Learning the Concept: Nursing in Chronic Illness

Abstract

IT HAS BEEN POINTED OUT on numerous occasions that one of the nursing skills needed in many areas is the minute-by minute assessment of the patient's state and the consequent adaptation of nursing care. Regardless of the patient's illness, he usually passes from a form of self-sufficient independence, to helplessness, and then to a gradually re-gained autonomy. One of the distinguishing features is the time taken by the patient to progress through these phases. A surgical patient, depending on the doc of surgery he has undergone, moves through these phases over a period of days or weeks. An obstetrical patient, as has been described in a recent div, advances through all stages in a matter of hours.1 A patient with a chronic illness may require weeks, months, or even years and in the end may still not regain a measurable degree of autonomy. From a teaching-learning viewpoint, one is concerned that the student learn how to assess, set objectives, and make appropriate adaptations in the methods she establishes for the achievement of her objectives. To care effectively for patients, the student needs to nurse them in the different phases of their illness. This goal can be readily achieved for the surgical or obstetrical patient because of the numbers of such patients, the rapidity with which they pass through the phases of their illness or need for care, and their hospitalization throughout. The patient who has a chronic illness receives care in a general hospital only until he has advanced through the acute phase or during