This document provides an overview of the nurse's role in the healthcare system. It defines key terms like nursing, nurse, and nursing practice. It describes the philosophy of nursing as respecting patient dignity and treating each person as an individual. The nurse's roles include caregiving, advocacy, education, research, and management. Healthcare is organized at national, hospital, and community levels. Hospitals are organized into levels that provide different services. Community health involves health centers, posts, and organizations that work together to promote health. The nurse collaborates as part of a multidisciplinary team that includes doctors, pharmacists, and others to provide comprehensive patient care.

1. FUNDAMENTALS
OF NURSING
UNIT :1
THE NURSE IN THE HEALTH CARE SYSTEM
BY JONES H.M-MBADMS
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2. PRESENTED BY:
MRS C. S. HAMWEETE.
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3.  General Objectives
Student should be able to demonstrate an
understanding of the role of the nurse in the health
care setting.
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4. Specific objectives:
At the end of the lecture/discussion students should be able to;
 Define nurse, nursing, nursing practice and fundamentals of nursing.
 State the nursing philosophy.
 Describe the organization and functions of the hospital and
community health services
 State the role of the nurse.
 Describe the multidisciplinary health care team in the hospital and
the community settings.
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5. INTRODUCTION
 Nursing is an important part of the health care system.
The core of nursing is those nurse-patient relationships
that result in a therapeutic outcome.
It encompasses the promotion of health, prevention of
illness, and care of the physically ill, mentally ill and
disabled people of all ages in all health care and other
community settings.
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6. DEFINITION OF KEY TERMS
1.Nursing
“The act of assisting the individual, sick or well, in the
performance of those activities contributing to health
or its recovery (or to a peaceful death) that he would
perform unaided if he had the necessary strength,
will and knowledge. And to do this in such a way as
to help him gain independence as rapidly as possible
“ (Henderson, 1966)
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7.  Nursing
“is the protection, promotion and optimization of health
and abilities, prevention of illness and injury, alleviation
of suffering through the diagnosis and treatment of
Human response, and advocacy in the care of
individuals, families, communities and populations
(American Nurses Association, 2003)
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8. 2.Nurse
Is a “person educated and qualified in the profession of
Nursing”( Anderson and Anderson, 1995)
3.Nursing Practice
It is a set of functions which a Nurse carries out either
independently or in collaboration with other members
of the health care team .
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9.  Example of independent nursing function-Feeding a
patient or bathing a patient
 Example of collaborative nursing function-
is giving medication prescribed by the Doctor.
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10. 4. Fundamentals of Nursing
Is a Course that aims at providing students with a foundation in
Nursing knowledge and skills in order to provide comprehensive
nursing care to meet the basic health needs of the individuals,
families and the community.
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11. The Fundamentals of Nursing are applied at four levels
i.e;
 to Promote health
 to Prevent illness
 to Restore health
 to Rehabilitate.
(The practice of nursing will be aimed at achieving one or
more of the above)
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12. Nursing philosophy
A Philosophy is a view, direction, commitment, purpose
which governs an individual or profession.
Philosophy of nursing
Leddy and Pepper (2003) define philosophy of nursing
as the intellectual and affective outcomes of the
professional nurses' efforts to understand the ultimate
relationship among humans, environment, and health.
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13.  The philosophy of nursing is based on the concept of
the worth and dignity of the individual.
 In nursing the belief is that, man is the centre of all
activities and each patient should be treated as an
individual.
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14.  Nursing believes in caring for, giving comfort and ease, helping
persons with health problems to become healthy in body and mind
or helping them to live with their disability or disease.
 Nursing believes that all persons have the capacity and potential to
develop better physical health and improve psychosocial well being
depending upon their desires, willingness to change and
adaptability to prescribed therapies.
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15. THE ROLE OF THE NURSE IN THE
HEALTH CARE SYSTEM
A role is a part one plays or functions one performs by
virtue of their position, qualifications or status in the
organization or community (David, 2006).
• The nurse assumes a number of roles in the care of
patients/clients( in the health care system).
• Some Roles are basic and can be carried out by each
and every nurse regardless of the level of training
while other are best suited for nurses with advanced
education/training.
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16. ROLES OF A NURSE
1.Care Giver
 This is the most basic role of the nurse which involves
the provision of direct care and promotion of
client/patient comfort.
 The nurturing actions of the nurse to the
client/patient to enhance the healing process and
assist the client to regain independence.
 The nurse shows concern for client welfare and
acceptance of the client as a person
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17. 2. Change agent
The nurse initiates changes or assist clients to make
modifications in themselves or in the system of care.
Nurses should lead by example in the communities
they live eg health promotion activities such as
cervical cancer screening, access to family planning,
going for VCT.
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18. 3. Client advocate
 The nurse protects the client’s human and legal
rights and helping clients and families to interpret
information from other health care providers.
 promotes what is best for the client, ensuring that
the client’s needs are met and protecting the client’s
right.
 provides explanation in clients language and support
clients decisions.
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19. 4. Manager
The nurse manager makes decisions, coordinates
activities of others, allocate resources, evaluate care
and personnel.
 She/He plans, gives direction, develop staff, monitors
operations, gives the rewards fairly and represents
both staff and administrations as needed .
