Did your school discriminate against the elderly? read to find out...

[LPNweezy]

My school discriminated the elderly big time. and in the most subtle way, too. Heres how:

I called them the "fall backs". When i first entered my school, they trained us the basics, and we were only allowed to work around and with geriatric people. Pediatrics, younger adults, and teenagers were totally off-limits. For my entire first year of nursing school, taking blood pressures, long sounds, assessments, etc. (totally non invasive and non dangerous procedures) were done on geriatric patients. It was only on my second and final year of nursing school that they let us assess young adults (ages 18-55). And peds? we had a rotation, but we weren't allowed to pass meds or anything nurse like. we were CNAs during the peds rotation.

i am having trouble describing this, i'm not too good with words, so let me give another example of my school doing this: the veterinary program lets first year beginner students work with cattle and farm animals. those are the "Fall backs" then the second year, the school lets them work with exotic animals.

They are clearly doing this because they think the elderly will "just die soon anyway" and if a mistake were to happen, its "not that big of a deal with the elderly." A human being is a human being despite age, anyone else find this disgusting? shame on you, school. SHAME :spbox:

[elkpark]

The smaller the person, the smaller the margin of error. That's why you're not likely to see students giving meds to pediatric patients and you NEVER see them working in a NICU.

Actually, in my diploma program, we did total care (meds and all procedures (after we had been checked off in school, and with our instructor's supervision)) in our peds rotation, and spent six weeks in NICU (four eight-hour clinical days a week) doing most everything the staff nurses did, including giving most meds and doing most procedures (again, with supervision). Of course, nursing education has changed a lot -- you can't do that if your NICU experience consists of observing for a day or two ...

The limitations on what students can do in clinical are primarily established by the clinical facilities, not the schools. Of course, I can understand their position -- they don't want to have to be responsible for errors made by students, esp. when they don't know much about how well-prepared the students are for the experience (what with students coming from all different schools from all over the community). My school was part of the hospital, so they knew exactly what kind of education we were getting, had confidence in us, and were willing to stand behind us in order to provide us with a great nursing education.

[LPNweezy]

Actually, in my diploma program, we did total care (meds and all procedures (after we had been checked off in school, and with our instructor's supervision)) in our peds rotation, and spent six weeks in NICU (four eight-hour clinical days a week) doing most everything the staff nurses did, including giving most meds and doing most procedures (again, with supervision). Of course, nursing education has changed a lot -- you can't do that if your NICU experience consists of observing for a day or two ...

The limitations on what students can do in clinical are primarily established by the clinical facilities, not the schools. Of course, I can understand their position -- they don't want to have to be responsible for errors made by students, esp. when they don't know much about how well-prepared the students are for the experience (what with students coming from all different schools from all over the community). My school was part of the hospital, so they knew exactly what kind of education we were getting, had confidence in us, and were willing to stand behind us in order to provide us with a great nursing education.

i did not know this! thanks :)

yeah this thread is very eye opening, i had no idea to think of the progression of it, i just always had this theory because of the attitude of my teachers. I guess i'll have to try to see things differently from now on in other situations.

[Esme12, ASN, BSN, RN]

Plain and simple........it's alot easier to learn how to take a blood pressure on a cooperative adult than a screaming outraged child!

Reallly....the majority of patients are "elderly" with chronic conditions....that is the patient population. Plus facilities place strict guidelines on the school what can and cannot be done. It really isn't a conspirancy..........I am glad you spoke up and learned how to see things from a different prespective. Good Luck!

[Nurse SMS, MSN, RN]

The smaller the person, the smaller the margin of error. That's why you're not likely to see students giving meds to pediatric patients and you NEVER see them working in a NICU.

Besides that, most people are comfortable changing a baby's bedding or diaper, but changing a 200 pound adult's bedding and brief are things that most of us don't have much experience with.

Not always true :) We passed meds in pediatrics (had to do all our own calculations too, of course) and I have two clinical days in NICU and one in newborn nursery coming up in conjunction with our L&D rotation.

It just depends on the hospital and its policies/comfort level with the local schools.

[Moogie]

thanks for all the replies! I just remember asking my teacher as a student "why don't we work with peds?" and she told me that "Parents are protective of their children and they don't like beginning students" This post is about my schools view, not mine. i seriously probably went to a horrible school. and im not comparing the elderly to farm animals i'm comparing the way my school does this. I always had this suspicion about why the beginning students started with the elderly, and the teachers definitely had a "they will die soon anyways" attitude. I don't think anyone else has had this kind of experience.

and i never thought about the stability of it, very very good point! But there was just something about my school and my instructors that i think is still fishy. If we made a small mistake in LTC, the teachers would brush it off, but in Peds or with a younger adult it would be a big deal. For example, if we said something about a procedure that was incorrect. Its our duty as a nurse to give correct education, and the teachers would say "whatever" in LTC, but in peds they would make us look something up in a medical dictionary and go correct it like we should.

i feel like my school had extra precautions for other patients that were not elderly. Any one else go to a school like this?

I bolded the comments in your statements that I would like to address.

If you had instructors who had the attitude that the elderly "will die soon anyways" or that a small mistake could be brushed off, I think those instructors need a new job. I've taught clinicals in long-term care as well as in acute care and NEVER gave students the impression that small mistakes were no big deal. I made students look up their drugs and would not permit anyone to give a medication he/she didn't understand, regardless of what drug it was.

Med errors in the elderly can be a very big deal especially because of the prevalence of adverse effects on older adults. Some drugs that are readily administered to younger patients are not recommended for use in the elderly due to adverse effects. One example is Benadryl. Additionally, polypharmacy is a huge concern with the elderly. Many elderly have chronic health conditions and some of their medications may inhibit or increase the effects of other drugs they're taking.

IMHO, any instructor who says "whatever" when a student makes a med error---in ANY setting---is one who is setting a very poor example for students and should be looking for another job.

[ChristineN, BSN, RN]

Remember that most NCLEX questions are related to med/surg senarios, so for a school to have a high NCLEX pass rate it makes sense that that would focus more on med-surg and adult nursing, and spent less time on peds/ob/psych since there will be less testable material in those areas.