Helping patients to navigate what comes after a difficult diagnosis is a necessary part of our profession. In my many years working with patients facing progressive diseases, like chronic obstructive pulmonary disease (COPD), I have found that they often have questions, namely:
do I do now?
That’s where we, as
nurses and other health care providers, can offer answers. COPD is not
currently curable; however, there is still hope for these patients. Lifestyle
changes and medical advancements make it possible for patients to improve their
ability to breathe and overall quality of life. The objective of treatment is
to slow the progression of the disease and assist with managing its symptoms. As
patients with COPD come to terms with their disease, here’s what I would
recommend to guide them through the next steps of their journey, from diagnosis
With Them to Create a Plan
After giving a
diagnosis of COPD, educating patients on the disease and working with them on a
personalized plan to start addressing their symptoms is an important first
step. In fact, there are many lifestyle changes that patients can make every
day to not only accommodate their new medical needs but also to help improve
lung function. Committing to a diet of anti-inflammatory foods — like fatty
fish or dark leafy greens — participating in regular low-impact physical
activities and other techniques can help to reduce inflammation in the lungs
that can exacerbate symptoms.
Them Take the Steps to Quit Smoking
Smoking can cause
significant damage in the lungs which only increases over time. One of the best
things that patients can do if they’ve been diagnosed with chronic lung disease
is to quit smoking if they currently smoke. It’s important to arm them with information
and tools they need to successfully do so — whether it’s helping them to
identify smoking triggers, create an exercise and diet regimen or connect to
support groups or other resources. For example, at Lung Health Institute, we
offer our patients access to programs like American Lung Association’s Freedom
From Smoking® Plus, a flexible online smoking
cessation program that can be completed in six weeks.
Have an Honest
Conversation About What Treatment Is Right for Them
patient is different, and treatments will vary for each patient with COPD — depending
on the severity of the disease and other factors, including age, fitness level or
medical history. That’s why it’s critical to create an environment where patients
are comfortable being completely honest about how they’re feeling both
physically and mentally. That will ensure that we can provide them with the
best course of action when it comes to their treatment.
Melissa Rubio, Ph.D., APRN, is a nurse practitioner and principal investigator for research at the Lung Health Institute, based at its Dallas clinic. Rubio also currently serves as a visiting professor at DeVry University’s Chamberlain College of Nursing in Downers Grove, Illinois. Prior to joining Lung Health Institute, Rubio worked at Pleasant Ridge Internal Medicine in Arlington, Texas, as a family nurse practitioner. Rubio holds a doctorate in philosophy from the University of Wisconsin-Milwaukee College of Nursing. She also earned a bachelor’s degree in nursing from the same school. She is a board-certified family nurse practitioner and a certified principal investigator. Rubio is also a member of the North Texas Nurse Practitioners and the Southern Nursing Research Society.
my nearly 20 years of experience as a registered nurse, I’ve learned that
simple steps make a significant difference. Fast-paced clinical settings make
the procedures and protocols that all medical staff are familiar with
incredibly important. Proactive steps, as simple as remembering to always wipe
down all patient areas and keep them clear of unnecessary or unused supplies,
have the ability to keep both patients and medical staff safer.
nurses, patient safety is fundamental to what we do. It’s the first thing that
we think about when we get up in the morning, and the last thing we think about
before we go to bed. But no matter what your role in the organization, patient
safety must be the priority.
This is especially true when caring for patients with chronic
diseases, who are at an even higher risk given their weakened immune systems. At Lung Health Institute, we
specialize in treating patients with chronic lung disease, such as COPD and emphysema,
and we’re proud to have earned The Joint Commission Gold Seal of Approval® for
ambulatory health care accreditation.
Because we are continually evaluated, this recognition reflects our longstanding
commitment to The Joint Commission’s National Patient Safety Goals focus on
identifying patients correctly, using medicines safely, preventing infection
and providing appropriate treatment.
that vetted protocols and procedures are in place across your organization
is the first step to providing the safest environment possible for your
patients. Formal accreditation is a great way to ensure this exists, but
you should also revisit and review your procedures regularly. Health care is dynamic, and these
processes need to constantly evolve along with the industry.
At any stage of the process in your organization, here are a few tips that nurses caring for patients with chronic disease should follow to ensure the safest environments:
- Never stop learning: Best practices and industry
standards are always changing, so you should strive to stay on top of the
latest and greatest. I would recommend getting involved with local or national
nursing organizations and attending any relevant conferences.
- Lend a helping hand: With more young nurses in
the field than ever before, experienced nurses need to lead by example, taking
the extra time to demonstrate the right procedures and protocols can go a long
- Open the doors of
Patients are often scared when in a health care setting and taking the time to
ask them questions about not only how they’re feeling physically — but mentally
— can ensure you’re adjusting treatment plans appropriately and collaborating
with physicians in real time to problem solve. A safe environment for patients
takes into account both their physical and mental health.
- Slow down and think: It’s incredible how many
errors can be prevented by taking the time to think, without rushing through your
- Speak up: If you’ve observed standards
and protocols and think something could be done differently, say so. Real life
experiences help shape and create the best processes, and every operation is
unique and should be tailored appropriately. Following a challenging situation,
take the time to debrief with your peers — those more experienced and less
experienced than you. Talk about what happened, and how you can work together
to make it better or more efficient moving forward. Update procedures and
When treating a patient with Chronic Obstructive Pulmonary Disease (COPD), the physical symptoms are usually easy to see. The psychological impacts, like depression and anxiety, are there too, but they can be more difficult to identify. That’s why it is critical for the nurses and other health care providers caring for these patients to have a better understanding of what they are experiencing – both physically and mentally – in order to guide the best possible care.
Because little research exists on the emotions and feelings a patient faces while living with this chronic disease, I set out to learn more. My findings from a series of interviews with severe (stage IV) COPD patients published in The Journal for Nurse Practitioners uncovered some of these “hidden symptoms” of COPD, shedding light on the mental struggles COPD patients must face every day. Additionally, I found that some health care providers can do more to lessen this burden for the patient.
I believe there are steps that nurses can take to ensure that they’re addressing all of the symptoms of COPD:
- Help Patients Make Sense of the Diagnosis: Many of the patients in the study spoke about being confused when they first experienced symptoms of COPD. They knew something was wrong when they started to experience breathlessness, one of the most common symptoms of COPD, but they didn’t fully understand what caused it. As you can imagine, it’s easy to feel afraid when you don’t know what is happening to your body. It’s our job to help educate our patients about their condition, communicating with their physician and offering recommendations beyond just telling them to quit smoking or to use an inhaler.
- Take the Time to Ask Thoughtful Questions: Once diagnosed, many patients are overwhelmed with feelings of guilt, fear and hopelessness. Specifically, severe COPD is often met with increased anxiety about the end of life, and many patients in the study admitted having a difficult time accepting that this is how they were spending their last years. They also often had a hard time being optimistic about the future. It is important to let patients know that they are not alone and encourage them to share anything they may be feeling. This will ultimately help us provide the best possible care and treatment.
- Connect Patients to a Support System: The patients in my research were brave enough to share their stories, and I know there are many more patients out there struggling with similar emotions and feelings. There are many resources that we can offer these patients in order to improve their quality of life, including social support groups, end of life planning, and counseling.