Learn about the most common nursing duties, responsibilities, and procedures
Nursing is an honorable profession and an incredibly rewarding career path. Not only do nurses save lives, but they offer compassion and kindness to those that need it most. They are often a source of comfort, safety, and security. If you are passionate about helping others, nursing may be a great career choice for you.
(Click here to learn how to become a Nurse).
If you’re an aspiring Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN), this article will cover some of the most common duties and procedures you may encounter throughout your career. We hope this information provides you greater inspiration while pondering a possible future in healthcare.
What Duties Do Registered Nurses (RNs) Have?
The U.S. Bureau of Labor Statistics (BLS) offers some insight into the most common roles and responsibilities of a Registered Nurse. Of course, these tasks can vary depending on your specialty, location, employer, and level of experience.
RNs typically perform the following duties:
- Assess their patient’s health conditions
- Record their patient’s medical histories and symptoms
- Monitor a patient’s health or recovery while recording their observations
- Administer medications and/or treatments to patients while under their care
- Develop or contribute to uniquely tailored patient-care plans
- Collaborate with physicians and other members of the healthcare team
- Operate and monitor medical equipment
- Perform and analyze the results of various diagnostic exams
- Teach patients and their families how to manage their illnesses or injuries
- Educate patients and their families on how to follow their prescribed treatment and recovery instructions upon returning home
Continue reading for a deeper dive into some of the specific duties and procedures typically performed by RNs and Advanced Nurse Practitioners.
Some people refer to venipuncture as the most common invasive medical procedure. It’s essential for a number of medical diagnoses, procedures, and tests. This important skill can be exciting for new healthcare professionals. It’s especially important for nurses to learn the proper methods for drawing blood, as well as the various methods and techniques for drawing blood in a healthcare environment.
What is Venipuncture?
Venipuncture (or Phlebotomy) is the process of drawing blood intravenously from a patient. This is typically done by inserting a hollow needle into a patient’s vein to collect blood samples for laboratory testing.
In most scenarios, blood is drawn from a vein inside the patient’s forearm or the back of their hand. The procedure may be performed by nurses, medical laboratory scientists, medical practitioners, phlebotomists, dialysis technicians, and other nursing staff. Here are the steps they follow:
- Sterilize the site with an antiseptic wipe.
- Place an elastic band around the patient’s upper arm to apply pressure to the area (the vein will swell with blood).
- Insert a needle into the proper vein.
- Collect the blood in airtight vials or tubes attached to the needle.
- Remove the band from the patient’s arm.
- Take out the needle and cover the spot with a cotton swab/bandage to stop any bleeding.
When Do Nurses Perform Venipuncture?
Most nurses should learn venipuncture. While not always taught in nursing school, many programs recommend that aspiring nurses take supplemental courses to hone this skill.
Although most hospitals will rely on phlebotomy teams to perform this procedure, it is still vital for nurses to develop this skillset so that they may provide patients with the best care. In fact, nurses in some intensive care units are required to become proficient in venipuncture. Generally, phlebotomy teams only make rounds at certain times in a hospital, so if there’s ever an urgent request for a blood sample, the responsibility for drawing that blood sample may fall in the hands of the hospital’s nursing staff.
Click here to read our Master’s Guide to Venipuncture.
Intubation can mean the difference between life and death. This procedure is used to aid patients when they can’t breathe on their own. Although intubation is not typically performed by most RNs, they are frequently administered by Nurse Anesthetists and other Advance Practice Registered Nurses (APRNs).
(Click here to learn how to become a Nurse Anesthetist).
What is Intubation?
When it comes to airway management, learning how to intubate is key. Endotracheal intubation is the process of inserting a tube through the patient’s mouth and into their airway. This is done for patients who need to be placed on a ventilator during anesthesia, sedation, or severe illness.
When Do Nurses Perform Intubation?
The frequency by which nurses perform intubation greatly depends on their location. A nurse’s scope of practice is defined by their state’s nursing rulebook, more technically referred to as the state’s nursing practice acts. For Advanced Practice Registered Nurses, such as Nurse Practitioners or Nurse Anesthetists, intubation is commonly included in their scope of practice. For Nurse Anesthetists, for example, intubation is the primary means through which they deliver anesthesia in the operating or delivery room.
However, some states, like Nevada, may allow RNs to intubate if they have completed special training (i.e. advanced cardiac life support training). In addition, nurses who work in emergency medicine or air-and-surface transport may also be allowed to intubate patients.
3. Blood Transfusion
Blood transfusion is a potentially life-saving procedure that replaces blood lost during surgery or injury. A blood transfusion can also serve as a treatment for patients with illnesses that stifle their ability to naturally produce enough blood cells for their bodies.
What is a Blood Transfusion?
