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Chapter 2: Literature Review
interviews with residents (n=101) and staff (n=48). The researchers found that the
approach to care varied across care sites. It suggested that the staff perspectives or
ethos of care was a factor in the quality of life for the residents and that this was
often dependent upon differences in staffing provision and skill mix. The skill mix of
staff has been discussed by numerous researchers in the literature, and in particular
the contribution that the skilled nurse can make to creating positive residential care
experiences.
2.3.3 The Nursing Role
Researchers suggest that working with older people is a specialty in nursing that
requires specific competencies (Hunter and Levett-Jones, 2010; Reed et al., 2007;
Ford and McCormack, 2000; Hope, 1994). McCormack (2001) describes these
competencies as listening, negotiating, enabling opportunities and choice, and
enabling decision-making. The Australian Nursing Board (1997) produced
“Competency Standards for the Advanced Gerontological Nurse” and these were
reflective of the complex and diverse role of nurses working in residential care.
The nurse working in residential care must be knowledgeable and professionally up
to date so that he/she can play an essential role in contributing to positive
experiences of the approach to care. In addition to those nurses working in residential
care, Hope (1994) suggests that all nurses would benefit from gerontological
education as older people are patients in all specialities. The American Nurses’
Association of Gerontological Nurses also identified that the most critical
professional nursing issue was continuing education and ongoing development, and
furthermore that residential care facilities should identify baseline knowledge of staff
and implement educational programmes in order to enhance that baseline (Huber,
Reno and McKenney, 1992).
Ford and McCormack (2000) explained that the gerontological nurse needs
experience of caring for and working with older individuals, an understanding of the
socio-political context of ageing, an understanding of biological and psychological
developments through the lifespan, and an understanding of the needs of the
population. The Royal College of Nursing (RCN) (1997) advised that gerontological