Advice to novice who wants to work with geriatric population.

[ebcifaldi]

I will be graduating with my BSN in May. I feel pretty positive that I want to work with a geriatric population. I'm no spring chicken. I spent 10 years teaching elementary/high school art. I'll be 42 when I graduate, coincidentally the age my mother was when she died of cancer and I swore I never wanted to be in another hospital. My father was almost 20 years older than her. I have spent a lot of time caring for him and his brothers and sisters (picture big farm family during the depression). I have grown very passionate for our senior population and advocating for quality care for them. My question, to get to the point, is what type of hospital floor would be a good place for me to start. I think I'll need 2 years experience before I can work in long term care. I'm thinking about our VA hospital. Would they hire new BSNs? Thinking about the future, I don't think I want to work in a nursing home if it means I'll be more of a supervisor to CNAs. I want to provide face to face patient care. Ideally, I would like to be a part of a client/family's long term care plan assisting them to have the best quality of life no matter what chronic illness they may have. Perhaps home health, or even hospice care some day. I need advice!! Please and thank you in advance.

[adventure_rn, MSN, NP]

You mentioned wanting to sit and talk with older people--perhaps you should consider geriatric psych? At the large academic hospital where I did my psych rotations, there was a dedicated gero-psych unit. Most of the patients were experiencing some form of dementia or delirium, rather than a psych diagnosis. I found it similar to being on a 'memory care' unit in an LTC facility, although most were hospitalized because it was unclear whether the patient was experiencing chronic dementia or acute delirium (or, if they didn't have a place to be discharged to).

A rehab hospital or unit might also be a good place for you (kind of like LTC). You work with many elderly patients (although not exclusively with the elderly), and you get to support them each day in becoming more independent and reaching their discharge goals.

Another thing I would recommend is looking into outpatient care with geriatric patients. When I worked in an outpatient setting, I adored my gero patients. They typically wouldn't complain about long waits since they weren't in a hurry to get back to work, and they were generally very kind and conversational because they were excited to get out of the house. I know I'm painting with a broad brush (and hope I haven't offended anyone with these generalizations), but my outpatient gero patients have been some of my favorites. I actually found it a bit jarring (and sad) working with elderly patients in the hospital during clinicals because they tended to have poorer outcomes and to lose a lot of their independence in the hospital.

The best thing you can do to figure out what you really want is to shadow!! Shadowing could help you to clarify the role of the nurse in these different settings, and it can give you a better sense for what precisely you enjoy (or dislike) about the nursing duties in each setting.

[kbrn2002, ADN, RN]

In every geographical area of this country there is usually a vast shortage of nurses willing to work in a SNF [skilled nursing facility], and fewer nurses still that actively seek out that specialty. I would be greatly surprised if you need any experience to find employment in elder care. Some parts of the country, like where I am, the pay is considerably lower than in a hospital setting. I was a little shocked when I found out this wasn't always the case. If you are passionate about geriatric care there are more options than a traditional nursing home, but as a new nurse you would most likely be better off getting your start in a traditional nursing home setting than in a setting like home health that requires much more independence in your practice.

A great entry to the field would be to get your CNA certification and work in a nursing home part time during your last year of school. A word of caution though. There are many fantastic nursing homes out there, but there are also a fair number that are shall we say less than stellar. Do a little research and avoid those bad ones when it's time to start your job hunt.

[Marshall1]

Not sure my post posted...anyway..the LTC where I live hire new grads - if that's the flavor of nursing you want, apply to those around you. I know several nurses who went straight from nursing school to LTC and never looked back.

[DisneyNurseGal, BSN, RN]

I work on a 36 bed general medical unit in a hospital and 80% of our patient population are geriatric. I love working on this unit because we see all kinds of diagnoses from UTI, GI Bleed, COPD Exacerbations, Pneumonia to Altered Mental Status. It is a great place to learn about the care of this population.

[mmc51264, BSN, MSN, RN]

I love the geriatric population. I work on an ortho unit and we get our fair share of falls/hip fx. They can be challenging if they have some AMS but they are great to talk to, most are very appreciative of what you do for them, I don't like to generalize-some can be quite difficult and they can have many comorbid conditions. It is a growing field and it needs people who are enthusiastic about treating them.

I agree with the PP that talked about geriatric psych. I am fascinated with that. very interesting-so a physician do a test for catatonia. Amazing.

[PANYNP]

After you have 1-2 years of experience, consider enrolling in an AGNP master's degree program to become an Adult-Gero Primary Care Nurse Practitioner.

Your clinicals will be in primary care settings, such as internal medicine or family practice offices, long-term care, ED, specialty clinics, and others.

As an AGNP in primary care, you will have an opportunity to diagnose and manage patients' health problems across the adult lifespan, from adolescence to extreme old age.

Gero is where it's at, baby!

[ebcifaldi]

Thank you so much! I think those are all great suggestions. I agree with you about working on a regular med surg floor with geriatrics, from what I've seen they do have poor outcomes. I want to be a part of their process too. Not just shuffle them through.

[joanna73, BSN, RN]

I work in a geriatric hospital. We have LTC units, palliative, respiratory and rehab. Since the population is aging, you will provide care to geriatric patients no matter where you work.

Unfortunately, we cannot spend the time we would like with them.