Preventing Hospital Acquired Infection - Nurses' Attitudes towards Elderly Patients - Essay Example

Preventing Hospital Acquired Infection Critical reflections are a vital approach to improving nursing critical thinking in the clinical situation. The nursing environment is changing and clinical reflections help nurses to evaluate and improve their practice (Bowden 2008). Clinical reflections are the self-critique that nurses undertake to evaluatehow they handles certain situations, to ensure continued competence in their practice (Williams 2001). The paper is a critically reflection on the issue of nurses’ attitudes towards elederly patients. The essay will follow the six stages of Gibbs model which are, “description, feelings, evaluation, analysis, conclusion and action plan” (Gibbs 1988). Description entails saying what happenned without making judgements or drawing conclusions. Feelings are about what the nurse’s reactions and feelings were in the situation. Evaluation entails looking at what was good or bad about the aituation by making value judgements. Analysis is about the sense that one can make out of the situation,conclusion entails making general as well as specific summary of the analyses of the situon. Lastly, action plan entails the steps to be taken inorder to avoid a similar situation imn future (Gibbs 1988). Negative nursing attitudes can impact on the quality of nursing care as was observed during the placement of a student nurse. In this past actual case, it was observed that a clinical nurse used harsh words and expressed “hateful looks” and distasteful remarks about “the smelling senescent patient”, when they were handing over to colleagues. The nurse ignored the elderly patient’s request for assistance when he reported having a headache, feeling cold and dizziness. After a while, the patient lost consciousness owing to acute hypoglycemia. Negative nursing attitudes have a significant impact on the quality of nursing care. This is especially so in the case of older patients seeing that in countries such as Australia, life expectancy is increasing and consequently the number of older patients (Courtney, Tong, and Walsh 2000). Negative attitudes towards elderly patients reflect ageism, and stereotypes that arise from a lack of knowledge, which in effect affect the quality of care given to the patients. Patient centered care for older patients is vital because older patients are greatly diversified in their care needs. Negative nurses’ attitudes thus, affect quality care as opposed to positive attitudes that enable quality care (Marshall 2010). In this case, the nurse’s attitude towards the older patient as seen through her hateful looks and indecent verbal address towards the older patient goes against the code of ethics for nurses in Australia. The first value statement of the code of ethics that the nurse violated was the requirement for all nurses to respect the needs of individuals, culture and vulnerability in providing nursing care (Australian Nursing Council Inc., 2002). In this case the nurse acted carelessly and irresponsibly especially in neglecting the aged patient’s pleas for nursing assistance as he complained of headache and dizziness. This is also in contravention of the value statement that nurses should uphold quality nursing care for all people (Australian Nursing Council Inc., 2002). Ageism affects nursing care negatively, as nurses provide offensive and poor treatment to older patients as in this case (Topaz and Doron, 2013). Research has shown that nurses who have negative attitudes and stereotypes towards older patients would prefer to work with younger patients. Ageism thus, leads nurses to mistreat older patients through restricting proper care in terms of drug administration and attention (Wai-Tong & Lee, 2007). As in this case, the nurse delayed to give the patient quick attention leading to acute hypoglycemia. At the same time, ageism causes nurses to disrespect the autonomy and dignity of older patients and to discriminate against them in regard to their physical state, such as in this case when the nurse referred to the patient as smelly. Negative nurses’ attitudes towards older patients bear significant impact on elderly care because a nurse could easily miss vital symptoms, leading to the worsening of a patient’s condition as in this case (Backrach- Lindstrom 2007). Research has indicated that the levels of knowledge about ageing have direct impact on ageism and how nurses treat older patients (Topaz & Doron 2013). In cases where nurses’ knowledge is limited, there are increased negative attitudes towards older patients, which lead to poor quality care. The words of a nurse can interfere with a patient’s perception of care by causing the patient to think negatively about the treatment they seek (Minding Your Medical Manners 2008). In the case discussed in tis essay, the nurses comments and attitudes towards the patient could lead to the patient not wanting to seek any more care from the health institution, because he will perceive