Flashcards in TERM 3- MY NOTES MENATL HEALTH NURSING CARE CH.4 "MENTALLY HEALTHY NURSING" Deck (101)
MENTALLY HEALTHY NURSING
Caring is concern for the well-being of another. It is a universal human phenomenon that exists in all cultures.
Attributes of Caring
Caring forms the foundation of nursing practice
The attributes of caring are "the five Cs"
These attributes of caring include commitment, which is a personal pledge to a course of action, such as the choice to be a professional nurse or to provide the care necessary to meet each client's needs.
Compassion involves sharing in the emotional stare of another. It includes empathy (trying to understand how another feels) and acceptance of others as they are (not necessarily as we wish them to be).
Competence is proficiency in understanding the principles underlying professional nursing practice and applying this knowledge to problem solving and decision making. It includes the ability to apply the nursing process.
Confidence (belief in oneself) fosters a trusting relationship. A nurse must have self-confidence in order to foster the trust of clients. When clients trust that the nurse has the ability to help with their problems, they have confidence in the nurse.
Finally, conscience is having an ethical conviction or belief about what is right and wrong and acting in accord with the ethics of the nursing profession
NURSES UNDER STRESS
Working as a nurse has always been challenging. Some of the challenges/stressors for nurses include the following:
The work- Nursing is hard work. Luckily we are not scrubbing floors anymore, but we work 8- to 12-bour shifts, around the clock (not to mention double shifts when we work overtime). The hospital is open and staffed by nurses 24 hours a day, 7 days a week. We lift, turn, and ambulate people who may be twice our size.
As the healrhcare delivery system changes, nurses are being expected to take responsibility for more clients who are more seriously ill and to delegate parts of their care to others. We also use more and more complex equipment to care for them.The work is exhilarating and rewarding. It can also be exhausting.
The profession-As healthcare professionals, we expect ourselves not only to "be there" for our clients, but to do an excellent job of caring for them. Our nursing role involves caring, applying the nursing process, reaching, participating in the therapeutic environment, cooperating with others, promoting prevention activities, humanizing client care, and advocating for clients. Meanwhile, our employer and our peers are evaluating us. They might say, "He is a really good nurse," or on a bad clay they might say something else. Their opinions marrer to us
The people-Nurses love people, of course. They are why we went into nursing. But people can be challenging. Physicians and coworkers can be demanding, impatient, critical, and frustrating. Sick people can be all these things also and so can their families. Sometimes family members feel powerless to help the client. They may become demanding and critical of nurses in an attempt to exert some control over the situation. Even when nurses know this, it is not easy to endure complaints and demands when we are working so hard to do our best. We know that we see clients at their worse, when they are in pain, anxious, or afraid. We try to make it easier for them, but they do not always recognize the contributions of nurses. Nurses are trying to please clients, families, coworkers, and supervisors. It is not easy (or possible) to keep everyone happy all the time.
The feelings-Nursing can be a heartbreaking profession. We see people die who should be alive and people for whom life itself seems a burden. Nurses work with people who are in the depths of suffering and grief. The clients see us, and we see ourselves, as the ones who come in to make a difficult or painful situation easier or more comfortable. Nurses ease human suffering, save lives, welcome babies into the world, and ease dying people our of it. Nurses really make a difference to people. What a great job! What a great responsibility!
We may lose our personal boundaries, the healthy limits people set on what is appropriate for them ro do. Without healthy boundaries, nurses do things for people that they should do for themselves.
An example is the nurse who calls in with an excuse for why her husband is sick when he really is drunk.
Another is the nurse who works several double shifts in a row because the hospital asks him to, even though he is exhausted. Saying "no" to unreasonable requests from others requires boundaries.
Another reason that nurses need healthy personal boundaries is for the maintenance of professional relationships. Potential areas of boundary crossing with clients are as follows ():
2. Gift giving
Codependency, paraphrasing Beattie (1992), is letting another person's behavior affect you and becoming obsessed with controlling that person's behavior. Codependents make it possible for others to avoid the consequences of their own maladaptive behavior, thus encouraging the behavior to continue.
Who are codependents? They are people who are in relationships with people who have substance abuse problems; they are people who love, care about, or work with troubled people
you may be in trouble wirh codependency:
• If concern has turned into obsession
• If compassion has turned into unhealthy care-taking
• If you are taking care of other people and not yourself
Codependents take on other people's responsibilities or enable people to avoid responsibility for their own behavior. In the classic example of codependency, a person worsens the substance dependency of a partner by making excuses, covering up problems, trying to control the partner, and allowing the habit to continue
The first step toward communicating and thinking in a healthy way is to recognize where the control is. Whose behavior can you control? Your child's? Your partner's? Your client's? The answer is none of these. Each of us only has real control over our own behavior.
Characteristics of Codependency
• feel responsible for other people's feelings, actions, well-being, and destiny.
• feel pity, anxiety, and guilt when other people have a problem.
• feel compelled to help other people solve their problems by giving unwanted advice, lots of suggestions, or"fixing their feelings."
• say yes when they mean no, do what they do not want to do, do more than their fair share of the work, and do things for other people that they can do for themselves.
• not know what they want or need or what their feelings are.
• try to please others instead of themselves.
• feel safest when giving and feel insecure and guilty when others give to them, rejecting compliments or praise.
• find themselves attracted to emotionally needy people and needy people attracted to them. • feel bored or useless if they do not have a crisis or problem to solve.
• feel stressed, pressured, and overcommitted.
• feel angry, victimized, and used and blame others for their difficult position and their feelings.
• come from troubled or dysfunctional families.
• think they are not good enough and expect themselves to be perfect.
• fear rejection, especially if they show anger.
• have difficulty making decisions. • get artificial feelings of self-worth from helping others.
• wish other people would like and love them and settle for being needed.
• focus all their energy on other people and their problems.
• wonder why they never get things done.
• feel controlled by events and people, especially other people's anger.
• ignore problems or pretend they are not happening.
• overeat, or cry a lot, get depressed, get sick, act hostile, or have temper outbursts.
• believe lies.
• not love or feel content with themselves.
• lie to protect and cover up for people they love.
• have difficulty asserting their rights and expressing their feelings honestly and openly.
• let others hurt them.
• not trust themselves or others.
• have difficulty having fun.
• not seek help because they tell themselves that the problem is not bad enough or they are not important enough.
These codependent characteristics contribute to problems with dependency, low self-esteem, unhealthy caregiving, obsessiveness, weak personal boundaries, poor communication, lack of trust, anger, and problems with intimacy, including sex.
Sick organizations undervalue the caregiver and emphasize financial and administrative functions. They demand more and more of nurses, who, because of their nature, give more and more. Codependency and weak personal boundaries set nurses up to be used and abused
Nurses' workload is directly associated with the mortality rate of clients
What do you get when you combine caregivers, codependency, weak personal boundaries, unhealthy organizations, and ever-increasing demands? The answer is burnout