Look after those who look after the elderly

However, there is a problem with the image of “older persons nursing”, or what is internationally referred to as gerontological nursing, as a career in Britain today. The problem exists in the pages of our newspapers when we read about sinful neglect taking place in care homes across the country or poor care of older people in hospitals. It exists in the attitudes of institutions which have been shown to fail to recognise humanity and individuality. And unfortunately it also exists in the minds of some of those entering the profession who view it as something they might do towards the end of their career and not as a positive career development option.

Gerontological nursing is highly skilled. It requires particular expertise in communication, integrated biomedical, psychosocial and interpersonal decision-making, as well as understanding complex disease processes in ageing. Thus it deserves to be lifted out of its backwater and celebrated for its crucial impact on the health and wellbeing of older people and their families. We should be aiming to reach a situation where older persons nursing is seen as a specialist area for progression of a nurse’s career, and that can only be achieved with a joined-up approach and continued investment in education and clear career pathways. Education programmes need to be developed that take a holistic approach to addressing gaps in knowledge about beliefs, values and attitudes towards older people.

If we are to successfully provide genuinely person-centred care to our burgeoning ageing population, then every nurse will require specialist education to ensure a consistently high quality of care, regardless of where it is provided. For example, nurses in acute wards nowadays find themselves managing the needs of older people almost as much as those who aspire to a career in older persons nursing in more specialist settings or nursing homes. It is fair to assume this is not necessarily what they might have thought they were signing up for, but the truth is two-thirds of hospital bed days are for patients over 65, with a quarter for over-80s, who will often have complex and multiple health conditions.

Nurses in acute wards, who may have been expecting to deal with a younger population, find themselves faced with the reality of caring for frail older people, who may also be living with dementia and other diseases of ageing. Long-term investment is needed to provide the ongoing training and support these nurses need to provide the best possible care of older patients, and to be able to respond to their very specific needs. It is not fair to criticise nurses who can only attempt to do their best using the skills they have been taught, if that teaching does not extend to cover the complexities of caring for the largest proportion of people in their care.

Older people have the same rights to services as any other person. They should be able to choose how their social and health care goals are met. To provide a truly person-centred service to patients requires the nurse to adapt learned approaches to suit the individual’s needs, drawing on practice experience and continuous professional development.

Nurses may find it difficult to articulate the complexity of the steps they have taken to ease the suffering not just of the patients in their care, but the patient’s family also, and should take pride in every small success along the way. Every nurse is a brand ambassador for the profession, and more needs to be done to ensure they all have access to the same gerontological education and on-going professional development that recognises the complex work of caring for older people. Organisations also need to do much more to demonstrate the value of this work.

• Prof Brendan McCormack is Head of the Division of Nursing, School of Health Sciences, Queen Margaret University, Edinburgh www.qmu.ac.uk