NRS 221A Nursing in Chronic Illness 2 and End-of-Life Care

This course builds on Foundations of Nursing in Chronic Illness I. The evidence base related to family care giving and symptom management is a major focus and basis for nursing interventions with patients and families. Ethical issues related to advocacy, self-determination, and autonomy is explored. Complex skills associated with symptom management, negotiating in interdisciplinary teams, and the impact of individual and family development cultural beliefs are included in the context of client and family centered care. Exemplars include patients with chronic mental illness as well as other chronic conditions and disabilities affecting functional status and family relationships.

Credits

4

Prerequisite

 NRS 112A and NRS 112B or NRS 115, and NRS 234, NRS 235, NRS 237, and NRS 238. One of the following: BI 101 (Cell Systems or Intro to Genetics), BI 102 (Genetics and Society), BI 112, or BI 221. All with a C or better and admission into the Nursing Program

Corequisite

NRS 221B 

Course Learning Outcomes

Upon successful completion of this course, the student will be able to:
1. Conduct a health assessment that is in-depth, evidence-based, family-centered, and both developmentally and culturally appropriate Interpret health data, focusing on:
• functional issues associated with complexities of co-morbid conditions in relation to ADL’s and IADL’s
• manifestations of psychiatric diagnoses and their impact on client self-care
• psychosocial issues and the impact of the illness on individual development and family function
• the client’s personal, social and cultural interpretation of the meaning of the illness and the impact on the client’s family
• capacity for and engagement in self care
• opportunities for health behavior change
2. Develop and use evidence-based interventions, individualized to client and family needs, specifically to:
• establish meaningful relationships with clients/families
• support client and family in development of capacity for self-health care management
• address caregiver needs for preparedness, predictability and enrichment
• manage symptoms/manifestations for specific disorders
3. Incorporate measures to enhance quality of life in the plan of care by:
• facilitating client in personal definition of quality of life
• addressing client needs for preparedness, predictability and enrichment
4. Identify and use community resources to provide support for the client and family caregiving by:
• supporting the client in negotiating the health care system
• accessing appropriateness of resources in meeting the client/family needs, (e.g. accessibility, financial feasibility, acceptability)
5. Communicate, as appropriate, with all agencies involved in patient care to assure continuity of care across settings (e.g. schools, day care, adult foster care, etc.) by:
• negotiating with others to modify care
• advocating for clients
6. Support patients and families across the life-span who choose palliative care or are experiencing transitions at the end of life by:
• negotiating with others to develop or modify patient care
• describing the epidemiology of dying: where, when, how people die
• dying trajectories across the lifespan
• using developmentally and culturally appropriate communication with patients and families at EOL
• using appropriate assessment techniques for individuals and families experiencing life threatening illness
• assessing family capacity to provide care, care-giving strain, strengths, and resources
7. Analyze impact of health care delivery system issues, policy and financing on individual and family care by:
• comparing basic funding mechanisms for chronic illness
• identifying decision-making issues for chronic care based on funding resources
• accessing appropriateness of resources in meeting the client/family needs, (e.g. accessibility, financial feasibility, acceptability)