Online Tutoring on Chronic Illness

The purpose of this analytical deconstruction of chronic illness regarding stigma whether perceived or experienced becomes important for relieving the condition of the chronically sick – for those whose illness lasts more than three months, where they have to frequent hospitals on a regular basis. A chronic illness usually denotes the possibility of a deteriorating condition, and the patients loss of confidence in their ability to perform regular tasks with the constant thought of eventual death on their heads. In this case scenario, the entire crux placing the utmost responsibility in the hands of the carer/the nurses in that their ability to systematically and wholistically utilize their role could have a tremendous impact on the patients’ mental health and recovery. The role of the carer will be assessed in these circumstances, especially how important is it for them to give the appropriate treatment, as often times as they are capable of being the first-medical responder. In other instances, their constant facilitation being the pertinent reason behind the recovery of the patient. The dimensions which will be analyzed, and play a focal role in ensuring effective supportive care for the chronically ill constitute defeating the stigma that only their physical wellbeing is to be catered to are: “palliative care” (Murray, Boyd and Sheikh, 2005), “advance care planning” (Cullen and Rew, 2012), “the cultivation of trust” (Robinson, 2016), “utilizing the role of mobile care technologies” (Nasi, Cucciniello and Guerrazzi, 2015) and “spiritual care” (Irajpour, Moghimian and Arzani, 2019). In lieu of these deconstructions will the paper aim to proceed in highlighting the importance of nursing in each of these respects to ensure the appropriate supportive care treatment for the chronically ill, while also relieving the stigma that physical care is all that they need.

 

            The foremost important factor is that of “palliative care”, one that chronically ill patients are unreasonably deprived of, simply because their potential “prognostic paralysis” was not catered to and a skewed focus was drawn regarding a categorical division of patients who will die in the next 6 months or patients who might reasonably die in the next few months (Murray, Boyd and Sheikh, 2005). Furthermore Murray, Boyd and Sheikh emphasize the UK and the United States’ role as the key leaders in this approach, whereby the United States has started targeting the “those who might reasonably die” philosophy whereas in the UK the opportunities to channel this approach are finally in existence; for the nursing domain in general, this then becomes highly beneficial as the two leading technological and medical proponent countries of this cause set a precedent to be followed globally. Regular assessments and investigations coupled with the community nurses’ approach to stay proactively engaged with their patients both individually and collectively tackle the problem of not only those with chronic obstructive pulmonary disease, ischaemic heart disease, and cardiac failure at their initial stages, but also those who start facing prognostic paralysis by utilizing a “proactive” and holistic” approach stress Murray, Boyd and Sheikh; an approach undertaken by nurses to ensure that their patients all patients needs are catered to, at both the earlier and the later stages – at first systematically, and then by incorporating carer characteristics to ensure the patients a sense of belonging, and relief from the fear of death and unwillingness to discuss their problems.

 

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            The second most important precursor of appropriate supportive care for the chronically ill is the system of an “advanced care treatment”, whereby advanced nursing roles, accountability, empowerment of health workers, supporting the carers and higher professional education in cancer, palliative and end of life care is essential in a systematic advanced care treatment approach, which will ultimately create an in-built mechanism in the policy of the supportive care, and will by virtue of its nature be automatically supportive in nature for the chronically ill (Cullen and Rew, 2012). As Cullen and Rew emphasize, the benefit that this yields to developing countries is that they can learn from examples set forth by the developed world already – a case in point being UK – and the in-built obstacles in the route to holistic supportive care, them being those of rudimentary cleaning tasks being assigned to the nurses, a lack of regulatory body which ensures the competence of its nurses, a lack of clear pathway for the entire sector to follow, an unformalized process with the patient and lack of support for the family carers who may not know how to deal with the situation.  The advanced care treatment system caters to this by virtue of a systematic approach followed by the developed world (for instance UK) and making it applicable to the developing world (for instance India), whereby eliminating the inefficiencies brought about by a lack of an advanced care system, and ultimately creating an at once more supportive environment for the patients and also a conducive system of improvement in the carers abilities.

 

            The third most important factor in health care relationships inevitably then, following from the first and second preconditions becomes “trust”; which if used effectively can be the most important tool through which a direct impact then comes onto health outcomes (Robinson, 2016). The interpersonal relationships between patients, their family members and professionals is the crux of healthcare relationships as focused on by Robinson, and nursing/carer staff plays an important role in serving as a trustworthy liaison between all parties by fulfilling the systematic gaps offered by the system. In this case then, the carer staff plays perhaps the most important role in confidence building in patients and boosting their morale so that chronically ill patients do not fall into “prognostic paralysis” as mentioned above by Murray, Boyd and Sheikh (2005) as the first precursor. There is indeed a direct link between health care relationships and their physical and mental health reinforcement as mentions Robinson and therefore the activation of this potential is necessary to yield the maximum results on the prior preconditions of palliative care and advanced care systems. This coupled with the fourth necessary means of effective supportive care insurance which is the utilization of “mobile technologies”, is what assists the patients in undertaking an empowered role through this interactive technology, especially in the case of cancer patients (Nasi, Cucciniello and Guerrazzi, 2015). As Nasi, Cucciniello and Guerrazzi mention, a more self aware and self managed role is then adapted by patients, who are then able to systematically optimize their abilities such as when carrying out their personal cancer treatment, they are regulating their process and hence feeling more in control and less prone to falling into prognostic paralysis (already mentioned). Therefore, this method is crucial to be incorporated by supportive care providers/carers.

 

            Lastly, a “spiritual care” approach is key regarding the supportive care assurance of chronically ill patients, where a spiritual dimension to the treatment rids of the patients of their fear of impending death (Irajpour, Moghimian and Arzani, 2019). By finding a greater purpose in life, not attached to their physical health only but derived from their mental peace and satisfaction, patients are able to more fully utilize their supportive care treatment. For this reason, this method too is integral for the carer/nursing staff to incorporate, to ensure a supportive care treatment in its most complete form.