Opinion 1 Response

1

Response #1

Behaviorism Gwen Hanna

Working on the neurology/neurosurgery floor for three years provided me the opportunity to see and observe undesirable health care practices and behaviors. At the same time, it gave me the chance to correct them. One undesirable practice that nurses often leave unnoticed is giving post-operative patients too much pain medications that hinder them from functioning cognitively and limit their mobility. I have cared for patients who underwent brain and spine surgeries, both young and old, who ended up in an extended care facility or inpatient rehab due to decreased mobility and functioning upon therapy evaluation. Possible causes can include too much pain medication, making the patient drowsy and uncooperative during evaluation, and failure of the staff to provide early ambulation. Some patients are afraid to walk because of pain and choose to stay in bed instead.

To replace this unhealthy behavior, I have realized that it is much better to let the patient endure the pain and ambulate them rather than keeping them in bed all day. Giving pain medications not strong enough to make them sleepy and loopy, offering nonpharmacological means of pain relief, and providing motivation can get patients functioning while staying on top of their pain. These strategies can decrease their hospital stay, medical cost, and hospital-acquired diseases.

Undesirable behavior can be changed through the principles of learning theory. Behaviorist learning theory generally ignores what goes on inside the individual by observing the responses to a situation and then manipulating the environment in some way to bring about the intended change (Bastable, 2019). This learning theory focuses on what is discernable by creating a motivation to generate learning and positive responses. Motivating the patient to ambulate and observing the positive responses it created spawns a behavior and learning that focuses on ambulation rather than medication, giving the patients the mobility they require to go home. Cognitive learning theory can also be applied to change undesirable behavior. While behaviorists generally ignore what is going on inside the individual, cognitive learning theorists stress the importance of what goes on inside the learner (Bastable, 2019). Emphasis is on the goal and understanding of the learner to change behavior. The patient’s past experiences and attitudes towards pain must be considered.

Changing an undesirable behavior in healthcare is challenging as it involves various factors to be effective and successful. The different patient population has complex needs. Based on my experience, the younger population, especially males, have low pain tolerance after a brain or spine surgery, requiring more pain medications as usual.  

Response #2

Samantha

            I currently work with Veterans at the VA hospital in Michigan. One of the most prevalent undesirable behavior I witness is smoking. Oftentimes, Veterans having been smoking for a number of years and can be resistant to reduced or quit their behaviors. I would attempt to change a patient’s smoking habit and increase their physical activity. Utilizing the principles of the social learning theory, the behavior of smoking can be changed, and the patient can be more active. Smoking cessation is a practice of separating the environmental and social ties that have been created with the act of smoking. Veterans may have begun smoking from a young age and continued throughout their services and adult years. Their family members and friends may smoke. These experiences and factors play a role in smoking behavior (Lochbuehler et al., 2016).

            In order to quit smoking, the patient must understand the involvement of their peers and role models in the reinforcement of the smoking behavior. The patient should work to implement self-regulating mechanisms to handle the cravings and eliminate situations that would promote smoking. The patient could seek walking groups or classes to increase their physical activity while decreasing the chances of being around individuals smoking (Lochbuehler et al., 2016).

            Likewise, the behavior learning theory can alter the smoking behavior. The patient should work to change their environment. The patient should identify situations that encourage the use of tobacco and manipulate the stimuli to encourage learning and change. For instance, the patient may meet with friends at a bar or location where smoking is common. The patient may work to change where he or she meets with friends and instead seek activities or places where smoking is prohibited. In addition, the patient should acknowledge the addiction process by mentally prepare for tobacco withdrawals and work to utilize activities that replace their act of smoking. This will also help keep negative thoughts at bay (Elshatarat et al., 2016).

             The behavior learning theory may work better for young people compared to older people. Younger people may be able alter their environment more readily in comparison to older individuals. They can seek different areas to socialize and function. Depending on the age of young people, changing their role models may be difficult. Young people can be highly influenced by the actions and thoughts of their peers. Consequently, young people may not recognize the harmful outcomes of their actions until after the experience. Older individuals may be able to utilize the social learning theory more readily to change their social group and think independently (Bastable, 2019).