Changing Maladaptive Behaviors In Nursing Essay

In your reading assignment, there are two sections on chemical dependency and codependency, which are maladaptive behaviors nurses may become “emotionally and physically” trapped in. Discuss your feelings about these behaviors affecting nurses in their careers and home life. If you were the unit manager, how would you try to help these nurses who have become chemically dependent or codependent in their practice?Changing Maladaptive Behaviors In Nursing Essay

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Behavior of a person ought to be gauged according to the conformation to the common behaviors accepted and upheld by the society. However, it is inevitable for the behaviors to be consistent across the broad. Maladaptive behavior is the behavior that does not conform to the normal set of behavior. The paper conducts a research into perspectives into maladaptive behavior. The paper will cover depression as a maladaptive behavior.

Introduction

Maladaptive behavior is any behavior that is contrary to the common. It is an outlier in the array of behavioral data in the society. There are many perspectives that can be used in the explanation abnormal behavior (Bonner, 2006). The viewpoints seek to offer more understanding on the causal agents for the behavior which is by large erratic and inconsistent with the expected behavior. The paper will focus on the perspectives on the maladaptive behavior. The two perspectives will be biological and psychodynamics (Caplan, 2008).Changing Maladaptive Behaviors In Nursing Essay

Biological perspective on the causes of the depression focuses on the role of the hereditary traits transferred to the genetically transferred material. It posits that the brain plays a vital role in the determination of the behaviors (Bonner, 2006). This perspective assumes that the malfunctioning of the body is the main cause of the depression. The role of the genetics makes the maladaptive behavior more of a permanent issue that cannot be corrected using the normal approaches (Smith, 2000). The biological factors are the most important in the diagnosis of the patients exhibiting depressive behaviour behavior (Bonner, 2006). Therefore, the perspective has wide applications in the diagnosis and treatment of the patients with maladaptive behaviors.

The second perspective on the depression posits that the behavior exhibited by the people comes from the notion that the thoughts and emotions of a person have a role to play in the determination of the maladaptive behavior (Caplan, 2008). Diagnosis of the patient also has to focus on the development of an opinion on the role of the psychodynamics. Emotional intelligence determines the effectiveness of the person in handling the issues.Changing Maladaptive Behaviors In Nursing Essay

How nurses can cope with change
One of the few constants in nursing is change. Nurses must be nimble and flexible as they navigate their careers.

Many types of change
During your career, changes can be both sudden and gradual. Some of us have witnessed major changes, like the transition from paper charting to EMRs. We’ve also witnessed seismic changes in the economics of healthcare and how they impact patient care.

In the 1980s, nurses were at the forefront as AIDS permanently altered the healthcare landscape. Some may remember when Diagnostic Related Groupings were introduced, much to our dismay. Recently, we see the repercussions of the Affordable Care Act.

Some changes can be far-reaching, (e.g.: the advent of AIDS), and others can be localized (e.g.: your hospital is downsized or your beloved supervisor is fired).

Change is inevitable, so how do you cope when it happens? Here are three important aspects of coping with change:Changing Maladaptive Behaviors In Nursing Essay

Reduce stress
A major change in your work life can generate significant stress. As your body reacts to stress, your health may suffer.

Taking steps to reduce stress is prudent during times of transition, and how you reduce stress is individualized. Your chosen path might be meditation, massage, exercise, nutrition or time off. Your faith may be helpful, and some might turn to psychotherapy or coaching. If you turn to alcohol or drugs, be aware that maladaptive behaviors may not produce the desired results.

Self-care figures largely in stress reduction, and it can be different for each individual. Some may need to sweat and work out, while others may need more naps.

Embrace the change
Embracing change can help you to get out in front of stress. This process involves acceptance, and a willingness to dive in headfirst.

If a new EMR is introduced to your facility and everyone is panicking, volunteer for extra training to become a superuser. Rather than embracing resistance, choose instead to be a champion of change.

Embracing change can be key to overcoming the negative impacts of change.Changing Maladaptive Behaviors In Nursing Essay

Practice excellent communication
If a major change is occurring in your workplace, use communication skills to keep information flowing. If you’re a manager, allay others’ concerns by listening to their thoughts and feelings. If you have a sympathetic colleague or supervisor, openly share your anxieties and concerns.

Communication in the face of change is like a pressure valve that allows fears and concerns to be assuaged. This can avoid the manifestation of maladaptive employee behavior such as passive aggression or subtle, unconscious sabotage. Communication is key.

Change is inevitable
If change is inevitable, we must embrace it, champion positive change and acknowledge the feelings that arise during the process.

Communication, willing acceptance and stress reduction are just three of the many aspects of working with the energy of change within your nursing career.Changing Maladaptive Behaviors In Nursing Essay

Therapeutic milieu is “the controlled environment of treatment facilities that shelters patients from what they perceive to be painful and frightening stressors, thus providing them with a stable and coherent social environment that facilitates the development and implementation of treatment.” (Stuart, 2009)

The chief purpose of selecting this topic is that it is an exclusive way of dealing with patients problems, it offers chance to acquire adaptive coping skills and lets the patient to try these new coping skills in a protected, comfortable environment as well as it provides recreational, occupational, social, psychiatric, medical and nursing therapies. Secondly in Karwan-e-Hayat during my clinical I witnessed that a woman of middle age had an interfering attitude and used to force others for the activities that were held there. She used to get aggressive on every small thing and now and then becomes difficult to control. She was incapable of differentiating between acceptable and unacceptable behaviors in the hospital setting.