Blood transfusions are a routine medical procedure that delivers blood into a patient’s body through a narrow tube that’s connected to a vein in their arm or hand.
To administer a blood transfusion, healthcare professionals place a thin needle into a vein—usually located in the arm or hand—which allows blood to move from a bag, through a rubber tube, and into the patient’s vein through the needle. Nurses must closely monitor their patient’s vital signs throughout this procedure.
When Do Nurses Perform Blood Transfusions?
Nurses often perform blood transfusions under the direction of a doctor’s order. Nurses Labs outlines this process in detail, but here are the first seven steps that nurses typically follow:
- Verify the doctor’s order. Inform the patient and explain the purpose of the procedure.
- Check for cross matching and blood type to ensure compatibility.
- Measure the patient’s vital signs.
- Practice strict asepsis.
- At least two RNs should check the label of the blood transfusion to review the following information:
- Serial number
- Blood component
- Blood type
- Rh factor
- Expiration date
- Screening test (VDRL, HBsAg, malarial smear) – This is to ensure that the blood is free from blood-carried diseases and, therefore, safe for transfusion.
- Blood for the transfusion should be warmed to room temperature to prevent chills.
- Prepare a needle for the transfusion using a needle gauge of 18 to 19 to allow easy flow of blood.
4. Tracheostomy Care
A tracheostomy may be performed for various reasons, all of which involve restricted airways. For instance, it can be necessary during an emergency, when a person’s airway is blocked. It can also be performed when a disease, injury, or any other health condition makes normal breathing impossible.
What is Tracheostomy Care?
Though there are several types of tracheostomies, they all follow the same underlying principle: An opening is created in a patient’s neck in order to place a tube into their windpipe. This tube is inserted through a cut, below the vocal cords, so that air can fill the patient’s lungs.
When Do Nurses Perform Tracheostomy Care?
Nurses provide tracheostomy care for patients to maintain the integrity of the tracheostomy tube and lower the risk of infection. This is partly because air inhaled by the patient is no longer filtered by their upper airways.
At first, a tracheostomy might need to be suctioned and cleaned every one or two hours. Once the initial inflammatory response has subsided, tracheostomy care may only be necessary once or twice per day.
Overall, tracheostomy care necessitates the application of scientific knowledge, sterile technique, and problem solving. It needs to be performed by a nurse or respiratory therapist.
5. Lifting Patients
This one may seem obvious, but some may not recognize the strength it takes to move patients in and out of their beds. While assisting their patient, nurses must simultaneously observe their patient’s vital signs (i.e. changes in color, pulse rate, dizziness, or sign of fatigue) while moving or lifting them.
What Does it Mean to Lift a Patient?
To move a patient from their bed to a chair or wheelchair, nurses need to take the following steps:
- Ensure that the chair or wheelchair is in operable condition.
- Place the chair so that the back of it is parallel to the end of the bed and facing toward the front of the bed.
- Put a pillow on the seat of the chair—be sure to line it with a blanket or sheet and arrange pillows against the back
- If you’re moving the patient to a wheelchair, put the wheelchair’s footrest up before you lock the wheels.
- Take the patient’s pulse.
- Assist the patient to a sitting position on their bed.
- Observe the patient to defect any change in color, pulse, and respiratory rate.
- Put on the patient’s robe and slippers. Place the foot stool of the wheelchair under the patient’s feet.
- Stand directly in front of the patient and assist them to stand up, step down, and turn around, so that their back is to the chair.
- Let the patient flex their knees and lower their body to sit in the chair.
- Anchor the chair with your foot or have someone else hold it.
- Help the patient get comfortable in the chair.
- Adjust the pillows as necessary and place a blanket over the patient’s lap. If they’re in a wheelchair, be sure to adjust the footrests.
- Frequently look for changes in color, pulse rate, dizziness, or signs of fatigue.
- Assist the patient back into their bed.
- Draw up the bedding.
- Take their pulse.
- Document the event.
When Do Nurses Lift Their Patients?
Nurses may have to lift their patients for a variety of reasons: changing a patient’s linens, cleaning their bedpan, or assisting them to the bathroom. They may also need to perform this task when helping their patients adjust their bodies or when helping them develop and regain strength in specific areas of their bodies. Depending on their patient’s needs, nurses may need to perform this task quite frequently.
6. Wound Care
Wound care covers every stage of wound management. It’s a critical component of healthcare, and one that may require special nursing skills.
What is Wound Care?
In the area of wound care, there are numerous factors to consider, including wound type, wound healing, and proper treatment for wound management. Once a wound is properly diagnosed and all elements have been considered, the best treatment options can be determined. Stitches are often included, not to mention bandages and medication.
When Do Nurses Perform Wound Care?