himself as a bother. Negative attitudes by nurses in caring for aged patients directly affect the patient’s atitude toward treatment and recovery. At the same time, negative nurses’ attitudes affect patient aprticipation in their care and treatment (Larsson, Sahlsten, Segesten & Plos 2011). Even aged patients consider participation in their own care as a vital factor of health care. However, when a nurse makes negative comments as in this case, it causes the patient to feel powerless. According to Eldh, Ehnfors, and Ekman (2006), patients withdraw from participation when they feel disrespected, as well as when they perceive the nurse-patient relationship to be imbalanced such that the nurse yields all the power. In addition, patients are also less likely to participate when they are not given enough information about their care and treatment. Nurses’ negative atitudes toward older patients also have a significant impact on other health care professionals. This is especially so in the case of studnet nurses who would be easily influence to adopt similar attitudes and stereotypes about older people. As Lovell (2006) observes, nursing studnets easily acquire attitudes through observation of how other medical professional behave in the practice. In the same way, otherhealth professionals within the institution who heard the comment in this case may decline from offering appropriate care to aged apteints. The implications of negative nurses’ attitudes toward older patients are dire to the patients’ health care and well being. One of the implications is that there is a decrease in trust between the nurse and patient, which arises when the independence of aged patients is threatened by the nurses’ attitudes (Courtney, Tong, and Walsh 2000). In addition, the risk of older patients’ developing complications is high, because with negative attitudes, nurses cannnot provide quality care, assistance and urgent attention as was needed in this case. Another implication would be reduced autonomy and decsion making abilities for older patients because agesist stereotypes have nurses disregarding the patients’ ability and right to make their own decisions about their health care (Courtney, Tong, and Walsh 2000). As already established, nurses’ negative attitudes toward older patients result from lack of sufficient knowledge on the ageing process, and the care needs od older people (Higgins et al., n.d.). In the case discussed here, for example, it would be best tackled from a point of providing the nurse with appropriate education both in regard to code of conduct and the care of older patients. While it is important for the health institution not to let such a case of iresponsible and careless attitude to go unpunished, the longterm solution would be to rpovide education about caring for aged patients, to enable the nurses develop positive attitudes. Alsenany (2009) sugests that nursing education on caring for older patients should be entrenched in cultural perspecctives. This is because cultures in which emphasis is laid on providing quality care for older patients produce larger numbers of nurses with positive attitudes toward caring for these patients (Carter & Xu, 2007). Nurses are required to be continuously oriented with the appropriate manner in which to care for older patients. This ought to be in adherence to the guidance for the care of older people as adopted by the United Nations (Nursing & Midwifery Council n.d.). The guidance highlights people, especially nurses working directly with older patients, as vital in providing appropriate care for the patients. Some of the important aspects that nurses are required to uphold are empathy, compassion and kindness in caring for older patients (Nursing & Midwifery Council n.d.). This means that nurses must be emphasized to show understanding, help patients to make their situation better and being gentle, as opposed to the nurse in this case who was hostile and unkind toward the patient. Nurses should be empowered through their healthcare institutions to use critical reflections in order to lessen the impact of ageist stereotypes. Critical reflections will allow nurses to be aware of their personal negative attitudes toward older patients, and thus alter them to foster better care for the patients (Simkins 2007). This awareness can be promoted through active advocacy in nursing conferences, meetings and other clinical settings. In addition, Simkins (2007) suggests that nursing curriculums should include ageism awareness and positive cultivation of positive attitudes to ensure that nursing students become aware of the negative effects of ageism. Thus, they will be able to treat older patients accordingly to give them quality care. In light of a case such as the one highlighted here, advocacy for non-judgmental attitudes and respectful/ professional verbal address toward older patients is vital. There ought to be adequate supervision within health care institutions, to ensure that nurses adhere to the proper code of conduct (Simkins 2007). Besides, healthcare