Working with older people: Beginning or end of a nurse's career?

BACKGROUND: The increasing numbers of older people (age 65+) make it important to understand how to attract nurses to work with this population. METHODS: A secondary analysis using qualitative descriptive methods was used to understand how student nurses' perceptions about older people may influence their desire to work with older people. RESULTS: Student nurses perceive a generational divide between them and older people, regardless of practice settings. They believe working with older people is heavy work, and not high acuity, and although good to learn skills as a student, not a population they want to work with until they are close to retirement themselves. CONCLUSIONS: It is important to enhance nursing education so that students understand the older generation, how to communicate with them and the prevalence of older people in healthcare settings, so that they are more likely to choose to work with older people.

Registered nurses' reflections on their educational preparation to work with older people.

BACKGROUND: Negative perceptions about working with older people within nursing contribute to the deficit of educators with expertise to teach student nurses, and nurses graduating ill-equipped to work with the ageing population. The perceptions of nurses who have recently graduated from a nursing programme can provide insights into what they wished they knew about working with older people before they graduated. METHODS: A qualitative descriptive study design examined recently graduated registered nurses' reflections on their education preparation to work with older people. Content and thematic analysis was used to develop the themes of first impressions and preparation to work with older people. RESULTS: Key findings were that nurses did not recognise the importance of learning about older people until they had graduated. Only then did they realise that the ageing population was so complex and prevalent. They perceived a lack of education particularly related to working with older people with dementia and their behaviours, as well as learning how to communicate to an older population. Participants perceived that as students, it was up to them to fit in learning about working with older people without the support of faculty. CONCLUSIONS: Faculty need to be supported in learning how to best incorporate content about older people into their curriculum. This could include the development of learning activities that dispel negative stereotypes about ageing and facilitates interest in older people, as this is the population, students are most likely to work with when they graduate. IMPLICATIONS FOR PRACTICE: Nurses in practice may require education on working with people with dementia as it is a deficit in nursing programmes.

Nurses' perceptions of their role in functional focused care in hospitalised older people: An integrated review.

AIM: The aim of this integrative review was to identify nurses' perspectives of their role in influencing the functional status of hospitalised older people. METHODS: An integrative review using Whittemore and Knafls' method was conducted using EBSCOhost CINAHL, Ovid MEDLINE(R), EBSCOhost, Social Gerontology, Cochrane Database of Systematic Reviews and ProQuest Dissertations & Theses data bases. Only studies with nurses' perspectives, or beliefs about their role in function-focused care were included. Content analysis was used to develop the themes nurses' role in function-focused care and barriers to functional care. RESULTS: The review found 12 relevant articles. Nurses believed that they were responsible for function-focused care, yet functional care tasks were often missed. Organisational contexts created many barriers to providing function-focused care for patients. Nurses felt powerless to address these overarching problems in their organisations. CONCLUSION: Nurses understand the importance of functional care yet often fail to carry out functional care interventions. Lack of organisational support creates a workplace that is short on staff, time and equipment and does not prioritise functional care needs. Nurse leaders and healthcare organisations need to reprioritise function-focused care for the good of patients, families and healthcare budgets.

Nursing faculty and students' perspectives of how students learn to work with older people.

BACKGROUND: Despite efforts to incorporate information about older people in pre-licensure nursing programs, there are inconsistent results from studies examining student nurses' perceptions towards the aging population. There is research suggesting that healthcare settings and nursing practice is perpetuating negative perspectives towards older people. OBJECTIVE: To gain an understanding of how social contexts are influencing student nurses' experiences when learning to work with older people. DESIGN: Descriptive case study guided by the theoretical framework of social learning theory. SETTING: A university in Western Canada that offers a pre-licensure nursing program. PARTICIPANTS: 28 student nurses and 13 faculty in the nursing program. METHODS: Participant interviews and focus groups were conducted with nursing faculty and students. RESULTS: Key findings from this study are that students' previous experiences with older people, through family or work experiences, and their first clinical experience in long- term care negatively influenced their perceptions about working with older people. Clinical nurses and faculty influenced students' perceptions about nursing practice with older people, sometimes in subtle ways, underscoring that students are learning from what they see and hear in practice. Students were ill-prepared for the complexity of the aging population, particularly those with cognitive impairment. CONCLUSIONS: Learning activities that engage students in active learning, such as simulation, providing students with a positive lexicon of how to describe older patients, and more overt attention to the perspectives students and faculty bring to the learning environment need to be carefully explored. Meaningful learning experiences with older people in multiple contexts are needed to thoughtfully plan how to disrupt negative perceptions that might emerge through the nursing education program.