Understanding Adult Nursing

In the nursing profession, adult nursing refers to the nursing practice in people from the age of early adulthood to an indefinite age. The role of adult nurses in health care is part of the advanced positions within healthcare. For instance, these nurses look not only on the patient, but they also extend their services to families and the caregivers of the patients. Besides, they must also consider both the health of the patient and other aspects of health such as the social life and environment. As adult nurses are trained specially to take care of adults and their needs, this role also entails forming a positive relationship with the patients, their family members, and the caregivers. For a better analysis of the scope of adult nursing, this paper will first provide an understanding of this role; then it will extend to discuss their role using a case scenario. Further, the paper will look at other professionals who also work with nurses to provide optimum care to the patient.  

Adult nursing is a broad term within the nursing career. In general, the term refers to the provision of nursing care to the entire population except for children. The profession of adult nursing has various branches. One of the branches is called geriatric nursing which is a branch that deals with the care of elderly persons. According to (Kim, et al., 2009), geriatric nurses play a major role in providing care to the older adults, and this role involves constant contact with patients, administration of geriatric programs, and management of geriatric resources.  Regarding elderly adults, this branch does not deal with the cases of mental health or even general health. Mental problems that do not involve general health are dealt with in mental health nursing, while matters of general health are referred to adult nursing.

The nursing profession is divided into various branches and sub-branches. These groups are the general nurses, the midwives, community, and public health nurse specialist branches (Cutcliffe & Forster, 2010). Among these branches, adult nursing comes as a subdivision along with mental health nursing, learning and disability nursing and the children’s nursing.

According to (Denisco & Barker, 2012), ill health is when a body has abnormal conditions or not function and it is characterized by illnesses or symptoms need medical intervention. The primary objective of an adult nurse is the restoration and maintenance and maintenance of well-being of the population. In this objective, the adult nurses’ in diagnosis of the disease and takes further steps of improving the patient’s health. Enhancement of health can be either engaging the patients in a therapeutic process or providing psychological support. Moreover, health promotion does involve not only restoration of health, but also its development through looking at the patient in a holistic approach. According to (NHS England, 2016), some of the essential elements in nursing are the compassionate care which also receives explicit recognition in pre-registration of nurses in England  Where total recovery is impossible, nurses must engage the patients in palliative care which involves looking at all the dimensions of the patients’ health as they progress through the end of life stage (Offen, 2015).

The Role of Adult Nurses in Palliative Care

The practice of adult nurse in palliative care begins with diagnosing the illness, and it is part of ill-health improvement approaches.  According to (Hunter, 2009), distinguishing between acute and chronic factors of ill health is a necessity expecially when diagnosing a disease to for the determination of the care approach.  In the cases of ill health, (Hunter, 2009) explain on role of a nurse as the management of acute symptoms without compromising the stability of pre-existing conditions. Similar comments were made in the work of (Maybin, et al., 2016)  that district nurses must understand the requirements of the patient either from them or from their caregivers.

This paper will be discussing a case of a 50-year-old male suffering from Huntington’s disease (HD). The paper will refer to the patient as Mr. X and his wife Mrs. X, his primary caregiver. After speaking to Mrs. X, some of the information that was revealed about Mr. X’s personal life was that he was a lawyer. Also, the couple had been living together for the past 20 years and had no child.   When his illness reached a later stage, he was forced to quit his job as a lawyer. Since his wife had no job, she immediately became the caregiver. Mr. X was diagnosed with the disease at the age of 40 years.

Mr. X had retained some speech and coordinated movement abilities and he could talk a little, using short sentences. He could also point at things and hold objects in his hand, but he couldn’t walk hence bound continuously to a wheelchair. His speech sometime would break, and he could take a long pause to capture his words.

Huntington’s disease is a degenerative genetic disease that causes the brain cells to die. It is progressive and neurodegenerative disease, and the disease is characterized by the decline of cognitive abilities, behavioral, and psychological symptoms (Videnovic, 2013). Since there is no ultimate solution, all the treatments focus on improving the patient’s quality of life (Roos, 2010). 

