Heart failure

Heart failure has been given much interest in healthcare field as chronic heart failure is a disease that threatens life as about 300,000 persons in Australia are affected with it( Heart Foundation, 2014), it affects more than 25 million persons worldwide and more than 5 millions in America (American Heart Association, 2014) and in KSA there is a percentage of 22% of total deaths resulting from heart failure yearly most occurring in older ages. (Saudi Heart Failure Group, 2013) The current assignment is going to present a critical discussion for nursing role in providing care for chronic heart failure patients to be self caring and the role of the multidisciplinary team in supporting chronic illness patients. Some key terms related with heart failure will be presented within this assignment such as self care management, multidisciplinary team and chronic illness in addition to explaining chronic illness characteristics and how it affects patients to be dependent in life.

According to Van Cleave et al. (2010) Chronic illness could be defined as a case of illness that lasts for a long period of time which could be more than three months and the treatment provided to a chronic illness patient lasts for a long term, such case of chronic illness is always accompanied with pathological symptoms which are difficult to stop without medical interfering and it is not sure to bring the full recovery for this case or symptoms. Chronic Heart failure is an example of such chronic illness that requires special care and treatment on long terms. A multidisciplinary team (MDT) is defined as a team of professionals from different specialties who work in the field of healthcare to deliver the best service to patients as they should be skilled and with the needed expert physically and psychologically and it can include physicians, nurses, nurse managers, psychologists, physical therapists, social workers, chemists, dietarian  and others and each member has a role that is done by the interaction and communication with other members to produce the best quality of care using a group of methods and strategies which are evidence bases to provide the utmost healthcare services to patients with chronic illness. ( Dziegielewski, 2010) Self care management is very necessary for heart failure patients as they need to learn how to cope with the illness by themselves as self care management can be defined as to care for oneself and follow actions learned from a physician and nursing staff in order to promote one's health by coping with the illness and to act properly with other members of family so as to co operate with them to reach the best results physically and mentally in addition to fight the disease conditions and prevent complications that patients may suffer and managing difficulties that hinder their nature lives in order to survive the illness and live happily. (  Goodacre and McArthur, 2013)

Chronic illness has various characteristics such as being prolonged lasting for long periods of time with little chance of spontaneous cure or complete one, it is always accompanied with deviations from the normal state which is usually continuous in addition to beyond repair changes, disabilities and serious psychological effects, it requires special self care management in addition to special nursing programs and a program of reformation.(Lewis, 2014) Example of chronic illness is Chronic Heart Failure affects patients when the patient's heart has no ability on pumping the required blood amount that the body needs as this occurs when the strength of the heart to pump becomes weak. (Greenberg et al, 2011) The impacts chronic illnesses leave on chronic patients are great on both physical and emotional sides as they affect the patients' capabilities to be dependent. Among these impacts is the social isolation when a nurse can diagnose it by finding a patient who wishes to engage with others but lacking the ability to do this and suffering loneliness feelings. Social stigma is another impact that lies as a burden on both the patient of a chronic illness and the family as trying to enjoy public meetings becomes a problem for the patient due to others comments, inquiries and showing over sympathy which results in staying at home and being unable to trust one's abilities and being dependence. (Larsen and Lubkin, 2011) Chronic illness affects the patient physically to the extent of having disability and being unable to do everyday simple actions as praying, eating, work and move. It also affects the patient's quality of life and psychological state. (Collingwood, 2010)

