BSC NURSING I YEAR. Nursing foundations. unit 1 introduction

CONCEPT OF HEALTH

1. INTRODUCTION MRS. C. MARY LALITHA KALA ASSOCIATE PROFESSOR AMERICAN NRI COLLEGE OF NURSING

2. CONCEPT OF HEALTH Health is a state of complete physical , mental and social well being but not merely absence of disease. Acc to World health organization It describes how wellbeing is more than simply an absence of illness, but also incorporates the individual's mental and emotional health.

3. CONCEPT OF WELLNESS AND WELL BEING Wellness is a state of well being Well being is: -- subjective perception of vitality and feeling well. -- described, measured and experienced objectively. -- plotted on a continuum

4. Dimensions of wellness 1. Physical dimension --- ability to perform ADL. --- ability to achieve fitness. --- ability to maintain nutrition. --- ability to avoid abuses. 2. Social dimension --- ability to interact successfully. --- ability to develop and maintain intimacy --- ability to develop respect and tolerance towards others. 3. Emotional dimension. --- ability to manage stress. --- ability to express emotion.

5. 4. Intellectual dimension. --- ability to learn. --- ability to use the information effectively. 5. Spiritual dimension. --- belief in some force that serves to unite 6. Occupational dimension. --- ability to achieve balance between work and leisure. 7. Environmental dimension. --- ability to promote health measures that improves,… Standard of living Quality of life.

6. MODELS OF HEALTH AND WELLNESS Holistic health models. Health belief model. Health promotion model.

7. I. Holistic health model

8. II. Health belief model- Rosenstock

9. III. Health promotion model- Pender

10. MASLOW’S HIERARCHY OF NEEDS Basic human needs are elements that are necessary for human survival and health. Ex: food, water, safety , love,…. Maslow’s hierarchy of need’s is a model that nurses use to understand the interrelationship of basic human needs. Acc to this model certain basic human needs are more basic than others. Self actualization is the highest expression of one’s individual potential

11. ILLNESS WELLNESS CONTINUUM Wellness is a process, never a static state. The Illness-Wellness Continuum is a graphic illustration of a wellbeing concept first proposed by John W. Travis in 1972. It describes how wellbeing is more than simply an absence of illness, but also incorporates the individual's mental and emotional health.

12. Travis believed that the standard approach to medicine, which assumes a person is well when there are no signs or symptoms of disease, was insufficient. This led to his development of the Continuum. The right side of the Continuum reflects degrees of wellness, while the left indicates degrees of illness.

13. The Illness-Wellness Continuum has been used to highlight how, even in the absence of physical disease, an individual can suffer from depression, anxiety or other conditions indicating a lack of wellness. While traditionally medicine typically treats injuries, disabilities, and symptoms, to bring the individual to a "neutral point" where no illness is present, the Wellness Paradigm seeks to move the individual’s state of wellbeing further along the continuum towards optimal emotional and mental states. The concept is premised on the idea that wellbeing is a dynamic rather than a static process.

14. The Illness-Wellness Continuum proposes that individuals can move further to the right, towards health and wellbeing, through awareness, education, and growth. Conversely, worsening states of health are reflected by signs, symptoms, and disability. In addition, a person's outlook plays a major role in moving along the Continuum in either direction. A positive outlook will enhance the individual’s health and wellbeing, while a negative outlook will hinder it, independent of present health status. For example, a person who demonstrates no symptoms of disease, but is constantly complaining, would be facing the left side of the Continuum, toward an early death.

15. However, a person having a disability, but still maintaining a positive outlook, will be facing to the right, toward a high level of wellness. It is less important where a person is on the continuum than which direction they are facing. The Illness-Wellness Continuum has been praised for promoting preventive treatment— improving wellbeing before an individual presents with signs or symptoms of illness, as well as educating people to be aware of, and consequently avoiding risk factors, protecting against pathology and an early death.

16. FACTORS INFLUENCING HEALTH

17. I) Biological factors: (a)Pathogenic microorganism (b) Biologic-heredity factor (c) Other factors: age, sex, growth and development II) Environmental factors Natural environment: air pollution, climate, water pollution, soil pollution, radiation, noise. Social environment: political and economic system in the society social and cultural system III) Life style IV) Psychological factors Psychological factors → emotion and feelings → Physiological function

18. Physical environment – safe water and clean air, healthy workplaces, safe houses, communities and roads all contribute to good health. Employment and working conditions people in employment are healthier, particularly those who have more control over their working conditions Social support networks – greater support from families, friends and communities is linked to better health. Culture - customs and traditions, and the beliefs of the family and community all affect health.

