The US has always relied heavily on Nurse Practitioners (NPs) for disease management. Today, they form the bulk of healthcare professionals, and they play a central role not just in caring for patients, but also in helping manage diseases, chronic or otherwise.
Over the years, as the population has grown, nurses have taken on a more expanded role in healthcare. Now, a significant number of Americans rely on nurses to provide for just about all their healthcare needs.
The history of nursing
The history of nursing and disease management is as old as the history of nursing in the US. The profession was first practiced during the Civil War, when wives and mistresses of soldiers began following armies to provide care and treatment to the injured. Many soldiers also suffered from diseases like malaria, pneumonia, dysentery and typhoid, and it fell to these women to take care of them. To accommodate the growing number of soldiers who needed care, both the North and South established temporary hospitals that were manned by volunteer nurses, and they helped save many lives.
Nursing in the US today
Today, America has more than 5.3 million nurses, and they form the bulk of healthcare providers in the country. Their role has expanded significantly and is no longer limited to providing basic care and administering medications.
Depending on their specialization, nurses can now perform tests, diagnose patients, and write prescriptions. Because they have more contact with patients than other healthcare providers, their feedback and advice are highly valued by care teams, and many have joined management ranks.
As the US population grows, the demand for nurses increases, resulting in excellent employment prospects. Those who train as nurses today can expect to be hired quickly, and depending on their specialization, they will go on to enjoy long and fruitful careers.
The online ABSN at Holy Family University, for example, prepares students for a wide variety of careers including critical ICU care nursing, surgical nursing, ER and OR nursing, and labor and delivery nursing. For those who prefer to work in a unique environment, the course can help them secure employment as travel nurses, case managers, home health nurses or public health nurses. The program covers topics like foundations of nursing practice, medical-surgical nursing, older adult health promotion, and nursing care of children. By the time enrollees complete the course, they know how to think critically within a healthcare setting, understand how to care for patients from diverse cultures and backgrounds, and can communicate effectively with both colleagues and patients.
It is important for any individual who wants to do an ABSN or any other nursing course to familiarize themselves with the role that nurses play in disease management. A basic knowledge of these issues sheds light on some of the modules they will cover during their training and improves their chances of passing their exams. Additionally, the more they know, the more competent practitioners they will become.
Understanding the role of nurses in disease management
Nurses are on the front lines; they provide hands-on care from the time a patient comes to the hospital until they leave, and as such, they are patient advocates.
They play a significant role not just in assisting doctors with diagnosis and other medical tasks, but in providing care for every patient who is under their purview. Below are some of the everyday tasks that these professionals undertake within the clinical environment.
Comprehensive patient assessment
Patient assessment is the first step for anyone who walks into a healthcare facility. Doctors and nurses talk to them about their symptoms and perform tests to determine what could be ailing them. They also determine the best course of treatment.
Historically, doctors alone performed patient assessments, but over the years, nursing training has taught practitioners to carry out this role too. Today, within most facilities, when a patient walks in they are met by a nurse who performs triage. This involves talking to the patient about their symptoms, taking their vitals, and doing any tests they think are necessary.
They also provide emergency care if it is needed, like helping patients who are in a lot of pain, who have very high temperatures, or who are suffering a life-threatening injury. Some types of nurses, like Family Nurse Practitioners (FNPs), are trained to treat minor ailments and will only refer patients to doctors if they need specialist care.
Assisting doctors to care for patients
Today, nurses continue to play a role in helping doctors care for patients. Typically, a doctor will have a nurse at hand to assist during the consultation process, helping with tasks like taking blood and other samples for tests. The doctor may also use them to administer injections and other medications as required.
Medication management and adherence
When patients are admitted into hospital wards, they are cared for by nurses. One of their primary roles is to make sure that each patient has their prescribed medications and that they take them accordingly. Typically, a nurse is assigned to a ward or a section of a ward, and it is their job to go through all patient charts, find out what medications have been prescribed, and prepare and administer them.
Monitoring vital signs
The nurse, just like the doctor, does ward rounds. They check the condition of each patient to make sure that they are progressing as expected. They may take vital signs such as temperature and blood pressure, and if they notice anything out of the ordinary they inform the doctor.
If they are qualified, they will take necessary steps to assist the patient. If the problem is out of their purview, they instead inform the doctor who advises on the next steps.
