A specialist nurse is a nurse who peruses certification in a given field and is able to demonstrate the capabilities. In such a case, the nurse is required to meet certain education and experience requirements. This paper will focus on a specialty nurse who has advanced heart failure nursing (Bosler, 2016). The specialist heart failure nurse ensures is responsible for meeting a variety of needs ranging from pharmacological needs to non-pharmacological needs. Other responsibilities include providing education to staff, consulting with the patient care manager, reviewing the available alternatives as well as current practices (Mancini, 2017). Moreover, the nurse is in charge of deciding on where various resources will be allocated, development of special treatment plans once a patient has gone through examination; provide education to the patient as well as their families on how to manage the heart failure condition (Gifkins, Loudoun, & Johnston, 2017). Other additional responsibilities include promoting staff teamwork and analysing outcomes as well as the patient’s data (David, 2013).
Another important role of a nurse specialized nurse in heart failure is the role of following up with the patient. This helps to determine whether the patient needs re-admission as well as monitor the progress of the patient. Such a role has been documented to have had significant improvements for patients. In the course of the follow-up, most nurses ought to take safety measures that will help prevent and control the heart failure condition (Auricchio et.al., 2012).
Some of the safety measures that the heart failure specialist nurses need to take include, immediate assessment, and triage. This assessment is crucial as most patients seek professional health care when it is too late or when their personal care fails. As a nurse, one ought to conduct the assessment, which can be identified with the shortness of breath, weight changes and loss of appetite as well as symptoms of oedema (Jolly, 2018).
Another safety measure that is required while dealing with patients experiencing chronic heart failure, is to ensure that once the patient arrives in the emergency department, the condition is recognized managed and the patient is transferred to a favourable environment. This is necessary to ensure that symptoms of breath shortness both emotional and physical are dealt with (John, 2018). Moreover, the nurse is required to assess the patient’s history as well as the severity of the condition and convey the information to the relevant team.
Other safety measures that the nurse should observe ongoing monitoring and management of the patient’s condition. Such safety involves administering dyspnoea, which will work to reduce fluid congestion by balancing positive action with any negative action in the renal function (Latimer, et.al. 2017). Moreover the measure will require that a catheter is used to monitor closely the renal function through urine output. However, according to the national and international guidelines, the use of catheters should be restricted to patients with cardiopulmonary instability (Neuenschwander, & Peacock, 2009).
In addition, the monitoring prompts a close monitoring of haemodynamic parameters throughout the process of stabilization. In addition, managing diuretics and vasodilators aggressively might lead to hypotension (Souter, 2014).
Another safety measure that is required is ensuring that the close monitoring takes place in an environment that provides expertise and time to identify and respond to changes in the physiological data.
Finally, after the patient is out of danger, the nurse is required to the patient’s compliance. This is done to help the patient manage potential effects such as lower systolic blood pressure. This can be achieved through reminding a patient to stand up slowly so that they do not fall due to dizziness, teach the patient how to manage diuretics while they are away from home to ensure they get the required assistance when necessary. The heart failure team, as well as the heart failure specialty nurse in such cases, as well as the heart failure specialty nurse in such cases, can further facilitate this effort where in-patient care is not provided (Gully& Richardson, 2016).
There is a huge responsibility bestowed on Nurse’s in terms of l of ethical and regulatory implications when it comes to sharing of patient information with anyone. The law, as well as ethics, requires nurses not to dispense any of the information relating to the patient, they are looking after without their permission (Latimer et al., 2017). Moreover, besides seeking permission from the patient regarding their health, the patient ought to consider the implications that might emanate because of sharing particular information in an effort to improve care. This, therefore, calls for the nurses and the caregivers as a whole to maintain privacy and confidentiality of information while they are taking care of the patient.
Moreover, the nurse should not provide any patient information to any organization or individual who has no contribution in assisting the patient (Margaret, 2015). However, there are some cases where such ethics and policies can be overlooked with the aim of improving the welfare of the patient. For instance, the woman who came in with acute heart failure would have been saved if at all her health information had been shared with the laboratory administrator (Medspace, 2018).