19. Genetics - inheritance plays a part in determining lifespan, healthiness and the likelihood of developing certain illnesses. Personal behavior and coping skills – balanced eating, keeping active, smoking, drinking, and how we deal with life’s stresses and challenges all affect health. Health services - access and use of services that prevent and treat disease influences health. Gender - Men and women suffer from different types of diseases at different ages.

20. Income and social status - higher income and social status are linked to better health. The greater the gap between the richest and poorest people, the greater the differences in health. Education – low education levels are linked with poor health, more stress and lower self- confidence.

21. THE DETERMINANTS OF HEALTH The determinants of health include: The social and economic environment,. The physical environment. The person’s individual characteristics and behaviors.

22. ILLNESS A disease or period of sickness affecting the body or mind. A specific condition that prevents your body or mind from working normally : a sickness or disease. A condition of being unhealthy in your body or mind.

23. ILLNESS BEHAVIOUR It is any behavior undertaken by an individual who feels ill to relieve that experience or to better define the meaning of the illness experience. Illness is a social state. It is not just a disturbance of body and has social meanings and impact i.e. it is partially the result of disease but is also determined by social and cultural factors. Sometimes a distinction is made between disease (medical definition) and illness (lay person’s perception). Can be sick but no symptoms, can feel ill but no disease/condition

24. SICK ROLE Two Rights Sick people are exempt from performing their normal social roles. Sick people are exempt from responsibility for their own state. Two Obligations To get better as soon as possible. To consult and co-operate with medical experts whenever severity of condition warrants it.

25. Component of sick role. Promotes individual health. Social control of occupancy of status ‘sick’. Doctor as gatekeeper (legitimates illness and occupancy of sick role). Privileges dependent on duties. Promotes health of society. Controls number of people opting out of normal roles & responsibilities. Returns sick people to health.

26. STAGES OF ILLNESS EXPERIENCE Edward Suchman (1965) devised an orderly approach for studying illness behavior with his elaboration of the five key stages of illness experience: (1) symptom experience. (2) assumption of the sick role. (3) medical care contact. (4) dependent patient role. (5) recovery and rehabilitation. Each stage involves major decisions that must be made by the individual that determine whether the sequence of stages continue or the process is discontinued.

27. IMPACT OF ILLNESS ON PATIENT AND FAMILY

28. Impact of illness on patient Short – term and minor illnesses awoke few behavioral changes in the functioning of the patient or family. Severe illness can lead to more extensive emotional and behavioral changes such as anxiety, shock, denial, anger and withdrawal.

29. Impact on family roles When an illness occurs, the role of patients and family may change. This change may be subtle and short term or drastic and long term. The patient and family require specific counseling and guidance to assist them in coping with the role changes during illness.

30. When serious illness or disability strikes a person, the family as a whole is affected by the disease process and by the entire health care experience. Patients and families have different needs for education and counseling. Because each person in a family plays a specific role that is part of the family’s everyday functioning, the illness of one family member disrupts the whole family. When a family member becomes ill, other family members must alter their lifestyle and take on some of the role functions of the ill person, which in turn affects their own normal role functioning.

31. Illness may cause additional strain as the result of economic problems and interruptions in career development. If the patient is a young child, there may be additional strain to the family if there are siblings whose needs must also be met. Illness in the middle stage of family life, when adolescents are trying to break away from family ties and parents are going through their own mid- life transitions, may put further strain on what is already a time of potential family turmoil.

32. Illness in later age may have an impact not only on grown children but also on the older couple who had anticipated a time of enjoyment together and are less able to care for each other because of their own physical limitations associated with aging. The extent of family disruption depends on the seriousness of the illness, the family’s level of functioning before the illness, socioeconomic considerations, and the extent to which other family members can absorb the role of the person who is ill.

33. In some instances, a major illness brings a family closer together; in others, even a minor illness causes significant strain. It is important to identify what the illness means, not only to the individual but also to the family. Asking them what they consider major problems and how they plan to handle specific situations can help you assess the meaning of the patient’s illness to the family.

34. To achieve effective patient teaching outcomes, you should make the family part of your teaching plan. For example, if your patient’s wife does all the cooking in the home, it is vital to include her in diet teaching. Involving family members may be an important future source of support for the patient as he or she works at behavioral change. Obviously it will be difficult for a husband to be supportive of his wife’s blood pressure treatment program if he does not understand the reasons for the recommendations and the consequences of not carrying them out.

