Why is it that nurses sometimes ask the wrong questions?

Key points

• The case of Kane Gorny is one of many instances that have come to light in recent years where a patient’s needs have been neglected
• When a patient is aggressive, a nurse can either seek a reason for it and act on this, or respond to the aggression directly
• Nurses should always ask “Why is this person behaving like this?”
• Nurses can improve their responses to “difficult” patients by becoming aware of their deeper cognitive processes
• When nurses see patients as “others”, they are less likely to meet their actual needs

Let’s discuss

In this article Steve Mee summarised the case of Kane Gorny as follows:

“A nurse chooses to respond to a man’s behaviour and ignore his life-threatening health needs. The health condition is known to cause aggressive behaviour if untreated. The man dies as a consequence.”

The author notes that a nurse had two choices in responding to aggressive behaviour; she can either actively seek a reason for it or respond to the aggression directly. What question should the nurses have asked about Mr Gorny?

After reading this article outline what we mean by attribution, schemas and social representation. How could you use these ideas to understand what happened to Mr Gorny?

What does the author mean by the term “othering”?

Look at this example of othering.

“Four people who have been resettled from a long-stay institution live in a house, with 24-hour support from a staff team. The staff are well organised. They keep a set of ‘staff cups’ in a high cupboard. In a lower cupboard there are ‘client cups’, which are cheaper and older than the ‘staff cups’. There is a dishwasher in the house and no one who lives there has a communicable disease.

Can nurses claim to value the people they support if they are not prepared to share the same crockery? Think about examples of othering in your own clinical area. How could you address these with your team?

You can email questions to Eileen.shepherd@emap.com or tweet @eileenshepherd

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