Care for patients with chronic diseases varies based on the condition, but across the board, nurses are at the center of care for chronic disease management. Unlike acute care, nurses who care for people living with chronic disease have the opportunity for more in-depth patient education and to build stronger patient-nurse relationships over time.
Cindy Richards, RN, BSN, CNN, president of the American Nephrology Nurses’ Association (ANNA) and pediatric nephrology nurse at Children's of Alabama hospital in Birmingham, Ala., has been a nurse for more than 35 years. According to Richards, “in caring for a patient in an acute care setting, the nurse will frequently care for that patient for a shift, or perhaps a couple of days, in hopes that the patient’s condition will improve enough for him or her to be discharged home. In a chronic setting, nurses provide care to the same patient or patient group for weeks, months or sometimes even years. That allows for a completely different type of patient contact and interaction.”
Chronic disease nurses provide care to patients in different settings, which makes chronic disease management one of the most diverse areas of focus for nurses. Nurses working with patients with chronic diseases and conditions can work in hospitals, physician’s offices, dialysis units, educational institutions or other settings, which allows nurses to interact with a variety of patients.
“Depending on where they work, nephrology nurses care for patients of every age, from infants to the elderly,” said Richards. “I started my nephrology career in an adult outpatient dialysis unit, with patients in their 20s to their 80s, and for the past 22 years, have worked in pediatric nephrology, where patients range from newborns to teenagers.”
Working in chronic disease management, Richards is familiar with the fact that different chronic diseases and conditions can provide a varied spectrum of symptoms and co-morbidities no matter the age of the person with chronic disease, which can pose a challenge when identifying and treating patients.
“Most patients with kidney disease have co-morbidities of some type,” said Richards. “Co-morbidities may include metabolic bone disease, issues with anemia, and issues with high cholesterol and/or cardiovascular disease. The kidney affects so many different organ systems that when the kidney doesn’t work properly, these other systems don’t work properly either.”
As a pediatric nephrology nurse, one of Richards’ main responsibilities is to educate patients and their families about their disease and how to manage it, including diet and medication guidance. If a patient needs a transplant, she acts as a transplant coordinator, assisting the healthcare team to perform an evaluation to assess for suitability for transplant, and providing education and support after the transplant. Providing support to patients and their families is an important aspect for all nursing specialties, but Richards believes that “being a strong advocate for your patients is one of the most critical things a nurse caring for chronic disease patients can provide.”
For more information about nursing specialties in chronic disease management including nephrology nursing, explore the nursing specialties database on www.discovernursing.com.