35.  Long-term illness, even in the most stable and supportive families, brings changes in family relationships. Illness produces disequilibrium in the family structure until adjustments can occur. When teaching the patient and family, it is important to identify patterns of relationships and to be alert to attitudes of family members. Illness in a family member tends to raise the anxiety of all those close to the patient.

36. BODY DEFENSES: IMMUNITY AND IMMUNIZATION

37. INTRODUCTION The environment contains a wide variety of potentially harmful organisms (pathogens), such as bacteria, viruses, fungi, protozoa and multi cellular parasites, which will cause disease if they enter the body and are allowed to multiply. The body protects itself through a various defense mechanisms to physically prevent pathogens from entering the body or to kill them if they do.

38. DEFINITION The term immunity refers to the body’s specific protective response to an invading foreign agent or organism. The human body has the ability to resist almost all types of organisms or toxins that tend to damage the tissues and organs. The capability is called immunity

39. TYPES OF IMMUNITY

40. Types of immunity Broadly there are two types of immunity. 1. Innate or natural immunity 2. Acquired immunity

41. 1. Innate or natural immunity Immunity with which an individual is born is called innate or natural immunity. Innate immunity is provided by various components such as skin, mucus membrane, phagocytic cells etc,.. Innate immunity acts as first line of defense to particular microorganisms.

42. Mechanism of innate immunity Anatomical barrier. Physiochemical barrier. Phagocytosis or phagocytic barrier. Inflammation or inflammatory barrier.

43. I. Natural immunity It is a nonspecific immunity present at birth. It is the ability to distinguish between friend and foe or self and non-self. Such natural mechanisms include 1. Physical and chemical barriers – Skin and mucous membrane – Antimicrobial substance in body secretions 2. The action of WBCs 3. Inflammatory response.

44. Physical and chemical barriers Skin and mucous membrane • Intact skin & mucous membrane - physical barrier to invading microbes. • Sebum and sweat secretion - contains antibacterial and antifungal substances • Hairs in the nose acts as a coarse filter. • One way flow of urine from the bladder during micturation Antimicrobial substance in body secretions 1. Hydrochloric acid in gastric juice 2. Lysosomes 3. Saliva 4. Immunoglobulin in nasal secretions and saliva ( IgG , IgA , IgM , IgD and IgE , which have a range of functions.) Inflammatory response • Major function of the natural immune system. • Chemical mediators assist this response by minimizing blood loss, walling off the invading organism, activating phagocytes and promoting formation of fibrous scar tissue and regeneration of injured tissue

45. TYPES OF INNATE IMMUNITY: Species immunity Racial immunity Individual immunity

46. 1. SPECIES IMMUNITY If one species is resistant to certain infection and the other species is susceptible to the same infection then it is called as species immunity. Anatomic, physiological and metabolic differences between species determine species immunity. For example, Birds are resistant to anthrax but Human are susceptible. It is simply because higher body temperature of birds kills  Bacillus   anthracis . Anatomic differences between species also determine species immunity. For example, Human are more susceptible to skin infection whereas Cattles are more resistant to the same skin infection. It is because of tough and hairy skin (hides) of Cattles.

47. 2. RACIAL IMMUNITY If one race is susceptible while other race is resistant to same infection, then it is called Racial immunity. For examples; certain African race are more resistant to malaria and yellow fever where are Asian or Americans are susceptible to same infection. Similarly Orientals (East Asia) are relatively resistant to syphilis. Racial immunity is determined by difference in Socio-economic status, habitat, culture feeding habits, environments, genetic, etc.

48. 3. INDIVIDUAL IMMUNITY If one individual of certain race or cast is resistant while other individuals of same race or cast are susceptible to certain infection, then it is called as individual immunity Individual immunity is determined by various factors such as health status, nutritional status, previous illness, personal hygiene, genetic differences etc. For examples; Individual with genetic deficiency of glucose-6 phosphate dehydrogenase are resistant to Malaria.

49. 2. Acquired or developed immunity Immunity which is developed later in life after microbial infection in host is called as Acquired or developed immunity. For example, If an individual is infected with chicken pox virus, he/she become resistant to same virus in later life. Acquired immunity is provided by Antibodies and certain T-lymphocytes. Components of acquired immunity such as Antibodies and T- cells are specific to particular microorganism. Therefore acquired immunity is also known as Specific immunity.

