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The Nurse's Role in Chronic Disease Management

One of the most important roles in nursing is patient education. We've moved firmly into an era where the patient plays a vital role on the healthcare team, and for good reason. Doctors can prescribe medicines, and nurses can administer those medications and educate their patients on what to do upon discharge, but without patients buying into the plan and being active participants, it's all for naught.

Patient education is particularly important in the case of chronic disease management. For these conditions, there's no quick fix. They require sustained treatment over time, and patients need check-ups to keep the diseases from becoming life-threatening. For patients to successfully manage those diseases, they have to learn about their illnesses and practice the treatments enough to be effective. For example, people who have recently been diagnosed with diabetes must learn to administer insulin and check their blood sugar.

Perhaps what's most startling about chronic diseases in the U.S. is how common they are. According to the National Council on Aging, 80 percent of adults 65 and over have a chronic condition, and 68 percent have two or more. The 10 most common (among Americans 65 or older who have them) are:

  • Hypertension (58%)
  • High Cholesterol (47%)
  • Arthritis (31%)
  • Ischemic Heart Disease (29%)
  • Diabetes (27%)
  • Chronic Kidney Disease (18%)
  • Heart Failure (14%)
  • Depression (14%)
  • Alzheimer's Disease and Dementia (11%)
  • Chronic Obstructive Pulmonary Disease (COPD) (11%)

For some of these chronic conditions, diet and exercise are common-sense routes to better management. For COPD and heart disease, quitting smoking is an obvious (though not always easy) measure, but it's also recommended for treating high cholesterol.

But for some chronic conditions, a nurse's knowledge will help patients get beyond basic, common-sense understanding of their conditions. For instance, in an article for Medscape by Dr. Anne Peters, titled "Helping Diabetes Patients Exercise Without Fear," she cautions people with diabetes to not have too much insulin in their systems before they start to exercise — with the caveat that as they might be trying to lose weight, they won't necessarily want to regulate insulin with diet alone.

She provides specific guidelines: 15 to 30 grams of carbohydrates for every 30 minutes of exercise, with a post-exercise cooldown and possible insulin dosing and additional carbohydrate intake. This knowledge is not so common for all patients, so it is crucial for doctors and nurses to stay current on recommended treatments and encourage their patients to exercise, eat and medicate appropriately.

Because so many patients have more than one chronic disease -- perhaps with a specialist overseeing the treatment of each disease -- it's helpful to have a team approach to educating patients to help them manage their chronic diseases.

According to an article in the July/August 2014 edition of Nursing Economic$, "The challenge of addressing the needs of patients with multimorbidities has led to interventions that focus on the patient rather than the disease. The greatest success has been found among programs that use a collaborative team-based approach to care management."

Because nurses oversee how multiple doctors' orders are implemented, they are particularly important members of that team. An RN with a BSN is best-equipped to handle that responsibility, having the research experience and the more holistic approach that comes with a BSN preparation.

The large number of American seniors with two or more chronic conditions make BSN-prepared nurses especially important in helping them manage their conditions to maintain a high quality of life.

Learn more about Eastern Michigan University's RN to BSN Online.


Sources:

National Council on Aging: Top 10 Chronic Conditions in Adults 65+ and What You Can Do to Prevent or Manage Them

Medscape: Helping Diabetes Patients Exercise Without Fear

Nursing Economic$: Role of the Nurse in Chronic Illness Management: Making the Medical Home More Effective


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