geriatric nursing

  1. I recently went from a leadership position in a nursing home, to
    a staff nurse position in a hospital. From my discussions, it
    appears that some of the opinions are that geriatric nurses donot
    know as much, skill level is poor, and you would have to be crazy
    to work in a nursing home. I would like to know if this is a general consensus--what is your opinion?
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  2. Poll: Are geriatric nurses "real" nurses?

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    2 Votes / Multiple Choice
  3. 28 Comments

  4. by   sandigapeachlpn
    i was a staff nurse in a hospital. NEURO, ORTHO, AND PEDS. frequently we would also receive overflow from other floors. so, i got a pretty wide range of experience. i now work as charge over noc. yes, i got to do more ng tubes there. but since i have been there in 4 years, i have learned many valuable skills that i would not have gleaned in the hospital setting. number one is handling a crisis at the drop of a hat with this chick the nurse in charge. no respiratory staff to call for a code, no doctor in the house. and now that our census is up lately yes we have to have a rn in the building but i have more experience than most of the rn's. dealing with geriatrics teaches you a whole new aspect for problem solving because there is no black and white. mostly grey's. if you don't know what to look for in these patients they can easily die very quickly. MANY cannot tell you what hurts where, or that they don't feel well, etc. it's my job to figure it out before they get that bad, or that is neglect. in the hospital setting i was a staff nurse only. the rn took the orders and spoke with the doctor in any change of condition situation. now i am the staff nurse, the charge, and i deal with staffing. i also worked with physicians in the office setting. it becomes invaluable when another nurse is having trouble with an order. most of the time i can figure it out, but of course not always. the most interesting thing; i have watched the skill level of acuity increase since i have been in LTC. LTC is evolving for the demand of marketing and the almighty dollar. niches are being sought after and specialties are making facilities more attractive. because of this our facility focuses on rehabilitation. i am now seeing more and more 20 year stroke victims, car accidents. another change is the hospice deal. in the last year i have taken care of countless end stage terminal residents that the family could not care for at home. i had a 47 yo women dying with ca brain mets with TPN. i have been taking care of a gentleman that is 48 with 3 surgeries to his hip because of complications , he has a groshong, dialysis patients with peritonel procedures; MS residents with ulcers that we heal so they can go home. it's kind of cool because of the younger age group that is now pouring in now i have way many full codes than i did before. yes i am sure there are more procedures in the hospital, but the way insurance has changed with hospital stays becoming shorter and shorter, and frequently these patients cannot take care of themselves at home quite yet; well we are becoming a step down unit. and, my job in comparison to the hospital is way more challenging, way more stressful, and equally as rewarding.
  5. by   caroladybelle
    I have a great deal of respect for geriatric care nurses, I don't think that I could have enough patience with long term care clients. It takes different skills to take care of the longterm and elderly client and different preferences.
  6. by   nursedawn67
    I feel and have experienced the bias that comes from Hospital nurses.....I have had them treat me like I had no clue. Not to say that all of them did this, but a great many. I do agree that they get alot more experiences, but it in no way means they are better nurses.
  7. by   eagleRN
    From a hospital nurse (20 yrs experience) to a convalescent center, it has been a challenge! But, where ever you are working you are a nurse, and a nurse's greatest asset is her ability to assess, no matter the age of the pt, the dx, or the place of employment, use your knowlege AND that feeling in your gut. Everything that I have learned is cumulative, just like every other nurse, knowlege is never wasted. And after all for skills that we need to brush upon, there is always a procedure book. I love geriatrics! Hopefully, all of us will be a geri one day.
  8. by   Tookie
    Daisy may isnt it sad that we have to even consider this thought - however l do think that it is a sad realitysome nurses do not beleive that nurses who work with the aged in long term care are true nurses - they cant cut it in the real world -
    However what would the percentage of the people for whom we care be aged - 60 and over - we have many chronic diseases that start at a much younger age. - I tell the student nurses who come to us on placement - if you can learn the basics here and take away how to holistically care for a person what ever their age then you will be a good nurse - (add a large dash of empathy) If you can make a difference in a perosn who maybe unresponsive - even if it only to make them comfortable and to be treated like a human being isnt that what nursing is really about -