50. Characteristics of acquired immunity Specificity Self/non-self recognition Immunological memory Diversity

51. Types of acquired immunity : Active immunity Passive immunity 1. Active immunity: If host itself produces antibodies, it is called active immunity. It is of two types; artificial active immunity and natural active immunity. Artificial active immunity:  Immunity provided by vaccination. Natural active immunity:  immunity provided by natural infection.

52. 2. Passive immunity: If host does not produce antibodies itself but antibodies produced in other host provides immunity, than it is known as Passive immunity. It is of two types; natural passive immunity and Artificial passive immunity Natural passive immunity :   IgG antibody produced in mother cross placenta and protects fetus up to 6 month old age. Artificial passive immunity :  if preformed antibody are injected into host for immunity. Eg. Anti-venom, Rabies vaccine (* it is not a vaccine, it is preformed anti rabies antibody)

53. IgG IgG (75% of total immunoglobulin) • Appears in serum and tissues (interstitial fluid) • Assumes a major role in blood borne and tissue infections. • Activates the complement system. • Crosses the placenta IgA IgA (15% of total immunoglobulins ) • Appears in body fluids (blood, saliva, tears, breast milk, and pulmonary, gastrointestinal, and vaginal secretions). • Protection against respiratory, gastrointestinal and genitourinary infections. • Prevents absorption of antigens from food. • Passes to neonate in breast milk for protection

54. 3. IgM IgM (10% of total immunoglobulins ) Appears mostly in intravascular serum Appears as the first immunoglobulin produced in response to bacterial and viral infections. Activates the complement system. 4. IgD IgD (0.2% of immunoglobulins ) Appears in small amounts in serum Possibly influences B-lymphocytes differentiation, but role is unclear. IgE IgE (0.004% of immunoglobulins ) Appears in serum Takes part in allergic and hypersensitivity of reactions Combats parasitic infections.

55. Line of defence Prevents infection through a number of non-specific and specific mechanisms working on their own or together. First lines of defense are external barriers that prevent germs from entering. Skin which acts as a strong, waterproof, physical barrier and very few organisms are able to penetrate undamaged skin. Skin a strong physical barrier, like a waterproof wall. Mucus a sticky trap secreted by all the surfaces inside the body that are directly linked to the outside, also contains antibodies and enzymes Cilia microscopic hairs in the airways that move to pass debris and mucus up away from the lungs Lysozyme a chemical (enzyme) present in tears and mucus that damages bacteria • Acid in stomach and urine, make it hard for any germs to survive Fever elevated body temperature making conditions unfavorable for pathogens to survive

56. IMMUNIZATION

57. DEFINITION Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infection or disease.

58. ADVANTAGES OF VACCINE Protect us from serious diseases Prevent the spread of those diseases Epidemics of once common infectious diseases such as measles, mumps, and whooping cough

59. HEALTH PROMOTION AND PREVENTION

60. Health promotion: Activities to improve health & well-being Health prevention : The Management Of Those Factors That Could Lead To Disease So As To Prevent The Occurrence Of the Disease. - Mosby dictionary Health promotion is about achieving the best possible health for everyone. It is difficult to improve an individual’s health if the economic, environmental and social conditions are bad. Interventions are changes made to individual and social circumstances to maximize opportunities to achieve good health

61. WHO defines health promotion as the process of “enabling people to increase control over, and to improve, their health”. (1986) Health promotion is based around the saying “Prevention is better than cure” and it aims at preventing morbidity and mortality.

62. Individual role in health promotion Individual’s play a key role in promoting their health, because personal behavior is the major determining factor of health status. For health promotion to be effective, individuals’ need to be empowered. This refers to an individual’s ability to make decisions about, or have personal control over their life. Individuals working in health-related areas are able to assist people to gain control over their health. Ex: general practitioners, counselors, dentists, health workers, community nurses. Other individuals who are involved in improving health also include health educators, social workers, community workers and environmental health officers.

63. Community groups and school role in health promotion  Community groups and schools are important settings for health promotion, after all these are the places where we live, work and play. Communities should be able to contribute to discussion and participate in the setting of health policies. Our schools also need to places that promote health among our young people.

64. Role of NGOs in health promotion Non-government Organizations are non-profit making organizations that operate at local, national or international levels. They are funded from a variety of sources including government grants, public donations and fundraising. Non-government organizations (NGO's) play a crucial role in the health of Australians. For example, many organizations such as universities conduct health research into the prevention, detection, and treatment of disease. While other NGO's contribute in various ways, including raising funds for research, running educational and health promotion programs, providing support services and coordinating voluntary care.

