Nursing's renaissance. An innovative continuum of care takes nurses back to their roots

Nurses in the Tucson area are not only serving persons in hospitals but also caring for them in their homes and neighborhoods and teaching them how to maintain their health. Three nursing programs--community nursing centers, home health services, and nurse case management--are part of the nursing continuum of care within Carondelet Health Care. Promoting clients' optimal wellness level, helping them maintain their highest level of functioning, preserving their dignity and independence, and enhancing their self-care are the goals of the Carondelet Community Nursing Centers. Nurse practitioners monitor clients' blood pressure and cholesterol and blood sugar levels and can test for episodic problems. Carondelet Home Health nurses teach clients about disease processes, symptom management, and medications; assess or monitor a patient's condition; care for wounds, and coordinate services such as physical therapy, occupational therapy, and home-delivered meals. Persons are usually referred to home health as they are discharged from the hospital. In addition to helping clients with psychosocial problems, nurse case managers perform traditional nursing functions like monitoring and teaching about medications. Nurse case management clients include the frail elderly or persons who have at least one of the following: a chronic disease that is causing steadily declining health; a terminal illness; an acute episode that requires monitoring and support; care-giver stress; or an inability to cope, as evidenced by anxiety, depression or substance abuse. Services for such clients will gain prominence in a reformed healthcare system.