Clinical Reflection
Clinical Reflection
Clinical Reflection
A Reflection of Patient’s Experiences of Boredom and Loneliness in the Acute Care Setting
Riley Murphy
NURS 3020
Martina McDowell
October 1 2018
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A Reflection of Patient’s Experiences of Boredom and Loneliness in the Acute Care Setting
After completing my first few weeks at clinical, I have noticed that a recurring thought
keeps popping into my head. Every time I walk by a patient’s room I see a different variation of
the same thing. For example, one patient might be sleeping, another in their chair reading, one
watching television, and another staring blankly at the wall. After making several laps around the
unit multiple times a day and seeing the recycling of these activities, it really made me wonder
how bored and lonely I would feel if it were me in the patient’s position. Looking back, one
patient sticks out to me specifically. He is an elderly gentleman (John Doe) with dementia who
has been admitted to the hospital awaiting a long term care bed. Personally, I believe he sticks
out to me because he reminds me of my own grandfather. I feel as though the connection I have
made between this patient and my grandfather has led me to dig deeper in regards to this
patient’s situation and the feelings he might be currently experiencing. This patient provides an
As stated previously, I was assigned this patient during my first shadow shift. This
shadow shift was my first day on the unit, so I was still getting oriented and becoming
comfortable with my surroundings. During this shift, I was not thinking as critically and deeply
arrived at clinical feeling much more confident in myself and with a general idea of how my day
was going to go. As I was walking around the unit, I noticed that this same elderly man was still
admitted. This surprised me, as I did not expect to be seeing the same patients a week later. I
knew that patients awaiting a long term care bed had a longer stay in the hospital than post-
surgical patients, but for some reason I had assumed that a long term care bed would be arranged
for these patients as soon as possible. A study conducted in New Brunswick revealed that the
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average length of stay for patients admitted into the hospital awaiting placement into long term
care was 379.6 days (McCloskey, Jarrett, Stewart, & Nicholson, 2014). This statistic shocked me
initially, but after putting further thought into it, I was less astonished. I know from clinical
placement first year that the wait list for long term care is extensive, I just never linked the fact
that the patients admitted to the hospital also have to wait on that wait list. Linking this back to
my experience at clinical, I was already beginning to think about how bored all of the patients
might be after only spending two days in the hospital, and not just those waiting for a long term
care bed. I can’t image how lonely it would be having to live in the hospital day in and day out
Something else to consider when reflecting upon this is that many of the patients
admitted to the hospital waiting for long term care, like John Doe, have some form of dementia. I
noticed that each time I would pop my head into John Doe’s room, he wouldn’t be reading,
watching television, or trying to entertain himself. He would just be sitting there blankly until
something or someone caught his attention. This led me to wonder if he is even aware of his
current situation, and if he knows how long he may have to be in the hospital for. Is he even
Another thought that came into my head when caring for this patient was the question of
why he could not be waiting for long term care at home with home care. I never did get a chance
to thoroughly look through his chart and see the reason why he was admitted, but other than his
ongoing confusion and several other complications that come along with the aging process, he
seemed generally well. With the extent of knowledge that I have regarding this patient, I feel as
though he would be more comfortable awaiting long term care in the familiar environment of his
home or a family members home, if possible. Costa and Hirdes (2010) explain that many patients
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considered to be at an “altered level of care” (meaning elderly patients who have been admitted
for acute care, have been treated, but cannot be discharged due to ongoing post-acute care needs
or a lack of support from their community) do not necessarily need to be admitted to the hospital
when waiting for long term care if there are proper community and home care services in place.
This would open up more beds in hospitals, allowing hospitals to admit patients who truly need
to be admitted, and would allow those waiting for long term care to wait in a familiar
environment.
As health care professionals, I think it is important for us to help patients alleviate their
feelings of boredom. Steele and Linsley (2015) have indicated that overall health is not just
based on the physical aspect, but it encompasses thoughts and feelings as well. They share that a
patient’s experience of loneliness and boredom can actually have a negative impact on their
physical health, and can alter their experiences with illness. They understand that due to time
constraints, it is not possible for nursing and other health care staff to sit with and entertain their
patients for long periods of time, but they do emphasize the importance of communication. They
state that in order to obtain an idea of the patient’s boredom, the health care provider needs to
have strong communication skills, and not focus solely on physical factors.
After thoroughly reflecting upon the subject of loneliness and boredom in the acute care
setting, I have come to some conclusions. There is a lot regarding the patient’s experience that is
out of my control, such as their length of stay, their discharge date, their room assignment, etc.
The one thing that I can do is communicate with my patients properly. When I go in to do a head
to toe assessment, instead of focusing only on the physical aspect of the assessment, I should ask
them how they are feeling in general. For example, I could ask questions like “Do you have any
plans for what you would like to do today?”, or “Do you have any visitors coming to see you
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today?”. These are some questions that may get the patient to plan some activities, such as
journaling, reading, playing games, or scheduling visitors to come in to talk to them. These
activities will all help to alleviate boredom. Additionally, as a student nurse only assigned to one
patient, I typically have more free time than the nurses. With my free time, I can go sit with
patients who are bored and lonely, and give them something to do and someone to talk to who
will have time to listen. I will keep all of these interventions in mind throughout my future
References
Costa AP, Hirdes JP. Clinical Characteristics and Service Needs of Alternate-Level-of-Care
2010;6(1):32-46.
McCloskey, R., Jarrett, P., Stewart, C., & Nicholson, P. (2014). Alternate Level of Care Patients
in Hospitals: What Does Dementia Have To Do With This?. Canadian Geriatrics Journal,
Steele, R., & Linsley, K. (2015). Relieving in-patient boredom in general hospitals: The evidence
doi:10.1192/apt.bp.113.011908