65. Role of state and local government in health promotion State Governments are also responsible for campaigns that target specific health promotion and disease prevention programs. Local Governments support the state government in implementing health promotion

66. LEVELS OF PREVENTION

67. Primordial prevention. Primary prevention. Secondary prevention. Tertiary prevention.

68. I. Primordial prevention Definition: “It is the prevention of emergence of risk factors in populations, in which they have not yet appeared”. INTERVENTIONS : The main intervention in primordial prevention is through individual and mass health education. II. Primary prevention Definition: Primary prevention can be defined as action taken prior to the onset of disease, which removes the possibility that a disease will ever occur.

69. Primary prevention Strategy….. Population (mass) Strategy : It is directed at the whole population irrespective of an individual risk levels. High- risk Strategy : It aims to bring preventive care to individuals at special risk. This requires detection of individuals or high risk by the optimum use of clinical methods.

70. General Health promotion Health education. Environmental modifications. Nutritional interventions. Lifestyle and behavioral changes. Health education to improve healthy habits and health consciousness in the community. Improvement in nutritional standards of the community. Healthful physical environment (Housing, water supply, excreta disposal, etc.) Good working condition. Marriage Counseling. Periodic Selective examination of risk population.

71. Specific protection: Use of Specific immunization (BCG, DPT,MMR vaccines). Chemoprophylaxis (tetracycline for Cholera, dapsone for Leprosy, Chloroquine for malaria,etc .,). Use of specific nutrients (vitamin A for Children, iron folic acid tablets for Pregnant mothers) Protection against accidents (Use of helmet, seat belt,etc .,) Protection against occupational hazards. Avoidance of allergens. Protection from air pollution.

72. III. Secondary Prevention Definition: The action which halts the progress of a disease at its incipient stage and prevents complications”. Objectives of secondary prevention: Complete cure and prevent the progression of disease process. To prevent the spreads of disease by curing all the known cases. To prevent the complications and sequel of disease. To shorten the period of disability.

73. INTERVENTIONS: Individual and mass case-finding measures. Screening surveys(urine examination for diabetes, etc.,). Selective examination

74. IV. Tertiary prevention Definition: All measures available to reduce or limit impairments and disabilities, minimize suffering caused by existing departures from good health and to promote the patient’s adjustment to irremediable conditions Modes of intervention : i ) Disability limitation ii)Rehabilitation Disability limitation: i ) Disease Impairment Ii) Disability Handicap Rehabilitation : Medical rehabilitation: (restoration of Bodily Function). Vocational rehabilitation:( restoration of the capacity to earn a livelihood). Social rehabilitation: (restoration of family and social relationship). Psychological rehabilitation: (Restoration of personal dignity and confidence)

75. HEALTH CARE TEAMS The health care team consists of a group of people who coordinate their particular skills in order too assist a patient or his family. The personnel, who comprise a particular team will depend upon the needs of a patient.

76. The Health Care Team consists of --- Health Team Physicians Nurses Social Workers Auxillary Personnel Village Health Guides Trained Dais Health Assistants

77. THE PHYSICIAN In hospital setting, the physician is responsible for the medical diagnosis & for determining the therapy required by a person who is ill or injured. A physician is a person who is legally authorized to practice medicine in particular jurisdiction. NURSE A number of nursing personnel may be involved in the health team & may have their own nursing team. A nursing team is comprised of personnel who provide nursing service to a patient or his family. The team leader “Head Nurse” is responsible for delegation of duties to members of her team & care given to the patients.

78. THE DIETITIAN When dietary & nutritional services are required a dietitian may also the member of the health team. Dietitians supervise the preparation of meals according to the doctor’s prescription. The nutritionist in a community setting recommends health diets for people & is frequently involves in board advisory services in regard to purchase & preparation of food. THE PHYSIOTHERAPIST The physiotherapist provides assistance to a patient who has problem related to his musculoskeletal system. Their functions include; assessing mobility & strength, providing therapeutic measures, & teaching patients news skills & measures.

79. MEDICAL SOCIAL WORKER THE SOCIAL WORKER The patient & his/her family member are assisted by social worker with such problems such as finances, rest home accommodation, counseling or marital problems, adoption of children. THE OCCUPATIONAL THERAPIST The occupational therapist assists patients with some impairment of function to gain skills as they are related to Activities of Daily Living (ADL) & help with a skill that is therapeutic. THE PARAMEDICAL TECHNOLOGIST It includes laboratory technologies, radio-logic technologists. The Laboratory technologists examine & study specimens such as urine, feces, blood & discharges from wound.