In Stuart 2009 it is cited that the idea of therapeutic milieu was coined by Abroms, 1969, which served the two main purposes. The first objective is setting limits on disturbed and maladaptive behavior. The intervention that could be helpful for patients for keeping maladaptive behavior under control and allowing treatment to progress includes the goal to control or setting limit on the maladaptive response but supporting the feeling that underlines the behavior, examining the behavior with the patient and identifying the consequences and convenient substitute approach, establishing a therapeutic association and working with patient to draw on any remaining parts of independence and strengths. Changing Maladaptive Behaviors In Nursing Essay Secondly it aims to teach patient the psychosocial skills. It comprises of orientation i.e. the patient has the knowledge and has understanding of the time, place, person and the purpose. For instance, introducing oneself, one’s role, and the rationale for an interaction helps in disoriented patients to have the mindfulness about their surroundings, Assertion i.e. supporting patients in expressing themselves effectively and in a socially acknowledged way over a specific topic or an issue. Some interventions includes assertiveness training groups, focus groups for lower functioning patients and interactive patients groups, Occupation i.e. the patient can feel confidence and success through the productive activity. Some interventions include individual or group hands-on-activities, jigsaw puzzles, physical skill development etc., Recreation i.e. providing patients a diversity of recreational opportunities and assisting patients to apply their learnt skills, comprising orientation, assertion, social interaction and physical dexterity. Some examples include informal games, brief outdoor walks etc. Thibeault CA in his article Understanding the milieu experiences of patients on an acute inpatient psychiatric units states that the inpatient milieu remains an important but often neglected component of psychiatric treatment as patients with acute and severe mental illness are admitted for short periods of intense treatment and are discharged quickly to community based care.Changing Maladaptive Behaviors In Nursing Essay

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The milestone contribution in the concept of therapeutic milieu is associated with Henderson (1978) that was cited in Stuart 2009; he described the framework that have the five specific components of a therapeutic milieu that includes containment, support, structure, involvement and validation. Containment offers for the physical wellbeing of patients, it includes making the food, shelter, medical attention accessible and taking the necessary steps for averting the patient harming self or others. Therapeutic practice of containment communicates to patient that for keeping them and the environment safe the nurse will impose external controls, support includes the staff’s conscious efforts to help patients in feeling better and enhancing their self-esteem. It can be communicated through empathy, being available, offering encouragement and reassurance, giving helpful directions and engaging patients in doings that they are reluctant to do, promoting reality testing, and modeling healthy relationships. Milieu that offers support also provides nurturance and encourages patients in engaging in other therapeutic efforts. Structure denotes to all the aspects of milieu that is a predictable organization of time, place, and person. It helps patients to feel safe. Some features of structures includes having a predictable timetable of meetings, groups sessions, setting limits and use of contracts, token economies, and expectation of attendance of meetings and groups. The further these uses are planned with the patient according to the shared ideas of what is adaptive and maladaptive, the more the structure grows into therapeutic itself. Involvement refers to the course that helps the patient to enthusiastically attend to their social environment and interact with it. The chief purpose is to strengthen a patient’s ego and modify the maladaptive interpersonal patterns.Changing Maladaptive Behaviors In Nursing Essay Nursing interventions includes practice of open door and open rounds, facilitating patient-led-groups, activities and self-assertive experiences. Through this patients learn appropriate interaction patterns and experience the consequences of unacceptable behavior. It strengthens the patient’s sense of self, behavioral control, and social interactive skills. Validation means that the individuality and value of each patient are recognized. It helps patients to develop greater capacity for closeness and a more consolidated identity. Nursing examples includes individualized treatment planning, showing respect for a patient’s rights, and providing opportunities for the patient to fail as well as succeed.Changing Maladaptive Behaviors In Nursing Essay

One of the ancient advocates of the importance of the environment for nursing care was Florence Nightangle. Since that time the inpatient environment and milieu management have continued to be important aspects of the role of all nurses. It is essential that psychiatric nurses working in structured setting realizes the potential impact that the environment can have on the patient. Milieu management has been described as environmental manipulation that minimizes stress and results in optimal benefit to the majority of patients (Benson and Briscoe, 2003). The nurse can engage aspects of the therapeutic milieu to meet the patient’s needs by providing physical safety and wellbeing (containment), education about the patient’s illness and treatment plan (support), therapeutic and predictable activity schedules (structure), opportunities for social interaction (involvement), and acknowledge the patient’s feelings (validation). According to (Delaney and Johnson, 2007)” nurses face the challenge of better articulating the nursing component of the inpatient treatment program and what specifically they contribute to improving patient outcomes.”Changing Maladaptive Behaviors In Nursing Essay

Safety, Structure, Support, and Symptom management are clinical functions that help to organize nursing practice from individual and environment perspectives (Delaney et al, 2000).

In hospital based psychiatric nursing it is anticipated that nurses must have clinical knowledge and skills are capable to apply them for the wellbeing of patients and families. The milieu created by the psychiatric nurse’s struggles to provide patients with activities and interactions prudently planned to encounter their needs. This includes both direct and indirect psychiatric nursing care functions as well as dependent, independent, and interdependent features of psychiatric nursing practice. The ultimate goal of the milieu setting is to provide patients with a stable and coherent social environment that creates a safe and therapeutic space by which healing, recovery and growth can occur. Changing Maladaptive Behaviors In Nursing Essay