Question

Discuss how elimination complexities can affect the lives of patients and their families. Discuss the nurse's role in supporting the patient's psychological and emotional needs. Provide an example.

Answer 1

Elimination complexities and its effect on lives of patients and their families :

Elimination is the act of discharging or excreting waste products or substances through the various emunctories. It is one of the basic biological need of a human being. Elimination complexities or the elimination complications such as incontinence and retention of urine and faeces can be seen in associated with the various diseases that affect Gastro intestinal and Genito urinary system and spinal injuries.

Elimination abnormalities such as Incontinence of urine and faeces, diarrhoea, constipation and retention of urine can adversely affect both patients and their family members. It may affect patient's /family's economic , social, psychological relem.

economic impact: Incontinence may make the patient depend on others especially elderly. Most of the case may go for institutionalization in hospitals, care homes, old age home etc. Cost for the health care services for incontinence and purchasing of diapers and other necessary items become a burden for family economy.

Psychological impact: Both patient and family members can be embarrassed due to the eliminatory problems such as incontinence of bowel and bladder or frequent diarrhoea. It may increase the psychological stress of patient and family members that may lead to various other medical illness such as hypertension. This problem may cause depression and loneliness in patient.

Social impact: Social withdrawal and social isolation may happen in patient due to elimination problems. Shame and associated embarrassment make the patient self withdrawn from social functions and from other family gatherings.

example: There are reports of complications of pelvic operations resulted in loss of bladder control in few women, ( developing countries)they are no longer confident to go for a job out side home. rest of the life , they have to confine to home environment.

Nurse's role in supporting psychological and emotional needs:

Nurses are having a great role in meeting the physical, psychological, emotional needs of a patient with elimination complications. Most of the people feel shame and embarrassment due to incontinence or retention of urine or faeces. Nurses can support them in a number of ways. Assisting them in their elimination needs such as urinary catheterization or helping them invchanging the diapers ( those who self care deficit), provide a safety and privacy for elimination and administering mediations as prescription   are the basic nursing intervention. Nurses can help the patient emotionally and psychologically also through number of ways such as:

* Provide psychological support to the patient and family.

* Express a calm and patient attitude

* Talk openly and encourage the patient to talk about his problems openly.

* Educate the patient regarding different management measures for Incontinence/ retention such as opening a tap while urinating for urinary retention patients ( Helps in urination), train them for voiding control ( incontinence patients).

* Suggests them about the different organisations that provides funding for pads and other necessary items

* Don't make the patient to be hurry in toilet. provide a facility of listening music.

* Assist them in maintaining their personal hygiene. Being clean and fresh may make them happy and confident.