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Chapter 7 Discussion
found that nursing staff who had little gerontological nursing education impacted
negatively upon residents’ experiences of autonomy and Hunter and Levett-Jones
(2010) added that it is imperative for nurses working with older persons to have
expertise as well as highly developed skills and knowledge. An Bórd Altranais
(2009) professional guidance for nurses working with older people also
recognises that working with older people is specialised and outlines six nursing
standards and relevant competencies that nurses working with older people
should be competent in. These are standards for person-centred holistic care,
therapeutic relationships, the care environment, end of life care, professional
development and quality of caring. The competencies are judged on the nurse’s
professional/ethical practice, holistic approaches to care and integration of
knowledge, interpersonal relationships with clients and clients’ families,
approach to organisation and management of care and their maintenance of
personal and professional development. In support of Hunter and Levett-Jones
(2010) and Jang (1992) only 25% of nursing staff in this study had specialist
gerontological education and a lack of resident autonomy was found across the
data sets.
In contrast, however, Moseley and Paterson (2008) argue that regardless of
educational qualification, the age of the nurse is also important and that older
nurses contribute a wealth of knowledge and experience to their employing
organisations. In this research study, analysis of the age profile of the nursing
staff revealed that the majority of nurses were aged 31-59 years (75%). The
nursing staff had an older age profile than the HCAs with 10% of nurses aged
60-65 years. However, while the age profiles may have been high in this study
the interviews revealed that many of the nurses in the older age category
acknowledged that they were unfamiliar with negotiating care with residents, and
that care planning which facilitated resident autonomy was particularly
challenging for them. The observations supported this and revealed an approach
to care that was not always resident-centred or focused on enhancing resident
autonomy. Consequently, phase two of the research began with an educational
programme for all staff in order to bridge this knowledge practice gap.