Living with Chronic Respiratory Disease

With close surveillance by a knowledgeable nurse, the patient with chronic obstructive lung disease can be helped to live his life rather than his disease. Chronic respiratory disease, now identified as a major cause of morbidity, disability, and mortality, has received more emphasis and study in the last few decades than ever before. As the entity becomes better understood, its treatment is becoming more scientific. The question is: how can we provide care for the estimated 20 percent of the United States' population with chronic respiratory disease, including the 2.5 million who have chronic limitation of activity(l)? A partial answer is the nurse's role in long-term surveillance of such patients, a role complementary to that of the physician. Each professional has skills and knowledge which can benefit the patient with chronic respiratory disease; the two professionals together, therefore, provide patients with a level of comprehensive care which would not be readily available from either alone. Thus, the nurse's role is not to assume some of the physician's tasks, but to work with him, each contributing skills and expertise necessary to the patient's care. The general goals of nursing care are promotion of optimal function, prevention and early detection of complications and exacerbations, provision of patient and family education, adaptation of the treatment program to the individual patient (including airway care measures and treatment schedule), and strengthening patient and family coping mechanisms. Nursing intervention based on these goals provides comprehensive care rather than, as is all too frequently the case, merely crisis intervention. Too often, nurses and others responsible for health care delivery think of the patient with pulmonary disease only in terms of an acute exacerbation that requires hospitalization. Once the patient is treated and discharged, they