Illness and Dependence in Nursing

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 analysed 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-centred 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. However, if three high dependency beds are required, one medical assessment bed could be left empty. Some high dependency patients come from the intensive care unit, not recovered enough to be transferred to a general ward but not requiring intensive care, some from accident and emergency and some are admitted to the medical assessment unit before requiring high dependency care (that is to say the patient has deteriorated).

Weller (1997) defines illness as a “condition marke...

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