Nursing Medical Patients: An Analysis of Problems Encountered by Student Nurses in Caring for Them

Abstract

BOUT four years ago it occurred to me that, although from the questions asked by the students nursing patients on the medical wards, I had a vague idea of the problems which they were encountering, I had no tangible record of those problems. I thought if I had such a record I might know better what student nurses needed in a course in medical nursing. To get a record of the problems in nursing various medical diseases I inserted the following question in the case report outline: What difficulties did you encounter in nursing this patient? As there were only a few reports coming in each year they have been saved, and this year an advanced student in medical nursing tabulated the problems. The reports were first divided, according to diagnosis, into studies in circulatory diseases; in respiratory diseases; in diabetes; in Basedow's disease; in gastrointestinal disease; and in nervous diseases. The problems were taken from the reports and under each disease they were classified into nursing problems and personality problems. Both of these classifications are more or less arbitrary. If the patient had more than one disease, the report was classified under the disease being treated. The classification into nursing and personality problems was even more difficult as personality lies at the bottom of so many nursing problems. There may be a wide difference of opinion as to where certain problems are to be placed. For instance, language difficulty has been included as a nursing problem in cases where sign language is inadequate in giving necessary instructions to the patient, but in reality the problem of dealing with a person who does not speak English, is a personality problem. These problems represent only those of bedside care for the patient, and do not include any problems due to inadequate supplies on the ward, inconveniences of nursing in an old hospital, or any problems of ward management. All the reports have been made by young student nurses doing bedside care of medical patients. They probably do not include all of the problems of bedside nursing, as the number of cases is small and it may' be that the nurse has not recognized all the problems she encountered. The cases are