The nursing programme is administered by her through appropriate planning of services, determining nursing policies in collaboration with hospital management and nursing procedures in collaboration with nursing staff, giving general supervision, delegation of responsibility, coordination of interdepartmental nursing activities, and counselling the hospital administration on nursing problems.
She has a dual role: the first one is the administrative responsibility towards the hospital administration, and the second one is the coordinating of all professional activities of nursing staff with those of medical staff.
For a hew hospital project, a senior nurse administrator is associated from the beginning of the project would be able to plan the pattern of staffing, viz. the case method, team method, etc. best suited to the architectural design and layout of ward units.
Conversely, she will be able to offer valuable help in suggesting design and physical layouts suited from the nursing point of view.
The role of nursing superintendent starts in a new hospital from helping to establish the overall goals, policies and organisation, and facilities to accomplish these goals in the most effective and efficient manner.
The functional elements of the role of the nursing superintendent include the following.
1. Formation of aims, objectives and policies of nursing service as an integral part of hospital service
2. Staffing based on nursing requirements in relation to accepted standard of medical care
3. Planning and directing nursing care
4. Coordinating interdepartmental activities
5. Maintaining supplies and equipments
7. Records and reports.
2. Nursing Supervisor:
Each department or clinical division, e.g. medical, surgical, and obstetrical, operation theatres, outpatient department, nurseries, etc. should have a supervisor.
As there may be more than one nursing unit in each division or department, supervisors have a general administrative and coordinating function within their respective division. However, supervisors will also have limited clinical functions.
It is generally accepted that a good nursing service depends upon strong supervision, no matter what type of nursing assignment seems best suited to the new hospital.
3. Head Nurse:
A head nurse is assigned to a nursing unit, or ward, or a section of department. She works under the general direction of the supervisor of the division.
4. Staff Nurse:
Staff nurses are employed at the “floor” level for carrying out skilled bedside nursing. This is the real work force of the hospital upon whose competency, state of training and dedication depend the success of the nursing department.
5. Student Nurses:
Student nurses cannot be employed on nursing duties except under supervision of fully qualified staff nurses. However, they are a factor in reducing the permanent nursing staff of a hospital. Repetitive and less skillful nursing tasks can be taken over by student nurses.
6. Motivation of Student Nurses:
A well-managed hospital at peak professional efficiency motivates student nurses to develop a lifelong commitment to their mission of nursing during their close encounters with death and the success of life-saving measures. But the high mortality and disability rates tend to lower the morale of nurses in training.
Therefore, there is a need for inculcating high degree of cheerfulness and developing stability of character during their training.
The trainers and the hospital should capitalise on the fact that working in critical care areas under efficient and mature nursing staff develops a sense of achievement and fulfilment, and this further acts as motivator in their mission of nursing.
Hospitals having nursing training programme must standardise the work to be allotted to the student nurses. In some hospitals, allocation of duties is determined according to seniority and in others it is left to the discretion of the ward sister.
Third year nurses are made mainly responsible for medicines, injections, and other technical procedures, and first-year nurses are responsible for toilet rounds, bed baths and feeding. The junior student nurses are an indispensable part of the ward work. Three quarters of the nursing is contributed by them.
There has to be a proper distinction between the work and responsibilities of the fully trained nurse and the nurse nearing the end of her training, who necessarily lacks experience.
The fact is that nurses in training bear so large and important a share of the actual nursing to be done in the ward that their particular needs as students are sometimes passed over.