Working in gerontological nursing can be immensely rewarding, but in order to be successful, it’s critical to familiarize yourself with the characteristics unique to this age group. Here are some key areas to focus on if you are pursuing a career in adult-gerontology acute care nursing.
Generations previous to our own often have different sociocultural norms. Being mindful of this will facilitate their care. They may be uncomfortable being addressed by their first name, or they may be very private. Giving respect and space where needed will go a long way toward earning their trust and confidence, making it easier to care for them effectively.
Even elderly individuals without a cognitive impairment can
experience a sudden change in mentation, often triggered by infection (UTIs are
common culprits) or by a change in routine, geography or both. Safety is
paramount, so be mindful of their room assignment as well as their potential
for confusion to ensure that they are well monitored.
The elderly often lose acuity of one or more senses, so it’s important to accommodate these changes. Due to decreased activity levels, muscle mass, and food intake, they often complain of feeling cold. This is also attributable to chronic conditions such as anemia, kidney disease, underactive thyroid, or even the medications they take.
Offer them warm blankets, light jackets, or slipper socks to help their bodies retain warmth. Adjust the room temperature as appropriate. Elderly patients often will ask that their hot beverages or food be reheated. This alteration in heat perception is quite common in older patients, so reheat with caution to avoid injury.
Their hearing and vision are likely to be impaired to some degree, so speak deliberately and clearly. Let them see your face as you’re speaking. Repeat what you’ve said when asked. And encourage the use of eyeglasses and hearing aids where indicated.
Functional impairments such as balance issues and weakness are common among the elderly. They should be closely monitored or assisted when ambulating. Be mindful of hazards that may cause falls: furniture placed too closely together, uneven walking surfaces, throw rugs, electrical cords, and IV tubing. Weakness may necessitate the use of assistive devices to ambulate. Monitor transfers to determine whether they may need greater assistance for the transfer order.
Due to their nutritional status, chronic conditions, and medication, many will have fragile skin—their skin may have a papery texture and is easily prone to tears and lacerations. Protect it by keeping it clean and well-moisturized. Choose an appropriate tape for dressings, IV tubing, etc.; this will help minimize damage to the skin and potential allergic reactions, or when appropriate use mesh sleeves.
Constipation is another common complaint, related to decreased fluid intake, reduced activity, and polypharmacy. Monitor their diet and fluid intake for fiber, nutrients, and adequate hydration; and encourage activity and fluids as tolerated per their doctor’s orders.
Want to know more about adult-gerontology acute care nursing? Visit here to determine which certification may be right for you.
It’s no secret that our elderly are the fastest growing segment of the U.S. population, fueled largely by aging Boomers. So it’s simple to deduce that nursing careers in adult-gerontology can offer many opportunities for growth and nursing leadership. However, working effectively with this demographic requires specific skills for success.
Nursing competencies should include a BSN and a minimum requirement of a firm base of experience in general medical-surgical nursing to care effectively for the disease processes that affect the elderly. Cardiac and respiratory conditions, diabetes, and cognitive impairments are among the most common pathologies troubling people over 55. Nurses must be adept with assessment skills to detect condition changes in their patients. Nurses advancing to management roles will be better prepared with their MSN, NP, and even a DNP.
You’ll need capable skills for working with the most common psychosocial issues of those in their later years. Many elderly patients suffer from social isolation and depression, which can exacerbate physical issues they may be dealing with. Nurses will also need to demonstrate empathy and patience when working with those suffering from cognitive impairments such as dementia or Alzheimers. They must also demonstrate the ability to anticipate their patients’ needs when the patients aren’t able to articulate their needs themselves.
The health of elderly patients can be mercurial. Their
immune systems are no longer as robust as they once were, and they’re often
further influenced by other disease processes. Something seemingly routine and
easily treated in younger patients, such as a urinary tract infection, can
trigger a cascade of symptoms that can send many clinicians scrambling. A nurse well-versed
in the care of the elderly will quickly identify the more subtle changes with
A good geriatrics nurse also knows about the best resources to
guide their patients to wellness. For example, making a patient or their family
aware of adult day care centers in their neighborhood can lighten the load of
caring for them during working hours. Asking the physician for a consult with a
neurologist or psychologist for developing cognitive issues, or a urologist for
intractable urinary infections facilitates the patient’s access to timely
treatment. Requesting a referral to a social worker to address neglect or abuse
issues in the patient’s home keeps the patient in a safe environment.
Interested in getting certified in adult-gerontology? Visit NursesGetCertified.com to learn more.
From New Years’ Day 2019 through April 11th, the United States has reported 555 cases of measles in 20 states—the second largest measles outbreak reported since the disease was eliminated in 2000. Keep reading to learn the 10 things nurses need to know about the measles outbreak:
1. Measles is brought into the U.S. by travelers who’ve been in foreign countries where the disease is prevalent—countries in Europe, Asia, Africa, and the Pacific. It is then spread in U.S. communities via contact with pockets of unvaccinated populations.
