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Chapter: Medical Surgical Nursing: Health Care Delivery and Nursing Practice

Roles of the Nurse

1. Practitioner Role 2. Leadership Role 3. Research Role

Roles of the Nurse

As stated earlier, nursing is the diagnosis and treatment of human responses to health and illness and therefore focuses on a broad array of phenomena. There are three major roles assumed by the nurse when caring for patients. These roles are often used in con-cert with one another to provide comprehensive care.


The professional nurse in institutional, community-based or public health, and home care settings has three major roles: the practitioner role, which includes teaching and collaborating; the leadership role; and the research role. Although each role carries specific responsibilities, these roles relate to one another and are found in all nursing positions. These roles are designed to meet the immediate and future health care and nursing needs of con-sumers who are the recipients of nursing care.



The practitioner role of the nurse involves those actions that the nurse takes when assuming responsibility for meeting the health care and nursing needs of individual patients, their families, and significant others. This role is the dominant role of nurses in pri-mary, secondary, and tertiary health care settings and in home care and community nursing. It is a role that can be achieved only through use of the nursing process, the basis for all nursing prac-tice. The nurse helps patients meet their needs through direct in-tervention, by teaching patients and family members to perform care, and by coordinating and collaborating with other disciplines to provide needed services.




The leadership role of the nurse has traditionally been perceived as a specialized role assumed only by those nurses who have titles that suggest leadership and who are the leaders of large groups of nurses or related health care professionals. However, the constant fluctuation of health care delivery demands and consumers re-quires a broader definition of nursing leadership, one that iden-tifies the leadership role as inherent within all nursing positions. The leadership role of the nurse involves those actions the nurse executes when assuming responsibility for the actions of others that are directed toward determining and achieving patient care goals.


Nursing leadership is a process involving four components: decision making, relating, influencing, and facilitating. Each of these components promotes change and the ultimate outcome of goal achievement. Basic to the entire process is effective commu-nication, which determines the accomplishment of the process. Leadership in nursing is a process in which the nurse uses inter-personal skills to effect change in the behavior of others. The components of the leadership process are appropriate during all phases of the nursing process and in all settings.




The research role of the nurse was traditionally viewed as one car-ried out only by academicians, nurse scientists, and graduate nursing students. Today, participation in the research process is also considered to be a responsibility of nurses in clinical practice.


The primary task of nursing research is to contribute to the scientific base of nursing practice. Studies are needed to deter-mine the effectiveness of nursing interventions and nursing care. Through such research efforts, the science of nursing will grow and a scientifically based rationale for making changes in nursing practice and patient care will be generated. Evidence-based prac-tice will be facilitated, with a resultant increase in the quality of patient care.


Nurses who have preparation in research methods can use their research knowledge and skills to initiate and implement timely, relevant studies. This is not to say that nurses who do not initiate and implement nursing research studies do not play a sig-nificant role in nursing research. Every nurse has valuable con-tributions to make to nursing research and a responsibility to make these contributions. All nurses must constantly be alert for nursing problems and important issues related to patient care that can serve as a basis for the identification of researchable questions.


Those nurses directly involved in patient care are often in the best position to identify potential research problems and ques-tions. Their clinical insights are invaluable. Nurses also have a re-sponsibility to become actively involved in ongoing research studies. This participation may involve facilitating the data col-lection process, or it may include actual collection of data. Ex-plaining the study to other health care professionals or to patients


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