Nursing Care

Nursing care for individuals with anorexia at first requires a lot monitoring of the patient.  Nurses are responsible for monitoring nutritional status.  In an inpatient setting this involves constant observation of patients especially before and after meal times.  Nurses look for unhealthy behaviors like excessive exercise before or after eating, and vomiting or abusing laxatives after eating.  If the patient is receiving treatment in an outpatient setting the role of the nurse becomes more of an educator.  The nurse is then responsible for teaching parents to monitor their child's behaviors.   Nurses can also contribute positively to treatment by building non judgmental trusting relationships with patients.  These relationships can be effective in facilitating discussion with the patient about eating patterns and giving the patient space to voice concerns.

An article called Effective Nursing Care for Adolescents Diagnosed with Anorexia Nervosa: the Patient's Perspective provides a unique understanding of these nursing intervention and how the patients perceive them as effective in the treatment process.  The article looks at an inpatient facility and breaks treatment there into 3 phases.  The nursing interventions in the first phase are focused on monitoring and teaching the patient.  In this phase the nurse is very involved in the patients decisions and eating behaviors, dictating when the patient will eat, what the patient will eat, and how much the patient will eat.  In retrospect patients viewed these behaviors as helpful as they recognized that at that part of their lives they simply did not know how to eat anymore.  The nurses constant presence forced them to follow guidelines to build healthier eating behaviors.  The second phase of treatment involved the nurses giving more space to patients in order for them to begin to make healthy choices for themselves.  The nurses were then involved in evaluating the patients decisions and helping them make better choices or encouraging them in the good choices they were making.  During this phase the patients also saw the nurse as a role model for eating behaviors, This also served as a positive factor in treatment.  The third phase involved the nurse facilitating reintegration into normal life.  To accomplish this the nurses helped patients practice managing difficult life situations.  During this phase the patients recognized that one of the factors that helped them rebuild self esteem was the trust the nurses placed in them.

van Ommen, J., Meerwijk, E. L., Kars, M., van Elburg, A., & van Meijel, B. (2009). Effective nursing care of adolescents diagnosed with anorexia nervosa: The patients' perspective. Journal Of Clinical Nursing, 18(20), 2801-2808. doi:10.1111/j.1365-2702.2009.02821.x