A CLOSER LOOK AT A NURSE'S RESPONSIBILITIES

Everyone has individual duties and responsibilities at work. It is a teacher's responsibility to impart knowledge to students whilst a lawyer's responsibility is to defend his or her clients' interest. Just like any other profession, nurses have a lot of heavy load or responsibilities that they need to carry out.

Such responsibilities are the following:

1. Endorsement

During the start and end of every shift of a nurse, a nurse has to make sure he or she completes this task to ensure the continuation of health care to patients. This is a tally of all the activities done during the shift. It will also include a list of tests to be done for certain patients, what medicine needs to be administered or stopped, the heath status of patients, diets, strict precautions, doctor referrals and etc. It is crucial that the information provided on this ledger be accurate and precise, again, this is called the endorsement.

2. Taking vital signs accurately

It is important that nurses take the baseline vital signs of patients especially during admission. This accurate report will be the basis of the patient's health condition, whether his or her health is improving or deteriorating so that proper reporting to the attending physician is ensured.

3. Checking of IV fluids, site and patency

It is very important for a nurse to check whether the IV fluids of a patient are running properly. This monitors the fluid intake of a patient. Nurses need to make sure that this is monitored regularly.

4. Carrying out doctors’ orders

Carrying out doctor’s orders is essential however if it is in conflict with health status, personal or religious beliefs of the patient, it is necessary to question what the doctor has written. Nurses have the right to question the doctor’s orders. Nurses should still perform a safety check and find if a certain medication ordered by the doctor is/are the right medication for the patient. It is necessary to verify what the doctor has written to prevent medication errors. It is important to have presence of mind in carrying out the orders and before carrying out, make sure that the doctor has signed the order after writing it. And most importantly, if you are in doubt with orders, don’t hesitate to ask or give ideas for the benefit of the patient and their improvements.

5. Monitoring

Monitoring is important especially if it is indicated in the doctor's order list. This is to make sure the progress of the patient is measured accurately. If the patient’s health status is deteriorating, it is imperative that the physician is alerted immediately. The following might be monitored as per doctor’s order such as vital signs,urine output, blood chemistry,hematology, blood sugar, etc

6. Giving medication

When giving medication, it is essential to double check that the doctor’s orders sheet and the medication sheet matches. Check the expiration date and potency of the medicine before preparing. While preparing the medication, make sure to double check the medication, dosage and dilution(if any). After preparing, check it again if it is correct. Following the “7 rights of medication administration based on the nursing practice”- right medication, right patient, right dosage, right route, right time, right reason.Also, check the patency and status of the IV fluid. Lastly, dont forget to document it in the patient’s chart (right documentation).

7. Taking rounds with the doctors

When you involve yourself during rounds with doctors, you learn more knowledge about the case of the patient and you may also contribute for their speedy recovery by giving your whereabouts or ideas for the welfare of the patient.

8. Checking of Emergency Drugs and Instruments as well as the Availability of IV Fluids and Medication for the next shift

Emergency situations are inevitable, we don’t know when it may arise so readiness is the key to it. Checking the completeness and expiration date of emergency drugs and instruments is essential because when emergency arises we can easily get and prepare for it. Once checked, it is important to place the emergency trolley in an accessible area. Before the end of the shift, also see to it that IV fluids and medications that will be used for the next shift are complete and available. 9. Updating patient’s records/Charting

When we were studying nursing, our RLE professors would always remind us that if we forgot to chart it, it means it didn’t happen because it wasn’t documented. “Charting provides a record of everything that was done for the patients' medical care. It includes information on medications, procedures, laboratory, diagnostic tests, monitoring, and all interactions with doctors and other health care professionals. It also gives a brief background to other medical workers on what is going on with the patient. It also serves as a protection on the event of legal action or concerns; so, accurate documentation is very critical”-as mentioned in gapmedics.com. In the said website, it was also stated that charting should be:

1. Objective- We need to document what we see, hear and feel. If the patient reports about something that she/he feels, state in the charting “patient stated that she/he feels…..”Don’t chart for someone else or something that someone else have told you.

2. Legible-make sure that the handwriting is readable, neat and legible. In short, handwriting is understandable.

3. Accurate-One of the most important factors in charting is accuracy. Even if you did the procedure correctly according to the patient’s bill of right, if you charted it incorrectly, it appears that you did it wrong.

4. Timely- not all the time that you may be able to chart on time but always try to chart as soon as possible after doing something on the patient to prevent addendum or late entry. And trying to chart as soon as possible will help you not to forget all the details that you have done for the patient and you will not missed something. 10. Counterchecking

Counterchecking is done to secure the records of the patient and the charting as well. It is to ensure that you haven’t missed anything from plotting the vital sign sheets, monitoring sheets, medication sheets, iv fluid sheets, doctor’s order sheets, etc .Lastly, make sure you have signed all the part of the patient’s chart that needs to be signed.

A nurse's responsibilities, just like other professions' are very important, so important that people's lives are at stake. Whatever field you are in or choose to be in, whether it's in health care, academe, law or even in agriculture, it is imperative that each professional or worker take his or her responsibilities with utmost care. That is how the world goes-responsibilities, lots and lots of it.