Nurses have an important role in strengthening chronic heart failure patients' self caring and controlling the symptoms of chronic heart failure as they have to relieve complications by telling patients to stop doing hard efforts, stop smoking and stop drinking alcohol. A nurse's role includes educating the patient with chronic heart failure about diet that limits sodium intake, includes the needed supplements of within small numerous meals everyday, keeping the patient on the right calories and cholesterol percentages specially when there is excessive weight or hypertension. A nurse has to follow the patients drug intake, teach the patient what symptoms and signs related to each stage of the illnesss, monitor blood pressure, make schedules of the patients meals and medications, help patients get rid of depression and anxiety, keep comfortable circumstances, keep the patient in the right position and educate the patients family about diet and rest for the patient. (Stanfield, 2010) A nurse has to monitor and detect any complications that could occur by keeping measuring the pulse rate of the patient, respiratory rate and give the patient a time for resting prior to and pre all activities. Nursing interventions should include strategies for relaxation, teaching patients and families how to monitor patients well , teach them ways of pulse rate measuring, measure patients retention of fluids, teach a patient and a family the right way a patient should stay in bed as legs should be rested in a position to be above the levels of the heart, explain how medications and drugs work and train patients on the required exercises methods. (Moyet and Juall, 2009) Management chronic illness depends on good healthcare services that depend on high quality of care levels and providing the best care services to patients in order to improve patient's outcomes, wellbeing and quality of life, this includes stressing the importance of the multidisciplinary team in helping chronically ill patients progress and have good self care. There must be a staff of specialists who are skilled in many fields to make sure of providing the required service of care in a communicative co operative attitude among all members of the multidisciplinary team. The team has to prepare a plan of care based on each patient's case and such a team that is set mainly for chronic illness patients such as chronic heart failure must include a good nursing staff, physicians, a social worker and a specialist dietarian who work together for the purpose of supporting the patients and controlling their conditions symptoms to prevent or reduce disease complications. A nursing staff that should include nurse practitioners with high levels of experience and skills is responsible for managing the patients' daily, education tasks, monitoring intakes of patients, managing timed missions, following up consults of physicians, keeping good hospitalization, doing reports of patients' progress and preparing the patients physically and psychologically for receiving medications and treatments. Nurses are also responsible for keeping collaboration among the team members by the right communicative approaches. (Bisognano, 2009) The multidisciplinary team should have physicians who make decision of consultation, diagnose the case, prescribe the medications, perform the required treatments, do physical tests and is ready for patients and families enquiries. A dietarian is also an important member of the team as a dietarian has a very important task of  providing the team with the diet plan and guidelines for the diet, meal times, contents and number.( NICE, 2014) A social worker is also a very important element in a multidisciplinary team for chronically ill patients such as those with heart failure as a social worker can learn about patients conditions whether financially, socially or legally and do the required tasks to help patients overcome the social stigma they may suffer by teaching the whole family basics of dealing with society when they have a chronic illness patient.(Chang , 2014)

Conclusion

Chronic illness is a main cause of most today worldwide death rates as chronic illness is a case that requires treatments on the long run due to its continuous nature for a long period of time. Heart failure is an example of chronic illness, it requires special healthcare treatment to be presented for patients through a pre set plan by a well prepared experienced multidisciplinary team consisting of members as a nursing practitioners, physicians, social worker and a dietarian. Good care services must include the work of the multidisciplinary team so as to focus on helping patients how to practice self care basics, self management while being dependent as a result of having a chronic illness. A care plan is vital when dealing with patients with chronic illness as it should be done by a co operation strategy from a collaborative multidisciplinary team.  

References

1. American Heart Association, 2014. www.americanheart.org

2. Bisognano, D. Baker, L. Early, B. (2009) Manual of Heart Failure Management. Springer Science & Business Medi.

3. Chang, E. Johnson, A. (2014) Chronic Illness and Disability: Principles for Nursing Practice. Elsevier Health Sciences

4. Collingwood, J. (2010). The Relationship Between Mental and Physical Health. Psych Central. Retrieved on October 19, 2014, from http://psychcentral.com/lib/the-relationship-between-mental-and-physical-health/0002949

5. Dziegielewski, S. (2010). DSM-IV-TR in Action (p. 624). John Wiley & Sons.

6. Goodacre, L. (2013). Rheumatology practice in occupational therapy promoting lifestyle management. Chichester, West Sussex, UK: John Wiley & Sons.

7. Greenberg, B, (2011).  Barnard, D. Narayan, S. Teerlink, J. Management of Heart Failure. Wiley and Sons.

8. Heart Foundation, 2014. Living Well with Chronic Heart Failure. http://www.heartfoundation.org.au/information-for-professionals/Clinical-Information/Pages/heart-failure.aspx

9. Juall, L , Moyet. C. (2009). Nursing Care Plans & Documentation: Nursing Diagnoses and Collaborative Problems. Lippincott Williams & Wilkins.

10. Lewis, S. (2014). Medical-surgical nursing: Assessment and management of clinical problems (9th ed.). St. Louis (Missouri): Elsevier, Mosby.

11. Morof Lubkin, I., & Larsen, P. (2011). Chronic Illness: Impact and Intervention (p. 70-104). Jones & Bartlett.

12. National Institute for Health and Care Excellence. (2014) Services for people with chronic heart failure. (n.d.). Retrieved October 24, 2014. http://www.nice.org.uk/guidance/cmg39/chapter/42-specifying-the-multidisciplinary-management-of-chronic-heart-failure

13. Saudi Heart Failure Group, 2013. http://www.saudi-heart.com/?q=saudi-heart-failure-group

14. Stanfield, (2010). S. Peggy. Nutrition and Diet Therapy: Self-Instructional Approaches. Jones and Bartlette Publishers. 

15. Van Cleave J, Gortmaker SL, Perrin JM. 2010. Dynamics of obesity and chronic health conditions among children and youth: JAMA; 303:623–630.