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Normalization of Neglect: A Grounded Theory of RNs’ Experiences as Family Caregivers of Hospitalized Seniors

Published online by Cambridge University Press:  25 May 2016

Tarnia Taverner*
Affiliation:
School of Nursing, University of British Columbia
Jennifer Baumbusch
Affiliation:
School of Nursing, University of British Columbia
Priscilla Taipale
Affiliation:
St. Paul’s Hospital, Vancouver
*
*La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Dr. Tarnia Taverner, Ph.D., MSc, RN Clinical Associate Professor, School of Nursing University of British Columbia T201-2211 Wesbrook Mall Vancouver, BC V6T 2B5 (Tarnia.Taverner@fraserhealth.ca)

Abstract

Often older people, while maintaining a level of independence, rely on family members to provide care and assistance. Caregivers who are also registered nurses (RNs) may provide a different perspective around the experience when their older relative is admitted to acute care. The aim of our research was to investigate and develop theory regarding nursing care provision as described by RNs, who were family caregivers to older adults, when that older adult was admitted to acute care. Over a six-month period in 2011, RNs meeting this criterion (n = 12) were interviewed individually. We identified two central categories: “Culture of Neglect” and “Vigil by the Bedside”. The core category “Normalization of Neglect” was identified as the theory, grounded in the data the participants provided which described a culture of neglect that had normalized poor nursing care. These findings highlight the issue of neglect and abuse, and further investigation is warranted.

Résumé

Souvent le personnes plus âgées, tout en maintenant un certain niveau d’indépendance, comptent sur les membres de leur famille de fournir des soins et de l’assistance. Les aidants naturels qui sont aussi des infirmières autorisées (IA) peuvent fournir une perspective différente de ce qui est vécu quand leur parent âgé est admis aux soins aigus. Le but de notre recherche était d’étudier et de développer une théorie relative à la prestation de soins infirmiers, comme décrit par les IA, qui étaient les aidants naturels pour les adultes plus âgés, lorsque cette personne âgée a été admis aux soins actifs. Pendant une période de six mois en 2011, les infirmières autorisées qui ont satisfait ce critère (n = 12) ont été interrogées individuellement. Nous avons identifié deux categories centrales: “Culture de la negligence” et “Veille par le chevet.” La catégorie de base “de la Normalisation de la Négligence» a été identifié comme la théorie, fondée sur les données que les participants ont fournies qui décrivaient une culture de la négligence qui a normalisé les soins infirmiers de qualité inférieure. Ces résultats mettent en évidence la question de la négligence et de l’abus, et une enquête plus approfondie est justifiée.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2016 

