9 Responsibilities You Didn’t Know Nurses Had

This post was contributed by guest author Sue Montgomery, RN, BSN, CHPN. Sue has been a registered nurse for over thirty years in various settings and roles—from staff nurse to administrator in critical care, hospice, and the health insurance industry. A communications consultant and digital health analyst, Sue creates content products in a variety of formats to support client needs for training, education, and content marketing. As a Certified Hospice and Palliative Nurse (CHPN)—and primary caregiver for her own mom for many years—Sue is passionate about end-of-life issues and the needs of seniors, sharing a unique perspective with family caregivers who are supporting the needs of those they love.

I’ve been a nurse for a very long time. Over the span of nearly 32 years I’ve worked in a variety of settings and roles, including staff nurse, nurse manager, and nursing administrator. I’ve worked in the neonatal ICU, pediatric ICU, adult trauma and surgical ICU, a bush hospital in Zimbabwe, and in patients’ homes providing hospice and palliative care. During this time, I’ve been privileged to work with many incredible nurses who continually go the extra mile to provide excellent care to the patients and families they serve. In doing so, they attend to many responsibilities that most people don’t know nurses have.

As a nurse, you step up to the plate as needed, to do what’s needed, when it’s needed in order to care for your patients and their families. Though a nurse’s responsibilities are endless, here are nine that most people don’t realize.

1. Staying ahead of the technology curve

With new technologies in health care growing at a rapid pace, learning tech skills is a continual process. The ability to combine critical new technologies with a personal touch to care is essential in today’s health care world.

2. Tracking narcotics

Before we had advanced tracking technology, there was one set of keys to the narcotics cabinet. There are a plethora of rules around how controlled substances are accounted for, and today’s technology in the acute care setting helps to keep track of each drug on site. However, nurses are still responsible to ensure that each unit of a narcotic is accounted for, whether that be through a distribution system in the acute care setting or at the kitchen table in a patient’s home.

3. Being a team player

Every busy unit has a refrigerator overflowing with leftover lunches and the remains of the latest staff celebration; and yes, it’s often a nurse who finally starts sniffing and throwing away the items that look more suited for the lab. Nurses are team players and willing to dig in as needed, whether it’s performing a high-tech procedure or taking out the trash. At the hospice house I worked in we cooked meals, cleaned, and did the patients’ laundry. I often made a batch of oatmeal cookies in the middle of the night.

4. Tackling Difficult Conversations

There’s a frequent misconception that difficult conversations with patients and families are the doctor’s responsibility, but often it’s a nurse that will initiate many of these conversations. As patient advocates, it’s our responsibility to make sure patients have a say in the course of their care. Some of the most significant conversations occur during times like a bath, when patients feel cared for and are more willing to open up. Experienced nurses won’t shy away from encouraging patients to advocate for themselves to make sure they get the care they need.

As patient advocates, it’s our responsibility to make sure patients have a say in the course of their care.

- Sue Montgomery Tweet:

5. Making a staffing plan

From the outside looking in, it might seem like everything just falls into place when a new shift begins, but there’s a lot of planning to ensure that transitions happen smoothly. A nurse is responsible for arranging appropriate staffing for patient care, and it is about much more than just numbers. Staffing involves knowing the experience and skill mix of the nurses and how that matches with patient acuity and conditions.

6. Going above and beyond

Even after nurses have worked long hours, many organizations expect employees to pitch in as representatives to volunteer in the community. For our hospice, the holidays always included wrapping presents at the local mall. Even if they’re drooping after a full day of patient care, most nurses enjoy the chance to be together outside of the usual work environment, doing something to benefit the communities they live in.

7. Attending Funerals

Nurses take it upon themselves to form lasting relationships with their patients. In environments where nurses care for the chronically ill, they often care for the same patients on a regular basis. Hospice and home care nurses especially form lasting relationships with patients and their families, as the home environment is much more intimate than the acute care settings. When these patients pass away, nurses often attend their funerals to provide the families support and to find closure for themselves. At hospice, attending the funerals of patients is a regular part of the job, and something that’s encouraged to help nurses cope with repeated loss. 

8. Creating order

Any ICU nurse will tell you about the web that multiple intravenous lines can create. If they’re organized and labeled, it’s a nurse who has worked to accomplish such a feat. This is about much more than making things organized; it’s about ensuring patient safety. Nurses create order in the patient care environment, whether that is in an ICU or a patient’s bedroom at home. Nurses do much more than provide direct patient care. They organize, clean, and make sure supplies are stocked and ready for when they are needed.

9. Fixing Equipment

In the hospital setting, support can be just a phone call away when equipment goes awry. However, nurses in the community setting are rarely afforded the luxury of such accessible support. They crawl under beds to see why the bed won’t lower, troubleshoot infusion pumps in the middle of the night, and rearrange the living room to accommodate patient care in a house full of stairs. Nurses could put MacGyver to shame, drumming up creative solutions to even the most head-scratching conundrums.

These are just a few of the many responsibilities that nurses have that most people aren’t aware of.