Joining Forces for Patients

The dyspnea clinic in Stuttgart is only the second facility of its kind in Germany. “Our objective was to pool a variety of skills within interprofessional care teams,” explains nursing scientist Eva-Verena Lindenau of the Robert Bosch Hospital. After all, patient care needs in the 21st century are becoming ever more complex: As many arrive at the hospital with multiple morbidities, long-term stabilization of their condition can only be ensured if they are also given tailored advice to prepare and empower them to cope beyond their hospital stay. “A lung cancer patient who also has kidney disease or diabetes doesn’t just need information about the individual conditions and their symptoms; they also need practical pointers, for example on nutrition,” says Lindenau. “This has often been lacking in the health care service up to now.”

This experience was echoed by Hannah Buß before she took over as head of the dyspnea clinic: “A lot of patients are brought to the emergency room in respiratory distress, where they are prescribed oxygen and then discharged shortly after,” she explains. They are only rarely given advice on how to better handle acute breathing difficulties at home themselves. Often in the high-pressure environment of a busy hospital there is simply no time or not enough resources, whereas exercises like the tripod position could prevent another admission and empower patients to feel more in control.

The “360° Nursing” project concluded that excellent and sustainable patient care is only possible if a care team combines a mix of expertise, from staff with one year’s training all the way through to academically qualified nurses. But one thing is clear: All nursing staff play a vital role toward the care and welfare of patients. After all, the COVID pandemic has reignited the debate on recognition in health care. It’s a start.

Already widespread in the U.S., the profession of Advanced Practice Registered Nurse is acquired through several years’ experience in direct patient care plus a master’s degree. In Germany too, the Science and Humanities Council recommends an academization rate of around 20 percent for the care profession over the long term. And with good reason. “Nursing staff with an academic background view patient care processes from a scientific perspective and ensure that all care measures reflect the current state of research,” explains Eva-Verena Lindenau. The “360° Nursing” project, too, saw the academization rate in direct nursing care at the Robert Bosch Hospital rise to six percent. And that’s just the first step

In the course of her work, Hannah Buß has often witnessed patients in particular benefiting enormously from the changes in care. Above all, they appreciate having someone take time for their individual needs. Only last week, Buß recounts, a man in his mid-60s was transferred from the ER to her clinic following his first ever dyspnea attack. “He was terrified,” she remembers. “I spoke with him for a good two hours about his condition and what he could do himself to alleviate the discomfort.” Afterwards, Buß also spoke with his wife, because relatives have an important part to play in successful self-management by patients. In the emergency room or in a normal ward, such in-depth advice sessions are rarely possible. Before he was discharged from hospital, the patient asked to see Hannah Buß once more so he could thank her. “For him it was important to realize that he can cope with the problem himself,” says Buß. “He then said he wants to be stronger than his breathing problems. And of course that’s lovely feedback for me.” hat dann gesagt, dass er stärker sein will als seine Atemnot. Das ist für mich natürlich ein schönes Feedback.“