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A difficult patient in the care of a nurse
ZUZÁKOVÁ, Marie
The topic of the bachelor{\crq}s thesis is the ``Difficult Patient in a Nurse{\crq}s Work.{\crqq} The thesis is divided into 10 chapters. The theoretical findings are listed in the chapter ``Current Situation.{\crqq} The theoretical part addresses more general topics such as the specific features of work of nurses in selected wards, the roles of nurses and their professional characteristics. However, particular attention is paid to the specific situations based on which the patient may be deemed ``difficult.{\crqq} These chapters describe the personality of the person affecting his role as a patient, the patient{\crq}s reaction to disease, aggressiveness, causes of aggressive behaviour and other aspects. The conclusion is devoted to the psychic burden on nurses and burnout syndrome. The objective of the bachelor{\crq}s thesis is to determine what criteria nurses have when selecting and stipulating the order of difficult patient. Two hypotheses were chosen: patients are deemed ``difficult by nurses in different ways, according to the specific features of the ward. The demands placed on treatment care affect the identification of a patient as difficult. A survey was performed at selected wards: ARO, JIP, ONP, CHO (anaesthesiology-resuscitation ward, intensive care unit, subsequent treatment ward, surgical ward) at the České Budějivice Hospital a.s. 140 questionnaires were handed out, of which 97 were returned. The return rate was 69%. The questionnaire contained 22 questions, which were to provide answers to the assumed hypotheses. The objective of the work was fulfilled and it was found that the most common criteria affecting the evaluation and order of a ``difficult{\crqq} patient are non-cooperation, unease, and alcohol or drug intoxication. Nurses determine the order of a ``difficult{\crqq} patient almost identically. The most difficult patients according to nurses are those that are aggressive, then those that are uneasy or confused. The first hypothesis was not confirmed, because when identifying a ``difficult{\crqq} patient, nurses almost always agreed, regardless of the specific features of the ward. The second hypothesis was confirmed, because the survey proved that care for a ``difficult{\crqq} patients places demands on staffing of the shift and the nurses{\crq} education. According to the respondents{\crq} demands, a recommendation for the future would be the possibility of attending more seminars and courses aimed at the given topic.
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