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Defining the Role of the RN

This virtual forum is intended to open a dialogue on what makes RNs unique in the provision of nursing care and the contribution we make within the health care delivery system.

Presenter: Virgil Guitard, RN 

NANB Nursing Practice Consultant

Technician, Clinician, Advocate, Leader? Defining the Role of the RN!

How often have you heard Registered Nurses (RNs) voice their concern about their role in the ever changing healthcare environment?  How often have you found it challenging to explain ‘’your’’ role as an RN to others?  Why do we find it easier to articulate what we do and who we are by listing nursing tasks? Why do we have difficulty explaining the difference between ourselves and other nursing care providers (LPNs and unregulated care providers)?

Registered nurses should be able to identify the aspects of their role that are unique to our profession and the specific contribution we bring to patient care.

This virtual forum is intended to open a dialogue on what makes RNs unique in the provision of nursing care and the contribution we make within the health care delivery system.

Take time to read what your colleagues will be sharing and you may want to build on their thoughts.  To get you started you may want to consider some of the following questions:

  1. Are there any specific, unique qualities or attributes that RNs have that are an added value to the delivery of care to patients?
  2. What makes RNs ‘’different’’ from other nursing care providers and other members of the healthcare team?
  3. How do you define and explain YOUR practice?

Archived Comments

Anonymous (7 years ago)

A registered nurse is a leader, by education and preparation, and in time, experience. We work together with LPNs, and other members of the healthcare team in many settings, or alone in an outpost as the sole care provider. As has been pointed out, when the others are not there to assist or take part of the care, we do it all. If care goes from acute to critical or unstable, the RN steps up to assume care in a setting of multiple team members or alone until assistance arrives. We are leaders, decision makers, advocates, educators, and caregivers. Ultimately, care, responsibility, and questions are directed to the RN. We need and appreciate all our colleagues, whatever their role. It is because of them that we are able to provide the best level of care we are capable of, and have earned and still have the trust of the public. It has been a long and continuing journey from the “lady of the lamp” to where we are today. We are proud of who we are, and strive to better our role as we move forward into the unknown. May the standards of excellence we pride ourselves on be taken further and higher by those who choose to light their “lamp” from the flame currently burning.

Marie (7 years ago)

Hello Virgil, thank you for the opportunity to speak on this subject. I have grave concerns for the future with respect to increased demands being put on an aging population of nurses. Yes, we’re all getting up there, and I fear that the role of the nurse is ever increasing, while our capacities , with the normal aging process, is not necessarily diminishing, but definitely slowing down. Having experienced many changes in my 25 plus years as an RN, I can definitely say first hand, I can no longer handle the pace. How government can arbitrarily decide that staffing cuts are a cost effective way to handle budget restraints is naive. I believe it’s time for the powers that be to study the effects of all the cutbacks on staff health. There are many colleagues of mine that are out on medical leave now, due to injuries and burnout. And the remaining staff are feeling overwhelmed with “carrying” the load. Defining the role of the RN……RN’s DO IT ALL!! When the manager isn’t there, we manage…when the RT isn’t there…we provide O2 therapy, we do phlebotomy, we co-ordinate extra mural care, we teach…we teach not only patients, but family…other nurses, students , and sometimes even doctors. When Physio is not there on weekends….we are physiotherapists….when psychologists aren’t there….we provide counselling…..WE ARE essentially a HEALTH CARE TEAM , because of our knowledge and experience, we can DO IT ALL! Unfortunately, more and more it seems we are expected to do it all . And though I realize there are younger nurses coming into the system, the situations we face in today’s settings are scaring the younger nurses into either leaving the profession, or they seek to get into managerial or supervisory positions right away. As many of us are approaching or are at a time in our careers when we have the option to retire or reduce our hours…..who will be left to teach, guide, mentor the fewer and fewer new nurses who decide to stay??

Joanne ↪ Marie (7 years ago)

Thank you Marie, I could not said it better myself. I recently changed areas of work to reduce the physical strain on my body in hopes I can continue to work until retirement age. I do not think the courses nursing students are currently taking are preparing them for our work force. Work ethics have changed over the years and not for the better. When people have been in the workplace less than five years and are talking about burnout and asking for stress leave, the system is not properly preparing them. What is going on when a senior nurse can work circles around a young nurse?

