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Introduction

The society requires attaining, maintaining and recovering from disease, ailments accidents. This calls for specialized care from a trained professional. In most case, care givers at home may lack this expertise. This calls for people who are trained, specialized and understand the medical aspect of the patients’ condition, such as nurse. The best suited group of people that can deal appropriately with these problems are nurses. Nursing is a health care profession and hence, their services are oriented to this direction.  In their duty, they give care to all members of the societies; both individual and families (Braverman, 1998). The main aim of this essay is to address the nursing care of psoriasis as a skin infection and relating it to 2 aspects of care from the list provided; patient education, patient assessment, planning care, discharging planning and process, continuity care and lastly health care professional education.

Nursing care is understood as being particularly crucial during patients’ recovery from serious illness or injury. Classically, it was thought that people requiring these services were probably people who were bed ridden. The objective of health services delivery is not only to care for bed ridden people but also anybody else that have a condition that is reducing their quality of life.  It is known that some diseases significantly reduce the quality of life led by individuals and not by necessarily sending them to bed. The aim of healthcare today is to assist any person with any disease, ailment or any form of suffering to recover and have a joyous and creative life.

Another factor that makes a nurse to be specifically suited to their job is because they are trained about community care. They deliver care in the context of the whole community. They are able to reach the society or community and teach or assist them on the best way to care for various people needing care in a society.

What is Psoriasis?

According to (Roenigk & Maibach, 1998), psoriasis is a non-contagious disease that affects a people’s skin. It is found in a class of diseases that are described as immune mediated. A person’s body starts sensing its’ skin cells that are foreign cells of disease causing microorganisms hence reacting against them. For this reason, the body responds to this faulty signal by producing the condition psoriasis. The patients’ skin cells in the affected places divide up to 10 times faster and lead to accumulation of dead cells on the surface. The skin of the patient appears to have a red plaque that is covered with white rashes. This disease is particularly acutely irritating and is probably the most frustrating and unpredictable skin disorder. This disorder is also the most inexplicable and continual skin illnesses. Some parts of the body are more affected by this disease than others. These include the scalp, elbows, and knees. Some other parts are affected but on rare instances. They include the soles, the palms, and the feet.

Commons symptoms of psoriasis include reddening of the skin with white or silvery scales occurring at the top. These areas can be exceedingly sore and may crack and bleed occasionally. In most cases, the affected patches expand and coalesce forming large and continuous patches. In other instances, this disease may affect the nails where nails become rough, crumbled or even detached from their bed. Another important characteristic of such a nail is that it loses its color. Both the fingernails and the toenails are affected in such cases. Another symptom that health care providers look for in diagnosing psoriasis is crusts, scales or plaques on a person’s scalp.

Some patients may experience pain in the joints which swells. This condition is called psoriatic arthritis. However, it is rare, as only 10-30% of people with psoriasis develop this problem. This disease may also occur in other forms such as Erythrodermic psoriasis, Inverse psoriasis, Pustular psoriasis, and Guttate psoriasis.

Patient’s Education of Psoriasis Patient

According to Papadopoulos & Walker, (2003) patients with Psoriasis feel self-conscious about their appearance, are embarrassed and avoid social activities, even dating or intimate interactions. The patients are reported to face stigma and antagonism by the society. They see how a single look at them initiates talks among people, among other forms of stigmatization.

It is essential in the nursing care process of any psoriasis skin infections to be educated and advised on how to live with the society, to avoid psychological torture and lastly to meet the prescribed medical instruction. The Patients are reported to face stigma and antagonism by such other people in the society. They become less indispensable resource to the society and hence said to experience negative attitude for the firsthand. They have seen how a single look on them initiates talks among people among other forms of stigmatization. Nurses teach patients to become ambassadors of truth. The society mistreats its members through stigmatization because of ignorance. The nurses also educate patients on how to protect friends, relatives and other members of the community (Smith et al, 2002). Moreover in Medical, the nurse give educational care techniques including assistance on the application of the medicine, monitoring the progress of the patient and advising the patients on the factors that aggravate psoriasis.

Nurses have noticed that, the patients due to stress are currently suffering from psychological disorders like post traumatic stress disorders and anxiety. They feel neglected and thus they need psychological education. Some of the nurses collaborate with psychologists to educate both the society and the psoriasis patients. In most case, nurses find themselves in a situation where the psychological health of the patient is crucial. Some patient feel like their ‘image’ has been dented after they suffer from a psoriasis condition. The nurse has to respond to this by educating the patient by providing financial and social education on how to deal with such psychological problems. 

Sometimes, the patient is so psychologically affected that the nurse has to refer the patient for specialized counseling among other interventions. Bearing in mind the wide spread nature of psoriasis nurses come up with a way of assisting the society. One of the activities that a nurse does is to educate the society as any person can be affected. It is an extremely crucial aspect of community care. The challenge that nurses faces is lack of an elaborate system of reaching the society in order to educate them. Most of the nurses begin with a person to person education beginning with the patients. The patients are advised on how to live healthy and boost their self-esteem. Nurses take this opportunity to educate parents and guardians how to handle the case and enhance the recovery of the patient. These educational programs are currently found to improve the health of the patient and to reduce stigmatization directed to the skin infections victims. Furthermore other patients educational campaigns carried out by the nurse are to educate the patients and the society on the symptoms and origin of the disease thus clearing misconceptions in people’s mind that have complicated peoples access to specialized care. For example, some people believe that psoriasis is a sign of a curse, due to this they fail to take the medication and the advice seriously (Mitchel & panzer,2005). This jeopardizes the process of treatment exceedingly and seriously. It may even increase stigma; people do not want to get close or in contact with a cursed person. It becomes the responsibilities of nurses to shed more light on psoriasis. Friends, family, and people living with the affected individuals are educated to provide the necessary support for the patient.

