Ongoing, informed care should be the focus for any travel nurse. Many of today's greatest chronic health challenges, including diabetes, heart disease and obesity, require daily decisions that rely on patient self-management.
As a result, nurses need to avoid simply telling patients about their treatment plan and find other ways to motivate them to make important changes to their lifestyles. More often than not, this requires proactive health care professionals who are invested in seeing results.
These protocols are even more important considering that the U.S. is moving toward a value-based payment model and steering away from the fee-for-service platforms of the past. Now more than ever, medical professionals need to focus on seeing clear and quantifiable results in their patients' well-being.
"As we age and develop more chronic illnesses related to lifestyle, the number of patients nurses come in contact with who need coaching and mentoring will go up," said Bonnie Pilon, DSN, RN, and senior associate dean of faculty practice for Vanderbilt University School of Nursing in Nashville, Tennessee, explained to Nurse Zone. "There will be more opportunities for nurses. There will be more people who need managing. It's a numbers game."
Chronic care: The numbers
According to the Centers for Disease Control and Prevention, the U.S. spends a whopping 86 percent of its health care dollars on treating chronic illnesses. Not only do these conditions result in higher mortality rates and impaired quality of life, but they also create financial uncertainty, both for patients and doctors.
Though the CDC does state that health equity is needed to make chronic care management more sustainable in the U.S., there are guidelines that health care professionals, and especially nurses, should generally follow to make these goals a reality.
What nurses need to avoid
Based on key points from the American Academy of Family Physicians, the "old models of care" when dealing with chronic illnesses don't pertain to modern medicine anymore. Not too long ago, doctors would mainly focus on simply outlining a treatment plan, handing it over the patient and then trying to motivate them to change (basically, the standard procedure for handling acute care, not chronic care).
The AAFP used the example of two patients that are struggling with Type 2 diabetes. One patient has a particularly hard time maintaining his or her health, while the other is able to live a balanced lifestyle. After examining the cases, the AAFP states that for many patients, the person who finds success in conquering chronic disease often has a keen level of acknowledgement about the role a patient plays in his or her health.
With diseases like Type 2 diabetes, daily decisions can have a lasting impact on the progression of the illness. As such, nurses need to have a proactive and robust stance when it comes to empowering their patients.
The AAFP admits that this plan can have its disadvantages. For instance, patients could take this empowerment to intense levels by becoming "activists" in their own health care plan by coming to RNs with misguided information they discovered on the Internet or other sources. Though they might be taking a proactive approach to their well-being, they could be doing so to their detriment – and this can create significant rifts in the doctor-patient relationship. This is why nurses need to have a game plan that steers patients on the right course, but also gives them the tools they need to make valuable decisions about their health on their own.
Ask valuable questions to solve complex problems
The AAFP also created a chart that showed the old models of dealing with chronic illness versus the new. The source used a patient stating "I don't think I can quit smoking" as an example. In the past, a medical professional might have presented facts to convince the patient to quit, such as telling him or her that it is the leading cause of preventable death. These statistics, however, have not proven beneficial.
However, under the new model, asking questions about their lifestyle can usually get to the root of the issue and help nurses find solutions to their problems. In the case of a patient who smokes, you might say in response, "What have you tried in the past that have caused you to think that you can't quit?" or "What are the biggest concerns you have about quitting smoking?" More often than not, the patient's answers will provide nurses with more accurate depictions of their patients' struggles, and as a result, help create a more holistic continuum of care.
It takes a village
Although nurses must take a proactive approach to chronic care patients, the chronic care model also has a social component that must be addressed, according to Nursing Center. The patient must learn to self-manage, but they will also be heavily influenced from outside influences like worksites, organizations and governments on a community scale, and also their friends and family on an individual scale.