Nursing Principles and Techniques. I

Author: Luo Lianxia
Editor-in-Chief: Li Weidong
Publisher:
Publish Date: 1999-05-01
Features:
Fragment: Health currently, the infant mortality rate has decreased, and there are more survival opportunities for (deformed children). The elderly and chronic diseases are increasing, so the role of rehabilitation in healthcare is becoming increasingly important. Appropriate treatment can prevent the deterioration of diseases and prevent secondary diseases. Providing equipment for disabilities and avoiding death, such as physical therapy for injured limbs, can prevent sequelae in disabled limbs, and permanent disabled individuals can undergo integrated psychological, social, occupational, and medical rehabilitation to prepare for vocational rehabilitation. Providing appropriate rehabilitation equipment and employment opportunities or long-term care in nursing homes, strive to restore the physical condition of disabled individuals to the maximum extent possible, assist or relearn the skills needed to survive. Rehabilitation begins when the patient enters a healthcare institution, teaching and encouraging patients to function normally without assistance. The above functions are interrelated and difficult to separate. For example, if a patient complains of severe chest pain and shortness of breath, and the examination diagnoses heart disease, they should be admitted immediately. During the treatment process, patients should be made aware of the causes of their illness, corrected health habits, and rehabilitation, gradually starting activities such as jogging or swimming, and further taught about diet, medication, lifestyle, and activity; encourage patients and families to express their fears and provide necessary assistance when appropriate; a good rehabilitation plan should prevent a heart attack from recurring.
Types of Healthcare Institutions
1. Hospitals
- Under 9 beds are called clinics, 10–50 beds are community hospitals, and over 500 beds are medical centers.
- Patients include acute (sudden onset, with the expectation of recovery), chronic (not curable, but complications can be controlled with appropriate treatment and care), and end-stage disease (dying).
1.1 General Hospitals (also known as Comprehensive Hospitals or General Hospitals):
Hospitals before the 19th century mainly cared for poor patients. In recent years, they have expanded to provide health services to all social strata. Due to urban development, the establishment of comprehensive hospitals has increased, and emphasis on medical care, education, and research has flourished. Many hospitals are affiliated with medical schools, where education and research are equally valued alongside patient care. In recent years, hospital stays have shortened, and services for long-term care (e.g., tuberculosis, mental illness) have decreased, showing less interest in chronic and bedridden patients.
1.2 Specialized Hospitals:
These limit their medical scope, such as ophthalmology, obstetrics, and pediatrics, and are difficult to meet patient needs. Due to changes in healthcare delivery, some specialized hospitals are declining, such as obstetric hospitals reducing services due to lower birth rates. Currently, comprehensive hospitals provide better care for mental patients than isolated special facilities. Some specialized diseases still play a major role, such as cancer diagnosis and treatment.
2. Community Healthcare Service Organizations
Provide home-based healthcare for patients who do not need hospitalization, supported by municipal, county, provincial public health departments or private enterprises.
2.1 Health Centers:
Hospitals have become short-term acute care and technical medical facilities, taking over community healthcare responsibilities. The focus is family-centered, not just individual health care, but also disease prevention. Key functions include: family safety, personal hygiene, environmental hygiene, nutrition, mental health, utilizing social resources, vital statistics, epidemic prevention and control, and family planning.
2.2 Group Medical Centers:
Originating from health centers in the U.S. in 1966, they were established to share the workload of health centers, address medical shortages in remote areas, and provide community healthcare services. Workers must be professionally trained, and funding is provided by government subsidies. Service offerings vary by region and are not limited to medical services.
2.3 Private Healthcare Organizations:
Non-governmental organizations such as cancer prevention associations, family planning associations, and tuberculosis prevention associations.
2.4 School and Factory Health Centers:
In addition to school and factory health services, they should participate in community health work.
3. Hospices; Palliative Care Rooms
Hospices are healthcare institutions designed for dying patients, which can be independent facilities or departments of comprehensive hospitals. They meet the physical, emotional, social, and spiritual needs of patients and their families as freely as possible, such as allowing children and pets to visit at any time and involving family members in care. The first hospice was St. Christopher’s Hospice, founded by Dr. Cicely Saunders in London in 1967. Currently, hospice facilities are continuously increasing in the U.S. and Canada; in Taiwan, the first palliative care room was established in Mackay Memorial Hospital in 1990, and since then, major hospitals have established palliative care units. To date, there are 11 hospitals in Taiwan with palliative care rooms (Palliative Care Newsletter, 1997).
4. Nursing Homes and Sanatoriums
Different names include rest homes and convalescent homes. The American Nurses Association defines licensed facilities that provide rehabilitation for non-hospitalized patients. They accommodate the elderly, chronic patients, and frail individuals, offering individualized special care. The reasons for their increasing popularity include:
① The rise in the elderly and chronic diseases;
② Changes in social structure, where families are unwilling or unable to provide care at home;
③ Some medical and pharmaceutical services cover the costs of nursing home care.
Nursing care in these facilities is similar to other organizations, including disease prevention, treatment, and rehabilitation.
The Role of Healthcare Professionals in Healthcare
A healthcare team consists of professionally trained staff who assist patients, including doctors, nurses, physical therapists, nutritionists, social workers, ministers, and respiratory therapists. Their tasks are to help patients reduce (at least control) their illness, address social, economic, and spiritual needs, and understand the patient’s health status. In this specialized and diverse era, doctors can no longer provide medical care independently, leading to many participants. Patients and families are important members of the healthcare team and should actively participate in medical care activities. In the team:
- Doctors determine the medical activities of patients;
- Professional nurses provide nursing care, nursing plans, and support doctors in medical work;
- Intern nurses assist professional nurses in implementing care, while assistant nurses help with non-professional direct care;
- Other healthcare team members work together to maintain or improve and restore the health of patients.