According to (Pidgeon & Rickards, 2013), the symptomatic characteristic of HD is chorea, saccadic eye movements, dystonia, gait disturbances, dysarthria, tics, and myoclonus. Other cognitive and behavioral signs are personality changes, aggression, depression, irritability, apathy, dementia, psychosis, and reduced executive function. These symptoms usually occur when the disease is in its early stages, and they significantly cause a decrease in the coordination of motor skills of the patients the disease gradually progresses in the patient’s body.  When the disease reaches a later stage, a permanent caregiving situation must be created. Later stages of the illness cause involuntary body jerks and movements in the body and the physical and mental state of the patient begins to deteriorate. According to (Georgiou-Karistianis, et al., 2014), the patient loses the ability to talk and make coordinated movements and his mental state declines into stages of dementia. Thus, permanent and full-time care must be given to the patient suffering from Huntington’s disease.

Case Scenario: Mr. X and Huntington’s Disease

Our responsibilities as care providers to Mr. X were to give provide him with healthcare which included physical support and psychological support. We also had to provide Mrs. X with training regarding the disease, and its possible outcomes in his therapeutic process. The responsibility also entailed correct examination and diagnosis of other mental problems associated with HD. According to (Downing, et al., 2012), healthcare professionals should avoid assuming that patients with HD do not suffer from depression so they should also examine them for the same.  

For the success of the current and future interventions, we first focused on creating a good nurse-consumers’ relationship. The work of (Tarolli, et al., 2017), states that a doctor-patient relationship can enhance the consumers’ confidence in palliative care. Creating a good relationship with our clients also helped in clearing misunderstanding between us and them. Once the relationship and the trust had been established, we then proceeded with education and introduced Mr. Xnd Mrs. X to palliative care.  

Our approach to care included several elements of the nursing practice. Among them, we engaged Mr. X to medication. We also planned for home visits which were meant to examine the conditions of the home environment such as food, water, taking him on and off the wheelchair, cleanliness of the washrooms among others. Moreover, we decided to take a role in engaging Mr. X in exercises and physical therapy. According to (Fritz, et al., 2017), exercise and physical activities in Huntington’s disease are helpful particularly in enhancing gaint speed, motor function, and balance.

Recreational Officers

According to (Bruggen-Rufi, et al., 2016), recreation officers help in guiding recreational activities. The purpose of these activities is improving communication skills as they encourage and stimulate the patient’s interaction.  A recreation officer was assisting Mr. X in different sessions of recreation therapy.

According to (Brotherton, et al., 2012), nutritionists and dieticians help patients of HD with nutritional guidelines and provide optimal nutritional assessment and screening as the patient moves through the HD stages. The nutritionists and dieticians for Mr. X need to make sure that he receives a diet that is full of nutrition and required a diet that is suited to his age and his disease.

General Practitioner

According, (Evans, et al., 2013), general practitioners help in the general diagnosing of the disease symptoms. The general practitioner scheduled bi-weekly visits to Mr. X to follow up with the patient care. The visits included evaluation of the care, medication and guiding other professionals on the next action.

Responsibilities of Care Providers to Mr. X

Physiotherapists

According to (Quinn & Busse, 2012), a physiotherapist in HD provides clinical guidelines in response to the patient’s clinical need during and throughout the treatment period. The physiotherapist’s job included providing an ongoing social and health care according to the needs of Mr. X.

Neurologist

According to (Halpin, 2011), neurologist help in providing an actual diagnosis that confirms the genetic test of HD. The diagnosis of HD by neurologist involves analysis of motor manifestations and detecting tangible changes within the patient’s brain.

Due to the complexity of the care needed in HD, we found that supportive care was the appropriate model starting from the time we diagnosed Mr. X with the disease throughout its prolonged trajectory. According to (Nopoulos, 2016), HD involves both severe neurological degeneration and psychiatric disorder. Moreover, the trajectory comes with family member’s concerns fearing that they might undergo the same predicaments. Supportive care in HD takes two essential approaches. The first one is offering psychological support, and the other one is giving practical support. In this case, practical support can extend even to providing financial support. Further, there were two other critical issues that we identified, and they informed our service provision. We found that we needed to ensure that the support was sufficiently choreographed and resilient enough to meet the patient’s circumstances. Also, we found that professionals providing supportive care in HD require much knowledge on the disease

Conclusion

The objective of this paper was to provide a detailed explanation of the scope of adult nursing. As outlined in this paper, adult nurses form a core profession within the healthcare services. Except for the children, these nurses can at a point be in a situation where they are handling all situations related to adult health. With the aim of giving practical explanations, the paper used a case scenario where consumer names were replaced with pseudocodes for confidentiality. Ultimately, this paper was able to explain how adult nurses execute their roles and finished by showing the most demanding part of their career when they engage cases of providing supportive care.

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