    Yes the technology and all the other areas are important and in equal vlaue - but everyone who has an older parent or grandparent will want the very best for them if they required long term care and it is only by valuing the nurses in this area and treating them with dignity that we are really valueing and treating with dignity our ageing population in what ever country that we live
    It can become a passioante subject for me - how can we keep the people in the aged care industry when governments dont vlaue us and pay us accordinlgy if sadly we are not even valued by some of our nursing peers - and worse even some of us who work in this sector
    I hate nothing more than when a nurse or a carer says l am only a carer or l only work in aged care - we are part of important process - the ageing and often dying process and we make a difference in peoples lives.
    Tookie
    I post this unread hope you can read it if l retype it l mught take it off
  9. by   TIREDmidnightRN
    I became a nurse to work in geriatrics. Did it for most of my carreer. BUT the NATION does not respect geriatric nurses! The pay is worse and the respect nonexistant! I would fight hard for changes, only to see the owners undo them for economic reasons (things like adequate staffing, real meals for the residents) ....we do not respect the elderly in America, as a result we do not respect the people who render personal care to the elderly!
    By adequate I mean adequate..I never asked for more than what was needed...at one facility I had three aides for 68 residents........and the owners refused to allow agency aides!
    At another they actually served residents ONE strawberry, a small scoop of cottage cheese and an apple wedge and a cup of coffee for dinner!!!!!!
  10. by   jevans
    WOW
    i read these discussions with great interest. I work in the UK I don't know the set up in the States but wards here are intergrated with all ages. there isn't a nurse here who can say that they do not work with older people. As we have an aging society together with the knowledge that in age we need more health care it is amazing to find that there are some who do not value staff who work with older people full time. Older people have the disadvantage of multiple disease/ conditions that require the nurse to have an extensive and comprehensive knowledge to provide quality care. The stroke unit I work at rejoice in the knowledge that we are experts in our field and can often be overheard expressing our satisfaction in providing excellent care in an environment where the individual is treated with dignity respect and appriciation of their life experiences
    Our unit has an occassional doctor so is mainly nurse lead. So how may cardiac arrests have occurred in the last year? NONE!!!!
    WHY???
    the expertise and knowledge of my staff who ensure that patients recieve urgent attention immediately

    Gosh don't we sound good. But seriously I'm proud to work with older people
    j
  11. by   kmp297
    I've worked in long term care for nine years. You have to be self motivated, and excellent assessment nurse. You are the Doctors eyes and ears. You get to know these people and their families very well. You have a first name basis. You also need to be able to identify suttle changes most non-geriatric nurses don't see in the elderly. The whole s&s of disease process is different in the elderly. I've been a charge nurse, supervisor, and unit manager over the last nine years. I did everything from
    simple foley caths, to vents, and even peritoneal dialysis. You name it we do just about everything including providing quality end of life care with extensive family involvement. It takes special nurses to work in geriatrics as it does every field of nursing no matter what area.
    ****Also please remember. Long term care, isn't long term care anymore. We have all ages from infants all the way to above 100 yrs old. We have short-term rehab. All with the State watching over us. The regulations are much more strict than in a hospital. Regarding restraints (physical & chemical). Skin issues etc... My hat goes off the to the "Geriatric" nurse.
  12. by   night owl
    Yes we are!
  13. by   nrsfear
    I have worked as a geriatric nurse my entire career(with the exception of 11m in corrections) I take every opportunity to people I am a Geriatric nurse! I started as an RN in a nursing home, thinking "I can crush pills in applesauce and feed them to little old people" WOW!!! talk about realitly shock. I feel in love with the specialty. I'm a member of the Geriatric nurses association. I'm currently working on a Medical unit, as a staff educator,(our pt population is about 80% over the age of 65.). Even our hospital unit is looked down upon, sometime it feels like we are th ugly step child of our hospital. My usual reply to those fellow nurses who look at me with distain or pity is; "I love the elderly, I'm sure you would want me taking care of your grandparents, over some one who does'nt" that usually shuts them up. I think geriatric nursing can represent nursing at it's most basic, if one thinks of Maslow's hierarchy of needs we take care of those needs on the bottom. I think Florence herself might be a geriatric nurse if she were here today. My Father is a Nuclear Engineer ( the nuclear business being a highly regulated field ) I was telling him once that "Long-term Care" had surpased the nuclear business as being the most regulated industry. After I told him a few stories of survey citations, regulations, MDS, PPS, blah-blah..... He said "Your right, you guys are number one"
  14. by   TIREDmidnightRN
    I went into nursing to do geriatrics...but finally left for hospitals when it was impossible to tolerate the way the "system" works in LTC. But I still have cringe attacks when I see the things that hospitals can do that a nursing home would be fined for...oral meds in the med cart drawer next to eye drops, linen on open carts, dirty linen close to clean carts, beds too close together, bedpans stored in the bathroom....restraints....even the most restrictive hospital guidelines are lenient to me!!!!!
  15. by   bandaidexpert
    I have to say, I have been in LTC all my life. In our sunny little tourist town, we have one hospital. The condition of the residents we receive is amazing. I understand DRG's and all that political BS, but my point is, our nurses are taking care of residents that should not have been discharged so soon. Thus, using their skills and knowledge just like they would in a hospital.
    Tired..I agree, the regulations for hospitals are not what they should be. I would go stir crazy working in one. In LTC you live each day in preparation for survey.

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geriatric nursing