Abstract
BackgroundCaring practice in nursing homes is a complex topic, especially the challenges of meeting the basic needs of residents when their behaviour evokes difficult emotions. Cognitive and physical changes related to aging and disability can contribute to behaviours considered to be unacceptable. For example, resident behaviours such as spitting, making a mess with food or grinding teeth are behaviours that most people do not want to see, hear or experience. The aim of this study was to gain a deeper understanding of how nursing home staff members deal with such behaviours in care situations.MethodsThis article draws on ethnographic data to describe how nursing home staff members manage unpleasant resident behaviours. The study was based on two long-term units in two Norwegian public nursing homes. The Region’s Medical Ethics Committee and the Norwegian Social Science Data Services granted approval. In total, 45 participants (37 nursing aides and eight nurses) agreed to participate in this study. Ten of the participants were interviewed at the end of the field study.ResultsThis study indicates that nursing home staff members experience difficult emotions related to some residents’ behaviours. However, they found these feelings difficult to express and rarely verbalized them openly. In addition, they were characterized by a strong obligation to help all residents, despite their own feelings. Therefore, it appears that an inner struggle occurs as a part of everyday practice.ConclusionsDespite these difficult emotions, nursing staff members believed that they needed to manage their responses and continued to offer good care to all residents. These findings extend our understanding of this unarticulated part of nursing home practice.
Highlights
Caring practice in nursing homes is a complex topic, especially the challenges of meeting the basic needs of residents when their behaviour evokes difficult emotions
Here we report findings from an ethnographic study of nursing home practice, which is often described as complex, [1, 2] even though it might be regarded as consisting of common everyday activities [3]
We were not focused on difficult emotions such as aversion when entering this field; it became important for us to investigate further when it appeared that such emotions were a challenge for staff members
Summary
Caring practice in nursing homes is a complex topic, especially the challenges of meeting the basic needs of residents when their behaviour evokes difficult emotions. Most residents in nursing homes suffer from cognitive and physical impairments associated with ageing and disability This might contribute to behaviours considered to be socially unacceptable, such as incontinence and assaulting staff members. Soiling can be a problem when a resident spits or makes a mess with food, and residents might display annoying behaviours, such as grinding their teeth. These are unpleasant behaviours that people in most cultures do not want to see, hear or experience [9, 10]. Nursing tasks dealing with others’ bodies and bodily excretions have been categorized as ‘dirty work’ [11,12,13,14]
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