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References

Aiken, L., Sloane, D., Clarke, S., Poghosyan, L., Cho, E., You, L., et al. (2011). Importance of work environment on hospital outcomes in nine countries. International Journal of Quality Health Care, 23, 357364.CrossRefGoogle ScholarPubMed
Aiken, L., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., et al. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet, 383, 18241830.Google Scholar
Allen, D. (2000). Negotiating the role of expert carers on an adult hospital ward. Sociology of Health and Illness, 22(2), 149171.CrossRefGoogle Scholar
Appleton, J. (1995). Analyzing qualitative interview data: Addressing issues of validity and reliability. Journal of Advanced Nursing, 22, 993997.CrossRefGoogle Scholar
Armstrong, P., & Armstrong, H. (2004). Thinking it through: Women, work and caring in the new millennium. In Grant, K., Armaratunga, C., Armstrong, M., Boscoe, M., Pederson, A., & Willson, K. (Eds.), Caring for/caring about: Women, home care and unpaid caregiving (pp. 544). Aurora, ON: Garamond Press.Google Scholar
Auslander, G. (2011). Family caregivers of hospitalized adults in Israel: A point prevalence survey and exploration of tasks and motives. Research in Nursing & Health, 34, 204217.CrossRefGoogle Scholar
Bauer, M., & Nay, R. (2003). Family and staff partnerships in long-term care. Journal of Gerontological Nursing, 29, 4753.CrossRefGoogle ScholarPubMed
Borland, S. (2011, March 21). Sleeping on the job and incompetent: Complaints about nurses double in just two years. Daily Mail. Retrieved from http://www.dailymail.co.uk/health/article-1368271/Sleeping-job-incompetent-Complaints-nurses-double-just-years.htmlGoogle Scholar
Braunschweig, C., Gomez, S., & Sheean, P. (2000). Impact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days. Journal of the American Dietetic Association, 100, 13161322.Google Scholar
Brown, A & Draper, P. (2002). Accommodative speech and terms of endearment: Elements of a language mode often experienced by older adults. Journal of Advanced Nursing, 41(1), 1521.Google Scholar
Campbell, D. (2011, February 22). Hospital patients complain of rude staff, lack of compassion and long waits. The Guardian. Retrieved from http://www.theguardian.com/society/2011/feb/23/hospital-patients-rude-staff-long-waitsGoogle Scholar
Castledine, G., Grainger, M., & Close, A. (2005). Clinical nursing rounds part 3: Patient comfort rounds. British Journal of Nursing, 14(17), 928930.CrossRefGoogle ScholarPubMed
Care Quality Commission. (2011). Dignity and nutrition inspection programme. London, England: Author.Google Scholar
Chenitz, W., & Swanson, J. (1986). Getting started: The research proposal for a grounded theory study. In Chenitz, W. C. & , J. M. (Eds.), From Practice to Grounded Theory (pp. 315). Menlo Park, CA: Addison Wesley.Google Scholar
Clissett, P., Porock, D., Harwood, R. H., & Gladman, J. R. F. (2013). Experiences of family carers of older people with mental health problems in the acute general hospital: a qualitative study. Journal of Advanced Nursing, 69(12), 27072716.CrossRefGoogle ScholarPubMed
Corbin, J., & Strauss, A. (2008). Basics of qualitative research: Grounded theory procedures and techniques (3rd ed.). Thousand Oaks, CA: Sage.Google Scholar
De la Rue, M. (2003). Preventing ageism in nursing students: An action theory approach. Australian Journal of Advanced Nursing, 20, 814.Google Scholar
Desbiens, N., Mueller-Rizsner, N., Virnig, B., & Lynn, J. (2001). Stress in caregivers of hospitalized oldest-old patients. Journal of Gerontology: Medical Sciences, 56A, M231M235.Google Scholar
Eaves, Y. (2001). A synthesis technique for grounded theory data analysis. Journal of Advanced Nursing, 35(5), 654663.Google Scholar
Elliott, R., Fischer, C., & Rennie, D. (1999). Evolving guidelines for publication of qualitative research studies in psychology and related fields. British Journal of Clinical Psychology, 38, 215229.Google Scholar
Francis, R. (2013). Report of the Mid Staffordshire NHS foundation trust. Public inquiry. Executive Summary. London, England: The Stationery Office.Google Scholar
Gallagher, A., & Seedhouse, D. (2002). Dignity in care: The views of patients and relatives. Nursing Times, 98(43), 38.Google ScholarPubMed
Gallagher, A., Li, S., Wainwright, P., Rees Jones, I., & Lee, D. (2008). Dignity in the care of older people—A review of the theoretical and empirical literature. BMC Nursing, 7(11), 112.Google Scholar
Giles, T. M. & Hall, K. L. (2013). Qualitative systematic review: The unique experiences of the nurse-family member when a loved one is admitted with a critical illness. Journal of Advanced Nursing, 70(7) 14511464 doi: 10.1111/jan.12331Google Scholar
