COMMENTARY

Nursing Care for the Aged: Can Students Handle It?

Laurie Scudder, DNP, NP

Disclosures

January 03, 2012

Student Attitudes and Educational Support in Caring for Older People -- A Review of Literature

Koh LC
Nurse Educ Pract. 2012;12:16-20

Study Summary

Background. The growing aged population is recognized as a significant challenge for the healthcare community, particularly in hospitals and long-term care facilities. Many nurses and nursing students view caring for the aged as a less attractive option, and long-term care facilities are often perceived as low-status places of employment. Studies have concluded that geriatric nursing is the least preferred area of practice for nursing students and that interest in this field actually may decrease during a nurse's education. The purpose of this study was to examine the role of nurse educators in fostering more positive perceptions about geriatric nursing in their students.

Methodology. Koh conducted an extensive international literature search using 4 electronic databases in addition to a manual review. The literature was then examined to determine current geriatric-specific curricular content, student perceptions of caring for older people, and the impact of clinical placements on student attitudes.

Results. Geriatric nursing requires the best of nursing. It is true person-centered practice, and nursing students are not prepared for the difficulties in using this approach with geriatric patients. In busy clinical settings, older patients may not be permitted the time that they require to be involved in making their own healthcare decisions. Additionally, nursing curricula may focus on a biomedical approach to aging rather than emphasizing the importance of promoting quality of life in older adults.

An examination of studies that explored student clinical experiences concluded that negative student experiences may be related to a lack of preplacement orientation to the practice environment. Student exposure to experienced nurse faculty, or "link lecturers," who provided both didactic information and supervision in their own practice settings, was viewed by students as both positive and inspirational. These expert nurses were able to share their own positive experiences of working with the elderly. Students may be overwhelmed or even frightened when caring for adults whose physical and cognitive health is deteriorating. Clinical placements that provide opportunities for dialogue with link lecturers and peers can reduce the stress of the clinical environment.

Koh also explored the potential role of online learning in educating students about the elderly. Web-based programs that illustrate communication techniques, online discussions and forums, and materials developed by older adults that give students an understanding of the adult's perspective are all strategies that have been demonstrated to be effective.

Viewpoint

This very interesting literature review provides a number of strategies for nurse educators that go beyond the traditional lecture/clinical paradigm. Incorporating a variety of modalities into the learning experience is essential for today's media-savvy student. Preparing students in advance of their clinical placement with first-person accounts of the experience of aging, either text- or video-based, developed by older adults with a range of health issues (including dementia) may allow students to see the world through the older patient's eyes without the stress and fear that may accompany a face-to-face encounter. It behooves all of us who will someday be one of these older adults to find the strategies that ensure a nursing population that is well prepared and even eager to provide the care we will need.

Abstract

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