Scope of Adult Nursing: Roles and Responsibilities in Ill-Health

This paper discusses the scope of adult nursing, including roles and responsibilities in ill-health, using a case scenario of a patient with Huntington's disease. It also covers the role of other practitioners in HD and appropriate nursing models of care.

Scope Adult Nursing
SCOPE ADULT NURSING
Author
Name of The Class
Name of The Professor
School
City and State
Date
1

Scope Adult Nursing
Abstract
Adult nursing is one of the utmost importance roles within a health care
system. This role handles almost all situations within healthcare except for children
cases which are handled by children nursing. However, adult nursing does not deal
with mental health or elderly health problems. An exception to this comes only where
mental or elderly issues involve matters of general health. In such cases, the
situation falls in the care of adult nursing. This paper will discuss the scope of adult
nursing. The paper will take into consideration one particular case of a patient who
needed to provide further explanation of the scope of adult nursing in ill health. The
paper will talk about the roles and responsibilities of adult nurses concerning the
patient and his family members in a life-threatening disease.
2

Scope Adult Nursing
Introduction
In the nursing profession, adult nursing refers to the nursing practice in people
from the age of early adulthood to an indefinite age. The role of adult nurses in
health care is part of the advanced positions within healthcare. For instance, these
nurses look not only on the patient, but they also extend their services to families
and the caregivers of the patients. Besides, they must also consider both the health
of the patient and other aspects of health such as the social life and environment. As
adult nurses are trained specially to take care of adults and their needs, this role also
entails forming a positive relationship with the patients, their family members, and
the caregivers. For a better analysis of the scope of adult nursing, this paper will first
provide an understanding of this role; then it will extend to discuss their role using a
case scenario. Further, the paper will look at other professionals who also work with
nurses to provide optimum care to the patient.
Scope of Adult Nursing
Adult nursing is a broad term within the nursing career. In general, the term
refers to the provision of nursing care to the entire population except for children.
The profession of adult nursing has various branches. One of the branches is called
geriatric nursing which is a branch that deals with the care of elderly persons.
According to (Kim, et al., 2009), geriatric nurses play a major role in providing care to
the older adults, and this role involves constant contact with patients, administration
of geriatric programs, and management of geriatric resources. Regarding elderly
adults, this branch does not deal with the cases of mental health or even general
health. Mental problems that do not involve general health are dealt with in mental
health nursing, while matters of general health are referred to adult nursing.
3

Scope Adult Nursing
The nursing profession is divided into various branches and sub-branches.
These groups are the general nurses, the midwives, community, and public health
nurse specialist branches (Cutcliffe & Forster, 2010). Among these branches, adult
nursing comes as a subdivision along with mental health nursing, learning and
disability nursing and the children’s nursing.
Role of the Adult Nurse in Ill-Health
According to (Denisco & Barker, 2012), ill health is when a body has abnormal
conditions or not function and it is characterized by illnesses or symptoms need
medical intervention. The primary objective of an adult nurse is the restoration and
maintenance and maintenance of well-being of the population. In this objective, the
adult nurses’ in diagnosis of the disease and takes further steps of improving the
patient's health. Enhancement of health can be either engaging the patients in a
therapeutic process or providing psychological support. Moreover, health promotion
does involve not only restoration of health, but also its development through looking
at the patient in a holistic approach. According to (NHS England, 2016), some of the
essential elements in nursing are the compassionate care which also receives
explicit recognition in pre-registration of nurses in England Where total recovery is
impossible, nurses must engage the patients in palliative care which involves looking
at all the dimensions of the patients' health as they progress through the end of life
stage (Offen, 2015).
The practice of adult nurse in palliative care begins with diagnosing the
illness, and it is part of ill-health improvement approaches. According to (Hunter,
2009), distinguishing between acute and chronic factors of ill health is a necessity
expecially when diagnosing a disease to for the determination of the care approach.
4

Scope Adult Nursing
In the cases of ill health, (Hunter, 2009) explain on role of a nurse as the
management of acute symptoms without compromising the stability of pre-existing
conditions. Similar comments were made in the work of (Maybin, et al., 2016) that
district nurses must understand the requirements of the patient either from them or
from their caregivers.
Adult Nursing Case
This paper will be discussing a case of a 50-year-old male suffering from
Huntington’s disease (HD). The paper will refer to the patient as Mr. X and his wife
Mrs. X, his primary caregiver. After speaking to Mrs. X, some of the information that
was revealed about Mr. X’s personal life was that he was a lawyer. Also, the couple
had been living together for the past 20 years and had no child. When his illness
reached a later stage, he was forced to quit his job as a lawyer. Since his wife had
no job, she immediately became the caregiver. Mr. X was diagnosed with the
disease at the age of 40 years.
Mr. X had retained some speech and coordinated movement abilities and he
could talk a little, using short sentences. He could also point at things and hold
objects in his hand, but he couldn’t walk hence bound continuously to a wheelchair.
His speech sometime would break, and he could take a long pause to capture his
words.
About the Illness
Huntington’s disease is a degenerative genetic disease that causes the brain
cells to die. It is progressive and neurodegenerative disease, and the disease is
characterized by the decline of cognitive abilities, behavioral, and psychological
5

