Abstract

It is often assumed that nursing care is given in response to the patient's degree of incapacity. This study indicates that rather than nursing care arising as a response to patients' dependency, nursing care is producing dependency. A considerable proportion of the measured dependency of 168 elderly patients arose from the type of nursing care they received--it was iatrogenic. Task allocation nursing was found to be positively unhealthy for elderly long-stay patients, whilst individualized care (nursing process) was associated with lower patient dependency, a shorter hospital stay and a better chance of surviving the hospital stay. The findings demonstrate the inadequacy of nurse staffing formulas which are based on patient dependency. It is suggested that despite the rising numbers of very old people in the population, the elimination of nurse-induced dependency could reduce the level of dependency in geriatric wards.

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