80. RADIOLOGIST The radiologic technologist assist with wide variety of x-ray procedures, from simple chest radiograph to more complex fluoroscopy. Through radio active materials, nuclear medicine technologist can provide diagnostic information about functioning of a patient’s liver etc. THE PHARMACIST The pharmacist prepares & dispenses pharmaceuticals in hospitals & community settings. The role of pharmacist in monitoring & evaluating the actions of medications on patients is becoming increasingly prominent

81. THE INHALATION THERAPIST The inhalation therapist or respiratory technologist is skilled in therapeutic measures used in care of patients with respiratory problems. These therapist are knowledgeable about oxygen therapy, devices, intermittent positive pressure breathing respirators, artificial mechanical ventilators, accessory devices used for inhalation. PSYCHOLOGIST The clinical psychologist constitutes an important member in the health care team. The psychological dimension of a person is looked into and the health care services are accordingly planned. CLERGY The spiritual dimension of a patient comes into play more during a person’s illness. Patients who draw their spiritual strength from God are the ones who successfully cope with illness. The role of a clergy is therefore very important.

82. HEALTH CARE AGENCIES ASSIGNMENT

83. HOSPITALS

84. Hospitals are organized Institutions, which are mainly designed to care for the sick, injured and the well. The later are usually admitted for physical check up and investigations which cannot be done elsewhere. The word hospital is derived from the Latin word "hospess“ which means a guest or a host. This is quite true for a patient leaves his home and comes to the hospital as a guest for brief periods of stay.

85. DEFINITION “ A hospital is an integral part of a social and medical organization, the function of which is to provide for the population, the complete care both curative and preventive and whose out patient services reach out to the family and his home environment” - Acc to WHO

86. TYPES OR CLASSIFICATION OF HOSPITALS. Acc to the type of patient or service offered: General hospital _ Care is given to many kinds of conditions such as medical, surgical, pediatric and obstetrics including psychiatry and communicable diseases. Special hospital _ It limits its services to particular condition or sex or age such as tuberculosis, maternity etc,…

87. II. Acc to the ownership: Government hospital _ T hese government hospitals may be general or specialized according to he need of the community Medical college hospital District hospital City or town or head quarter hospital Primary health centre Rural hospital ESI hospital Non government or private hospital Medical college hospital Mission hospital Private hospital Industrial

88. III. Acc to the size of the bed capacity: Small hospital 100 or less than hundred beds Medium size hospital 101-300 beds Large hospitals 301-1000 bedded hospital

89. IV. Acc to the bed strength: Teaching or referred hospital 500 or above beds District hospital 200 -300 beds Taluk hospital 50-200 bedded hospital Community health centre 30-50 beds Primary health centre 06-10 beds

90. V. Acc to the Objectives: Teaching cum referred hospital General hospitals Specialized hospitals Isolation hospitals VI. Acc to the System: Allopathic hospital Ayurvedic hospital Homeopathic hospitals Unani hospitals

91. VI. Acc to the Management: Union govt / Govt of India State government Local bodies Autonomous bodies Private Voluntary hospital

92. Functions of hospital The main aim of a hospital is patient care and comfort and the nurse has much to contribute in not only doing her functions, but also in coordinating the activities of the health team. Besides the basic functions of a hospital such as care of the sick and injured, diagnosis, treatment and rehabilitative services, many undertake education of doctors, nurses, technicians etc., as an added function. Some hospitals do research work.

93. So as to list down, the functions are as follows— Investigation, disease and care of the sick and injured people. Health supervision and prevention of disease. Education of medical workers as doctors, nurses, dieticians, social workers… etc. Medical research. Promotion of health. Rehabilitation. Scientific therapy of hygiene and mental therapy.

94. There are various departments in a hospital like medical, nursing, pharmacy, and dietary. Every hospital and its departments have own policies and rules, which govern their various activities. The nurse should acquaint herself with the policies and interpret those connected with the patient's admission, treatment and discharge to the patient's relatives in a simple language. They must be careful and get the guidance of seniors when dealing with accident patients and other patients with legal implications (medico-legal).

95. ORGANIZATIONAL CHARTS OF A HOSPITAL --- ASSIGNMENT

96. THANK YOU