Patient Neglect Paper
Patient neglect, as described by Hem and Heggen (2018), is a caregiver’s failure to address the requirements of a dependent. They mirror public concern, with patients and families complaining about professional attitudes, transparency, and patient dignity. Patient neglect includes patients being regularly physically (e.g., left nutrient deficient, dehydrated, in pain, and unwashed) or emotionally (e.g., being overlooked whilst in need, not shown a sense of empathy, loss of dignity) neglect by healthcare staff (Hem & Heggen, 2018).
Due to the sometimes complicated situations of patients and their care, it is difficult to link patient neglect to particular measures of patient distress or therapeutic results. Furthermore, doing research is difficult owing to the toxicity of the issue, such as calling into question staff talents, motivation, and ethics, as well as a media narrative that aims to blame rather than explore why neglect treatment happens.
As a psychiatric nurse for 10 years, I know that most people think of hospitals as places where they go when they are in emotional, physical, or psychological distress. Psychiatric hospitals assist patients suffering from various mental diseases and function differently than other hospitals to better respond to these patients’ special requirements. Unfortunately, patients in mental facilities are more prone to neglect and abuse.
One of my biggest concerns as a psychiatric nurse at both academic and community medical institutions is patient neglect and abuse, which is evident in both nurses and physicians caring for the patient and among the patients themselves. My experience: I have 3 memorable experiences that I believe fall under psychiatric abuse and neglect from the staff.
In the first case patient was a 45-year-old Caucasian guy who was homeless at the time of his psychiatric hospitalization despite having supportive relatives. At the age of 13, he was diagnosed with schizophrenia. Severe behavioral issues (aggression) and a possible seizure condition were among the presenting symptoms. He suffered severe bilateral congenital hearing loss as well as a developmental language problem.
His mother was an alcoholic and drug addict who had rubella during pregnancy, which caused the patient’s sensory impairment. Because he couldn’t hear, the patient was cruelly abused and neglected during his hospital stay, and his aggressiveness was addressed with physical assault from the personnel. Since no nurse assisted the patient with ADL, he typically developed additional health concerns like eczema, foul body odor, tooth decay, and multiple body sores.
In the second case, the patient was a 16-year-old Caucasian man in the foster care system. The patient presented with noncompliance, regressive conduct, emotional instability, anxiety, dysphoria, and staring spells. The discharge diagnosis were atypical bipolar illness, mild mental retardation, and moderate bilateral hearing loss. He was sexually attacked frequently by fellow patients throughout his manic period of hospitalization. Oral and anal intercourse were both complaints of sexual abuse. The patient’s sexual abuse was revealed, but the nurses believed he was faking it.
The 3rd patient was a 44-year-old Caucasian guy who lived with his mother at home. Complaints included stereotypic behavior, social disengagement, and temper outbursts. He was diagnosed with severe depressive illness, borderline intellectual functioning, and expressive developmental speech impairment. The patient had experienced job loss, divorce, and the death of his only kid.
During his hospitalization, he lost motor capabilities and had classic tardive dyskinesia and speech. He was unable to eat and was bedridden. He received no physical treatment at the time and ended up acquiring severe bed sores that turned septic, finally leading to his death.
From the above cases, it is obvious that one threat unique to psychiatric hospitals is the threat of violence between patients. Patients in mental facilities may have behavior problems and hallucinations, which can lead to their becoming furious and aggressive (Reader & Gillespie, 2019).
While this aggression is occasionally aimed at staff members, it can also be directed at other patients, as seen in the second example. Psychiatric facilities have a duty to protect patients from danger, especially injury from other patients. Patients may be subjected to physical abuse by other patients, but sexual abuse among patients is also a severe concern.
Sexual violence can be avoided by separating male and female patients and isolating known sexual offenders. If psychiatric patients are abused or neglected, they frequently have nowhere to turn. Staff, governing authorities, and family members may not usually take their concerns seriously since they suffer from mental problems.
Describe Why This Situation Was Meaningful To Me
Abuse and neglect of mental patients are important to me as a psychiatric nurse since institutional systems, clinical settings, and healthcare worker behavior all affect patient safety. Interventions like team training, care packages, and skill validation help to decrease medical errors and enhance clinical outcomes that eventually curb neglect and abuse from staff.
Many practitioners and academics stress the significance of developing a nurse-patient connection in which nurses utilize themselves as therapeutic instruments. In psychiatric nursing, nurses must emphasize the relevance of interpersonal dynamics and therapeutic engagement. The concrete goals of the nurse-patient interaction are to investigate and become acquainted with the patient’s own knowledge of their current condition and history, as well as to contribute to the patient’s well-being and personal progress (Reader & Gillespie, 2019).
Furthermore, a healthy nurse-patient connection is regarded as a prerequisite for giving care, which is regarded as the fundamental essence of nursing. The primary professional traits that the nurse must demonstrate to avoid patient neglect are acceptance, affirmation, and generosity. Other considerations include the nurse’s ability to demonstrate empathy and identify the patient’s needs.
