9 Duties of a Nurse That Might Surprise You
Most people have an idea of what nurses do. Odds are good that you’ve seen a nurse in action at some point in your life and can picture a few tasks. But even though the general population is pretty familiar with the image of a nurse, there are some huge misconceptions out there about nursing job duties.
“The reality is that tasks or skills are only a small part of nursing, and they really are a means to an end,” says Susan Pasley, MS, BSN, RN and vice president of nursing at Bravado Health. “I think the true nature of nursing is the critical thinking that is required to understand what’s happening physiologically and mentally to the patient, why you are performing various tasks and what the anticipated versus actual outcomes are.”
If you’ve looked into nursing before, you might know it’s one of the most trusted professions out there and is growing much faster than average, according to the Bureau of Labor Statistics (BLS).* That unique combination is a result of what nurses do every day for their patients. We asked nurses to explain the duties of a nurse that most people don’t know about to give you a better look behind the scenes of this impactful career.
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9 Nurse duties you may not have known
Nurses do so much more than just take vitals and administer medication. Learn more about the incredibly versatile role these superheroes in scrubs play during every shift.
1. Noticing irregularities and problems
Nurses are the vanguard for changes in patient symptoms. The formal and informal assessments they do give them front-row seats to every patient’s particular situation. They catch any changes, knowing which symptoms might be expected and which are indicators of a deeper problem. “I don’t think the public realizes the vital role nurses have in the care team,” says Amelia Roberts, BSN, RN and owner of The Business of Nursing.
“When labs and other results come in, we review them, make decisions and communicate our concerns to the rest of the care team.” Roberts says she was surprised at how often she was relied upon for suggestions in diagnosis and care planning.
“While nurses do not make medical diagnoses, we use patient data to make care decisions on a continual basis. When you call a physician about a concern, the physician is usually anticipating that you will also have a recommendation for how to proceed.”
On a daily basis, that translates to paying close attention to your patients. Kayla Valiquette, BSN, RNC-NIC and coordinator of research and education at Bravado Health says it’s vital to be thorough in assessments and even forecast ways to make patients more comfortable. “An infant can’t tell you if something is wrong, but you can pick up on subtle cues during the assessment and catch something early.”
“I did not expect that I would also be a teacher,” Valiquette says. “There is a tremendous need to educate your patient and the family—which makes perfect sense because they need to know how to care for themselves or the family member once they get home.”
Nurses regularly educate others about the illness, procedures and symptoms they experience in the healthcare environment, as well as their plan of care upon leaving.
“In the NICU (neonatal intensive care unit), I provided a lot of education on breastfeeding, medical devices, medication administration, feeding, infant sleep and car seat safety, bathing and developmental expectations,” Valiquette says.
Valiquette adds that patients can go home with extremely complex care regimens and the family needs to be empowered to handle it all.
3. Advocating for patients beyond the healthcare environment
It may not be an everyday thing, but nurses are often responders who step in to assist patients long after their time at a healthcare facility. For Pasley, this “duty” is part of a holistic approach to nursing. She says this approach allows her to look at patients from a physical, mental and spiritual perspective and treat the whole patient.
While time restraints are always a factor, Pasley says consolidating resources and removing barriers for patient health might extend far beyond the simple signs and symptoms that brought them to the hospital.
“It is definitely the most rewarding part of the job when you get to know your patients and can provide assistance in a broader context with things like connecting them with a chaplain, working with social services to address food insecurity and more.”
4. Caring for the patient’s loved ones
Nurses often wind up taking care of everyone in the room, which includes the patient, of course, but also the family members, friends and loved ones who may be experiencing devastating emotions.
“You end up providing a lot of emotional support,” Valiquette says.
In the NICU, you may have to give parents bad news about a disease or their child’s progress, Valiquette explains. “In the midst of that, mothers are trying their best to pump breastmilk for their infant, and sometimes it’s a struggle. It’s important to encourage them so they know their hard work is appreciated.”
Sometimes caring for loved ones also means letting them take some of your time or slow you down when you have a lot to do. Valiquette says families would come to the NICU wanting just to hold their child and needing a nurse to help them get situated with all of the monitor cables and IV tubing. But taking the time to do these things, while being supportive and emotionally present to the patient’s loved ones is worth it.
