"We need to promote improved patient and family engagement in their care."
Listening to a lecture today, I'm struck by this statement, as my morning was once again challenged by the reality of a family member who is oh so engaged, but whose healthcare providers are not adequately meeting his needs. With advanced complex multifactorial chronic illness, he is experiencing ongoing symptoms and worsening limitations, and yet is reluctant to contact his specialist yet again. More challenging yet, he has multiple specialists- his heart problems the domain of cardiology, the lung problems the responsibility of the pulmonologist and the pain management under the care of his primary care provider. Yet no one really sees him as a whole person, or has attempted to treat all problems together to improve his quality of life. No one is really following him, or is proactively engaged in his care.
This is just one representative of the growing population of individuals living for years, even decades with complex chronic illnesses. They have survived the cancer and the codes. They are living with multiple organ failure. Yet how are they living? Often it is challenging.
How can we change this situation?
How can we promote enhanced provider engagement in patient and family-centered whole-person care?
I believe that nurses hold the answer. We have the knowledge, skills and attitudes necessary to promote holistic chronic illness management for individuals and families. We have the numbers to ensure that all individuals living with chronic illness have a nurse who is coordinating their care, advocating for them and navigating and communicating across this very complex healthcare system. What I don't know, is how this will be paid for. These are important directions for role development and healthcare financing developments.
I hope that soon we will be able to say that we have both engaged patients and engaged providers, as engagement is needed in both directions.