The Nurse-Patient Encounter: Attitudes and Behaviors in Action

Publisher Website
Google Scholar
Abstract
The articles prior to January 2008 are part of the back file collection and are not available with a current paid subscription. To access the article, you may purchase it or purchase the complete back file collection here Caroline M White That attitudes are important to the quality of nursing care has long been recognized. The purpose of this paper is to explore various thoughts on the attitudes of nursing persons and their impact on patients. This paper is specifically addressed to nurses who care for older patients; but, the broad concepts are equally relevant for nurses in other settings. Frameworks selected from nursing and other literature for their relevance for nurses as they go about their work will be presented. A general proposition about attitudes and behaviors will be developed. Specific research findings relating patient characteristics to attitudes of nursing persons will be shared, and some implications for the organization and delivery of nursing care will be suggested. Before discussing attitudes and behaviors, it may be desirable to construct a context in which to view the nursing encounter. Nursing persons (nurses and nursing aides) interact with patients within a health care environment. Often, this is within the walls of an institution (hospital or nursing home). The quality of this environment influences the nursing person and the patient. And, the actions of the patient and nursing person are influenced by the attitudes and actions of each other. Figure 1 presents this schematically. The patient-nurse encounter is conceptualized as a result of the interplay of a number of factors. These are associated with the patient, the nursing person, and the environment within which the encounter occurs. The environment is important in terms of its expectations of the nursing person, the rewards which it offers, and the educational and other supports it gives to increase quality of care. The actions (behaviors) of the nurse reflect both her own attitudes and knowledge and the influence of the environment upon her. Attitudes: What Are They? Attitudes can be defined as the affective and cognitive responses which we have for an object or stimulus. They can be described as responses which reflect attraction or repulsion. The stimulus may be an idea, a mountain, a person, rain falling, the immediate situation. In response to the stimulus, we have feelings (affect) and knowledge (cognition) about it. We try to fit our new experience with past experiences. We try to make sense of what is occurring. One output of this process is redefinition of the stimulus in terms of our new experience with it. Thus, attitudes should not be viewed as "fixed" or permanent. Attitudes of nursing persons come from their previous experiences. Some of these experiences are those of living life in our society, being a part of a family, reading, going about in the world. Some of the experiences are special ones gained during the processes of education and training for work as a nursing person. A pertinent example of this centers on our attitudes toward older persons. In our society there are many negative attitudes toward the aging. We tend to segregate the aged; we tend to become impatient with their ways of doing things; and, we become worried for ourselves when we see older persons not able to do the things or lead the kind of life which we want to lead for ourselves. We also have positive attitudes - love, respect, desire for the health and well-being of the older members of our families. It is hoped that our attitudes will become more favorable as programs and opportunities for older persons reduce the negative impact of aging. With respect to attitudes of nursing persons, educational experiences for nursing students are being planned so that students will come to have, or have re-affirmed, positive attitudes toward the aging, and we are beginning to be able… 10.3928/0098-9134-19770501-05