University Nursing Discussion: Elderly Patient Risks and Bullying

This essay presents a detailed discussion on two significant nursing issues: the risks faced by elderly patients during hospitalization and the problem of bullying in the nursing workplace. The first part of the essay highlights the various risks associated with elderly patients, including delirium, bedsores, medication side effects, malnutrition, infections, and immobility, along with preventive strategies like improved mobility, medication management, and increased nurse availability. The second part focuses on nurse bullying, describing its common signs, the stressors in the nursing workplace, and strategies to manage personal and professional stress. The essay emphasizes the importance of addressing these issues to improve patient outcomes and create a healthier work environment for nurses, drawing on relevant research and providing practical solutions for both areas.

Running head: DISCUSSION ON SOME NURSING ISSSUES
DISCUSSION ON SOME NURSING ISSSUES
Name of the Student
Name of the University
Author Note

1
DISCUSSION ON SOME NURSING ISSSUES
Table of Contents
Discussion 1:....................................................................................................................................2
Introduction:................................................................................................................................2
Discussion:...................................................................................................................................2
The risks involved in elderly hospitalised patients:.................................................................2
Prevention strategies involved:................................................................................................3
Conclusion:..................................................................................................................................4
Discussion 2.....................................................................................................................................5
Nurse Bullying:............................................................................................................................5
Common signs of bullying in nursing:....................................................................................6
Common stressors in nursing workplace:....................................................................................6
Strategies to manage personal and professional stress:...............................................................7
References:......................................................................................................................................8

2
DISCUSSION ON SOME NURSING ISSSUES
Discussion 1:
Introduction:
Hospitals are occupied with an increasing number of elderly patients confronting risk of
adverse events in the course of hospitalization. Older adults are most probable to get hospitalized
because of acute health events, compared to other age groups. There is a need of constant
monitoring of the Geriatric risk to identify the patients who are confronted to risk. This indicates
a decline in performing daily activities because of reduced functioning of physical, emotional or
cognitive functioning.
Discussion:
The healthcare system needs to be upgraded targeting an improved treatment and health
outcome of the patients. Hospitalization can led to unnecessary complications irrelevant to the
problem for which the patient was admitted. The elderly patients are usually susceptible to
diminishing appetite, an increasing risk of medication side effects, decline in oxygen capacity,
reduced bone density, immobility and delirium.
The risks involved in elderly hospitalized patients:
 Delirium occurs to older patients who are over 65 years of age and a high
percentage of older patients are from intensive care units. Delirium occurs as a
result of acquaintance to new medications, disruption in normal routines including
insufficient sleep.
 There is a probability of bed sore or pressure ulcers that can happen if the patient
cannot reposition himself or unable to move and continuously fixed in one
position on the bed.

3
DISCUSSION ON SOME NURSING ISSSUES
 Older patients may have multiple medical conditions and therefore needs the
attention of multiple specialists.
 Strong medications are likely to have adverse side effects and new medications
can increase the chance of side effects.
 Older patients can also have malnutrition and diminished appetite that can further
can cause slow recovery.
 There is an increasing chance of getting hospital infections including MRSA and
pneumonia that are most common in hospitals and can led to serious infections
making the situation complex and harder to treat.
 Throughout the pre-, peri- and post-operative periods, some aspects like patient
blood management principles help to improve the health outcomes of geriatric
patients.
 New interdisciplinary geriatric models including geriatric and orthopedic
specialties needs to be recognized for taking care of the special requirements of
geriatric patients.
Prevention strategies involved:
Long stay on bed can cause bed sore or pressure ulcer. Immobility can also cause
delirium in older adults and weakens the patients that can be a risk factor for fall of the older
patients. Improved mobility should be considered an important aspect and should be started right
from the patient’s admission at the emergency department and encouraging the patients to use a
bedside commode or by assisting the patient to the bathroom instead of providing urinal or
bedpan. There is a huge responsibility of nurses in this area because they are the ones assisting
help to the patients. The number of new medication introduced should be minimized

4
DISCUSSION ON SOME NURSING ISSSUES
significantly. The chance of adverse effect increases with an increase in medications or making it
greater than 85 % (Lee, 2013). The availability of nurses should be increased to constantly
monitor and treat the patients with quality care. The rate of physiotherapy should also be
increased to get better health outcome of the hospital patients (Gronewold, Dahlmann, Jäger&
Hermann, 2017).
Conclusion:
The treatment and care provided during hospitalization mainly focuses on the therapeutic
and diagnostic interventions that aim at treating acute illness. The geriatric care must not
overlook the corresponding geriatric illnesses associated with them. Resource management in
hospitals is important in providing the right care to the patients and selection of patients must
correlate with the resource availability of a particular hospital.