Rowena ↪ Marie (7 years ago)

I concur with Marie. We older Nurses unfortunately do not have the stamina to carry the Profession into the future. Age happens and we cannot stop this process. I despair at the limited time an RN gets to actually spend quality time at the bedside. The most rewarding part of my Profession!! I watch as Patients get the bare minimum care from all caregivers and wonder how the powers that be continue to claw back the “bodies” that provide care. It scares me.

Anonymous (7 years ago)

Hi Virgil, thank-you for the opportunity to participate in this very timely discussion. I would like to offer another perspective to the discussion, simply something to consider. Point #1: As a professional
Registered Nurse, we know our role, it’s dynamic evolution and the value we provide to the healthcare system. I believe the public is, and has been for many years, well aware of what RN’s contribute to the healthcare system. The profession of Nursing has had a “social responsibility”, more so a “social contract” with the public for many years. One that states we are competent, will practise within our competencies and we will continue to maintain our competency in order to provide you, “the public”, with the best possible care outcomes.(best care possible, best practise … etc.) Currently, in my opinion, the policy makers, the healthcare delivery systems, the universities and colleges are breaking this “social contract” by allowing(creating, promoting, legitimizing ) other, sometimes non registered individuals to participate in the delivery of patient care. No wonder the public are confused at times about who is actually providing care and what their qualifications are to do so. Studies from across North America in the 1980’s and 90’s indicated that the most cost effective care models, had the best
patient outcomes, were provided by all Registered Nurse staff. Unfortunately when funding issues arise … the rules change! Who thought this would be acceptable? Point #2: I believe the universities & colleges are doing a disservice to the Profession, to new nurses and to those who wish to study
nursing in the future, by promoting the idea that all Registered Nurses will be managers, that bedside nursing will be done by other, less educated, less skilled and less committed individuals. What a disappointment for those who want the advanced education of a degree but also want to care for patients. Clinical expertise is one of the longstanding hallmarks of the nursing profession. Educators should be maximizing their charges exposure to the wide variety of clinical settings open to registered nursing students. As a profession we need to go back to the policy makers, healthcare delivery
systems, universities & colleges and say this not acceptable. Registered Nurses are and have always been the benchmark for patient care.

To a Registered Nurse it’s is not a job or a paycheque… if it is they have entered the wrong profession for the wrong reasons …Registered Nurses are committed to the profession and to providing their
patients with the best outcomes possible.

Anonymous (7 years ago)

As an R.N. i appreciate the position I am in to gather information from so many sources that perhaps no other member of the team have access to. Consider these sources please; the shift report, the patient”s
input or lack of same, my assessment, the Doctor’s opinion on rounds, the doctor’s orders and progress notes, the nursing history and nurses notes since admission, the lab reports, x-ray reports the medication list and in many times just knowing the patient and their wishes all are so important when that sudden
emergency crops up and within a few seconds you positively know exactly what you want done, who to call and who to appoint to look after the rest of the pt. load while the emergency is delt with. or better yet, you are working with the best LPN ever and you know she knows exactly what she should do! Greatest job

Anonymous (7 years ago)

I am an RN working in the Extra-Mural Program in the community. RNs in this position are case managers.
WE are responsible for the treatment and management of the patients in our care. We provide the assessment, management and co-ordination of care to our patients.
We provide ongoing reports to the physician of the patients progress and any concerns that arise during care. We identify changes and initiate interventions before these changes develop into emergencies. We also identify the need for the input of other health care team members such as
physio therapist, occupational therapist, respiratory therapist, dietician and social workers.
A large part of our role is to give ongoing teaching to enable the patient and family to understand their medical conditions and be better able to partake in their own care and management of the symptoms they must live with.
Our scope of practice covers acute care, chronic case management and palliative care for the patient and family involved. This position demands sharp assessment skills and a broad knowledge of medical and surgical coditions as well as complications that may develop and the instinct to know when to call for further investigation and or treatment.
The RN is the facilitator between the patient and family and the health team members involved in the care and with the physician or physicians invoved in the patirnts care. We are the one at the patients side to co-ordinate the best care and best outcome for those in our care.
Being an RN is far more than performing nursing duties and skills. It is It is ensuring that they recieve optimal service that they require and deserve and also a strong advocate who will act on their behalf to
ensuer they the best health care experience that we are capable of delivering.
I am proud to be an RN and very proud of my colleagues who strive to deliver nothing but the best in an ever changing and expanding profession that is nursing.

