Gerontological nursing is a specific field that must consider the age of the patients. Moreover, multiple factors have to be included when building the plan for caring for senior adults. This field is patient-based, but nurses can take into consideration family members as active participants. Furthermore, intentional learning can be applied in regards to learning about the specific strategies used when working with older patients.
For example, cultural aspects, therapeutic conversations, evidence-based models, and safety practices depend on each individual in particular. Nurses may work individually or as a team, but the preferences of the person in question must be considered in complex with safety practices widely applied in medicine. Quality gerontological care is a symbiosis of multiple different variables that have to be implemented for patient satisfaction and effective treatment and care.
Client-Centered and Culturally Competent Care for Older Adults
Gerontological nursing has been analyzed in regards to effective leadership styles and methods of care that are most effective for this particular medical field. Researchers have different opinions about this topic, but there are similarities when it comes to the overall scope of the implementations. In terms of leadership, one of the most effective leadership styles in organizations and institutions is transformational leadership. Researchers refer to transformational leadership as effective in gerontological nursing due to the implications of team motivation and conflict mitigation (Fiset et al., 2017).
Nurses may experience burn-out and low morale if working for long hours or experiencing difficulties with particular patients. Transformational leaders tend to ameliorate such issues and create a positive work environment. Moreover, employees with high job satisfaction are more likely to provide patients with high-quality care. Other researchers suggest innovative leadership as a successful model in the field of care for older adults (Burggraf & Mueller, 2020). Such leaders use innovative tools, methods, and strategies when dealing with medical providers and patients. However, innovative leaders are not as prone to conflict mitigation and team motivation and, instead, focus on new techniques and models that may benefit the facility. Thus, transformational leadership appears to have more benefits.
Differences also occur in the methods of care. For example, the case method is the model in which the healthcare provider is responsible for all the nursing functions that a patient requires. Such individualized strategies have been positively received by patients who prefer this particular tactic (McDaniel et al., 2020). On the other hand, team nursing is rather functional during crises, which was illustrated during the COVID-19 pandemic when multiple nurses were responsible for many patients (Beckett et al., 2021). However, this model does not contribute to the patient-nurse connection that is valuable in gerontological nursing. Thus, the case method is more effective.
The objectives in regards to gaining new knowledge about leadership and methods of care in gerontological nursing allowed me to have a general understanding of the strategies that I will use in my nursing practice. I have met the objectives by improving my theoretical skills that will be put into practice by mitigating conflicts and focusing on case method care. Thus, in a position of leadership, I will focus on motivating the team and minimizing challenges. When working with patients, I will put effort into creating a one-on-one connection and providing individualized care.
Intentional learning is widely used in nursing, including in care for older adults specifically. This method of learning illustrates the conscious decision to receive new information, analyze it, and possibly use it based on the situation. Researchers mention this specific action as a way to enhance the level of care for older adults (Boscart et al., 2020). An example would be observing how patients react to different approaches to communication.
In one case, the interaction can be direct and fact-based. On the other hand, communication can be more empathic and subjective. Learning about whether senior patients prefer the first or the second method will allow for a more effective communicative strategy in the future. Questioning patients is another excellent example of purposeful learning. The question may approach the topic of wounds or injuries. If the nurse asks senior patients what action, location, or circumstance is most likely to compromise their mobility, the answers will give insight into how to mitigate risk factors. In this case, if the patient is more vulnerable to such issues in the morning after waking up, monitoring during this time will be an effective solution.
Examining the topic of intentional learning in both physical and psychological areas of care provided me with a strategy to approach challenges and situations based on observations and feedback purposefully examined. This method will help me in my practice since I understand how to utilize information in a way that will be helpful in future practices. Moreover, looking at such factors as analytical data can minimize possible mistakes, errors, or misunderstandings in my nursing practice.
Evidence-Based Gerontological Nursing Concepts
There are several nursing practices that can be applied to senior care based on the overall objective and goal. First, it is essential to highlight family-centered care as one of the strategies. Researchers define this notion as the aim to create centered attention towards the importance of caring for the older adult for family members (Harvath et al., 2020). Based on this concept, the nurse is focused on including family members into the process as much as possible. Thus, the close members that receive information and help in regards to the process of providing help to seniors are the key individuals within this theory.
On the other hand, patient-centered care is based on the individual in question. According to researchers, this method acknowledges the patient as the central figure whose preferences, ideas, and opinions are always crucial (Jayadevappa, 2017). Moreover, the authors of the research mention that if the senior individual has all the necessary medical information about their diagnosis or conditions, they are often capable of making adequate and efficient decisions. Thus, between the two concepts, the one that respects the patient’s complete integrity (patient-centered) proves to be productive.
Meeting the objective of learning about different evidence-based gerontological nursing concepts has helped me understand how to approach a patient in the future. I realized that both family-centered and patient-centered care is essential. By focusing on family members, I can ensure that the senior will receive good quality care outside hospitals and nursing homes. Moreover, I came to the conclusion that considering the individual’s preferences as a priority is essential.
Clinical Reasoning and Decision-Making Skills
Making decisions successfully and approaching clinical reasoning from a patient-centered perspective can be challenging. One example is treating and preventing bed sores in older patients. Researchers have examined this topic by creating two groups and monitoring the results. The group that only received instructions had worse results than those who received physical care and support from nurses in preventing bedsores (Kaur et al., 2018).