How I Felt About This Situation
The case shows an unacceptably high prevalence of abuse and neglect in psychiatrically hospitalized patients, confirming that psychiatric patients are especially vulnerable to neglect. These cases highlight the need for psychiatrists, psychologists, and other health care professionals to be diligent in detecting and acting in situations of neglect.
In earlier investigations, patients reported at least one episode of neglect by their psychiatric nurses. Patients are upset by nurses’ misuse of authority, use of restriction, and lack of support. Patients frequently develop the perception that nurses are ambiguous, aloof, and not physically or emotionally present when they want assistance.
Patients on the ward tend to feel lonely and acquire a sense of not belonging to the community, which is also a kind of neglect. As a result, patients appreciate nurses who are available, listen, kind, tolerant, and show respect (Reader & Gillespie, 2019).
The Challenge I Faced
Abuse and neglect detection in psychiatric patients is not often a formal component of inpatient evaluation. Although most hospital management teams are aware of these behaviors, neglect data is seldom gathered in a systematic and thorough manner (Belsiyal C., 2020).
Certain features of mental patients can make identifying neglect and abuse more challenging. For example, patients with cognitive deficits or who are nonverbal may be unable to communicate their neglect to others. It is also challenging to separate patient neglect from inadvertent error or purposeful abuse for practical and conceptual reasons (Reader & Gillespie, 2019).
This is because reports on neglect, such as the ones mentioned above, frequently allude to i) staff behaviors that may not directly cause patient harm, for example, not assisting patients to use the restroom, but are critical for care and most likely do not reflect a competency gap; ii) staff attitudes and behaviors toward psychiatric patients that cannot be controlled or accurately determined, like compassion; iii) a mix of correlational factors contributing to patient neglect, a number of which demonstrate neglect to be inadvertent, example, owing to a lack of resources or alternatively not related to error example, rudeness; iv) differing beliefs among patients, families, and staff as to whether neglect has occurred (Belsiyal C., 2020).
Evidenced-Based Interventions To Address The Clinical Situation And My Intervention
Interventions to address patient neglect correspond to the primary causal factors for the neglect. The most widely cited cause of patient neglect is heavy workloads (Ammerman et al., 2018). They frequently resulted in neglect by creating situations in which nurses did not have time to participate in ‘caring’ behaviors (e.g., listening to patients, reacting swiftly to their requests) or completing required chores (e. g helping patients with ADL).
Training is crucial for managing such workloads, as is recruiting extra employees for training (Reader & Gillespie, 2019). Healthcare personnel should also be put in positions of care for which they have received enough training (e.g., for managing complex patients).
Patient neglect is also caused by issues in interdisciplinary collaboration. Effective cooperation is required for sharing job responsibilities and coordinating tasks vital to patient care. Patient neglect can arise from staff communication problems or shared failures to detect or act on irregular or problematic parts of patient care.
According to patient safety studies, organizational and team leadership is very critical for setting norms of behavior and quality of care, and team leaders’ inability to create suitable standards for multidisciplinary healthcare teams frequently underpins inadequate care (Ammerman et al., 2018). Nursing and administrative leadership enhance the quality of care and patient happiness by clarifying goals, fostering open communication, and generating chances for improvement.
How the Situation Is Significant To Psychiatric Advanced Practice Nursing
psychiatric patient neglect is important to advanced practice nursing in that it impacts the efforts that directly focus on healing and discharge of patients from mental hospitals, leading to longer hospital stays. Incidences of neglect also impact the efforts of advanced practice mental health nurses to reduce forceful readmission of the patients as a previously neglected patient will not want to seek help during the many instances of relapsing (Belsiyal C., 2020).
The mental health act on neglect and the contribution of the national government in mobilizing current societal social services, psychological wellbeing, healthcare, educational, constitutional, and enforcement agencies systems to address the difficulties in the preventive measures and intervention of neglect are the insights I gained in relation to the PMHNP role from the cases of neglect I experienced (Reader & Gillespie, 2019).
I’ve also learned how to improve community engagement and the quality of care delivered to mental patients. I learned my professional duties and expectations in the prevention, detection, and treatment of mental health patient neglect from the case and my position as an APRN. I’ve also gained knowledge and improved my capacity to intervene successfully in patients’ lives.
Ammerman, R. T., Van Hasselt, V. B., Hersen, M., McGonigle, J. J., & Lubetsky, M. J. (2018). Abuse and neglect in psychiatrically hospitalized multi-handicapped children. Child Abuse & Neglect, 13(3), 335–343. https://doi.org/10.1016/0145-2134(89)90073-2
Belsiyal C., X. (2020). Abuse & neglect among mentally disabled. Community and Public Health Nursing, 1(2), 145–153. https://doi.org/10.21088/cphn.2455.8621.1216.14
Hem, M. H., & Heggen, K. (2018). Rejection–a neglected phenomenon in psychiatric nursing. Journal of Psychiatric and Mental Health Nursing, 11(1), 55–63. https://doi.org/10.1111/j.1365-2850.2004.00687.x
Reader, T. W., & Gillespie, A. (2019). Patient neglect in healthcare institutions: a systematic review and conceptual model. BMC Health Services Research, 13(1), 156. https://doi.org/10.1186/1472-6963-13-156