Let’s shout about the complexity of nursing
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It’s a long time since I worked as a care assistant in a home for older women with dementia, and back then older people’s nursing (or geriatric nursing as it was known) was called the Cinderella service. It was seen as a backwater where nurses went if they had either no talent or no aspirations.
An episode of The Undercover Boss on Channel 4 recently featured the MD of a care home group going into her homes to see first-hand the challenges her staff faced. One manager spoke of the difficulties in recruiting qualified nurses - the stress of trying to cope without the continuity offered by nurses on staff was written all over her face. Despite her obvious dedication to her job and love for her residents she resigned while the programme was being filmed.
I don’t think anyone who understands the challenges of nursing older people would say it’s a specialty for people with no talent or aspirations, but it does still seem to be something of a backwater. I’ll admit to a personal interest here - my Mum is frail and confused and living in a nursing home, albeit one in which the care is excellent. However, it saddens me some elements of the Cinderella image prevail.
Nursing older people requires a range of clinical skills to manage comorbidities for which treatments often conflict. It also requires excellent communication skills to compensate for sensory or cognitive deterioration. But it is also a hugely rewarding specialty. Older people have so much life experience to share, and if you take the time to get to see beyond their health problems many are great company - and the long-term contact of nursing homes offers real opportunities to develop meaningful nurse-patient relationships.
Older people deserve the best - maybe it’s time for Cinderella to go to the ball and gain recognition as a career destination for the best and most ambitious patient-focused nurses.
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Readers' comments (15)
Anonymous | 20-Aug-2012 11:37 am
Everyone deserves the best, sometimes it seems easy for people to forget that.
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Anonymous | 20-Aug-2012 12:03 pm
"Older people have so much life experience to share, and if you take the time to get to see beyond their health problems many are great company - and the long-term contact of nursing homes offers real opportunities to develop meaningful nurse-patient relationships."
I totally agree and have extensive personal experience, socially as well as professionally, of this but it is an attitude which should be right across society and not exclusive to nursing. somehow we need to get the message across so that the elderly are treated with respect with the same rights as all other citizens and receive the attention and care that they need. there is no reason why they should be treated as as an 'out' group separated from the rest of society.
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Anonymous | 20-Aug-2012 12:44 pm
Everyone has life experiences to share that can be wonderful to hear, and also sad. I work with many homeless people and some of their stories are very sad but also uplifting.
I think many 'groups of society' get forgotten and don't seem to receive equal rights to healthcare or respect from others - the homeless, the mentally ill, those with substance abuse issues, it's not just the elderly who we look after.
Everybody is entitled to respect from society, excellent healthcare, safe accommodation, warmth, food - the list is endless and should be the same for everyone regardless of age.
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Anonymous | 20-Aug-2012 12:58 pm
"Everybody is entitled to respect from society, excellent healthcare, safe accommodation, warmth, food - the list is endless and should be the same for everyone regardless of age."
I totally agree with you and am very disturbed by the fact that a few nurses on the NT website have said that respect has to be earned. It is an interesting argument but I find such an attitude, especially from healthcare workers, arrogant and a matter of grave concern.
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Anonymous | 20-Aug-2012 6:41 pm
I thought that Cinderella nursing was all part of the Norton model, back in 1962 - were you really a nursing assistant then, it is 50 years ago.
I always hear good things said about the elderly and elderly health care but I have not heard many good or positive things said about other members of society who are easily forgotton.
I should like to see NT taking more of an interest in mental health nursing, disability nursing, the homeless, the drug and alcohol users, sex workers, asylum seekers, the unemployed, the ex-military who have fallen on hard times - they are people too. Many of them have had terribly difficult lives, let's hear about them for a change please.
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Anonymous | 20-Aug-2012 10:29 pm
Everyone deserves the best.It doesnt matter what branch of nursing you are in.Respect should be given to ALL clients. Respect is earnt through example so what you give is what you get.
However just remember because you are old /young doesn't always follow that respect is always freely given!!
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Anonymous | 20-Aug-2012 10:31 pm
"However just remember because you are old /young doesn't always follow that respect is always freely given!!"
why not?
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Anonymous | 20-Aug-2012 11:42 pm
“Older people deserve the best” of course they do, just like anyone receiving care. Now wake up and smell the coffee.
