Professional roles of nurses

Professional roles of nurses who have a Bachelor degree
The Professional Profile makes no distinction between nurses at levels 4 and 5 (upper secondary
(Dutch ‘mbo’) and higher vocational (Dutch ‘Bachelor’) training. The bachelor level is expressed
in bachelor core competences, see appendix II.

To make the bachelor level more visible five roles and the accompanying twelve core
competences, have been described for nurses who hold a Bachelor degree (Pool et al., 2001). A
nurse fulfils the following five roles:
1. caregiver
2. director
3. designer
4. coach
5. health professional

All about the nurse profession en the educational profile, sept. 2009, a description of the various roles is given. At the individual level, the extent to which nurses fulfil each of the roles depends on the work situation. The five roles are complementary and regularly coincide in daily practice.

Caregiver
The role of the caregiver is open to change; there is a shift in tasks from the physician to the
nurse, care is increasingly organized around the patient rather than around special fields of
medicine (meaning that the nurse is also responsible for the budget), and since the patient is
assisted within models of collaboration, the nurse must act as an advocate of the patient’s
interests, where necessary. The role demands the necessary technical competences, ethical
considerations and intellectual skills such as being able to think critically and to work with
evidence-based practice. The role of caregiver is the most basic one of all the roles nurses fulfil.

As a caregiver, the nurse tries to meet the needs of the parties requesting care and works
according to the professional standards and values. He or she bases actions, ranging from
anamnesis to evaluation, on theoretical and practical knowledge as well as on the results of
scientific research. In each situation, decisions can be made regarding technical and moral
actions, which can be supported and justified (critical thinking). The caregiver contributes to
improving the quality of life of those requesting care and can be consulted. He or she can give
advice in all stages of the nursing process, for example in making a diagnosis, in selecting
interventions and determining results, and in providing care, and he or she provides care,
especially in situations in which standard procedures do not apply (complex interventions). The
nurse must have knowledge and skills that are context-related, specific, and generic, i.e. which
extend beyond the context.

Director
A director creates and safeguards continuity. He or she organizes a cohesive package of care
around the patient and can work beyond the limits of a particular area. That means that the
nurse is able to determine which factors influence the need for care (the guide to the social
services), to indicate how this care should be given by others, and to assign people to health
care tasks. As a director, a nurse is able to convince others and to organize things. In short, this
role involves the ability to organize, coordinate and safeguard the complete and integrated care
process, which involves various disciplines.

Designer
As a designer, a nurse contributes to defining measures relating to the nursing policy. This
involves regulations for the daily provision of care. In a designer role, a nurse focuses on
innovation and quality improvement in the content of care and on (the procedures in) the care
process. It involves safeguarding, managing and improving quality. In order to form the role of
designer, the nurse is familiar with research methods for developing evidence-based standards
(procedures, protocols), for applying evidence-based practice, and carrying out applied research.
Intellectual skills such as critical thinking and being able to critically evaluate scientific research
are required here.

Coach
A coach stimulates, motivates, gives and receives feedback, and sets an example. He or she
supervises and helps to train colleagues, and can assist in meetings focussing on sharing views.
The coaching role of a nurse is the core part of practical training.

Health professional
A nurse as a health professional is member of a professional organization and acts within the
professional nursing standards and the framework of the Professional Code. He or she helps to
formulate and realize values and standards that are relevant for carrying out the nursing
profession.