Glaser, B., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. New York, NY: Aldine.Google Scholar
Goergen, T. (2001). Stress, conflict, elder abuse and neglect in German nursing homes: A pilot study among professional care givers. Journal of Elder Abuse and Neglect, 13, 126.Google Scholar
Health Advisory Service. (2000). Not because they are old: An independent inquiry into the care of older people. London, England: Help the Aged.Google Scholar
Herr, K., & Garand, I. (2001). Assessment and measurement of pain in older adults. Clinics in Geriatric Medicine, 17, 457478.CrossRefGoogle ScholarPubMed
Hertzberg, A., & Ekman, S. (2000). “We, not them and us?” Views on the relationships and interactions between staff and relatives of older people permanently living in nursing homes. Journal of Advanced Nursing, 31(3), 614622.CrossRefGoogle Scholar
Higgins, I., Van DerRict, P., Slater, L., & Peck, L. (2007). The negative attitudes of nurses towards older patients in the acute hospital setting: A qualitative descriptive study. Contemporary Nurse, 26, 225237.CrossRefGoogle ScholarPubMed
House of Commons; House of Lords. (2006, 2007). Joint committee on human rights eighteenth report—Treatment of older people in hospitals and care homes. London, England: Publications Parliament UK.Google Scholar
Jewkes, R., Abrahams, N., & Mvo, Z. (1998). Why do nurses abuse patients? Reflections from South African obstetric services. Social Science and Medicine, 47, 17811795.Google Scholar
Jootun, D., & McGhee, G. (2009). Reflexivity: Promoting rigor in qualitative research. Nursing Standard, 23, 4246.Google Scholar
Kelly, B. (1991). The professional values of English nursing graduates. Journal of Advanced Nursing, 16(7), 867872.Google Scholar
Keogh, B. (2013). Review into the quality of care and treatment provided by 14 hospital trusts in England: Overview report. National Health Service UK. Retrieved from http://www.nhs.uk/NHSEngland/brucekeoghreview/Documents/outcomes/keogh-review-final-report.pdfGoogle Scholar
Kyle, U., Unger, P., Mensi, N., Gneton, L., & Pichard, C. (2002). Nutrition status in patients younger and older than 60 years at hospital admission, a controlled population study in 995 subjects. Nutrition, 18, 403409.Google Scholar
Lachs, M., & Pillemerk, K. (1995). Abuse and neglect of elderly persons. New England Journal of Medicine 332, 437443.Google Scholar
Landi, F., Onder, G., & Cesari, M. (2001). Pain management in frail community-living elderly patients. Archives of Internal Medicine, 161, 27212724.Google Scholar
Laurance, J. (2011, May 25). Hospital patients ‘left so thirsty doctors had to prescribe water’. London, England: The Independent. Retrieved from http://www.independent.co.uk/life-style/health-and-families/health-news/hospital-patients-left-so-thirsty-doctors-had-to-prescribe-water-2289098.htmlGoogle Scholar
Li, H. (2005). Hospitalized elders and family caregivers: A typology of family worry. Journal of Clinical Nursing, 14, 38.CrossRefGoogle ScholarPubMed
Li, H., Stewart, B., Imle, M., Archbold, P., & Felver, L. (2000). Families and hospitalized elders: A typology of family care actions. Research in Nursing and Health, 23, 316.3.0.CO;2-U>CrossRefGoogle Scholar
Lindhardt, T., Bolmsjo, A., & Hallberg, I. (2006). Standing guard—Being a relative to a hospitalized, elderly person. Journal of Aging Studies, 20, 133149.CrossRefGoogle Scholar
Lomas, C. (2012). One year on: The campaign for better care. Nursing Standard, 27(13), 2023.Google Scholar
Lowson, E., Hanratty, B., Holmes, L., Addington-Hall, J., Grande, G., Payne, S., et al. (2013). From ‘conductor’ to ‘second fiddle’: Older adult care recipients’ perspectives on transitions in family caring at hospital admission. International Journal of Nursing Studies, 50, 11971205.Google Scholar
Marcellus, L. (2005). The grounded theory method and maternal-infant research and practice. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 34, 349357.Google Scholar
Mays, N., & Pope, C. (1995). Rigor and qualitative research. British Medical Journal, 311, 109112.Google Scholar
McDonald, L., & Collins, A. (2000). Abuse and neglect of older adults: A discussion paper. Family Violence Prevention Unit. Ottawa, ON: Health Canada.Google Scholar
Meade, C., Bursell, A., & Ketelsen, L. (2006). Effects of nursing rounds. American Journal of Nursing, 106(9), 5870.Google Scholar
Murphy, E., Dingwall, R., & Greatbach, D. (1998). Qualitative research methods in health technology assessment: A review of the literature. Health Technology Assessment, 2, 167198.Google Scholar