Whilst it might not be your experience Ann, in a great many care homes something like 70% of residents are funded by local authorities and PCTs who have closed their own geriatric beds because they couldn’t afford to run them. These commissioners now do their utmost to avoid paying more than £500 per week for a nursing care home bed (compared to the £600 a day for a hospice bed), they delay continuing care assessments to avoid paying higher fees, count out the incontinence pads they provide and cheat residents out of the access to NHS funded resources which is their right and instead try to get private sector care home providers to foot the bill.
The result is that nurses working in private sector care homes usually earn significantly less that their NHS colleagues on AfC grades, most don’t have pensions or sick leave and can only dream about the paid holiday enjoyed by the public sector. Of course they can move, and when they get the chance they do. RN staff turnover can be as high as 30% in some care homes, but don’t forget the carers. They ‘enjoy’ the same conditions but usually on minimum wage rates!
Despite all of this there are some fantastic nurses and carers working in aged care in care homes, but you do have to wonder why when their dedication and love for what they do is receives such little recognition.... small wonder that the Cinderella image still prevails.
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Florence | 21-Aug-2012 10:13 am
Ive spent most of my 20 year nursing career caring for older people in a variety of areas. Hospitals - acute care and rehabilitation, Care homes and a Falls clinic.
Care of older people is beginning to be recognised as a speciality now. But it's right everyone deserves respect and the very best care possible.
My experience in caring for older people has enabled me to develop a diverse range of skills.
I would not change my area of speciality. Despite the challenges it can be massively rewarding.
We are all going to get older and I would want to know that there are professionals with the right skills and that there will be resources avaliable to support me at that time in my life.
There are some fantastic examples of care out there and some very dedicated , hard working Nurses.
The Practice Nurse who cares for my Dad, who is in his late seventies, helps him manage his asthma and hypertension. She is a kind, experienced Nurse who has a great knowledge base. My Dad is very reserved and finds it difficult to talk about any health problems . This Practice Nurse has helped him to open up and he looks forward to his monitoring appointments with her. My Dad used to be very anxious about his '' White coat Hypertension''. However this Nurse has used her skills and understanding of the sometimes multiple health problems older people face to support and reassure my Mum and Dad.
She has made such a difference to their lives and Im very grateful to her.
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Anonymous | 21-Aug-2012 10:56 am
Anonymous | 20-Aug-2012 11:42 pm
surely it is up to nurses to negotiate adequate conditions for their patients, their staff and themselves?
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Anonymous | 21-Aug-2012 11:06 am
morag cunningham | 21-Aug-2012 10:13 am
the nursing care for your Dad you describe is what nursing is all about and extremely important for all our patients and shows a nurse who really cares about the job she does. we need more like her.
care of the elderly is highly complex and is a speciality which cannot be done without adequate training or at least under supervision from somebody who has relevant training for more basic tasks. Doctors, GPs, nurses and those working in mental health who are involved in the care of the elderly also need more appropriate specialist training.
there seems to be a lot of confusion when talking about care of the elderly who are dependent and those who need specialised nursing care. not all of the elderly are ill and need this costly level of care throughout old age but may do at some stage in their life.
there are plenty of highly specialised courses available around the world in many branches of gerontology to meet the different and complex needs of the elderly and these should be made available to nurses in the UK. Career structure and appropriate levels of pay should follow this. In some countries nurses and other healthcare workers are paid higher rates for their specialisation.
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tinkerbell | 21-Aug-2012 6:57 pm
Unfortunately i don't think this fairy tale is going to have a happy ending. Working as i do in elderly care 5 of our NHS beds have already been sold to the private sector. Kerching!
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Anonymous | 22-Aug-2012 9:04 am
Nurses used to get paid extra for working on 'geriatric' wards - also on psych wards but no more of course
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Florence | 24-Aug-2012 8:34 am
Yes I remember we used to recieve what was called a '' Geriatric Lead''. Our Student Nurses, and other professionals who come to work in our area for the first time are often surprised at the complexity of care that Older people often require.
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Anonymous | 24-Aug-2012 10:05 am
I am pleased that the complexity of care of the elderly is recognised. now the acknowledgement that it necessitates specialist care is urgently required.
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