Congestive Heart Failure as a Concept in the Field of Nursing - Essay Example

? Congestive Heart Failure (CHF)Q as a Concept in the Field of Nursing Congestive Heart Failure (CHF) as a Concept in the Field of Nursing As membersof the growing numbers of people under the nursing profession, it is important that all aspects of the career be taken up, including the identification of nursing roles in providing care among patients, recognizing the potential legal issues when dealing with them, as well as classifying the evidence-based practices that could be done while taking care of patients. Those who have chosen to have nursing as a career must be aware of their roles in making their patients feel better, secure, and have a better quality of life, whether in acute, long-term or palliative care. Whatever disease the patients have, it is the nurses’ job to see to it that the patients’ health remains as the top priority. This is most applicable to diseases that are most often found among the susceptible members of the population, such as the elderly, the children, and people with compromised immune systems. The need to integrate several concepts makes nursing a dynamic and challenging career. The identification of roles, potential legal issues, and evidence-based practices with regards to the care of patients, particularly those that have congestive heart failure (CHR), as well as the integration of these practices with the conceptual framework of the Helene Fuld School of Nursing (HFSON) shall be discussed in this paper. Congestive Heart Failure as a Health Problem Congestive heart failure (CHF) is one of the most debilitating diseases that affect adults, with up to 670,000 people getting diagnosed annually, as well as one of the primary reasons why people at the retirement age get hospitalized (WebMD, 2012). It can occur either as an acute or chronic condition among susceptible individuals, and it could affect the left, right, or both ventricles of the heart (ADAM, 2012). It is not necessary that all heart failures are the results of heart attacks, arrhythmias, or heart valve diseases, but these can be the major causes for the onset of the disease. Other causes of CHF are: ischemic heart disease; hypertension; alcohol; viral myocarditis; thyroid disease; cytotoxic drugs; familial congenital heart disease; amyloidosis; sarcoidosis; and hemachromatosis (Johnson and Brooksby, 2009). A person with CHF develops a weakened heart, and its thickening and weakening causes it to fail in pumping enough oxygenated blood within the body, which in turn causes the patients to have fatigue and slow movements. Aside from these symptoms, CHF patients also have lung crepitations, pulmodary edema, swollen ankles, enlarged liver, or dyspnea (Paulus, et al., 2007). If the onset of the disease had early prognosis, patients may have better chances of survival and quality of life by undergoing surgical enhancements of the heart such as bypass surgery or having an electronic pacemaker, and followed up by medications such as ACEI, ARB’s and diuretics. But if not, and the disease has been long term, palliative or end of life care is given to CHF patients (Johnson and Brooksby, 2009). Whether under outpatient, inpatient or palliative care settings, nurses have an important role in providing care for patients with CHF, and they able to give this care by having proper lessons and trainings, as well as being familiar with the guiding principles in the nursing profession. These are usually provided for by the schools that nursing students study in. Integration of the HFSON Conceptual Framework in Handling Patients with CHF The Helene Fuld School of Nursing or HFSON is a college that recognizes nursing as a multi-level career, which is the root of its commitment in advancing licensed practical nurses to associate degree registered nurse level in the short span of one year (Helene Fuld College of Nursing, [HFSON], 2011). Their curriculum is based on the philosophy, the faculty’s beliefs on education, nursing, nursing education, person, health, and environment, and the incorporation of the legal definition of Registered Professional Nurse in the New York State, the Roy Adaptation Model, the nursing process, and expected outcomes and competencies for nursing graduates and other advanced degrees (HFSON, 2011). As primary care providers in the healthcare settings, the students are taught the importance of applying the steps in the nursing process, and at the same time applying evidence-based practices to suit the needs of their patients. By emphasizing non-traditional teaching approaches along with the nursing process, students can be better prepared in making decisions for the safe and effective care of patients. The nursing process is an approach that uses data gathering, checking the capacities and needs of the human as a system, proper selection and implementation of nursing care, and weighing in the effectiveness of the results (HFSON, 2011). In applying this kind of approach for patients with CHF, nurses are expected to first check all of the existing medical records of the patient including the laboratory results and radiological records, medications and contraindications, perform