Wednesday, February 13, 2008

Geriatric Nursing for the Modern Nurse



Geriatrics, which is the branch of health care dealing with the diseases, debilities, and the care of aged persons involves the study of aging in humans (Columbia Electronic Encyclopedia, 2004). It also covers the social, psychological, and biological aspects of aging. The main priority of a geriatric nurse is to focus on maximizing his/her older patients’ functional abilities as well as promoting, maintaining, and restoring their patients’ physical and mental health (Gerontological Nursing, 2004).




PHOTO: Nurse bedside with an elderly patient (UPMC St. Margaret, 2007)


Geriatric nursing is different from other fields of nursing because even though aging is not a new topic, the large number of aging “Baby Boomers” has increased both the profile and the importance of this nursing specialty. This issue is one that should interest every nurse since all nurses (except those in pediatrics and OB) provide care to older adults in some capacity. According to the National Center for Health Statistics, in 2004, there were 36.3 million U. S. residents 65 and older (Older Persons’ Health, 2007). However, there are too few doctors, nurses, and other medical professionals who have received any formal training on how to provide the best care for elderly patients (Alliance for Aging Research, 2002). Before Medicare came into existence, the content in growth and development courses ended when teen-agers became adults: the whole epoch of adulthood and old age was left unaddressed (Kick, 2003).

PHOTO: Cartoon portraying active elders (CartoonStock, 2008)

A vast body of information on the care of older adults exists for all health care professionals, but much of it has not yet been integrated into basic nursing programs. Although non-OB and non-pediatric nurses will provide care to mostly older patients, only 23% of the baccalaureate nursing programs in the U.S. have one required course in geriatric nursing (Rosenfeld, Bottrell, Fulmer, & Mezey, 1999). Only thirty baccalaureate nursing programs (4%) have met all the criteria for an ideal geriatrics education (Kovner, Mezey & Harrington, 2002). Accordingly, most practicing nurses have limited preparation for the care of elderly patients.


PHOTO: Aging cycle graph (Indiana University, 2008)

In combination with a general lack of geriatric knowledge, there is also the terrifying shortage of registered nurses. The shortage of RN’s could not have come at a worse time with the increase of complex care needs for the aging population. These result from new diseases and other prevalent diseases such as Alzheimer’s or dementia, and the increasingly labyrinthine technological care environment. Thus, the lack of skilled RN’s will be very detrimental to our aging society.

PHOTO: Healthcare team explaining treatment to an elderly patient (Florida University, 2008)


So what can we, as nurses, do to improve the delivery of care to the elderly? The American Nurses Association has made suggestions for the future. We need to focus on improving the work environment to make it more inviting for prospective nurses. We need to promote a positive image of geriatric nursing, instead of the "cleaning-bed-pans image", which is one of the prevailing issues in nursing homes. One of the most important suggestions is to increase the education and training in geriatrics to all practicing nurses (Mion, 2003).


PHOTO: Geriatric nurse maximizing patients' functionality (MU Direct, 2007)



For More Information:
National Institute on Aging
National Center for Health Statistics




References


Alliance for Aging Research. (2002). Medical never-never land: Ten reasons why America is not ready for the coming age boom. Washington: Alliance for Aging Research. Retrieved July 6, 2002, from www.agingresearch.org/advocacy/geriatrics/02016_aar_geriatrics_text.pdf



Geriatrics. (2004). Columbia Electronic Encyclopedia. Retrieved January 28, 2008, from Reference.com website: http://www.reference.com/browse/columbia/geriatri



Gerontological nursing. (2004) Retrieved January 28, 2008 from http://www.nurseweek.com/careers/gerontological.asp


Kick, E. (2003). Health Care and the Aging Population: What are Today's Challenges? Overview. Online Journal of Issues in Nursing. , 8(2), Retrieved December 2, 2007, from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodials/OJIN/TableofContents/Volume82003/Num2May31_2003/HealthCareandAgigChallengesOverview.aspx



Kovner, C.T., Mezey, M., & Harrington, C. (2002). Who cares for older adults? Workforce implications of an aging society. Health Affairs, 21(5), 78-89.



Mion, L. (2003). "Care Provision for Older Adults: Who Will Provide?". Online Journal of Issues in Nursing, 8(2). Available: www.nursingworld.org/ojin


Older Persons’ Health. Fast Stats A to Z. Retrieved January 28, 2008 from Center of Disease Control and Prevention website http://www.cdc.gov/nchs/fastats/older_americans.htm



Rosenfeld, P., Bottrell, M., Fulmer, T., & Mezey, M. (1999). Gerontological nursing content in baccalaureate nursing programs: Findings from a national survey. Journal of Professional Nursing, 15(2), 84-94.


Picture Credits

Aging Cycle Graph (2008). Indiana University. Retrieved January 28, 2008, from http://www.iuinfo.indiana.edu/homepages/2-18-2000/pixs/aging_graph.jpg



Geriatric nurse maximizing patients’ functionality (2007). MU Direct. Retrieved Jaunary 28, 2008 from http://mudirect.missouri.edu/webphotos/200166625-001%20copy.jpg

Healthcare team explaining treatment to an elderly patient (2008). Florida University. Retrieved January 28, 2008, from http://www.fsu.com/media/2003/08/29/geriatrics_01.jpg.

Nurse bedside with an elderly patient (2007). UPMC St. Margaret. Retrieved January 28, 2008, from http://stmargarets.familymedicine.pitt.edu/content/Geriatrics11b.jpg


Cartoon portraying active elders. (2008). CartoonStock. Retrieved January 28, 2008, from http://www.cartoonstock.com/lowres/nsu0082l.jpg