5
DISCUSSION ON SOME NURSING ISSSUES
Discussion 2:
Annoying co-workers are a reality of life. They intend no damage, but they can lead us
battle, making our real work harder than it requires to be. Nevertheless, we must know how to
press anger and do the job.
During my placement as a nurse, I was constantly bullied and criticized by my peers.
They interfered with almost everything I did. They criticized my decisions and actions. They
even laughed at me whenever I did something wrong and insulted me in front of others. I did not
complain and brought this matter into my supervisor’s attention because I did not want them to
suffer because of me. I used to get upset and unwilling to go to work. The incidents had a major
impact on my work and I realized I was unable to concentrate on my job. As a result, I was even
scolded by my supervisor that made me losing up confidence related to work. I was feeling
restless and helpless. However, with time, I learnt how to deal with them once I got really good
appreciation from my supervisor because of saving a patient’s life by preventing a major error
that could have happened due to lack of attention by a doctor. That one incident triggered my self
esteem and actually helped me realizing my strengths and capabilities. It was the time I decided
to take actions against them, not verbally, or taking revenge, rather responding through my
actions by demonstrating my patience, not showing them how much I am annoyed and keeping a
gentle smile on my face. These not only boosted my confidence, but also, helped me in
confronting these issues.
Nurse Bullying:
Nursing bully is inevitable and cause unnecessary stress in the workplace. The workplace
of the nursing organization was recognized as one where harassment takes place quite frequently.

6
DISCUSSION ON SOME NURSING ISSSUES
Relational violence (psychological factors such as harassment and bullying) is believed to be
important in this context. Some wellness organizations seek to inform employees and wellness
group members on how to enhance personal relationships, the proper business etiquettes and
promote beneficial workplace abilities. In fact, communication and cooperation are primarily
measures towards improving the capacity of nursing staff employees to engage in skilled
interactions with peers as well as with the patients.
Common signs of bullying in nursing:
 The person makes unwarranted remarks and comments in any situation.
 Excessive and angry cussing at peers
 Unnecessary shouting and intimidation while conversing
 emotional/verbal abuse
 A constant criticism and harassment is noted
 Spreading harsh rumors and gossip
 Suppression of necessary information about a patient or a change in the work
environment (Ariza-Montes, Muniz, Montero-Simó & Araque-Padilla, 2013)
Common stressors in nursing workplace:
The working environment is one of the common and most important source of
occupational stress. Intrapersonal relationship also matters in workplace and staff conflicts can
cause additional stress. Occupational stress can also cause as a reason of variety of factors
relating to workload when there is a nursing shortage (ArashNajimi, 2019).

7
DISCUSSION ON SOME NURSING ISSSUES
Strategies to manage personal and professional stress:
The American Holistic Nurses’ Association offers solutions that companies can introduce
to decrease stress among nurses that includes:
 Having stress management programs making available for the staff members
including nurses.
 Conducting regular staff meetings.
 Offer flexible staffing arrangements.
 Provide regular in-service/education programs that permit staff to stay well-informed
of the changes in healthcare (Holistic Stress Management for Nurses, 2015).

8
DISCUSSION ON SOME NURSING ISSSUES
References:
ArashNajimi, G. (2019). Causes of job stress in nurses: A cross-sectional study. PubMed Central
(PMC).
Ariza-Montes, A., Muniz, N., Montero-Simó, M., &Araque-Padilla, R. (2013). Workplace
Bullying among Healthcare Workers. International Journal of Environmental Research
and Public Health, 10(8), 3121-3139. doi:10.3390/ijerph10083121
Deandrea, S., Bravi, F., Turati, F., Lucenteforte, E., La Vecchia, C., &Negri, E. (2013).Risk
factors for falls in older people in nursing homes and hospitals. A systematic review and
meta-analysis. Archives of gerontology and geriatrics, 56(3), 407-415.
Gronewold, J., Dahlmann, C., Jäger, M., & Hermann, D. (2017). Identification of hospitalized
elderly patients at risk for adverse in-hospital outcomes in a university orthopedics and
trauma surgery environment. PLOS ONE, 12(11), e0187801.
doi:10.1371/journal.pone.0187801
Holistic Stress Management for Nurses. (2015, May 27). Retrieved from American Holistic
Nurses Association
Lee, E. (2013). Making Hospitals Safer for Older Adults: Updating Quality Metrics by
Understanding Hospital-Acquired Delirium and Its Link to Falls. The Permanente
Journal, 32-36. doi:10.7812/tpp/13-065