In some cases, it may disappear, in others it does not; thus, medical help is required. Additionally, it may and leave an individual with extraordinarily large psychological problems that require specialized assistance. In most cases, nurses know specialists who can counsel and help the patient to fully recover. Nurses offer their advice regarding medical care and refer the patient for further counseling and peer support. In home care, the nurses are also educating the patients on how to handle stress. Medically, it is known that the careless and irresponsible behaviors that people develop during the stress cause psoriasis. Such behavior may include rubbing of hands and face. Stressed people have destructive tendencies of holding onto anything and bringing things in contact with their faces. During care of a patient or other members of the community, the nurses shed more light on these issues so that people can lead a more informed life. It is a method of illnesses prevention in a community, as observation of such basic rules can keep psoriasis at bay, at least for some people for some time (Walji et al,1994).

Thus in summary, the nurses has been carrying out the patients educations across the medical services, stigmatizations and stress from other people, misconceptions and myths about the origin of the disease, treatment methods, society approach to psoriasis victims and lastly on how to handle psychological perception found to affect them adversely.

Discharging Planning and Processing of Nursing Care

In most cases, acute based care hospital discharging planning and process starts immediately upon admission in the hospitals where the hospital defines means of discharging the patient. In most cases it’s found to ensure that the nurses follow the right psoriasis disease medical guidelines and system (Fabian et al, 2011). It’s defined as a multi disciplinary nursing approach by the nurses and other medical practitioners to the patient’s signs, treatment process and discharging means. The discharging planning and process contains the following;

Immediately after admission of the patient, the first step in the nursing care designing planning and process is to examine the skin in general circumstances. The nurse should contact this within three hours. At the same time the patient is prepared for discharging through contacting the Medicare organizations such as insurance. At the same time the nurse should interview the patients about the problems linked to the disease, when did it start, what are some of the medications the patient accessed before and lastly, whether they have any hereditary problem of the disease across their family lineage.

The next discharging planning and process is the nurse to describe the information given in line to the prevailing psoriasis diagnosis a situation known as Skilled Nursing Facilities (SNF). At this process, the patients are instructed not to scratch themselves even if they are itching and home cares prepared for discharging process .This help to reduce more infections and complications. Moreover, in this stage, the patients are instructed to isolate themselves from the other people in the society, utilize their own clothing and even take bath using the bath oils. Moreover, the patient should avoid any skin injury that is going to complicate the medical process (Walji &.Kingston,1994).

Third step in the discharging planning and process of nursing care method include keeping the analysis of Medicare so as to know the best for covering the costs. The nurses are trained to apply epidemiological prescription to ensure the patient skin is treated at all costs and thus later the cost covered in the discharging process. This involves reducing the Medicare costs by applying the necessary medical bath oils and staying in a cool place free from any dust and high temperature. The patients are also provided with some injections and clothing necessary to reduce itching, smell and pains.

In the next stage, the patients are nursed in a manner as to keep the wounds clean and to apply the necessary antibiotics carefully and skillfully. This ensures that the patients do not have pain and the itching reduces. The nurses take this opportunity to educate the family members on how to prescribe the medical drugs to the psoriasis patients and thus improved services. At this moment, the nurses must monitor the risk of infections, outcomes of the diseases and lastly the implication of the bath oil to the skin (Papadopoulos & Walker,2003).

Lastly, some of the patients found to be stressed, stigmatized and psychologically affected are provided with advices or even referred to psychologists for guidance and counseling. The nurses have a goal to improve the mind perceptions of the patients and to positively impact on their health. The nurses consider some numerous patients factors in the process of discharging planning and process of the duties. They have to make necessary recommendations in line to the Medicare guideline so as to ensure that psoriasis patients enjoy the best Medicare services (Braverman, 1998). In the process, they must have insurance and Medicare eligibility so as to ensure that the psoriasis patient has in patient services and hospitalized for at least three consecutive calendar years for observation purposes. Secondly, they must observe the cognitive status and especially their safety awareness while in the discharging process. This help in reducing unnecessary infections to both the nurses and other patients. The clothing and bed sheets of the psoriasis infections must be handled with a lot of care (Camisa, 1994). Lastly, the nurses should observe the illness history and the future falls of the patient. Moreover, other factors that should be observed in the planning and discharging of psoriasis patients includes; age, living situation and lastly the daily nutrition and activities of the patients. The nurses have various discharging options such as Skilled nursing facility (SRF) and Inpatient rehabilitation Facility (IRF) among others.

Conclusion

The nursing process of any psoriasis patient like any patient requires assessment and planning of care albeit on an outpatient basis. It requires observation of the two aspects physical and psychological as discussed above. Moreover it requires an interdisciplinary team to maintain patients with psoriasis educate and empower them by providing advice on treatment methods during the periods of remission and exacerbations. This will help improve the health of this skin condition victim and reduce society misconception about the disorder.

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