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20. 5. Educator
provides information and helps the client to learn or
acquire new knowledge and technical skills.
 encourages compliance with prescribed therapy.
 promotes healthy lifestyle
 interprets information to the client
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21. 6. Counselor
 helps client to recognize and cope with stressful psychological or
social problems; to develop an improve interpersonal relationships
and to promote personal growth
 provides emotional, intellectual to and psychological support
 focuses on helping a client to develop new attitudes, feelings and
behaviors rather than promoting intellectual growth.
 encourages the client to look at alternative behaviors recognize the
choices and develop a sense of control.
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22. 7. Researcher
 participates in identifying significant researchable
problems.
 participates in scientific investigation and must be a
consumer of research findings.
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23. 
 THE ORGANIZATION AND
FUNCTION OF THE HOSPITAL
AND COMMUNITY HEALTH
SERVICE
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24. THE ORGANIZATION AND FUNCTION OF THE HOSPITAL
AND COMMUNITY HEALTH SERVICES
Organization is the structure or arrangement of related or connected
items.
The structure of the hospital and community health services can be
said to be at 3 levels.
1. NATIONAL LEVEL-Ministry of Health
2. Provincial level- General hospitals
3. District level- District hospitals, health centers, health posts.
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25. FUNCTIONS OF VARIOUS LEVELS OF
HOSPITALS
1. First Level Hospital or District Hospital
 Found in all the “72” districts
 Intended to cover a catchment population of 80,000 to
200,000.
 Provide technical back-up services to health centers.
 Offer medical, surgical, obstetrics and diagnostic
services.
 Have Doctors, Clinical officers, Registered
Nurses/Midwives and Enrolled Nurses and Midwives
 Provide technical back-up services to health centers.
 Receive referrals from HC.
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26. 2. Second Level referral Hospital/General Hospital
 Found at provincial Level
 Serves catchment population of 200, 000 to 800,000.
 Provide services such as; internal medicine, ICU, Paediatrics,
Obstetrics, Gynaecology
 They are referral Hospitals for level 1
 Staffed by disease specialists
 Medical doctors, Nurses , physiotherapists, Dentists etc
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27. 3. Level 3 or Central Hospital
 Have catchment population of 800,000 and above
 Have Specialties in medicine, surgery, psychiatric, ICU
 Provides training and research services eg UTH, Kitwe
and Ndola central hospital.
 Provide referral services to second level hospital.
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28. Organization of health
services at Community level
 The health services at community level Consists of:
Health Centers
Health posts
The general community.
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29. The Health Centre (H/C)
 Two types; urban and rural
 Urban serves catchment population of 30,000 to
50,000
 Rural serves catchment population of 10, 000
 Should have a radius of 29km
 Both should operate 24hours
 Should have bed capacity of 30.
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30.  H/C provides Primary Health Care PHC services of
diagnosis band treatment of minor illness, maternal
and Child Health service (MCH), Outreach, school
health services, preventive services e.g. promoting ITN
usage
 H/C formulates their own action plans in conjunction
with the community
 They work in partnership with TBAs, CHWs NHCs.
 H/C are accountable to the District Management
Team.
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31. The Health Post (HP)
 The most basic unit in the provision of health services
in the community
 Intended to cater for a population of 500 household,
with estimate 3,500 people in the rural area .
 In urban areas HP should cater for 1000 households
with estimated 1000 people.
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32.  HP should be with 5Km radius
 A multi-skilled health worker (integrated competent
trained health worker ICT) should run a HP
 At HP the ICT offers diagnostic curative services
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33. General community
 The community are supported by voluntary “health
care workers” such as; Traditional Birth Attendants
(TBAs), Community Health Workers (CHWs),
Community Based Distributors (CBDs).
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34. Community Health Workers (CHWs),
Someone Trained in basics of health. They
provide home based care, case
simple case-management, making referrals
and collection of data on referrals and give
Information, Education and Communication
on disease prevention.
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35. Community Based Distributors (CBDs)
 These are people Responsible for distributing health
care products such as condoms, family planning pills
and Chlorine. They are supported by The Health
Centre or health partners for supplies. and
based Agencies or organizations.
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36. Neighborhood Health Committee (NHCs)
This is a committee made up of community members
identified by the community to work for the
community in health related issues.
 They are a link between the community and the
center.
 Select community Volunteers for training in health
promotion, disease prevention and case detection
management.
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37.  Help in mobilizing the community in implementation
of community health related projects
 Submit statistics to the H/C on regular basis e.g on
ITNs distribution
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38. THE NURSE AND HEALTH CARE TEAM IN
THE HOSPITAL & COMMUNITY SETTINGS.
 A health care team is a group of people with expert knowledge and
skill who help a client in the health care delivery.
 It is composed of people/experts from various disciplines who work
in collaboration for the good of the patient/client.
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39.  The nurse assumes the various roles as she/he works in
collaboration with the health care team for the common good of the
patient’s welfare.
MULTIDISCIPLINARY HEALTH CARE TEAM
 Patient
 Nurse
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40.  Doctor
 Clinical officers
 Pharmacist
 Physiotherapist
 Radiologist
 Nutritionist
 Environmental health technicians
 Laboratory technician
 Chaplain
 Social worker
 Auxiliary worker e.g cleaners, porters, drivers etc
 Support staff eg Clerks, cashiers, accountants etc.
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41. The nurse % health care team in the community setting
 Individual, Family and community
 Nurse/Community health nurse
 Environmental health technician
 Neighborhood health committee
 Community based agents( community health workers, Traditional
birth attendants, community based distributors, peer educators,
malaria agents etc).
 Faith based organizations
 Nongovernmental organizations.
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42. THE END
 THANK YOU FOR YOUR ATTENTION AND
PARTICIPATION.
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