Anonymous (7 years ago)

Im an RN in an active hemodailysis unit and I use critical thinking on a daily basis to provide care to the clients .Each time a new client starts its the RN that makes decisions on the care and well being of this person .We also consult the Dr for orders .WE have an order set but its the Rn that recognize if other issues need to be dealt with . Rns on this unit are also responsible for charge duties and directing care of a team .

Anonymous (7 years ago)

Nurses are knowledgeable, compassionate, caring individuals with a desire to serve others…motivated to serve…

Anonymous (7 years ago)

Replacing RN’s with providers who have less qualifications, knowledge and skill sets is a big mistake. “There is no substitute for an RN”, and with the help of competent qualified assistants such as LPN’s one
is assured of the best care possible. This statement is not meant to demean other types of care givers who also have an important role which I respect.
Reading other comments, I could not agree more and they have covered all aspects of your “Wheel”
In defining the role of an RN and more.
Thank you

Anonymous (7 years ago)

I have had to re-think about who I am as a RN: I am not just a doer of
tasks, but rather an educated professional who often times performs
tasks. I find that both my BN and MN degrees have served me very well in
many ways such as: educating patients (and families) regarding their
health and their treatment plan; thinking outside the box to address a
symptom that others might have missed; having confidence to advocate on
behalf of my patients because I know what I know and I can admit what I
don’t know with the message that I’ll try my best to find the answer;
working on policy change; engaging government officials for change;
collaborating with the healthcare team because I try to understand their
role and explain my role to them, as needed; etc. The more I learn, I
realize how much I need to learn. As a RN, I have a lot of knowledge to
try to prevent worsening of patient conditions and yes, that BN program
has helped me to communicate a lot better. Yes, I execute tasks, but
while I am doing that, my brain is thinking about the holistic well
being of those I am serving. I have learned how to research and learn,
so that I may keep on learning. I am a doer but I am also an educated
professional who is able to coordinate, implement, evaluate and
communicate for effective nursing care delivery.

AM (7 years ago)

I see the RN as the “conductor” of health care; like the leader in the orchestra with the knowledge of each player’s roles, overseeing and acting when necessary to achieve the best possible outcomes. Skilled nurses have the knowledge, attitude and competencies to work within and beyond the health care system to help the person achieve their health goals. While other providers each have their valuable roles, when the RN is involved, she or he is often on the front line, intimately involved, coordinating the care.

Rowena ↪ AM (7 years ago)

True, true, so true. Great words.

Nursing 2016 (7 years ago)

I work at a nursing home where I call in replacement staff for nursing, laundry, housekeeping, kitchen staff and maintenance after 4 pm. as well as holidays and weekends. I am the resident’s advocate in calling the families and the doctor when changes in their physical condition merits, I draw blood to send specimens to the lab. LPN’s and PSW’s call themselves nurses until a problem arises and then they run to get the RN who then assumes the responsibilities and decisions to fix the problem. RN’s are the glue that holds the whole operation together! I go without my breaks to get my work done, I work overtime without pay to see my residents are cared for, and I make those phone calls that are not easy when the doctor on call doesn’t want to talk to me. Being an RN is a big responsibility!

Front liner (7 years ago)

As an RN who is a front line worker, I am the person who implements and coordinates the medical care plan on behalf of the physician. I monitor patient progress assessing for deviations from the normally expects outcomes and communicate those to the physician for adjustments in the plan of care. I lead the case on behalf of other providers and consult with other disciplines for better outcomes.

Disappointed RNBN (7 years ago)

I think that LPN’s have continually added new skills to their LPN portfolio. I was an RN for 30 years and then took my BN. Other than the research course I did not learn anything that advanced my ability as an RN to deliver patient care. I did learn to write an excellent essay. The BN course needs to have advanced pharmacology, advanced leadership management skills, advanced patient care skills, test interpretation etc. I really believe the BN for a practicing RN with experience was a waste of my time.
BN’s need to have a masters level of knowledge so they do have superior knowledge and judgement skills. The LPN’s keep advancing their knowledge in increments that are compatible with working full time and, caring for their families. The BN’s should have advanced care modules that are compatible with working full time and, caring for their families such as Nurse Practitioner and physician assistant.