professionals should point out such negative attitudes in each other, to boost awareness and foster a change of attitude. In this particular case, the nurse’s colleague should have pointed out her negative attitude and perhaps even reported it to the supervisor to ensure that the nurse receives appropriate direction and training in dealing with ageist attitudes. Critical reflection is one of the fundamnetal approaches in dealing with negative attitudes and stereotypes that nurses have toward older patients. Critical reflections allow nurses to reflect on personal beliefs, attitudes and other influences that influence their ageist attitudes in their practice. As in the case highlighted here, the nurse who utered distatestful words to the older patient lack the awarenes to realize that what she was doing was unprofessional, irresponsible and careless. As established in the essay, nurses’ negative attitudes toward older patients affect the quality of care provided. This is because nurses are most likely to be blinded by their negativity and tus fail to acknowledge the genuine needs expressed by the patients. Besides, negative atitudes hinder the nurses from exercising compassion, empathy and kindness toward patients. Consequently, patients feel intimidated when nurses are aggressive toward them, because they feel that their independnece and decision making ability are disregarded by the nurses. This reduces patient participation in their own helth care, which often intereferes with efficient care and tretment and often leads to complications from otherwise treatable consitiosns. Ageist attitudes can be countered by increased awareness through critical reflections. This should be fostered through training to equip nurses with knowledge on the ageing process, the care needs of older patients and ageist stereotypes that lead to bias in caring for the patients. As a result, there will be improved nurse-patient relationhsip, patient autonomy will be upheld and utlimately there will be greater satisfaction amon older patients. References Alsenany, S., 2007. Student nurses’ attitudes and knowledge towards the care of older people in Saudi Arabia. British Society of Gorontology, [online].Available at: [Accessed 15 May 2013]. Australian Nursing Council Inc., 2001. Code of ethics for nurses in Australia. Available from: .[Accessed 15 May 2013]. Bachrach-Lindstrom, M.,Jensen, S., Lundin,R., and Christensson, L., 2006. Nutrition and Older People. Journal of Clinical Nursing, [e-journal] 2007-014. Avaiable through Ebsco Host website . [Accessed 15 May 2013]. Bowden, S.D., 2008. Enhancing your professional nursing practice through critical reflection, Abu Dhabi Nurse, Summer, pp. 28-31. Carter, K.,F., and Xu, Y., 2007. Addressing the hidden dimension in nursing education - promoting cultural competence. Nurse Educator, 32(4), pp. 149-153. Courtney, M., Tong, S.,  and Walsh, A., 2000. Acute-care nurses’ attitudes towards older patients: a literature review. International Journal of Nursing Practice, 6(2), pp. 62-69. Eldh, A.C., Ehnfors, M., and Ekman, I., 2006. The meaning of patient participation for patients and nurses at a nurse-led clinic for chronic heart failure.  European Journal of Cardiovascular Nursing, 5(1), pp. 45-53. Gibbs, G., 1988. Learning by Doing: A Guide to Teaching and Learning Methods. Oxford, Further Education Unit. Higgins, I., van der Riet, P., Slater, L. and Peek, C., n.d. The negative attitudes of nurses towards older patients in the acute hospital setting: A qualitative descriprive study, Contemporary Nurse, 26(2), pp: 225-237. Larsson,I.E., Sahlsten, M.J.M.,  Segesten, K., and  Plos, K.A.E., 2011. Patients' perceptions of nurses' behaviour that influence patient participation in nursing care: A critical incident study. Nursing Research and Practice, (2011), pp. 1-8. Lovell, M., 2006. Caring for the elderly: Changing perceptions and attitudes. Journal of Vascular Nursing, 24 (1), pp. 22-26. Marshall, L.C., 2010. Student’s corner: Potential implications of registered nurse attitudes towards caring for older people. Contemporary Nurse, 35(1), pp.95-99.   Marketing Health Services, 2002. Minding Your Medical Manners?[online]. Available at: [Accessed 15 May 2013]. Nursing & Midwifery Council, n.d. Guidance for the care of older people. Available from: [Accessed 15 May 2013]. Simkins, C.l., 2007. Ageism’s influence on health care delivery and nursing practice. Journal of Nursing Student Research, 1(1), pp: 24-28. Topaz, M., Doron, I., 2013. Nurses' attitudes toward older patients in acute care in Israel. OJIN: The Online Journal of Issues in Nursing, 18 (2). doi: 10.3912/OJIN.Vol18No02PPT01. Wai-Tong, C., & Lee, I. 2007. Psychiatric nurses' knowledge and attitudes toward the use of physical restraint on older patients in psychiatric wards. International Journal of Multiple Research Approaches, pp. 52-71. Williams, B., 2001. Developing critical reflection for professional practice through problem-based learning. Journal of Advanced Nursing, 34 (1), pp. 27-34. Read More