Monitoring disease progression
Many nurses are trained to monitor different diseases, and it is their job to make sure that patients are responding to medication as expected. For cancer patients, for example, oncology nurses monitor how they respond to chemotherapy, and they work together with doctors to determine if the treatment has had any effect on the cancer.
During the COVID-19 crisis, many nurses were tasked with monitoring patient progress, and if they noticed deterioration, they took the necessary steps.
Nurses were not traditionally expected to monitor disease progression; it was left to doctors because they had the right kind of training. However, as the role of nurses expands, specialties now teach them how to monitor the progression of different diseases. By the time they graduate, nurses have the necessary skills to take over this role from doctors.
Symptom management and comfort care
This is all about looking after patients, making sure that they are not in pain or discomfort, talking to them about their symptoms, and doing what is necessary to alleviate them. It can be something as simple as a patient needing an additional pillow or as complex as needing a different type of medication to ease their pain.
Symptom management is important because it tells practitioners whether the patient is healing, whether prescribed medications are working, and whether they are receiving adequate care. The nurse collects feedback from the patient and reports back to the care team, and if the patient isn’t doing as well as was expected, the team can decide on an alternative course of action.
Comfort care has become central to healthcare, and unlike in the past, today’s patients can tell their doctors and nurses how they would like to be cared for. It is called patient-centered care, and it comes with important benefits. Because the patient is included in decision-making, they are happier with the treatment they get. This tends to shorten healing time, which reduces the resources the hospital uses to treat the patient. Healthcare facilities that have adopted patient-centered care tend to report better outcomes for patients and lower costs per patient too.
Education and patient empowerment
Education and patient empowerment were one of the first roles that nurses took on back in the 18th century.
As immigrants arrived in the country, many were poor and living in terrible conditions which led to rampant disease. Mothers didn’t know how to properly care for their children in such conditions and child mortality rates were high. People who suffered from chronic conditions were dying at higher rates due to lack of care and poor diet.
Nurses, who were volunteers, would teach these communities how to make do with the few resources they had. They taught mothers about sanitation for better health, taught family members how to care for their critically ill, and gave advice on diet and nutrition.
Nurses in the US still play this role albeit on a smaller scale. When patients come in for treatment, the nurse gathers a patient history and uses this to give advice. They provide education about diet, exercise, disease management, childcare, and even stress and anxiety management.
There are many community nurses across the US, and they are tasked with educating communities about ways they can improve healthcare. They are also advocates for those they represent, making sure they have a voice and helping them acquire the necessary resources to stay healthy.
Nurses are expected to take a proactive rather than reactive approach towards healthcare. As much as possible, they should prevent disease and illness instead of waiting to cure it at a later stage.
These practitioners, for example, lead inoculation drives for children and the elderly, making sure that they are protected against future potential illnesses. They also advise families on how to take care of the young, the elderly and those with chronic illness, and the overall effect is that it reduces the healthcare burden on all levels.
Not only is it cheaper for families and healthcare facilities, but the government also spends less because the number of patients is reduced.
In recent years, nurses have become more involved in creating healthcare policies and the results have been impressive. Nurse leadership, as a career, is on the rise, and many are opting for degree courses that qualify them for it.
Because they spend so much time with patients, nurses have a good understanding of the challenges they face, as well as the issues that afflict healthcare in families in communities. As such, their contribution to healthcare has come to be appreciated, and many of these professionals are now trained in policy contribution and formulation.
They work within hospitals and other healthcare facilities, in government institutions, non-governmental organizations, and think tanks, giving advice and ideas. Many of them also play an important role in implementing new policies to improve healthcare delivery.
Furthermore, nurses have increasingly taken on political roles in recent years. They want more for their patients and one way they can do that is by empowering them through political representation. It isn’t unusual to find nurses running for office so that they can provide better healthcare within their communities.
Does nursing training prepare nurses for all these roles?
Most nursing schools offer curriculums that cover these roles in one way or another. Students are introduced to the different roles of nurses and taught how to perform each one in a structured environment. However, most nurses will tell you that they also developed a great understanding of their roles and responsibilities after they were employed.
Because there is so much innovation in healthcare, nurses need to keep learning throughout their careers. Some opt for higher education, adding new degrees to their qualifications, while others opt for short courses that help them boost their current skill set. Continuing education is recommended for anyone who wants to climb the nursing career ladder. The more they learn, the more responsibilities they can take on, and the better they are paid.
Ultimately, the role of the nurse in disease management may vary from one facility to another but some fundamental duties do not change. These include patient diagnosis, treatment and care, education, and empowerment.