“In nursing, there is so much emphasis on the patient—but family needs matter, too,” Valiquette says.
5. Building trust with patients
When a child needs an IV, you spend plenty of time preparing them first, according to Valiquette. “I couldn’t just walk in the room and stick the IV in. I learned to use their baby doll or teddy bear to my advantage by demonstrating first on that.” After kids saw and even mimicked Valiquette, they felt more trusting of what she needed to do.
This exemplifies some of the emotional work nurses do with their patients—children or otherwise—to make their healthcare experience as painless as possible. “It wasn’t easy, but giving young patients the feeling that they were in control worked better in the long run than just pinning them down and inserting the IV to move onto my next task.” When nurses earn their patients trust, those patients will have fewer barriers to their own healing.
“Patience is a skill, and gaining a patient’s trust is a skill,” Valiquette says.
6. Consistently and carefully adhering to protocols
Though so much can be said about emotional communication and the support patients need psychologically—nursing is also very technical work. Dr. Leigh Ann Bradley, COO of the Healthcare Experience Foundation, emphasizes the constant need for your complete attention on the job.
“Many of our tasks are intricate and done according to very specific protocols with procedure, safety, and cleanliness. They require our focused attention so that we do not harm our patients in the process,” Bradley says.
Balancing the clinical requirements that need to be performed with precision with the more emotional work nurses often do can get very tricky. “We are outstanding nurses when our assessment and actions, which comprise the bulk of our time when working, are well-thought out and competently performed,” Bradley says. “And we are better nurses when we recognize all our patient’s needs in the process.”
7. Staying up-to-date in nursing and healthcare
“I do think nurses have increasing responsibility toward learning about technology trends,” Roberts says. This can look different from place to place—some healthcare systems may require nurses to learn specific programs and embrace new technologies as they arrive.
But it goes beyond that as well. Roberts says nurses should keep tabs on new advancements in healthcare technology on their own initiative. “I know that the responsibility to stay relevant in these rapidly changing times lies with me.”
“We have so much technology and information at our fingertips to help us on both the care side and the business side of Nursing,” says Michelle Greene Rhodes, MHS, RN, CCM, CMCN and author. “It would behoove any nurse to stay sharp. Take review classes, seek various certifications or pursue higher learning in areas such as practitioner, educator, informatics or entrepreneurship just to name a few.”
8. Analyzing variables to deduce the impact on a patient
“Nursing is detective work—Sherlock Holmes-style,” Pasley says. “We use astute assessment skills to uncover what the underlying issues are and how they affect the patient.” Pasley explains that many different variables impact the work nurses do to care for their patients—treatments and interventions, anticipating what could go wrong and responding decisively when needed.
“As a new nurse, I had all this information—Anatomy, Physiology, Pharmacology, Microbiology, etc.,” Pasley says. “But bringing it together and thinking critically about how it all affects the patient physically, mentally and spiritually was the biggest challenge I faced.”
9. Niche duties connected to specialties
Nurses work in several different settings and have way more specialized career options than most people realize.
“When I first started out, I was surprised to learn that there were so many different opportunities out there.” Rhodes’ interests led her into case management, coaching and mentoring, quality assurance, risk management, utilization review and even population healthcare. “In the end, it led to me becoming a nurse entrepreneur because I loved business so much!” Nursing is full of opportunity to advance, grow and specialize as you go.
What will you bring to the job?
These lesser-known duties of a nurse are only scratching the surface. Nursing is such a huge, diverse profession, and everyone who chooses it as a career has the chance to put their own unique talents and experiences to use.
“Unlike any other work, nurses are a unique combination of caregiver, scientist, technical specialist, minister and healer,” Bradley says. “We work with our hands, our brains and our hearts to help people along their journey, at times in their lives when they are most vulnerable.”
Nurses do so much—you might guess becoming one would take ages. The path to a rewarding career in nursing isn’t a cake walk, but it might be less difficult than you think. Check out our article, “How to Become a Registered Nurse: Your Step-by-Step Guide,” to learn more about what you’ll need to get started.
*Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, [career information accessed July 1, 2018].