This would have been possible since blood sample would have been taken for testing without her consent. Another case that would have necessitated for the ethics to be overlooked is if the patient was not of sound mind or a minor. In such a case, the individual brought in the patient or represents the patient, such as the parents of a minor are allowed to give the consent and at the same time ensure the privacy and confidentiality of the patient’s health information (Philip, & Poole, 2018). In the case of the old woman, a family member that brought her would take the position of a custodian, unfortunately, she brought in by an ambulance, and no one had accompanied her. This, therefore, proved to be a challenge in obtaining consent from the patient as acting without the consent would have been a violation of ethics (Mitty, 2013).
On the other hand, when it comes to acting in the best interest of the patient, nurses need to be given the right to obtain the information from their patient without consent. However, this might be viewed as controversial nurses having understood the ethical requirements regarding patient information, in the case of minors, there are no specific rule has been put down elaborating about the age of a mature person or the age of a minor (Nohria, & Desai, 2015).. When dealing with an individual whose mind is not sound, it is a requirement that the patient has a representative who has the authority to give consent to ensure the decisions and steps taken are in the interest of the patient (Saunders, & Wallis, 2017)).
Therefore, the issue regarding ethical procedures has many gray areas and therefore seems to be a dilemma. However, in the midst of all the dilemmas, the overriding goal should act in the interest and welfare of the patient as the main goal of a caregiver is to ensure patients get well.
References:
Auricchio, A., McMurray, J. J., Adamopoulos, S., Anker, S. D., Böhm, M., … & Sanchez, M. A. (2012). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. European journal of heart failure, 14(8), 803-869.
Bosler, B. (2016). Legislature Update on the Family Caregiver Support and Designated CareGiver Acts. Home healthcare now, 34(9), 528-529.
David, M. (2013). Regulations and policies for nursing programs.Albuquerque, N.M.: The Board, pp.221-298.
Gifkins, J., Loudoun, R., & Johnston, A. (2017).Coping strategies and social support needs of experienced and inexperienced nurses performing shif-twork. Journal of advanced nursing, 73(12), 3079-3089.
Guly, U. & Richardson, D. (2016). Acute medical emergencies.1st ed. Oxford: Oxford University Press, pp.76-80.
John, F. (2018). Hyponatremia Treatment & Management: Approach Considerations, Medical Care, Diet. [online] Emedicine.medscape.com. Available at: https://emedicine.medscape.com/article/242166-treatment [Accessed 3 Oct. 2018].
Latimer, S., Hewitt, J., Stanbrough, R., & McAndrew, R. (2017). Reducing medication errors: Teaching strategies that increase nursing students’ awareness of medication errors and their prevention.Margaret, B. (2015). Patients’ Rights, Law and Ethics for Nurses.2nd ed. Brisbane: Hodder Education, pp.345-480.
Medspace (2018). Heart Failure Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy. [online] Emedicine.medscape.com. Available at: https://emedicine.medscape.com/article/163062-treatment [Accessed 3 Oct. 2018].
Mitty, E. L. (2003). Policy Perspectives: Assisted Living and the Role of Nursing: As many as half a million people reside in assisted living facilities, the regulations of which vary from state to state. Nurses have an opportunity—and an obligation—to help develop policies. AJN The American Journal of Nursing, 103(8), 32-43.
Neuenschwander, J. & Peacock, W. (2009). Management of heart failure in the emergent situation.Philadelphia, Pa.: Saunders, pp.653-801.
Nohria, A., & Desai, A. S. (2015). Reducing Readmissions With Novel Cardiac Resynchronization Therapy Programming: Is Meeting the 30-Day Metric Enough?.
Philip, L., & Poole, R. (2018).Double trouble: managing diabetic emergencies in patients with heart failure. Practical Diabetes, 35(4), 139-143.
Saunders, N. A., & Wallis, B. J. (2017).Learning decision?making in clinical medicine: a card game dealing with acute emergencies for undergraduate use. Medical education, 15(5), 323-327.
Souter, K. (2014). Understanding and Dealing With Heart Disease. Summersdale Publishers LTD-ROW.
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