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'A&P knowledge is as important as the 6Cs values'

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Lynne Yates explains the importance of knowing how the aging process can affect a person’s body - and their response to treatment

As we all know, nurses require a comprehensive variety of expert skills and knowledge to successfully care for patients.

The 6Cs epitomise what nurses should be; they should be compassionate, caring, committed, courageous, excellent communicators and competent. These values are without doubt an integral component of nurses’ roles and that is undisputable.

However, I would like to add that as nurses that we also need to consider “A” and “P” in equal measures. I believe that a broad understanding of the anatomy and physiology of the human body is equally as important as any of the 6Cs for nurses to provide expert patient care.

The human body is a marvelously complicated structure derived from many different cell types which form tissues, organs and systems; complex processes involved in the functioning of the multiple body systems. The aging body is deemed to be even more complex due to loss of reserves, both physically and physiologically, leading to a more rapid deterioration in the health of older people (Besdine, 2016).

“We all know the anatomy and physiology of aging, don’t we?”

Because we all know the anatomy and physiology of aging, don’t we? Greying hair, a few extra wrinkles and middle-age spread. That’s what we tend to consider as signs of aging; but it’s so much more than that.

Sepsis, delirium, frailty, falls and polypharmacy are also extremely common in older people and can be the cause of significant harm. A good understanding of the anatomy and physiology of the ageing body would enable nurses to perform a holistic geriatric assessment which would assist in the early detection of disease or the development of frailty syndromes.

This would help to minimise the risk of prolonged hospitalisation and the complications that acute illness and chronic disease present in older people.

“Being aware of the effect the aging process has on the body greatly assists with decisions surrounding medications”

My current role involves using advanced clinical skills and knowledge to assess, diagnose, treat and manage older people. This includes regularly reviewing and prescribing medications due to polypharmacy.

When it comes to polypharmacy in particular, anatomy and physiology must be considered, especially when prescribing for older people. Being aware of the effect the aging process has on the body greatly assists with decisions surrounding medications and with assessing signs and symptoms.

For example, knowing that the aging process causes a loss of muscle mass which, in turn, can increase the effect of certain medications can help practitioners understand why a narrow therapeutic range needs to be considered very carefully in the elderly. Or that the reduction of dopamine receptors and increased muscarinic parasympathetic responses, which can happen in the aging body, means that older people are more prone to develop Parkinsonian symptoms, such as reduced arm swing and increased muscle tone (Besdine, 2016). For this reason caution needs to be exhibited when prescribing drugs that will affect the central nervous system.

“More specialties in nursing will encounter older people”

Going back to the 6Cs; focusing on competence. The Department of Health (2012) stated that those caring for individuals should understand the health of those individuals and be able to demonstrate the clinical and practical skills and knowledge to deliver effective evidence-based care.

The increasing aging population means that more specialties in nursing will encounter older people and so it is vitally important that all nurses are able to understand the aging process and how the aging body works.

All nurses should be able to utilise the necessary skills and knowledge to monitor and assess these patients to ensure homeostasis is maintained and to improve the outcomes for the older people in their care.

Lynne Yates is an advanced nurse practitioner at Derbyshire Community Health Services NHS Foundation Trust

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