Scope Adult Nursing
symptoms (Videnovic, 2013). Since there is no ultimate solution, all the treatments
focus on improving the patient’s quality of life (Roos, 2010).
According to (Pidgeon & Rickards, 2013), the symptomatic characteristic of
HD is chorea, saccadic eye movements, dystonia, gait disturbances, dysarthria, tics,
and myoclonus. Other cognitive and behavioral signs are personality changes,
aggression, depression, irritability, apathy, dementia, psychosis, and reduced
executive function. These symptoms usually occur when the disease is in its early
stages, and they significantly cause a decrease in the coordination of motor skills of
the patients the disease gradually progresses in the patient’s body. When the
disease reaches a later stage, a permanent caregiving situation must be created.
Later stages of the illness cause involuntary body jerks and movements in the body
and the physical and mental state of the patient begins to deteriorate. According to
(Georgiou-Karistianis, et al., 2014), the patient loses the ability to talk and make
coordinated movements and his mental state declines into stages of dementia. Thus,
permanent and full-time care must be given to the patient suffering from Huntington’s
disease.
Nurse’s Role on Mr. X
Our responsibilities as care providers to Mr. X were to give provide him with
healthcare which included physical support and psychological support. We also had
to provide Mrs. X with training regarding the disease, and its possible outcomes in
his therapeutic process. The responsibility also entailed correct examination and
diagnosis of other mental problems associated with HD. According to (Downing, et
al., 2012), healthcare professionals should avoid assuming that patients with HD do
not suffer from depression so they should also examine them for the same.
6

Scope Adult Nursing
For the success of the current and future interventions, we first focused on
creating a good nurse-consumers’ relationship. The work of (Tarolli, et al., 2017),
states that a doctor-patient relationship can enhance the consumers’ confidence in
palliative care. Creating a good relationship with our clients also helped in clearing
misunderstanding between us and them. Once the relationship and the trust had
been established, we then proceeded with education and introduced Mr. Xnd Mrs. X
to palliative care.
Our approach to care included several elements of the nursing practice.
Among them, we engaged Mr. X to medication. We also planned for home visits
which were meant to examine the conditions of the home environment such as food,
water, taking him on and off the wheelchair, cleanliness of the washrooms among
others. Moreover, we decided to take a role in engaging Mr. X in exercises and
physical therapy. According to (Fritz, et al., 2017), exercise and physical activities in
Huntington’s disease are helpful particularly in enhancing gaint speed, motor
function, and balance.
Role of Other Practitioners in HD
Recreational Officers
According to (Bruggen-Rufi, et al., 2016), recreation officers help in guiding
recreational activities. The purpose of these activities is improving communication
skills as they encourage and stimulate the patient’s interaction. A recreation officer
was assisting Mr. X in different sessions of recreation therapy.
7

Scope Adult Nursing
Nutritionists and Dieticians
According to (Brotherton, et al., 2012), nutritionists and dieticians help
patients of HD with nutritional guidelines and provide optimal nutritional assessment
and screening as the patient moves through the HD stages. The nutritionists and
dieticians for Mr. X need to make sure that he receives a diet that is full of nutrition
and required a diet that is suited to his age and his disease.
General Practitioner
According, (Evans, et al., 2013), general practitioners help in the general
diagnosing of the disease symptoms. The general practitioner scheduled bi-weekly
visits to Mr. X to follow up with the patient care. The visits included evaluation of the
care, medication and guiding other professionals on the next action.
Physiotherapists
According to (Quinn & Busse, 2012), a physiotherapist in HD provides clinical
guidelines in response to the patient’s clinical need during and throughout the
treatment period. The physiotherapist's job included providing an ongoing social and
health care according to the needs of Mr. X.
Neurologist
According to (Halpin, 2011), neurologist help in providing an actual diagnosis
that confirms the genetic test of HD. The diagnosis of HD by neurologist involves
analysis of motor manifestations and detecting tangible changes within the patient’s
brain.
8

