A nurse working in a hostile environment can feel stress and overwhelmed, which can lead to an altered emotional state. Blevins (2015) reports in Impact of Incivility in Nursing that nurses working in this type of environment can “experience stress-related disorders and physical illness” which can decrease work attendance. A nurse or healthcare provider providing patient care in this emotional state can turn their negative feelings into uncivil behavior toward the patient or miss something critical to patient care, leading to patient harm or death. For example, if a nurse is upset about being disrespected from a fellow healthcare worker the nurse might turn her emotions on the patent by not asking the right assessment questions, or writing off a critical detail the patient is reporting. Incivility can also reach the patient level when a nurse is afraid to ask questions regarding patient care to the charge nurse as a result of recent bullying.
The symptoms can cause more severe symptoms if ignored or untreated. Some caregivers may use denial or avoiding to push the emotions away. (Alzheimer 's Foundation of America - What is Dementia, 2016) Depression is commonly seen in caregivers of Dementia clients. Depression is able to break the spirit of coping with the anxiety and stress that comes from caregiving. There is a link between that greater levels of caregiver burden and depression.
Nurses are not able to advocate for their patients. Therefore, it is not a safe environment while even nurses’ attempt to fix it did not make any difference. “Acquiescing and accepting unsafe or inappropriate practices, even if the individual does not participate in the specific practice, is equivalent to condoning unsafe practice. Nurses should not remain employed in facilities that routinely violate patient rights or require nurses to severely and repeatedly compromise standards of practice or personal morality” (code of ethics, 2011). Since in this case nurses might have a hard time finding another hospital in their community, they should find another solution instead of quitting their job in this
The complexity of dementia presents a number of behavioural challenges to those who live with dementia and their care providers. Aggressive behaviour seems to be one of the most prevalent challenging behaviours in the different stages of dementia (Weitzel et al 2011). As acute care settings are not the best places for people afflicted with dementia , it is necessary to empower the hospitalised people with dementia and their family members. As nurses are often the central core of care, they should have the potential of positive long-term effect on the lives of people with dementia (Harrison-Dening 2013). Inadequate training, lack of specialised education, negative attitudes and poor practice development can precipitate a failure in the delivery of high-quality care for the hospitalised dementia people (Chater & Hughes 2012).
Dementia and Delirium are perplexing conditions both to differentiate and experience. Dementia is a progressive intellectual function and other cognitive skills decline condition which results to a decline in an individual’s performance of their daily activities. Unlike dementia, delirium also known as acute confusional state is an acute medical condition which results in confusion and other disruptions in a person’s thinking and behavior including attention, activity level and perception. It is very important to distinguish between the two conditions because, delirium can be found in a person that already has dementia. A study done by Fick and Mion (2008) indicated that, about 22% of adults with dementia develop delirium.
. Pitkälä, K. H. (2009). Family Care as Collaboration: Effectiveness of a Multicomponent Support Program for Elderly Couples with Dementia. Randomized Controlled Intervention Study. Journal of the American Geriatrics Society, 57(12), 2200-2208. doi: 10.1111/j.1532-5415.2009.02564.x Koivusalo, M. (1999).
Journal of Gerontological Nursing, 34(5), 19-24. Social support. (2010, September 1). Retrieved from http://www.takingcharge.csh.umn.edu/explore-healing-practices/social-support White, A. M., Philogene, S. G., Fine, L., & Sinha, S. (2009). Social support and self reported health status of older adults in the United States.
(2004) Fuszard’s innovative teaching strategies in nursing. 3rd edn. Sudbury, MA: Jones and Bartlett Publishers. Matiti, M. and Trorey, G. (2008). Patients’ expectations of the maintenance of their dignity.
Improving medication management for older adult clients. Iowa City (IA): University of Iowa College of Nursing, John A. Harford Foundation Center of Geriatric Nursing Excellence; 2012 May. 31 p. [117 references]. Retrieved from http://www.guideline.gov/content.aspx?id=37826 Hanlon, J. T., Schmader, K. E., Ruby, C. M., & & Weinberger, M. (2001). Suboptimal prescribing in older inpatients and outpatients.
The nurse may face unreasonable workloads from the acuity of the patients, behavioural issues, elopement risks and the patient nurse ratio. As a result of these situations ultimately leaves the nurse in an ethical dilemma when it comes to the use of physical restraints. Unfortunately, they may feel that this is the only option to manage patient safety during times of increased workloads or being under staffed. Researchers suggest the nurses experiences with ethical issues lead to moral distress through patient and family behaviours, nursing shortages, and unrealistic expectations of care(Oh & Gastmans, 2015). Unresolved moral distress can result in the loss of concentration of the nurse when making ethical decisions that ultimately have a negative impact on how they think, feel and make future decisions.