Running head: PATIENT BOREDOM AND LONELINESS 1

A Reflection of Patient’s Experiences of Boredom and Loneliness in the Acute Care Setting

Riley Murphy

NURS 3020

Martina McDowell

October 1 2018
PATIENT BOREDOM AND LONELINESS 2

A Reflection of Patient’s Experiences of Boredom and Loneliness in the Acute Care Setting

After completing my first few weeks at clinical, I have noticed that a recurring thought

keeps popping into my head. Every time I walk by a patient’s room I see a different variation of

the same thing. For example, one patient might be sleeping, another in their chair reading, one

watching television, and another staring blankly at the wall. After making several laps around the

unit multiple times a day and seeing the recycling of these activities, it really made me wonder

how bored and lonely I would feel if it were me in the patient’s position. Looking back, one

patient sticks out to me specifically. He is an elderly gentleman (John Doe) with dementia who

has been admitted to the hospital awaiting a long term care bed. Personally, I believe he sticks

out to me because he reminds me of my own grandfather. I feel as though the connection I have

made between this patient and my grandfather has led me to dig deeper in regards to this

patient’s situation and the feelings he might be currently experiencing. This patient provides an

example of the context for which I will be reflecting on.

As stated previously, I was assigned this patient during my first shadow shift. This

shadow shift was my first day on the unit, so I was still getting oriented and becoming

comfortable with my surroundings. During this shift, I was not thinking as critically and deeply

as I would’ve if I were to be accustomed to my surroundings and routine. The following week, I

arrived at clinical feeling much more confident in myself and with a general idea of how my day

was going to go. As I was walking around the unit, I noticed that this same elderly man was still

admitted. This surprised me, as I did not expect to be seeing the same patients a week later. I

knew that patients awaiting a long term care bed had a longer stay in the hospital than post-

surgical patients, but for some reason I had assumed that a long term care bed would be arranged

for these patients as soon as possible. A study conducted in New Brunswick revealed that the
PATIENT BOREDOM AND LONELINESS 3

average length of stay for patients admitted into the hospital awaiting placement into long term

care was 379.6 days (McCloskey, Jarrett, Stewart, & Nicholson, 2014). This statistic shocked me

initially, but after putting further thought into it, I was less astonished. I know from clinical

placement first year that the wait list for long term care is extensive, I just never linked the fact

that the patients admitted to the hospital also have to wait on that wait list. Linking this back to

my experience at clinical, I was already beginning to think about how bored all of the patients

might be after only spending two days in the hospital, and not just those waiting for a long term

care bed. I can’t image how lonely it would be having to live in the hospital day in and day out

for more than a year.

Something else to consider when reflecting upon this is that many of the patients

admitted to the hospital waiting for long term care, like John Doe, have some form of dementia. I

noticed that each time I would pop my head into John Doe’s room, he wouldn’t be reading,

watching television, or trying to entertain himself. He would just be sitting there blankly until

something or someone caught his attention. This led me to wonder if he is even aware of his

current situation, and if he knows how long he may have to be in the hospital for. Is he even

aware that he is bored or lonely?

Another thought that came into my head when caring for this patient was the question of

why he could not be waiting for long term care at home with home care. I never did get a chance

to thoroughly look through his chart and see the reason why he was admitted, but other than his

ongoing confusion and several other complications that come along with the aging process, he

seemed generally well. With the extent of knowledge that I have regarding this patient, I feel as

though he would be more comfortable awaiting long term care in the familiar environment of his

home or a family members home, if possible. Costa and Hirdes (2010) explain that many patients
PATIENT BOREDOM AND LONELINESS 4

considered to be at an “altered level of care” (meaning elderly patients who have been admitted

for acute care, have been treated, but cannot be discharged due to ongoing post-acute care needs

or a lack of support from their community) do not necessarily need to be admitted to the hospital

when waiting for long term care if there are proper community and home care services in place.

This would open up more beds in hospitals, allowing hospitals to admit patients who truly need

to be admitted, and would allow those waiting for long term care to wait in a familiar

environment.

As health care professionals, I think it is important for us to help patients alleviate their

feelings of boredom. Steele and Linsley (2015) have indicated that overall health is not just

based on the physical aspect, but it encompasses thoughts and feelings as well. They share that a

patient’s experience of loneliness and boredom can actually have a negative impact on their

physical health, and can alter their experiences with illness. They understand that due to time

constraints, it is not possible for nursing and other health care staff to sit with and entertain their

patients for long periods of time, but they do emphasize the importance of communication. They

state that in order to obtain an idea of the patient’s boredom, the health care provider needs to

have strong communication skills, and not focus solely on physical factors.

After thoroughly reflecting upon the subject of loneliness and boredom in the acute care

setting, I have come to some conclusions. There is a lot regarding the patient’s experience that is

out of my control, such as their length of stay, their discharge date, their room assignment, etc.

The one thing that I can do is communicate with my patients properly. When I go in to do a head

to toe assessment, instead of focusing only on the physical aspect of the assessment, I should ask

them how they are feeling in general. For example, I could ask questions like “Do you have any

plans for what you would like to do today?”, or “Do you have any visitors coming to see you
PATIENT BOREDOM AND LONELINESS 5

today?”. These are some questions that may get the patient to plan some activities, such as

journaling, reading, playing games, or scheduling visitors to come in to talk to them. These

activities will all help to alleviate boredom. Additionally, as a student nurse only assigned to one

patient, I typically have more free time than the nurses. With my free time, I can go sit with

patients who are bored and lonely, and give them something to do and someone to talk to who

will have time to listen. I will keep all of these interventions in mind throughout my future

clinical practice as well as professional practice.

PATIENT BOREDOM AND LONELINESS 6

References

Costa AP, Hirdes JP. Clinical Characteristics and Service Needs of Alternate-Level-of-Care

Patients Waiting for Long-Term Care in Ontario Hospitals. Healthcare Policy.

2010;6(1):32-46.

McCloskey, R., Jarrett, P., Stewart, C., & Nicholson, P. (2014). Alternate Level of Care Patients

in Hospitals: What Does Dementia Have To Do With This?. Canadian Geriatrics Journal,

17(3), 88-94. doi:https://doi.org/10.5770/cgj.17.106

Steele, R., & Linsley, K. (2015). Relieving in-patient boredom in general hospitals: The evidence

for intervention and practical ideas. BJPsych Advances, 21(1), 63-70.

doi:10.1192/apt.bp.113.011908