Greer Glazer's Reply:

Your letter is indicative of what is going on throughout the United States and internationally. Nurses are being asked to take on numerous responsibilities that they have previously not taken on, and feel that their roles are changing constantly. I am not sure whether your last question of whether nurses are going to be asked to perform minor surgery was factitious, but in fact, I believe that our roles will continue to change drastically over time to respond to the changing needs of our clients and the healthcare system.

You ask what rights nurses have when being asked to take on new roles and responsibilities. Nurses need to have the knowledge and skills to provide safe, quality care to their clients. This means that if nurses have never performed certain skills, like drawing their own labs, or doing EKG’s, the health care facility where they practice has the responsibility to educate them and assure practice proficiency so that nurses feel comfortable performing the new skills.

The same is true for taking on new client populations. I am a women's health nurse too, and would find it very difficult to feel comfortable providing medical-surgical care to clients, especially men, whom I haven't cared for in 25 years. In your situation, I would first find out if it was absolutely necessary that the unit take on the medical-surgical clients. Ask what went into the decision. Is it possible that the vacant beds could be used to service another type of women's health or child client that the unit is not currently servicing? Could the unit find another way of making money, such as providing a 24 hour helpline for women and children, that would offset the vacant beds? These are illustrations of alternatives you could try; your nurses need to think about other ways of addressing the vacant beds. If all efforts fail in averting the scenario of taking on medical-surgical clients, the principle described above holds true for taking on new clients. The health care facility has the responsibility to educate the nurses and assure practice proficiency so that they feel comfortable giving nursing care to these medical-surgical clients.

The real issue is that nurses want to provide the best care that they can to their clients. When they are asked to take on new roles and responsibilities without adequate education and skill practice, they feel badly because they know that the clients are not getting the care that they deserve. Even though we may not like the changes that come our way, as employees, we need to adapt to the changes if there is adequate education and skill practice. When this is not forthcoming, which is unfortunately often the case, we have the obligation to demand it from our health care institutions. Our goal is and will always be that we have the knowledge and skills to provide safe, quality nursing care to our clients.

Greer Glazer PhD, RN, FAAN
Legislative Editor

Go to the article.
Letter by a RN from Florida

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