, prevention, surveillance &investigation
of communicable diseases on community.
13)REHABILITATION NURSE-Rehabilitation nurse as a nurse who
specializes in assisting with disabilities and chronic illness to attain
optimal function, health, and to adapt to an altered life style.
Functions - They work as a part of multidisciplinary team and often
coordinate patient care and team activities.
- Rehabilitation nurse provides care that helps to restore and maintain
function and prevent complication
-Provide patient and family education, counselling and case
management.
14)OFFICE NURSE-Office nurse is called as clinic nurse. Office nurse
provide patient care along with physician in setting such as physician
office, medical office. - The main focus is on diagnosis and treatment
of specific illness rather than health promotion.
Functions - identifies trends in the type of
problems client present and treating them,
provides health promotion activities by health
education and health counselling. Acts as
problem solver who helps with referral
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15)NURSE EPIDEMIOLOGIST- Nurse epidemiologist searches for

new diseases and its reporting and taking part in health programs.it
may include survey method to identify the new diseases.
16)CRITICAL CARE NURSE- Qualification of critical care nurses are
basic b Sc, degree or diploma in nursing and advanced preparation in
critical care nursing.
Function
o Monitoring balloon angioplasty, pacemaker, hemodynamic,
bedside haemodialysis and surgical procedures.
o Manages patients total care.
o Performs defibrillation.
17)NURSE ADMINISTRATOR-The nurse administrator manages client
care, including delivery of nursing service. - the function of nursing
administrator includes budgeting, staffing and planning programmes.
18)NURSE PRACTITIONER A nurse who is qualified to treat certain
medical condition without the direct supervision of doctors Nurse
practitioner who are educated and trained to provide health promotion
and maintenance through the diagnosis and treatment of acute illness
and chronic condition
19)NURSE MIDWIFE-The nurse midwifes gives perinatal care for the
mothers. They also conduct pap smear, family planning and routine
breast examination.
20)COMMUNITY HEALTH NURSE-The
goal of community health nurse is to
improve health of community as a whole.
Community health nurse function within the
community framework and serves the health
needs of public and deliver care to the
community. - Functions of community
health nurse
 Home visiting
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 Assisting in ANC and PNC

 Collection of information and data collecting
 Conduct school health services
 Health education
21)OCCUPATIONAL HEALTH NURSE ;- The occupational health
nurse work in traditional manufacturing, industry services,
construction sites and government setting.The role includes:
assessment, primary health care, case management counselling, health
promoting and protection, research, administration and management
22)PSYCHIATRIC NURSE- it is a branch of nursing that deals with
mentally challenged and mentally disturbed clients and their needs.
The role includes educator, surrogate, counselling, psychotherapist
and advocate.
23) MEDICAL SURGICAL NURSE- It is a branch of medicine that
deals with the overall medical and surgical needs of the client and the
functions include assessment of problem help in diagnosis, treatment,
administration of medication etc.
EXPANDED ROLE OF NURSE

INTRODUCTION:-

Expanded role of nurse is the responsibility assumed by the nurse

within the field of practice. Increasing educational opportunities for
nurses, the growth of nursing as a profession and a greater concern for
job. The nursing profession offers expanded role and different kind of
career opportunity.
DEFINITION: Expanded role of nurse means enlargement of nursing
within the boundaries of nursing.
The expanded role of nurse includes the following;-
 Advanced nurse practitioner
 Clinical nurse specialist
 Nurse anaesthetist
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 Nurse researcher
 Nurse educator
 Acute care nurse practitioner
 Nurse entrepreneur
 Operating home nurse
 Travel nurse
 Nurse oncologist
 Nurse informatics
 Sport nurse
 hospice nurse
 space nurses
 Tele nurses
 Cruise nurses
 Disaster nurses
 Nurse as author nurses
 Epidemiology
 ethicist
1)ADVANCED NURSE PRACTITIONER- a nurse who has an
advanced education and is a graduate of nurse practitioner program
is employed in health care agencies.
Job responsibility includes-
- taking client history
- Conducting physical examination
- ordering performing diagnostic test
- providing primary care
- consultant for individual, families and communities
2)NURSE CLINICIAN/CLINICAL NURSE SPECIALIST - clinical nurse
specialist has a master degree in nursing and expertise in a specialized
area of practice.
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Functions-the main function as client

