The aim of this essay is to discuss the nature of illness and dependence in relation to the issues that the nurse should take into account when providing evidence-based care. The issues that will be analyzed are the nursing process and nursing models, the implications of nursing technology on the nurse, the patient and their family, the psychological issues for the patient and their family, the consequences of disability and chronic illness and the importance of patient-centered nursing. These issues will be discussed, for the most part, in relation to the patient care received by patients admitted to a ‘high tech' area. The ‘high tech' area will be, on the whole, focused in a medical high dependency unit in a local general hospital.
The medical high dependency unit concerned is part of the medical assessment unit. Admissions to the medical assessment unit are taken from either the Accident and Emergency department or from General Practitioners (GPs) when patients need assessment and/or investigations before they are discharged home or transferred to other wards in the hospital. The medical high dependency unit is a four-bedded bay with two side rooms. Two of these beds are classed as high dependency beds and the other four are medical assessment beds.
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[...] Whilst on placement on the medical high dependency unit I had the opportunity to observe and participate in the nursing care of a patient who had been on the unit longer than most high dependency patients because she required the specialist skills of the nurses on the unit. The patient had a tracheotomy insitu and was dependent on a Harmony ventilator and the nurses on other wards were not competent with this piece of technology and would not take the patient. [...]
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