Scope Adult Nursing
Appropriate Nursing Model of Care
Due to the complexity of the care needed in HD, we found that supportive care was
the appropriate model starting from the time we diagnosed Mr. X with the disease
throughout its prolonged trajectory. According to (Nopoulos, 2016), HD involves both
severe neurological degeneration and psychiatric disorder. Moreover, the trajectory
comes with family member's concerns fearing that they might undergo the same
predicaments. Supportive care in HD takes two essential approaches. The first one
is offering psychological support, and the other one is giving practical support. In this
case, practical support can extend even to providing financial support. Further, there
were two other critical issues that we identified, and they informed our service
provision. We found that we needed to ensure that the support was sufficiently
choreographed and resilient enough to meet the patient's circumstances. Also, we
found that professionals providing supportive care in HD require much knowledge on
the disease
Conclusion
The objective of this paper was to provide a detailed explanation of the scope of
adult nursing. As outlined in this paper, adult nurses form a core profession within
the healthcare services. Except for the children, these nurses can at a point be in a
situation where they are handling all situations related to adult health. With the aim of
giving practical explanations, the paper used a case scenario where consumer
names were replaced with pseudocodes for confidentiality. Ultimately, this paper was
able to explain how adult nurses execute their roles and finished by showing the
most demanding part of their career when they engage cases of providing supportive
care.
9

Scope Adult Nursing
10

Scope Adult Nursing
References
Brotherton, A. et al., 2012. Nutritional management of individuals with Huntington's
disease: nutritional guidelines. Neurodegenerative Disease Management, Volume 2,
pp. 33-43.
Bruggen-Rufi, M., Vink, A., Achterberg, W. & Roos, R., 2016. Music therapy in
Huntington's disease: a protocol for a multi-center randomized controlled trial.. BMC
psychology, 4(1), p. 38.
Cutcliffe, J. & Forster, S., 2010. Professional Regulatory Nursing Bodies:
International variation in the protection of the public. International Journal of Nursing
Studies, Volume 47, pp. 1343-1345.
Denisco, S. M. & Barker, A. M., 2012. Advanced Practice Nursing. 2 ed.
Massachusetts: Jones & Bartlett Publishers.
Downing, N. et al., 2012. Perceived stress in prodromal Huntington disease.
Psychology & Health, Volume 27, pp. 196-209.
Evans, S. J. W. et al., 2013. Prevalence of adult Huntington's disease in the UK
based on diagnoses recorded in general practice records. Journal of Neurology,
Neurosurgery & Psychiatry, Volume 84, pp. 1156-1160.
Fritz, N. E. et al., 2017. Physical Therapy and Exercise Interventions in Huntington's
Disease: A Mixed Methods Systematic Review.. Journal of Huntington's disease,
6(3), pp. 217-235.
Georgiou-Karistianis, N. et al., 2014. Movement sequencing in Huntington disease..
The world journal of biological psychiatry : the official journal of the World Federation
of Societies of Biological Psychiatry, 15(6), pp. 459-471.
Halpin, M., 2011. Diagnosis, psychiatry and neurology: The case of Huntington
Disease. Social Science & Medicine.
Hunter, S., 2009. Distinguishing between acute and chronic elements of ill health
when assessing patients. Nursing times, 105(37), pp. 20-23.
Kim, H., Capezuti, E., Boltz, M. & Fairchild, S., 2009. The Nursing Practice
Environment and Nurse-Perceived Quality of Geriatric Care in Hospitals. Western
Journal of Nursing Research, Volume 31, pp. 480-495.
Maybin, J., Charles, . A. & Honeyman, . M., 2016. Understanding quality in district
nursing services Learning from patients, carers and staf. The King's Fund.
NHS England, 2016. A framework for nursing, midwifery and care staff.
https://www.england.nhs.uk/wpcontent/uploads/2016/05/nursing-framework.pdf.
Nopoulos, P. C., 2016. Huntington disease: a single-gene degenerative disorder of
the striatum.. Dialogues in clinical neuroscience, 18(1), pp. 91-98.
11

Scope Adult Nursing
Offen, J., 2015. The role of UK district nurses in providing care for adult patients with
a terminal diagnosis: a meta-ethnography. International Journal of Palliative Nursing,
Volume 21, pp. 134-141.
Pidgeon, C. & Rickards, H., 2013. The Pathophysiology and Pharmacological
Treatment of Huntington Disease. Behavioural Neurology, Volume 26, pp. 245-253.
Quinn, L. & Busse, M., 2012. Development of physiotherapy guidance and
treatment-based classifications for people with Huntington's disease.
Neurodegenerative Disease Management, Volume 2, pp. 11-19.
Roos, R. A. C., 2010. Huntingtons disease: a clinical review. Orphanet Journal of
Rare Diseases, Volume 5, p. 40.
Tarolli, C., Chesire, A. & Biglan, K., 2017. Palliative Care in Huntington Disease:
Personal Reflections and a Review of the Literature. Tremor and Other Hyperkinetic
Movements.
Videnovic, A., 2013. Treatment of Huntington Disease. Current Treatment Options in
Neurology, Volume 15, pp. 424-438.
12