Working on the neurology/neurosurgery
Working on the neurology/neurosurgery
Working on the neurology/neurosurgery floor for three years provided me the opportunity to see and observe undesirable health care practices and behaviors. At the same time, it gave me the chance to correct them. One undesirable practice that nurses often leave unnoticed is giving post-operative patients too much pain medications that hinder them from functioning cognitively and limit their mobility. I have cared for patients who underwent brain and spine surgeries, both young and old, who ended up in an extended care facility or inpatient rehab due to decreased mobility and functioning upon therapy evaluation. Possible causes can include too much pain medication, making the patient drowsy and uncooperative during evaluation, and failure of the staff to provide early ambulation. Some patients are afraid to walk because of pain and choose to stay in bed instead.
To replace this unhealthy behavior, I have realized that it is much better to let the patient endure the pain and ambulate them rather than keeping them in bed all day. Giving pain medications not strong enough to make them sleepy and loopy, offering nonpharmacological means of pain relief, and providing motivation can get patients functioning while staying on top of their pain. These strategies can decrease their hospital stay, medical cost, and hospital-acquired diseases.
Undesirable behavior can be changed through the principles of learning theory. Behaviorist learning theory generally ignores what goes on inside the individual by observing the responses to a situation and then manipulating the environment in some way to bring about the intended change (Bastable, 2019). This learning theory focuses on what is discernable by creating a motivation to generate learning and positive responses. Motivating the patient to ambulate and observing the positive responses it created spawns a behavior and learning that focuses on ambulation rather than medication, giving the patients the mobility they require to go home. Cognitive learning theory can also be applied to change undesirable behavior. While behaviorists generally ignore what is going on inside the individual, cognitive learning theorists stress the importance of what goes on inside the learner (Bastable, 2019). Emphasis is on the goal and understanding of the learner to change behavior. The patient’s past experiences and attitudes towards pain must be considered.
Changing an undesirable behavior in healthcare is challenging as it involves various factors to be effective and successful. The different patient population has complex needs. Based on my experience, the younger population, especially males, have low pain tolerance after a brain or spine surgery, requiring more pain medications as usual.