Neno, R. (2004). Male caregivers: Myth or Reality? Nurse Older People, 16(8), 1416.Google Scholar
Nurses Improving Care for Hospitalized Elders (2013a). NICHE hospitals near you. Retrieved from http://www.nicheprogram,org/find_a_niche_hospital near youGoogle Scholar
Nurses Improving Care for Hospitalized Elders (2013b). Program Overview. Retrieved from http://www.nicheprogram.org/program_overviewGoogle Scholar
Patients Association England. (2011). Listening to patients, speaking up for change. Care Campaign. Retrieved from http://www.patients-association.com/Default.aspx?tabid=237Google Scholar
Phelan, A. (2010). Socially constructing older people: Examining discourses which can shape nurses’ understanding and practice. Journal of Advanced Nursing, 67(4), 893903.CrossRefGoogle ScholarPubMed
Quality Care Commission. (2007). Adult in-patient survey. London, England: Department of Health. Retrieved from https://www.gov.uk/search?tab=government-results&q=in+patient+experience+2007Google Scholar
Rachel, B., Doyle, Y., Gundy, E. (2009). Health systems and policy analysts. How can health systems respond to population aging? World Health Organization. Retrieved from http://www.euro.who.int/_data/assets/pdf_file/0004/64966/E92560.pdfGoogle Scholar
Reader, T. W., & Gillespie, A. (2013). Patient neglect in healthcare institutions: A systematic review and conceptual model. BMC Health Services Research, 13, 156.Google Scholar
Reed, J., & Proctor, S. (1995). Practitioner research in context. In , R. J, & , P. S, Practitioner Research in Health Care: The Inside Story (pp. 331). London, England: Chapman and Hall.CrossRefGoogle Scholar
Shreiber, R., & Stern, P. (2001). Using Grounded Theory in Nursing. New York, NY: Springer.Google Scholar
Singh, H. (2006). Malnutrition is prevalent in hospitalized medical patients: Are house staff identifying the malnourished patient? Nutrition, 22, 350354. doi: 10.1016/j.nut.2005.08.009Google Scholar
Statistics Canada. (2010). Annual demographic estimates: Canada, Provinces and Territories. Ottawa, ON: Government of Canada. Retrieved from http://www.statcan.gc.ca/pub/91-215-x/91-215-x2010000-eng.htmGoogle Scholar
Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Techniques and procedures for developing grounded theory. Newbury Park, CA: Sage.Google Scholar
Strauss, A. L., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory. Thousand Oaks, CA: Sage.Google Scholar
Taverner, T. (2005). The evidence on perceptions of pain in older people. Nursing Times, 101(36), 3638.Google Scholar
The Patients Association UK. (2011). Listening to patients, speaking up for change. CareCampaign. Retrieved from http://www.patientsassociation.com/Default.aspx?tabid=237Google Scholar
Thomson, S. B. (2011). Sample size and grounded theory. Journal of Administration and Governance, 5(1).Google Scholar
Turner, A., & Findlay, L. (2012). Informal caregiving for seniors. Health Reports, 23(3), Statistics Canada, Catalogue no. 82-003-XPE.Google Scholar
United Nations. (1996). The Universal Declaration of Human Rights. Geneva, Switzerland: United Nations. Retrieved from http://www.un.org/en/documents/udhr/Google Scholar
Walker, D, & Myrick, F. (2006). Grounded theory: An exploration of process and procedure. Qualitative Health Research, 16, 547559.Google Scholar
Ward-Griffin, C. (2004). Nurses as caregivers of elderly relatives: Negotiating personal and professional boundaries. Canadian Journal on Aging, 36(1), 92114.Google Scholar
Ward-Griffin, C., Brown, J. B., Vandervoort, A., McNair, S., & Dashnay, I. (2005). Double-duty caregiving: Women in the health professions. Canadian Journal on Aging, 24(4), 379394.Google Scholar
Ward-Griffin, C., St-Amant, O., & Brown, J. (2011). Compassion fatigue with double duty caregiving: Nurse-daughters caring for elderly parents. Online Journal of Issues in Nursing. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No1-Jan-2011/Compassion-Fatigue-and-Double-Duty-Caregiving.htmlGoogle Scholar
World Health Organization (WHO). (2011). Global Health and Ageing. Retrieved from http://www.who.int/ageing/publications/global.health/en/Google Scholar
Yonge, O., & Molzahn, A. (2002). Exceptional non-traditional caring practices of nurses. Scandinavian Journal of Caring Sciences, 16(4), 399405.CrossRefGoogle Scholar
Zhang, Z., Schiamberg, L., Oehmke, J., Barboza, G., Griffore, R., Post, L., et al. (2011). Neglect of older adults in Michigan Nursing Homes. Journal of Elder Abuse and Neglect, 23, 5874.Google Scholar
Zheng, Z., Gibson, S., Khalil, Z., Helme, R., & McMeeken, J. (2000). Age related differences in the time course of capsaicin-induced hyperalgesia. Pain, 85, 5158.Google Scholar