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Expanding nursing roles is necessary in hospice care to allow the patients and families to direct care based on their own values, goals and needs. Interventions and assessments are necessary because people experience illness, care giving, death and bereavement in unique and personal ways.  In order to meet these goals, the hospice case manager, will form an inter-disciplinary team care management (IDT). This will build an integrated community between the patient, family and the hospice team. As a result, the dynamic needs in health care have a response to all round the clock.


The IDT will be accountable to carry out all care settings involving the overall well being of the patients and their families. These include the inseparable physical, psychological, spiritual and bereavement needs. Meaningful collaborations are important for problem solving and goal formulation that will later yield expertise in care planning. Effective IDT care management, will improve daily practices that are   beginning from the time the time the patient is admitted, continues until his death, through to the bereavement of the survivors.

In an attempt to meet multidimensional goals in health care, interdisciplinary team will incorporate expertise of members from several disciplines. These are goals aiming to meet other needs relating to nursing practice. For example, emotional and financial strain caused by chronic and terminal illness.

To be most effective, the IDT design will add up a sub-team of the end of life care team. This is a supporting team helping patients and families to deal with difficult experiences of life limiting illness, death and bereavement. Hospice care will change from singular discipline to inter dimensional approach. As much as each nursing discipline involves special areas of expertise, responsibilities and duties, each team member will have to expand and blend their defined roles. These members must have basic competence to provide holistic and comprehensive approach to the nursing field. Role blending will ensure that all roles are growing, changing, dynamic and overlapping.

As a registered nurse, the primary goal is to offer coordinated physical care responsibly. Centrally, these involve the physical conditions and comfort of the patient. In a holistic approach, these are goals aiming to ensure that practicing nurses are highly skilled in end stage physical assessments, pain alleviation, and pain and symptom management (AACN, 2013).

The registered nurse will be to educate patients and their families regarding physical care. For instance, medication administration, equipment use, skin care and nutrition. To ensure the psychological and spiritual wellbeing, group work will be necessary. Social workers, counselors and chaplains will provide emotional support to the families through the utilization of community resources. For example, Aiding with legal and financial issues, advance directives and funeral arrangements.

As an advanced registered nursing practice (ARNP), it is necessary to establish standards and guidelines to erect routine levels of health care. These precognitive goals will lead to detailed procedures on a full range nursing practices. In addition, this will deal with biological functions, nutrition, hygiene and psychological distress.

The demands of ARNP require that the nurses should be highly sensible and thoughtful to undertake roles that are not always available in health care. The privacy and dignity of the patients will be emphasized. Patients will be educated on their rights, which need consideration to constitute a sound basis for the nursing practice. Principles of self-care will have emphasis too to promote viable and reasonable personal hygiene (AACN, 2013).

While working as per diem in the intensive care unit, the nurse should not only focus on health matters nut also on the need for problem solving. Identifying the key players and bringing together all involved or affected parties is the first step. These will objectively evaluate and solve problems to minimize blaming specific individuals. When managing a conflict, all members from conflicting groups must be involved. These may create the need to rotate their positions to facilitate understanding. For instance, transferring a member from the ICU room to the emergency department.

Apparent problems and their root causes will be explained by getting the participants to have brainstorm ideas. These solutions will be listed without judgments or commentaries. Using the elimination technique, best ideas will be isolated foreshadowing their implementation.  For effective decision-making, it is important to create action plans and implementation strategies (AACN, 2013). In the ICU room, the primary goal should be on patient’s outcome. Bedside care management will be mandatory to achieve a positive and perfect fitness of the client. Furthermore, perspective care planning will decrease the length of hospital stay.

Going back to school for a BSN degree is a requirement for improving the mobility of nursing career. These programs recognize the legitimacy and the importance of developing alternative tracks to accommodate diverse and unique nursing practice. As a nurse, enrolling for a BSN degree is driven by the aim of getting wider opportunities in clinical and scientific research. The baccalaureate nurse is in a god position to move across community-based settings like home healthcare, outpatient centers and neighborhood clinics.

BSN learning will help to incorporate technological advances into the nursing field. Illustratively, obtaining a degree online facilitated by distance learning. In addition, technology is partially the dilemma on the increased number of nursing students enrolling for degree programs. Through virtual environments, clinical competencies will include clinical exams, demonstrations and clinical portfolios. This will results to proper structuring, well monitoring and careful offering of health care.


  1. American Association of Colleges of Nursing. (2013). Expanded Roles for Advanced Practice
  2. Nurses. Retrieved from

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