What do nurses do?
In my PhD, I found out that nurses understand their work differently. Nurses explain their work by its role in the healthcare system, not by the tasks they do. Nurses told me they understood their work by its role or purpose, and what their overall goals were. This was true no matter where a nurse worked.
This frame is important for two reasons: 1) it meant that nurses weren’t defined by their tasks, and 2) a role frame enabled nurses to adapt their work. Nurses told me that they would do whatever they needed to do during their shift, whether it was in the job description or not. They had a spirit of teamwork and weren’t picky about what specific jobs they were ‘supposed’ to do. Nurses also recognized that nursing changes every day, and there is no rigid list of things that they do. Nurse did not define their work by its tasks, so understanding nurses based on the tasks nurses completed didn’t make sense.
Nurses also adapted their work constantly. Thinking of their work as a role helped them do this. If nurses were focused on tasks, they couldn’t adapt. However, they focused on their role, and then they could respond to any needs in their setting.
Nurses described their roles in three ways: clinical work, managing work, and enabling work. These roles aren’t separate. You might do all three in the same job. What was different was the purpose of this work, and which type of work was the most prominent.
Clinical work was perhaps the most obvious type of work- work where nurses work directly with patients, families, and communities. This work involved giving medications, assessments, teaching, and other activities that were directly patient facing.
This isn’t a surprise. The interesting findings were that this is not all that nurses do. Nursing is much more than patient care.
Managing workis a unique contribution that nurses make to healthcare. Nurses’ managing work keeps the healthcare system running. In hospitals, managing work refers to looking after a ward. It can include everything from ordering towels to hiring new staff. Nurses are the ones who do this, because other professions move all over the hospital. Nurses tend to stay in a specific space, so they have developed this role. In community settings, nurses may manage things like equipment for someone’s home, rather than a physical space like a ward.
Managing work can also be for patients, such as arranging discharge, diagnostic tests, or appointments with other professionals. Nurses may think managing takes them away from their ‘real’ work, but my research found managing IS real nursing work. Nurses know who to phone, what to ask for, how to navigate the system, and take for granted the skills and knowledge that are required to keep everything going.
Enabling work ensures we have a nursing profession and a health system! Enabling roles include education, policy, organizational leadership, and research. These roles are the things that make nursing a profession with a distinct body of knowledge. This work does not necessarily connect with patients, but that doesn’t mean that it isn’t essential for our profession.