Experiencing Hospitalisation Flashcards
Florence nightingale influence
- Acknowledged importance of environment during crimean war (clean living areas, fresh air, light)
- Shifted focus from disease process towards enviro conducive to healing
Illness
Subjective experience, diminution in physical, emotional, intellectual, social, developmental, spiritual functioning
Disease
Alteration in bodily functions resulting in reduction of capacities , objective state of ill
Impact of illness
Pt: anxiety, helplessness, shock, denial
Family: role adjustment/reversals, heightened vulnerability to illness
Genogram do what
- Concise visual depiction of family structure
- Helps team members understand family situation
Lack of what in hospital for pt (ex sharing room)
Privacy/confidentiality
4 main threats to hospitalization
- Powerlessness
- Dependency
- Depersonalization
- Loneliness
Powerlessness: loss of control
- Physical (illness)
- Psychological (must provide personal info, don’t know doctor)
- Lack control abt unit/room/equipment
- Feelings of frustration
Increase sense of control by
- Provide explanations (procedures, incisions)
- Allow expression feeling
- Ensure needed objects within reach (call bell, tissues…)
- Encourage participation (hygiene care)
Powerlessness: lack of knowledge
Can imagine unrealistic complications/limitations
Avoid that by
1. Not use medical jargon
2. Clarify pt understanding/situation
3. Give time to absorb info
Dependency
- On institutions
- Stripped individuality by procedures and rituals of institutions
- Pt express anger but gratitude is expected
Decrease dependency by
- Respond to anger, investigate the need expressed
- Give pt choices if possible
Depersonalization
- When seen more as illness than person
- Privacy forgotten
- Most common emotional response is anger
Decrease dehumanization by
- Introduce yourself
- Use pt preferred name
- Don’t talk down (our instead of your (ex walk))
- Promote pictures and belongings
- Insure privacy
Loneliness
- Desire contact (meaningful)
Decrease loneliness by - Spend time w pt
- Get to know pt
- Take out of room
- Encourage family visits
3 prominent themes experienced on acute care
- Disconnection vs connection
- Fear vs less fear
- Confinement vs freedom
Disconnection vs connection
Connection to nurse is crucial for experience of acute care, staff make or break pt’s stay”
Promote connection
- Friendly, attentive, encouraging nurse (increased comfort and feeling of being cared for)
- Positive connections through non verbal
- Frequent check ins
Fear vs less fear
- Vulnerability
- Health/illness/disability
- Powerlessness
Decrease fear
- Physical proximity
- Attentiveness of staff (more safe and secure feelings)
- Check ins (caring attitude)
- Nurse advocacy
Confinement vs freedom
See hospital as place don’t want to go, be, glad to leave
Provide sense of freedom
- Nurse being “right there for pt”
- Check ins
- Positive relationship w staff (to allow pt to leave unit for ex)
- Wide open spaces
- Windows (temporary escape)
- Keep door open
Pt wants interpersonal connections
- Friendly, check ins, responsive nurses
- Positive non verbal, presence, protective against possible errors, non intervention time
Implications for nursing practice
- Brief but frequent contact: competent, organized but caring nurse
- Regular presence creates security/comfort/caring attitude
- Positive demeanour
- Attend pt feelings of confinement
- Have family present to decrease isolation/fear
