Aged Care Nursing - Term Paper Example

Running Head: AGED CARE NURSING Aged Care Nursing Name: College: Course: Tutor: Date: Aged Care Nursing Introduction Nurses’ attitudes toward elderly patients may greatly affect the quality of care provided. Care for the elderly poses significant challenges because they are less independent, have limited decision-making abilities and are at a high risk of developing complications (Pope,2012). Consequently, nurses may have ageist stereotypes, which make it difficult to help the elderly who often have inadequate consideration for their needs, lack adequate health education and often live in social isolation. This essay establishes how negative attitudes by nurses toward care for the elderly affects the quality of care provided, and how nurses can be educated to adopt healthy attitudes. Patient rights will also be examined in relation to the elderly such as privacy, access to information and adequate care. In Australia, the aged population is increasingly rapidly, especially those aged 80 years and above (Pope,2012). This numbers are expected to increase in the coming years, and it is, therefore, important for the health care system to adopt practices that improve nurses’ attitudes in order to provide quality care for the aged population in the country. Negative attitudes and beliefs in caring for elderly patients Nurses’ attitudes toward elderly patients affect the quality of care they provide. There are various factors that cause negative attitudes among nurses in caring for the aged such as the preferred area of practice. Nurses who prefer to work in areas other than gerontic care tend to have negative attitudes towards the elderly(Pope,2012). This ideally, is because such nurses prefer to work in areas where patients’ needs are not burdensome such as intensive care units. In the scenario presented for this essay, it is clear that the nurse’s remarks that ‘I really hate looking after old people – they are all senile and they smell’, is a resentful remark, which means that the nurse would prefer to work in another area as opposed to caring for the elderly man. Knowledge is also a major influence on nurses’ attitudes towards aged patients. It is reported that nurses with higher levels of professional education have more positive attitudes toward the aged patients. At the same time, nurses who lack adequate knowledge about ageing do not necessarily have negative attitudes toward the aged, but lack of the ability to modify care to fit their challenging needs such as lack of adequate independence in decision making (Mellor, Chew and Greenhill, 2007). A nurse’s negative attitude toward elderly patients could affect them negativelyin both the quality of care andthe patients’ willingness to seek care. In the scenario given, the elderly man could have heard the nurse’s negative words, which could have result him in think negatively about the care he was going to receive. This could lead to the patient shying away from health care altogether because they perceive the environment there as uncaring and hostile toward their needs (Marshall, 2010). At the same time, other healthcare professionals who heard the comment could be influenced to adopt similar negative attitudes toward older patients, especially judging by the first impression they perceive from the patients’ physical state. Thus, other healthcare professionals especially trainees are likely to experience displeasure in taking care of aged patients. As noted by Lamet et al., (2011), only older healthcare professionals show interest in caring for aged patients. Considering the despondent attitudes already existing in caring for these patients, a negative comment such as the one made by the nurse in this case has immense potential to create an environment in which other healthcare professionals allow negative attitudes and prejudices to affect the quality of care provided to the aged population. The healthcare institutions would thus, be subjected to the possibility of reduced quality of care and subsequently erosion of public trust in the care provided (Lamet et al., 2011). Many nurses are caught up in ageism so that it interferes with the care they give to elderly patients. As in the scenario presented, the nurse’s attitude and comment was motivated, by the way the old man looked; disheveled, incoherent, and smelly. Her generalization that all old people are senile and they smell is a stereotype but perhaps one that is born out of many such experiences with old people in her nursing duties. Nurses are often barriers to quality care for patients, and in this case the elderly, in several ways including previous unpleasant experiences with aged patients or even close relatives (Bakhtiari, Zade, and Moshtagh, 2007). Trust is an influential component of nurse-patient relationships especially among elderly patients. Owing to the vulnerability of patients in their dependence on nurses for care, trust entails keeping promises, being honest and friendly (CRNBC, n.d.). The elderly often face discrimination and isolation which lead to defensiveness (Bakhtiari et al., 2007). Trust, thus ensures that the elderly shed their defensiveness inorder to cooperate with care providers for the care to be effective. The elderly are especially at a disadvantage when it comes to nurse-patient relationships because as visible in the scenario given they are not often able to make sound decisions. They have to depend heavily on the nurses for care and creating a trusting relationship is a tool that nurses can use to create a therapeutic relationship, in which the elderly feel safe in regard to the care they receive (CRNBC, n.d.). The impact of the negative attitudes The quality of care for elderly people by nurses with negative attitudes is affected in several ways. The elderly are not accorded independence or involvement in the decision making process about their care. They are also not given enough information of their care choices such as in the case of which drugs to use and their side effects (Doherty, Mitchell and O’Neill, 2011). In the scenario presented, the elderly patient obviously needs medical assistance, to ascertain his exact condition seeing that he is incoherent. However, as witnessed by the nurse’s negative attitude, this medical attention is delayed because the nurse refuses to care for him simply because he is old. This delayed or denied care is one of the negative impacts of negative attitudes by nurses towards elderly patients. Besides, as Webster and Bryne (2004) point out, privacy is a vital part of the nursing profession that should be accorded all patients including the elderly. In this case, the nurse is oblivious of the old man’s right to privacy because when he says that he wants to urinate, the nurse should immediately