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It’s National Nurses Week! Nurses play a big role in rheumatology care

On National Nurses Week, we want to thank you to all the nurses in the world!

Picture of nurses from American Nurses Association

Picture of nurses from American Nurses Association

Nurses play a major multidisciplinary role in health education and management of arthritis in the community. Patients living with extensive joint damage need ongoing treatment, care, and monitoring, along with motivation and instructions to adhere to prescribed drug therapies. The best way to do so is through a multidisciplinary approach where a varied healthcare team is made available to the patient. This team may include a rheumatologist, rheumatology nurse, registered nurse, pharmacist, physical therapist, occupational therapist, podiatrist, physician assistant, social worker, dietician, and counsellor. To ensure optimal physical, psychological, and social functioning and quality of life, the team provides education and support based on the patient’s goals.

Nurses can help patients manage and coordinate the plan of care established by their rheumatologist. We have outlined the role of the nurse in the disease journey below. Are you a nurse practitioner? Email us at feedback@jointhealth.org and tell us what you do to help patients!

Initial assessment

During the initial assessment, a nurse can help alleviate a patient’s anxiety, anger, frustration, and depression by establishing a therapeutic relationship with the patient and his or her caregiver. Nurses can also assess the patient and caregiver’s understanding of the disease and its management, and evaluate their physical, emotional, and psychological well-being.

Monitoring disease symptoms

Nurses are able to recognize the signs and symptoms associated with arthritis. They can use the information observed and given to them to identify the appropriate nursing diagnosis. A nursing diagnosis may be part of the nursing process and is a clinical judgment about individual, family, or community experiences/responses to actual or potential health problems/life processes. For example, American Nurse Today states that the common nursing diagnosis for patients with rheumatoid arthritis are “pain and discomfort, activity intolerance and impaired mobility, self-care deficits, fall risk, ineffective coping, altered body image or role performance, ineffective health maintenance, nonadherence to the therapeutic regimen, and caregiver role strain.”

Care planning

Nurses can work with the patient and caregiver to set measurable short-term and long-term goals to ensure optimal patient outcomes. Nurses encourage patients to learn and participate in their own care by:

  • reinforcing the multidisciplinary team approach to care
  • discussing psychological factors related to arthritis, such as depression, anxiety and stress
  • explaining medication and treatment therapies to treat and manage arthritis
  • discussing nonpharmacologic approaches to manage arthritis symptoms, such as heat and cold therapy, joint protection, range-of-motion and strengthening exercises, and complementary and alternative therapies (as prescribed by the provider)

Nurses are encouraged to ask open-ended questions and reminded to be sensitive to cultural preferences and family communication styles, and avoid arguing with the patient or caregiver.

Implementing the care plan 

After reviewing a patient’s care plan, nurses can implement evidence-based strategies based on established priorities, and provide patient education. Nurses can provide assistance in this phase in the following ways:

  • discuss the importance of adhering to prescribed drug therapy and nonpharmacologic treatment to control pain and achieve remission
  • review the signs and symptoms of arthritis with the patient and caregiver
  • identify the learning styles of the patient and caregiver
  • discuss the adverse reactions, drug interactions, and use of herbal and complementary remedies with prescribed medications
  • monitor medication efficacy and the patient’s tolerance
  • promote self-care practices
  • discuss ways to cope with stress or depression
  • review and obtain appropriate adaptive devices to help patients with daily living
  • provide resources on arthritis and information on how to connect with local support groups
  • teach the patient and caregiver how to recognize and manage flares and other complications associated with arthritis
  • remind and schedule patients for follow-up appointments

Evaluating outcomes

Nurses can help patients determine if the expected outcomes and goals of care are being met. They can:

  • monitor medication therapy, including efficacy, side effects, and assessing changes in signs and symptoms associated with arthritis (morning stiffness, fatigue, painful or swollen joints)
  • inform other health care team members of the effectiveness of medications, nonpharmacologic measures, and disease progress
  • collaborate with other health care team members to help the patient or caregiver achieve unmet goals
  • work with the patient and caregiver to adjust or create new goals according to current outcomes