The frequency by which nurses perform wound care can depend entirely on their location, specialization, and level of experience. You can become a specialized nurse, known as a Certified Wound Care Nurse (CWCN). They become certified in treating wounds, continence care (CCCN), ostomies (COCN), or all three, meaning they are a fully Certified Wound Ostomy and Continence Nurse (CWOCN).
These nurses are often considered specialists in the field of wound treatment. They tend to fill central roles in hospitals, nursing homes, and home health agencies. Wound Care Nurses typically manage various wound-care programs, where they provide consultations for treating wounds in addition to providing direct patient care and education.
7. Splints and Casts
Both splints and casts are meant to immobilize part of a patient’s body. These hard wraps support and protect injured bones, ligaments, tendons, and other tissues.
What are Splints and Casts?
Splints and casts are used to support the healing process for broken bones and fractures by holding your bones together while your body recovers. They are applied in a way to keep your bones as straight as possible so that your physical motions don’t exacerbate the injury. Most importantly, they protect your body from further damage while reducing pain and swelling to your injury.
Casts are custom-made molds made of plaster or fiberglass and they are designed to wrap all the way around an injury. They can only be safely removed in a doctor’s office. On the other hand, a splint is more like a “half cast.” Because the hard part of the splint doesn’t wrap all the way around the injury, it is held in place with an elastic band or similar material. One big difference is that splints can be easily adjusted or removed.
When Do Nurses Apply Casts or Splints?
Upon a physician’s request, nurses may be asked to apply or remove splints or casts. This task can fall within the scope of a Registered Nurse in some locations. For instance, in Kentucky, nurses can apply and remove casts. APRNs can perform the closed reduction of a fracture. This means that they are permitted to set a broken bone. Once the bone is put in place, it can grow back together.
The purpose of catherization is to relieve urinary retention. It’s also used to obtain a sterile urine specimen from a woman, to measure the amount of residual urine in a patient’s bladder, to acquire a urine specimen when it can’t be gathered by other means, or to empty a patient’s bladder either before or during surgery.
What is Catherization?
Catherization is the introduction of a catheter—a soft, hollow tube—through the urethra of a patient and into their bladder so urine can be withdrawn.
When Do Nurses Apply Catheters?
Nurses may often be tasked with inserting and removing catheters. In fact, some consider it to be one of the fundamentals of nursing. It is an especially critical skill for delivering care in nursing homes.
9. Ear Irrigation
Nurses irrigate ears to remove ear wax or to remove foreign objects from their patient’s ear canal. Typically, it’s performed on patients who suffer a wax buildup that weakens their hearing.
What is Ear Irrigation?
Ear irrigation is a procedure in which nurses will flush their patient’s ear canal with sterile water or saline solution. This is usually done to cleanse the ear canal of any discharge, to soften and remove impacted ear wax, or to extricate a foreign body from a patient’s ear.
When Do Nurses Perform Ear Irrigation?
In almost any healthcare setting, nurses will likely be required to perform ear irrigations for their patients. It may sound like a simple procedure, but if performed incorrectly, ear irrigations can easily lead to infection or ruptured eardrums. Nurses who handle these procedures must take all the necessary precautions. Some RNs may even be tasked with training new employees on how to perform ear irrigations.
10. Patient Counseling
Patient counseling is a near-universal duty for nurses around the world. To create an ideal environment for their patients, nurses should develop a supportive relationship with them. Why? Patients armed with proper knowledge can make vital positive changes to their health, alter their lifestyles, and remain self-sufficient, even if they have been diagnosed with a chronic condition. Education often has the power to create successful outcomes and enhance patient safety.
What is Patient Counseling?
Patient counseling is the practice of educating patients on how to improve their health status. If patients become actively involved in their care, they may be more likely to engage in significant lifestyle changes. Some benefits of patient counseling include:
- Prevention of serious medical conditions (i.e. obesity, diabetes, heart disease).
- Reducing the risk of complications by coaching patients about medications, lifestyle modification, and self-monitoring devices (i.e. glucose meter or blood pressure monitor).
- Reduce the number of patients who are readmitted to hospitals.
- Help patients retain their independence by learning self-sufficiency.
When Do Nurses Provide Patient Counseling?
Nurses play an important role in patient education. You could say it’s one of the most significant responsibilities of a nurse’s job. The timeline for active patient education starts from the moment patients are admitted to the hospital and continues until they are discharged.
Nurses can take advantage of various opportunities during a patient’s visit to educate them about self-care. This instruction may include a crash-course on how to inject insulin, bathe an infant, or change a colostomy bag. They can also instruct patients on how to recognize the warning signs of an illness or injury, as well as what to do and who to contact when those types of health issues arise.
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