A historic examination of the major responsibilities of nurses in providing care to individuals with mental retardation indicates that the responsibilities have remained relatively constant, whereas the roles have shifted and expanded over time from nursing assistant activities to advanced practice roles. Regardless of the setting, nurses have been involved in primary and secondary prevention, case finding, health care management of the individual with mental retardation and their family across the life span, instruction about this care to other nurses, and referral. This specialty nursing practice has a long history. In recent years, the role of nurses in interdisciplinary care has waned with the continual trend of institutional closings and movement of the clients to small community group homes. As individuals with mental retardation achieve greater participation in their communities, the roles and responsibilities of nurses who specialize in the care of persons with mental retardation will also change, but much effort is needed today to enforce nursing's contribution in this field to the other disciplines involved in the care of these individuals and to society. The recent Surgeon General's report [57], Closing the Gap: A National Blueprint for Improving the Health of Individuals with Mental Retardation (2001), could serve as such a springboard for renewal of nursing action in this field.
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