care provider, educator, and consultant
researcher, manager and improve the
quality of care provided to the client and
family members.
3)NURSE ANESHETIST-A nurse
anaesthetist is a registered nurse who received advanced traning in an
accelerated program of anaesthesiology.
Functions- carries visit and assessment
- Administration of general anaesthetic agent for surgery.
- Assessment of post-operative status of client.
4)NURSE RESEARCHER- Nurse researcher may be employed in an
academic setting, hospital, or community service agencies
Functions - The nurse researcher investigates problems to improve
nursing care and to further define and expand the scope of nursing.
5)ADVANCED NURSE EDUCATOR-The nurse educator is usually
degree holder or more advanced or more advanced and frequently an
expert in particular area of practice
6)ACUTE CARE NURSE PRACTITIONER-An acute acre nurse
practitioner function in setting where critically ill patient reside this
type of nurse provide special expertise.
7)NURSE ENTERPRENEUR-An entrepreneur is an individual who
organize operates and assumes business. Such as independent nursing
practice, consultants service etc. the nurse may be involved in
education consultation research etc
8)OPERATING ROOM NURSE- - When patient is admitted before and
after surgery, the operating room nurse monitors the patients progress.
She also performs preoperative assessment, prepare the patient for
surgery, assist the surgeon during procedure and manage patient
recovery.
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9)TRAVEL NURSING-Travel nursing and the travel nursing industry

developed in response to the nursing shortage in which nurses are
relocated for short term nursing positions
10)NURSE ONCOLOGIST- Advance oncology nursing practice it
means practice of expert and leadership in the provisional care to
individual with an acute and potential diagnosis of cancer.
11)NURSE INFORMATICS/NURSE ANALYST-The nursing analyst
work within the management team to ensure high quality of
performance and technical support to both the management and the
nursing staff. A nursing analyst must have a strong statistical
background a be able to interpret data in a logical manner.
-The nursing analyst must be able to work on multiple project at one
time, focus on details.
12)SPORT NURSE-The nursing profession has yet to officially
develop a specialty in fitness nursing or sport nursing on either the
professional or academic level, a growing number of nurses become
involved in these areas.
-The connection between physical fitness, wellness and disease
prevention is well documented.
-Some nurses are involved in sport medicine on a full-time basis
while others work on a full time, contract basis for sport time.
13)HOSPICE NURSE- The focus of hospice care is a comprehensive
physical, psychosocial, emotional, and spiritual care to terminally ill
person and their families.
-Hospice providers promote quality of life by protecting patient from
burdensome intervention and providing care at home.
14) SPACE NURSE-Space nurse provides a on the ground monitoring
and a full range of health services to astronauts, who are screened to
determine if they meet the NASA health requirement.
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-Flight medicine nurse also coordinate dietary and fitness services;

clinical nurse staff a sick call service for astronauts to use before and
after flight.
15)TELE NURSES ;-It carries out telephonic communication with
patients thus providing response to medical care/treatment Among its
many benefits telenursing may help solve increasing shortage of
nurses, to reduce distances and save travel time, and to keep patient
out of hospital.
16)CRUISE NURSE- These nurses work on ships or resort to provide
emergency and general care to passengers /vacationers, should it be
required.
- Responsibility includes providing patient care in the health centre
and dealing with onsite emergencies.
-The requirements are registration with a minimum 2 years of
experience in a recent Hospital required,experience with cardiac care,
trauma, and internal medicine etc.
-They must have excellent interpersonal skills,strong health
assessment skill.
17)DISASTER NURSE/BIOTERRORISM NURSE- these nurses works
in disaster areas that are the
result of bioterrorist attack or
a situation caused by natural
disaster, war, or poverty, red
cross nurse is often part of
wing of nurses.
The skills include:-
emergency room and critical
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care experience, management
skill, ability to meet the needs
of the people in high crisis situation.
18 NURSES AS AUTHOR- A registered nurse who works in area of
writing this written material may be used in research education,
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training, sales and marketing, and other mediums and communication

forums.
-The quality of journals which publish to nursing practice, material
concerning nursing issues depend on quality of material submitted.
19)EPIDEMILOGY NURSE-A nurse epidemiologist investigates trends
in groups or aggregates and studies the occurrence of diseases and
injuries.
 The information is gathered from census data and statistics and
reportable disease records.
 They identify population at risk monitor the progress of disease,
specify areas of health care needs.
 They don’t provide direct nursing care, but they do research and
publish the latest trends in health care.
Functions
 Administration of general and specific health surveys
 Participation in early diagnosis and treatment
 Identification and treatment of certain specific diseases
 Health education.
20 ETHICIST- A nurse who knows about legal/moral/ethical issues
and provides services for patient and families is called nurse ethicist.
-The nurse may work with an ethicist team to develop a detailed
investigative plan.
-The criteria are a master degree in bioethics or related field along
with a registered nurse certificate.
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BIBLIOGRAGHY
P. Shebeer, S. Basheer, khan Y. Textbook of advanced
nursing practice ,2nd edition, Page no.945-954.
Rawat H.C., Brar N.K., Textbook of advanced nursing
practice, 3rd edition, Page no.482-494.