Nursing Family Care Plan: Diabetes

Introduction

Healthcare systems around the world are constantly changing and these changes have a crucial impact on the roles and functions of nurses. Roles of nurses are now complex necessitating them to be extremely alert and caring with their patients. The practice of nursing transcends professional barriers and requires them to maintain and uphold compassion while caring for their patients, a goal which can become clear by knowing and applying Jean Watson’s caring theory in practical scenarios.

This paper aims to analyze the important tenets of Jean Watson’s caring theory and how it can be applied by nurses to practical situations to deal with patients so that nurses serve and function not simply because it is simply their job to do so, rather because they achieve a sense of commitment and contentment by being compassionate to patients and their families and contributing to ease their suffering through their kind and empathetic attitudes.

Watson’s (2001) caring theory includes major factors including carative factors, transpersonal relationships with patients and the caring moments or occasions with patients and their families.

Nursing Assessment

The patient is a 33 year old female married woman with two children and a healthy marriage with type 2 diabetes. Individuals with disease or diabetes could experience feelings of fear, anger, guilt or denial, and feelings of denial and grief are normal aspects when a disease has been diagnosed, especially in type 2 diabetes which occurs due to the invisible nature of the disease due to no presenting symptoms often causing the patient to disbelief and deny the occurrence of the disease (Trisha Dunning, 2009). The patient does not have knowledge of the disease and shows no inclination to gain it. However, the family is extremely supportive and wants to help the patient in coping with the new diagnosis.

As a nurse, I am also required to be aware of the psychosocial factors impacting the patient. The patient is a Caucasian and is a manager in a casino in the marketing department with tremendous family support. However, the patient has an extremely busy schedule and does not have much time for herself. The patient does exercise but not very often and is overweight by about 30 lbs. Research confirms that diabetes is a major clinical problem within some racial and ethnic groups and has the potential to cause serious health complications (Healthy People, 2010). Diabetes is also a wasteful disease which causes serious complications and harms many of the body parts and organs including the kidneys, eyes and if ignored could also result in disability and death (Healthy People, 2010).

Diseases such as diabetes are crucial indicators of “health improvement” and health professionals like nurses can have a crucial impact on the perceptions of patients with these diseases, enabling them to lead healthier lifestyles, thereby improving the overall success of preventive treatment programs of such diseases (Healthy People, 2010).

Family diagnosis and intervention

The family of the patient plays a vital role in diagnosis and intervention of the patient. Family members with their knowledge and beliefs affect the management and outcomes of the diabetes intervention plan and have a crucial impact on the success of preventive programs (Healthy People, 2010). There are certain behaviors common to family members which could explain the probable causes of the disease in the patient, like westernized behaviors and frequency in consuming fast foods or lack of exercise. However, in this case, the patient’s husband exercises regularly and appears to be health conscious; this fact is a positive factor in the patient’s life and denotes the probability for “readiness for enhanced family processes” to support the health and well being of the patient.

Plan of Care

The goal of Healthy People is to increase the years and quality of life of patients. The family centered objectives in this case would be:

In the first 2 weeks, the family members will identify the goals and structured directions which include reduction of weight in the patient. In order to achieve this, the patient’s family, especially the children will discuss the changes in their dietary and food intake and will ensure that a fatty diet and foods are avoided. The family will also try to make the patient more active and motivate her to exercise ensuring that there is a specific schedule and routine for the patient to get sufficient exercise. Going to the gym or going for a regular jog in the morning could be some options which the family members could consider.

Nursing Intervention plan

In this case since there is denial on the part of the patient, an important nursing intervention would be to encourage the patient to express her feelings in a safe environment. This will enable the patient to gain insight of the problem at hand and empower her to self manage and control her diabetes (Anderson et al, 1995). Nursing intervention is also believed to be a crucial aspect of diabetes management because research confirms the association between the information received by diabetes patients and the degree to which they follow the management program (Frandsen & Kristensen, 2002).

Family Assigned Interventions

The family members of the patient should be motivated and encouraged to identify the primary goal of ensuring loss of weight in the patient through exercise. Family members should also play a vital role in ensuring that the patient sets up an appropriate exercise routine and takes medications on time. Since the patient is in a denial mode, the family can play a crucial role in making the patient aware of the practical situation and in helping the patient deal with the situation rather to achieve health and longer life expectancy according to the goals of Healthy People 2010.

Nursing Evaluation

Evaluation in nursing is carried out through the education and testing process, and occurs steadily over a period of time. Clinical tests are crucial to gain knowledge about the health improvement of the patient with the ideal evaluation period occurring between three to six months. Goals should be specific, measurable, timed and patient centered. Life style changes and health status are crucial indicators of evaluation and the bio-medical indicators include blood glucose, lipid, weight, BMI and so on. Evaluation is carried out with the help of tools like interviews, oral questions, written forms etc.

Conclusion

Diabetes is health condition which causes deterioration in the health and fitness level of the patient and requires the patient to be in control of the situation. Empowering patients is a crucial tool which patients need, and nurses with their carative attitudes and knowledge can help patients to become independent and take care of themselves. Nurses need to assess the health situation of the patient and diagnose the family members as well. Accordingly, a nursing intervention plan should be devised after taking into account all the factors while interviewing and assessing the patient. The intervention plan should not only be individual but should also be family oriented. Self management should be a primary objective of the management plan and the primary objective at all times should the healthy outcomes, enhanced life style and behaviors for greater life expectancy.

References

Anderson RM, Arnold MS, Funnell MM, Fitzgerald JT, Bulter PM, Feste C: Patient empowerment: results of a randomized controlled trial. 1995 Diabetes Care18:943–949.

Dunning Trisha (2009). Care of people with diabetes : a manual of nursing practice, Wiley-Blackwell, Oxford, England.

Frandsen, K., & Kristensen, J.,S. (2002). Diet and lifestyle in type 2 ´diabetes: the patient’s perspective. Practical Diabetes Int. 19 (3): 77-80.

Healthy People, 2010. Objectives for improving health. Web.

Watson, J. (2001). Jean Watson: Theory of human caring. In M.E. Parker (Ed.), Nursing theories and nursing practice (pp. 343-354). Philadelphia: Davis.