assist him and safeguard his dignity. Nurses should protect older patients from intrusion into their privacy and regard them as worthy of respect. Afolayan, Fatai and Afolayan (2011) also observe that negative attitudes by nurses toward elderly patients often lead to abuse of the patients. The nurses may perceive them as not worthy of respect, or more so as a bother, leading to cases of inflicting pain, misuse of medications, inflicting psychological distress and confining care, food or drugs. Abuse is also evident in cases where nurses perceive the elderly as complaining too much to seek attention, and this may often lead to delayed care and ignoring of serious symptoms or conditions that pose a threat to the elderly patients’ lives. In this scenario, the nurse is already withholding care from the old man just because he is old. There are serious consequences in this case arising from the nurse’s negative attitude. To begin with, the elderly patient has several symptoms that could be as a result of serious problems that need urgent medical attention. Unfortunately, the nurse may fail to recognize the haematoma on the right side of the patient’s forehead which could be as a result of brain injury (Chen, Guo, Chen, Wang, Cao, Chen, Gu and Tian, 2012). This could have easily been the cause of the patient’s incoherence, and because cases of brain damage are serious, the nurse could easily let the patient experience greater harm by dismissing him as just another senile, smelly old person. Besides, the nurse’s attitude about how old people smell is dangerous, because that could lead her to overlook the acetone odor breathes on the patient. Overlooking this symptom means that if the patient is suffering from serious metabolic problems associated with diabetes, he could go untreated and leads to serious health complications (Ghimenti, et al., 2013). As already stated, a nurse’s attitude bears direct consequence to the way the patient perceives his or her presence in the care institution. In this case, if the old man heard the distasteful comment by the nurse, he could interpret it as a sign that he is disrespected. As Higgins et al., (2007) observe, a patient feels that their independence is threatened by the nurses’ attitudes, and this could cause the old man to leave the facility without seeking proper treatment. By the nature of being incoherent and at the Emergency Department, the nurse expressed total disregard for the patient’s urgent needs and went ahead to judge him before establishing what his problem was. The appropriate conduct Nurses have a responsibility to treat patients using positive reinforcement, which calls for positive attitudes on their part. Older patients, just like other patients deserve to be treated with respect. Patient’s rights are part of human rights that should be accorded all, including the aged patient in this case, regardless of his physical and emotional state. According to the World Health Organization, patients should be granted their informative right to access information and make decisions in regard to their health care (WHO, 2013). In this case, the nurse should not disregard the patient by judging him by his disheveled state. Instead, she should act responsibly in accordance to the nursing profession’s code of conduct that requires nurses to conduct themselves in a manner that maintains trust and confidence among patients and the public at large (ANMC, 2008). The nurse in this case should also have engaged in a decent conversation with the patient, by first directing him to the washrooms and being attentive to his needs. This way, the patient would try and explain what had happened to him so that he could be accorded proper medical attention. Besides, the nurse should also strive to break the power imbalance that exists with the nurse being in control and the patient feeling less independent and disrespected (Larsson, Sahlsten, Segesten and Plos, 2011). It is vital that the nurse does not treat the old patient as a burden, but respect and accord him his dignity and autonomy regardless of his physical state (Welford, Murphy, Rodgers and Frauenlob, 2012). Educating and training nurses on caring for aged patients is vital in eradicating ageist attitudes and stereotypes. Education will grant the nurse in this case the knowledge on the process of aging and the health complications that arise which require nurses to be sensitive towards older patients. Nurses with knowledge in geriatrics are reported to have more positive attitudes towards older patients, which consequently improve the quality of care (Brenner et al., 2006). As Carlisle (2000) reports, health advocacy is the best tool to deal with vulnerable patients such as the elderly. Advocacy entails protecting patients that are vulnerable to mistreatment and discrimination, as well as empowering them to be able to express their needs and make decisions in regard to their medical care. Health advocacy should be a central agenda in all health care institutions to ensure that the aged, such as the old man in his case, are accorded the appropriate care. Nurses should strive to uphold the autonomy and personal identity of aged patients, which have been violated in this case (Calnan, Badcott and Woolhead, 2006). The old patient’s personal identity, in this case, is violated because the nurse views him as part of the generalization of old people, which she considers senile. Nurses should exercise care in the true meaning of the word, which entails expressing compassion, empathy, and giving patients their rightful dignity and respect. Privacy and confidentiality are key aspects of respect that are overlooked in caring for older patients as evident in this case, where the nurse fails to cater for the old man even as he keeps saying that he wants to urinate. Nurses must realize that even the older patients deserve privacy and quality attention despite their physical or emotional state. Conclusion The attitudes of nurses towards elderly patients have direct effects on the physical and emotional condition of the patients. Negative attitudes and stereotypes affect a patient’s attitude in turn, which often leads to poor recovery or adherence to treatment. At the same time, negative attitudes by nurses toward elderly patients the quality of care they provide as it may lead to delayed medical attention, neglect, and abuse. Nurses should, therefore, strive to build trustworthy relationships with older patients by according them respect, autonomy and privacy as necessary to enhance nurse-patient relations. Nurses should be the source of positivity for patients, in order to ensure that the patients also adopt positive attitudes and are engaged in their own health care processes. 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