2. Measles outbreaks, defined as three or more reported cases, are currently ongoing in Rockland County New York, New York City, New Jersey, Washington state, Michigan, and the counties of Butte County California. In addition, new cases have recently been identified in New York’s Westchester and Sullivan counties.
3. Once a person is exposed to the measles virus, it may take up to two weeks before symptoms begin to show. A person is contagious four days before the tell-tale rash appears and for four days after. Measles is an airborne virus that can be shed by those infected long before the symptoms arise.
4. There is no available antiviral therapy to cure measles—only supportive therapy for the symptoms, among which are those similar to the common cold: fever, cough, runny nose, sore throat, followed by conjunctivitis and body rash. Measles can sometimes lead to more serious and life-threatening complications such as pneumonia and encephalitis.
5. New York City Mayor Bill de Blasio has declared a health emergency in the neighborhood of Williamsburg, Brooklyn and is mandating unvaccinated residents to become vaccinated. Those not complying could receive violations and fines of $1,000.
6. Mayor de Blasio has sent a team of “disease detectives” into the Hasidic Community in the Williamsburg neighborhood of Brooklyn, where nearly half of the U.S. cases reported are identified.
7. Coincidentally, the New York State Nurses Association just reached an agreement with the NYC Hospital Alliance to hire more nurses to fill vacancies and add new positions.
8. Detroit is urging those Michiganders vaccinated prior to 1989 to receive a booster vaccination.
How Nurses Play a Role
9. The role of nurses in these outbreaks is education and the promotion of vaccination.
10. It is critical that frontline health care professionals are vaccinated themselves in order to prevent the further spread of the virus, particularly when treating those patients infected by the disease.
Longing for flexible schedules? An opportunity to spend time
with patients? Many nurses have achieved these goals in their nursing career by
making the move to home health nursing. Rather than juggling the care of
several patients simultaneously, these nurses can see each patient one at a
time, without the usual distractions that hamper the ability to care for
patients in hospitals or other facilities.
Although patients are also seen by other health professionals when
under medical care, nursing often takes the leadership role. Home care can
involve visits by occupational, physical, and speech therapists, as well as
pharmacists and nurse specialists.
Most patients have follow-up appointments after a hospital admission, surgery, or other change in condition as ordered by their physician, while other patients are visited in the home for palliative and end-of-life hospice care.
The nursing competencies most critical in the delivery of
home care are built on a nursing education followed by a good foundation of
experience in medical or surgical nursing. Independence and creative thinking
are also important, especially in assessment, phlebotomy, and IV, as well as
wound care while working independently in the field.
Home health nurses should
be comfortable being alone as they navigate their service area and travel to
unfamiliar places. Having a GPA program in your car and a map is crucial in
case you get lost.
There are some important safety considerations
for success in home health nursing. These include keeping your vehicle in good
working order, monitoring your fuel tank’s level, and leaving all non-essential
valuables at home. If you are assigned with an electronic point of care device
for documentation, guard it carefully. Staying alert and observant can prevent
unexpected mishaps, theft, and violation of the patient’s privacy.
Visiting patients in their own homes make it possible to develop relationships with them while allowing for more time to focus on educating them about their health. For many nurses, this is the most rewarding work of all.
To learn more about home health nursing, visit here.
Nurses working in busy clinical arenas often hear about nurses who have left the floor to work in administrative departments. Such nurses may be encountered when they come requesting an update regarding a patient’s condition. However, most clinicians are far too preoccupied with their own responsibilities to learn what those nurses actually do or where they fit in their patient’s care continuum.
Utilization review is one of the least understood but
incredibly essential departments in managing the cost of health care.
Experienced nurses can bring a valuable perspective to this field.
Utilization review nurses perform frequent case reviews, check medical records, speak with patients and care providers regarding treatment, and respond to the plan of care. They also make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions. Furthermore, they also assist with determining whether a treatment meets the criteria for reimbursement by the insurance plan.
Utilization review nurses are also found in discharge
planning roles to ensure that patients make a safe transition from acute to
home care. They are involved in pre-certification, which determines whether a
recommended procedure, medication, or therapy is appropriate for an individual
according to the guidelines of their insurance plan.
The minimum credentials for working in utilization review are being licensed as a registered nurse and having a good base of general nursing experience in medical-surgical nursing. Many employers require a BSN over an associate’s degree, and sometimes specific certifications in utilization review or risk management.
Good communication skills, attention to detail, and the ability to excel under stress with minimal supervision are also critical for a successful utilization review career. Fortunately, on-the-job training is often provided for these roles.
The benefits of moving to utilization review can include a more regular schedule, a predictable salary, and perhaps even the ability to work remotely.