Baffled

Anna Flaxis, BSN, RN · May 19, 2012

"hospital induced paralysis. it is a syndrome in which an individual becomes completely helpless upon crossing the hospital threshold."
hospitals can "induce" the kind of behavior you describe -- if they have that power -- then they also have the power to induce the opposite. poor hospital "cultures," policies designed merely for efficiency, staff burnout and poor attitudes, (which too often come out on these blogs), lack of any kind of patient-centered care -- these things and others most often cause the kind of behavior you're describing. if patients feel like their being treated like objects, they start behaving like objects. they don't all of a sudden become stupid when they enter hospitals. humans quickly adapt to the atmosphere around them. when they feel powerless, many become powerless in order to survive. unfortunately, the cultures of too many hospitals enable this kind of behavior.

i'm sure that's part of the picture, but i think it's more complex than that. in other words, learned helplessness does not just suddenly appear in the vacuum of the hospital. the tendency of a person to adapt to the environment in this way is established earlier in life, through an interaction between their innate personality, environment, life experiences, etc.

the fact that so many people adopt helpless behavior while in the hospital shows just how pervasive in society this is. it's a reflection of how powerless people feel in general.

i don't see hospitals as inducing this behavior so much as it being an issue pertinent to the larger society in general.

i do agree that hospitals can enable it, for example with the growing emphasis on the customer service (or hilton hotel) model of healthcare delivery, where the patient's wants are prioritized over clinical outcomes.

allnurses Guide · May 19, 2012

My stepdad's father called his wife "mother". I noticed that with other couples of the same age (born late 1800s) and background (rural midwest) and always wondered what the roots of that were. It struck me almost as a term of respect.

He tended to defer to her as chief caretaker especially in their later years perhaps because women identified so much of their role in life with motherhood but with no daily outlet for it at that point, and I doubt very much the dynamic between them was like that when they were young, therefore I find Altra's solution both useful and pretty humorous, "do you know where you are?" lol.

AOx1 · May 19, 2012

When I first married my spouse, he behaved in a similar manner. I think he learned this from his mother. I refused to take part. When he forgot his insurance card and had to pay a cancellation fee, he worked extra hours to cover it. When he forgot to renew his driver's license and wasn't allowed to pick up his pain medication after a procedure, he had to take care of it before he could get his medication. When he forgot an appointment and was billed for it, he had to pay the cost. It took him nearly a year to learn that I was not his mother, and that adult choices have consequences, but after nearly 20 years of marriage, he is a wonderful and equal partner. This would not have happened if I had swooped in and "fixed" his mistakes. He has learned to use technology to his advantage and keeps his medications and important information in his password-protected phone.

As others have mentioned, this is a choice on the part of both partners. I didn't want an additional child, I wanted an equal partner. I personally would find it hard to be attracted to someone I felt I had to "mind" and "mother," and I don't want to be the nagging wife. Of course, this would be different if he were to become incapable due to illness or injury.

MzMouse · May 19, 2012

A few years ago my husband was in the ER; sick as a dog but very much able to speak for himself. I accompanied him and added a couple times to the consult with the ER doc but for the most part sat back and allowed him to answer. He was livid! He didn't feel well, of course, and though I should be answering all the doctor's questions since I am nurse. I explained that is as much a part of the consultation as the physical exam and therefore important HE answered the questions. :uhoh21:

Fortunately his good qualities far outweigh this moment of ridiculousness.

Tess Deco RN · May 19, 2012

Yes! All you can really do with a patient like that is to emphasize the importance of knowing their own health history and medications but sometimes that is just the kind of relationship a couple has ..probably for years! Our job as nurses is to get the information we need however we can ..so it really doesn't matter who provides it.

Except current symptoms and pain level ..if the patient can talk, that info needs to come from the patient!

Cul2 · May 19, 2012

I don't deny that there are people who are helpless before they arrive at the hospital and then continue the behavior there, and are often enabled. But there are many people who are not helpless who become so when they enter the hospital. Why is that? It's more a factor of the hospital culture and perhaps the general culture of what hospitals are "supposed" to be than it is the personality of these patients. Human beings pick up quickly and subconsciously the atmosphere and "rules" of their surroundings. They either adapt or fight. For sick people, it's just easier to adapt and go along with the program, even if they don't agree. But hospitals have tremendous potential to influence patients as to how to behave. I recommend the book "Influencer" by Patterson et. al. There's much hospitals can do to lead many patients along the path to self-care, if they utilize recent research about how to influence people.

Anna Flaxis, BSN, RN · May 20, 2012

I don't deny that there are people who are helpless before they arrive at the hospital and then continue the behavior there, and are often enabled. But there are many people who are not helpless who become so when they enter the hospital. Why is that? It's more a factor of the hospital culture and perhaps the general culture of what hospitals are "supposed" to be than it is the personality of these patients.

I don't buy this. If this was true, then all patients would assume helplessness upon admission to the hospital. But not all patients do. So, there *must* be a component of the *individual's* makeup that comes to bear.

Anyway, I'm not really interested in this discussion. My original comment was tongue in cheek, and not meant to inspire serious commentary.

GitanoRN, BSN, MSN, RN · May 20, 2012

and the beat goes on....

Cul2 · May 20, 2012

you said: "

i don't buy this. if this was true, then all patients would assume helplessness upon admission to the hospital. but not all patients do. so, there *must* be a component of the *individual's* makeup that comes to bear."

i had said: "

[color=#333333]i don't deny that there are people who are helpless before they arrive at the hospital and then continue the behavior there..."

why would this have to be true for all patients? this isn't an all or nothing world. people are different. and whether you're interested in this topic or not -- i think it comes to the heart of this discussion, which too often is stereotyping patients. i realize it would be easier if everyone were the same, but, that's not the case. i am sometimes astounded at the lack of psychological insight i find on some of these threads.

Anna Flaxis, BSN, RN · May 20, 2012

I read your post. I know what it said.

The original post, and the topic of this thread, was an observation of human behavior that we nurses encounter frequently. Sometimes we can make stereotypes from these observations. That's the interesting thing about stereotyping, is that it has such a negative connotation, but yet there are studies that suggest that stereotyping is typically quite accurate.

I agree that there are a lot of comments on AN that do seem to be a bit lacking in areas such as psychological insight and emotional intelligence, but that phenomenon is not limited to AN.

Which brings me to a side note, I understand you are not a nurse. May I ask what your occupation is, and what you expect to gain by participating on a discussion forum for nurses?

allnurses Guide · May 20, 2012

and the beat goes on....

yes it does . . . . .

i didn't see this thread initially.

my experience with my own husband and his consult with a new physician regarding diabetes was interesting. i decided to sit there and listen to my husband's take on his symptoms and the disease process.

the physician knew i was a nurse and my face must have shown my disbelief :icon_roll at times in my husband's answers because the doc asked me what i thought.

i gently disagreed with many of my husband's answers - he had sugarcoated many of his symptoms.

so, maybe the wives know their husbands won't 'fess up to the real truth and they go along to make sure the doc knows the real truth.

it is frustrating for me because diabetes is a dangerous condition and if you don't take it seriously and the doc doesn't have truthful information . . . bad things can happen.

i like the thoughts people had earlier in the thread about wives being the gatekeepers for medical care in the family - who makes the appts for the kids for their immunizations? who takes them to the doc for flu symptoms x10 days? who gets their eyes checked? usually mom.

BlueDevil,DNP, DNP, RN · May 20, 2012

I see it all the time, so much so that I don't even think of it as unusual. It has more to do with the patient's intrinsic personality and the dynamics of their relationships than it does with the culture in any health care environment.