Thus, the physical implication of nurses is more effective in preventing such conditions, which is why the decision-making process will be based on such evidence. Another scenario often occurring in gerontological care is patients falling and dealing with severe consequences. Researchers concluded that an assessment of all elderly patients is required to manage the care in relation to this particular problem (Pearce, 2017). Thus, seniors with lousy vision, low activity levels, and prescribed certain medications need to be monitored more attentively to prevent falls.
This objective of learning about clinical reasoning and decision-making has helped me assess a problem from the perspective of a healthcare provider for older adults. Caring for seniors is different in regards to particular problems that need to be addressed in practice. As a result, issues such as falls and bedsores are among the significant issues which may occur in such environments. Moreover, they need to be confronted based on evidence from research and current medical information in addition to patients’ personal wishes.
Leadership in the Community and Impact on Older Adults
It is essential to highlight the role of community leaders and organizations in caring for older adult patients. One example is a transportation service that helps the elderly with mobility problems by providing them with transportation (Bond et al., 2017). Such an implementation is helpful for people who cannot access places, including hospitals, by offering them safe rides that take into consideration their possible medical needs. Another example is offering moral support via phone calls. Such a measure was used by medical students during the COVID-19 lockdown as a way of mitigating the consequences of social isolation (Office et al., 2020). Thus, senior citizens were able to feel a human connection without putting themselves at risk for the infection.
I was not aware of such communal support groups, but it is inevitable that they are necessary for both physical and moral support. Due to the importance of such organizations and volunteering proposals, I will make sure to find out more and become an active participant. Leadership in such community-based implementation is crucial, which is why I will try to find a way to create a group that will also offer such help in my own community.
Evidence shows that therapeutic communication is a vital part of any facility that provides services for older adults. Several concepts have been examined by researchers. One of them is communication using empathy as the main driving factor. Researchers found a correlation between empathic approaches and effective interactions between healthcare providers and senior patients with dementia (Brown et al., 2020). Another model that has been analyzed is the concept of sharing instead of teaching, which was found to be efficient (Pang & Ho, 2018). Furthermore, when nurses take the approach of being teachers who give instructions, older patients may be resistant. On the other hand, providing information during a two-way dialogue rather than from the position of a mentor is more beneficial.
During my nursing career, I have understood that most older adult patients are more communicative when I have a friendly and empathetic approach during our conversations. Rather than being just a nurse and providing direct instructions, people like when I have deeper conversations, listen to them and am careful when providing instructions. Since research shows my way of communication is evidence-based, I will continue forming more personal connections and use therapeutic communication to help patients become more relaxed and open.
Taking culture into consideration is a vital part of gerontological nursing. However, culture and safety have to go hand-in-hand for the patient’s sake. For example, seniors with diagnosed depression may not choose western medicine and, instead, pick acupuncture due to their individual beliefs. According to researchers, this can be an additional measure that may be effective for some individuals (Krta et al., 2019).
Thus, acupuncture can be a procedure used alongside therapeutic measures and medicine. On the other hand, some practices are not as safe. For example, polymedicine is not preferred among many older adults. Such patients may be apprehensive when it comes to taking multiple drugs at once, which can compromise safety (Weir et al., 2017). In these cases, healthcare providers have to discuss all the nuances with their patients, maybe cut down on medicine that is not essential, and build a plan based on the preferences of the individual.
I would achieve safety without denying someone of their cultural preferences. Moreover, my decision would be based on both patient’s values and standard safety practices. This topic has taught me to consider culturally-competent practices as an essential factor since it increases patient satisfaction. Due to the fact that patient-centered care is the key, it is vital to build a plan based on their personal overviews but without compromising safe practices known in medicine.
Team Approach to Collaborative Client Care
There are various techniques when it comes to providing older adult patients with quality care. On the one hand, working as a team with other members may be beneficial for the patient. For example, multiple people may take turns when it comes to monitoring patients prone to falling. A team is more successful in mitigating this risk factor (Bahrami et al., 2018). Thus, collaborative care is a safe practice that benefits seniors. On the other hand, patients find it essential to form a human connection and have a primary care provider who can understand, listen, and help them (Kabadayi et al., 2020). This can be achieved at a higher level when one primary nurse is assigned to a patient. Both methods have evidence behind them stating they are effective.
My experience of being a part of a team versus being the individual care provider allowed me to assess both conditions. Both have benefits, but working as a team member is more accessible in terms of mitigating risk factors. If multiple people have the same objective, safety is maintained at higher levels because the senior patients are less prone to being unattended for more extended periods of time. Meeting this objective has given me experience in being a part of a group and working together towards the goal of increasing patient satisfaction and decreasing errors.
Gerontological nursing is a field that has to consider specific factors based on patient-centered care standards. Nurses have to imply intentional learning when studying the field of therapeutic communication, decision-making, culturally-specific models, risk mitigation, and team approaches when working with older adults. Thus, this healthcare field is based on standard medical practice. Yet, specific preferences and cultural specificities have to be considered for providing the level of care that would allow the patient to have high satisfaction levels, low risks, and quality services.
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