Psychological issues surrounding faecal incontinence: experiences of patients and nurses

Abstract

Continence care breaches social norms about privacy, nakedness and bodily functions. Faecal incontinence (FI) is a condition that is associated with a significant emotional impact, which extends to not only the patient but also the nurse or care worker. Patients can experience feelings of guilt and shame and a sense of ‘incompetence’, which can be connected to childhood experiences. Similarly, nurses and caregivers can encounter feelings of disgust and revulsion, which are often denied, as part of the perceived professional expectation. Nurses can develop self-protective behaviours including emotional detachment and development of a task-orientated approach to physical care. This can, in turn, accentuate the negative feelings experienced by patients with FI. Nurses developing self-awareness through reflection on their own difficult feelings can help to improve communication, which will meet patients' emotional needs and improve the therapeutic relationship. This article aims to encourage nurses and care workers to develop an empathetic understanding of the basic human emotional responses experienced by patients. It also aims to improve nurses' awareness of their own feelings and help them recognise the effect of these emotions on their own behaviours and their patients. Lastly, the importance of providing emotional care to patients with FI is discussed.

Experience of rehabilitation specialist nurses in providing bowel care for stroke patients: A qualitative study

“…Throughout this transformation process, they were inclined to adhere to established rules over personal discomfort, despite any uneasy sentiments. This behaviour can be attributed to nurses' expectation to uphold professionalism, while concurrently exhibiting a non‐judgemental and supportive approach towards patients with bowel dysfunction (Butcher, 2020). Nevertheless, this proactive transformation attitude was notably absent among nurses at the workplace.…”

Abjection and the weaponization of bodily excretions in forensic psychiatry settings: A poststructural reflection

“…This socialization to the repression of abjection or feelings of disgust begins in nursing school (Alavi, 2005) and carries on throughout a nurse's career. Across all fields of nursing, exposure to the abject, from fecal incontinence (Butcher, 2020) to the bodies of the deceased (Hadders, 2007) to the frail elderly (Higgs & Gilleard, 2014) to wounds and tumors and terrible odors (Kaiser et al, 2019; Van Der Riet, 2006) to plegm (Lindahl, 2011) to excessive body hair (Montgomery, 2014) to the use of leeches (Reynolds & O'Boyle, 2016) to burns (Rudge, 1996) to patients behaving in a disturbing manner (Hellzen et al, 1999), occurs with professional expectations to maintain a calm presence, to clean and treat the abject body or person regardless of the nurse's own feelings. It is simply viewed as part of the job (Van Dongen, 2001).…”

“…A fear of contamination results in nurses creating additional physical barriers between themselves and patients, such as plastic bags and rubber boots (Ostaszkiewicz et al, 2016). This “professional distance” (Butcher, 2020, p. 35) is a form of self‐protection. Despite early socialization and professional expectations to maintain a calm demeanor when encountering the abject, to provide care in a manner unlike any other nursing encounter, this is not always possible.…”