The Full Scope of Nurses’ Work in Hospitals

Acute and critical care nurses often occupy an intimate space with patients and their families, providing care during some of the most vulnerable periods of their lives. This unique position allows nurses to offer not only physical support but also emotional and psychological comfort. Although nursing care is complex and nuanced, traditional hospital-based outcome measures have failed to fully capture the depth and breadth of what nurses really do in clinical practice and what really matters to patients and families. In fact, publicly reported patient/family outcome measures of care highlight only failures in our care (eg, falls, pressure injury, infections) rather than offering a reflection of good care.1In our recent article “Call to Action: Blueprint for Change in Acute and Critical Care Nursing,”2 we advocate for recognition of the full scope of a nurse’s work in hospitals that is essential for optimal patient outcomes. The blueprint emphasizes the importance of acknowledging the rich and diverse skill sets and contributions of nurses, which include patient and family advocacy, education, and emotional support. By fostering a supportive hospital environment and implementing precision-based outcomes, the blueprint aims to enhance the visibility and impact of nursing care, ultimately benefiting both patients and the nursing profession.When nurses engage in meaningful care, they significantly enhance patient outcomes by providing comprehensive, holistic support that buids upon meeting the care needs of patients. Nurses who practice patient-centered care can positively influence whether patients feel respected and well cared for while hospitalized. Additionally, a positive practice environment enhances nurses’ ability to deliver high-quality care, coordinate effectively with other health care professionals, and manage care transitions seamlessly. This approach not only improves patient satisfaction but also fosters a deeper connection between nurses and patients, leading to better overall health outcomes.As we continue to advance the ideas explicated in the blueprint article, we need to hear from you – the nurses who provide direct care in acute and critical care practice settings. We are specifically asking for your input on the 9 discrete domains of practice articulated in the blueprint, including (1) creating safe healing environments; (2) building caring relationships with patients and families; (3) assessing and managing patient symptoms; (4) administering physical, therapeutic, preventative, and end-of-life care; (5) providing surveillance, vigilant of patient risks, and being ready to intervene; (6) teaching patients and families what they need to know to actively participate in their own care and decision-making and manage their own care after hospital discharge; (7) collaborating with and coordinating care within the interprofessional team; (8) advocating for the patient and family ensuring that their needs and preferences are known and respected within the interprofessional care team; and (9) navigating patient transitions in care across and out of the health care system.We invite bedside nurses to engage in much-needed conversations about impactful nursing practice, and we encourage you to participate in the measurement process by completing the Nine Domains of Acute and Critical Care Practice Survey. We want to hear from you—did we get this right? Specifically, for each of the blueprint’s 9 domains of practice, we need your opinion on whether the activity is relevant to the practice of nursing within hospitals, the frequency with which your patients require this activity, and the importance of the activity to patient and/ or family outcomes. Your input will help develop and inform new patient-centered outcomes measures that highlight the positive impact of our work as nurses.Access the survey at https://redcap.nursing.upenn.edu/surveys/index.php?s=XYEE7WP9J4MFK8T4 or by scanning the QR code below.