routine checkup such as blood pressure and heart rate readings to evaluate the patient’s health, to select which care best suits the patient depending on whether the CHF is acute or chronic, and to check whether the selected method of care in either inpatient or outpatient settings has positive, negative or neutral results. The nurse must be able to adjust these care methods depending on the clinical settings, the patient’s age, condition, culture and values, as well as the place where the care is being provided since not all methods available for nurses may give positive results or reception by patients (MacKenzie, et al., 2010). Thus the imperative role that nurses have with regards to this process is essential, because if errors are committed or not corrected early on, it could have devastating results to the patient’s health (Henneman, et al., 2010). Patients and their families may also suffer other consequences such as diminished perception of quality of life, depression, or even monetary problems. Nursing Roles and Evidence-Based Practices for Patients with CHF As primary care givers for CHF patients, nurses have many roles whether these are based on traditional approaches of treatment or evidence-based practices. Roles that are expected of nurses are as providers of pharmacological therapy and coordination of other services that the patient might have. Aside from these, nurses are also expected to provide psychological support and patient and family education with regards to the care and management of CHF (Travers, 2009). They are also expected to follow up on patients to reduce readmissions, create interventions to prevent the worsening of the patient’s CHF, identification of susceptibilities to other diseases due to heredity, detect subtle changes in patient condition and record signs of improvement or deterioration, and facilitate the continuity of patient care especially during patient transfer (de la Porte, et al., 2007; Frazier, Wung, Sparks, & Eastwood, 2009; Kleinpell, Ely, & Grabenkort, 2008). By observing which methods work best for patients, nurses are essentially performing evidence-based practices on their own. An example of an evidence-based practice on CHF patients is using care metrics based on data from the registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient settings. The study used the most effective methods observed in CHF patients, such as the use of either or both ACEi’s, ARB’s, ?-blockers, ARA’s, anticoagulation therapy, implantable cardioverter defibrillator, and cardiac resynchronization therapy among patients without contraindications, and educating the patients with the importance of daily weight-monitoring, reduced salt intake, self-checking for CHF worsening signs, and additional daily activities (Fonarow, et al., 2008). The selected metrics were used due to the observed improvement of the health in CHF patients, and the data provided additional insight in the characteristics and care patterns for CHF patients in the outpatient settings. Potential Legal Issues with CHF Patients Most of the medical practitioners involved with caring acute or chronic CHF patients may not have problems with legal issues due to their patients being able to decide for themselves. However, for those that provide palliative care, issues such as the removal of cardiac devices, feeding tubes and artificial ventilators could face issues due to lack of enough knowledge with the legalities and ethical parameters of the deactivation of life-sustaining devices (Kramer, Kesselheim, Brock, & Maisel, 2010). Inconsistencies in their decision-making skills could both prolong the suffering of the patient and create additional expenses for the family. Thus, aside from the ample education of the legal aspects of the use of medical devices, care providers must also think of other alternative ways of not just granting the wishes of the patient but also to respect their rights. Conclusion Nurses have vital roles in the provision of care for their patients, and their care are most often geared towards the susceptible members of the population, such as the elderly, the children, and immune-compromised people. To prepare them for this role, nursing students are taught how to identify their roles, recognize potential legal issues in providing care, and the use of evidence-based practice, particularly those that have CHR. In addition, for the students of HFSON, the integration of these practices with the school’s conceptual framework is also imperative in providing adequate care for all patients that need it. The nursing process is also a necessary component for the development of the ability to recognize the needs of the patients, to assess them and the care that they might need, as well as in providing support not just to them but also their families. Thus, the integration of many processes makes nursing a dynamic career choice. References WebMD. (2012). Congestive heart failure symptoms, causes, and treatment. Retrieved from WebMD Heart Disease Health Center: http://www.webmd.com/heart-disease/guide-heart-failure ADAM. (2012, June 23). Heart failure - overview - PubMed Health. 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