Nursing Skills For Caring Of Aged Person Introduction Ageing population means when median age in a country or region increases, life expectancy increases or decline in fertility rate. It is also observed that the number of older person increases rapidly in developed countries as compared to the developing nations. Between 1994 to 2014 in Australia proportion of aged 65 and above increases from 11.8% to 14.7 %. It is observed that elderly people have a negative attitude about such developments in life when they have to take assistance in aged care facilities. Primarily they believe and feel that their autonomy and dignity has been taken away when they are taking assistance from nursing professionals and other allied staff members. Residential aged care facilities create an imagination of a house full of people who are debilitating and spending their last years of life through continuous help of others (Wong & Laschinger, 2013).
Brief Overview Population ageing causes by two factors:
Increases life expectancy rate
Decreases fertility rate
Remedies of population ageing:
Health care centers provide more facilities to ageing people.
Retirement age should be increased so that they are busy in their doing.
Private sectors increase the amount of pensions and health care services.
Registered nurses Nurses are skilled or trained in caring for sick or injured people. Nurses play a vital role in patient care as caregivers, as decision maker, as patient advocate and as communicator. In Australia those who have completed a board approved courses in the field of nursing are known as Registered Nurses (Stanley and Sherrat , 2010).
Impact of nursing on ageing population
In the future, demand of nursing profession is expected to increases as more person reaches at the age of 60s and above.
Patient mortality & nurse outcomes affect the environment of the hospital.
Shortage of nurses in the hospital became a major problem now a days.
As surveyed before, major problem is that nurses are over stressed which leads to decrease in the quality of patient care which may cause nurses to leave their profession.
Due to increases in number of patients, nurses get over exhausted and there is high level of job dissatisfaction.
As more number of people reaches at the age of 60 and above, the demand of nurses also increases in Australia. The population whose age is 60 years and above will be doubling between the year 2000 to 2030. This mismatches the future demand and supply of the registered nurses. As more people reaches at the age of 60 and above, then there are more number of people suffering from diseases like heart related problem, blood pressure, diabetes etc also increases. To overcome with these problems people need nursing professionals who can take care of them. After consulting with the nurses and staffs, the main objective is to analyze the net effects of nurse on patient outcomes and practice environment. In Australia around 168 hospitals were surveyed and about 10,184 nurses over 232,342 surgical patients were found. By using the nursing work index, care of nursing environment is to be measured. Outcomes like quality of care, incentives, satisfaction of the job and reduction in patient mortality and failure gets affected with increased work stress (Ewart, 2014).
Nursing skills for caring of aged person Interrelated skills and interventions are required for a nurse to acute the old age patients. In order to conduct a holistic assessment the nurse need to communicate effectively with the old age person and their family members. Old people care centers are to be open for old age person by which old person could be admitted for triage in older-friendly environment which help them to meet better and multidimensional care. For care of old person, nurses are playing a vital role. As surveyed last year it was identified that only 48% of the staff were working as registered nurses and then frequently ratio was reduced and 11 patients over one registered nurse were found (Australian Government Department of Health and Ageing, 2015)
Specialist, skilled and experienced staff should be worked for caring the old age people. Old age people with problems like arthritis, osteoporosis and dementia have needs which is not as simple as other patients. These needs are in areas like hygiene, nutrition and washroom usage, nurses can play important role in addressing these issues and provide sustainable solutions to the elderly.
Chronic shortage of nurses The major problem in Australian hospital is the shortage of nurses, which reflects on the quality of patient care. As registered nurses are the back bone of the hospitals, supply of nurses is very important for growth of the hospitals. Since many years hospitals are facing the shortage of the nursing staff. Shortage is also described as little growth in the salary, increases the demand of the nurses, the change in the nature of registered nurses workforce that decreases the supply. This shortage also described with the ageing population and great impact on chronic diseases. It has been observed in a research that there is a relationship between inadequate hospital nursing staff and increased mortality rate among patient outcomes by hospital administrative data. It was found in many studies that almost all nurses get over stressed which lead towards decrease in the quality of patient care which may cause nurses to leave their profession. A higher level of job satisfaction can be gained by nursing professionals especially in rural areas if they have access to advanced technology, better equipments, communication with the regional centers and proper training and development programs. The hospital management must provide more incentives, training and educational opportunities in the rural hospitals which improves nursing system (Wilson, et al. 2012).
Challenges faced by nurses In Australia more people become older and near about 40 million people who aged 60 and above and 10 million people who aged above 85 were found. For taking care of the older there are more than 10,000 organizations running in Australia. Many people left their job and start their own private care centers, where they offer services to senior citizens. It is very difficult for the care centers to find the right person for a right job. It is not an easy task to cares for the older people, which require skills and patience. Many care workers were quitting and they found it very depressing. Round the clock many health care assistant were replaced. Aged care facilities in Australia are designed in a state of the art manner where infrastructure availability is world class and standard of care is one of the best in health care industry, however problem which is commonly observed in current aged care system is lack of human resources, trained staff who can take care of various needs of a challenged age old person while at the same time Australia also faces a problem of attitude towards aged care in country. Aged care facilities are commonly referred as a ‘home’ for old age people and this has a negative connotation attached to it. It is felt that old age people are sent to a home or they prefer a home when their family is not able to take care of them or they have no one to take care of them. Removing this
negative connotation with aged care is also a challenge for nursing professionals (Byrne, et al. 2014).
Culture and its influence on nursing services It is to be understood here that Australian population is increasingly getting diverse and it needs some specific changes in the way aged care is planned for the population of 65 years and above. There are cultural and community based needs of patients and each type is defining aged care in their own ways. In this case, role of a nurse suddenly changes from a disciplinarian to a support provider and they aim to provide comfort and mental peace to the patient during their elder days. One approach which is used by the nurses is to offer them a comforting advices and solution to their doubts and their mental dilemmas. Nurses can play a role of an advisor here and provide them assurance that what decisions they made in their life were the best possible decision according to that circumstance (Nolan, 2004). Nurse’s role should include educating the patient’s family and modifying their behavior to ensure that their behavior should be positive and encouraging. Non activity towards improvement of socio economic status of aged care facilities and creating a positive impact in mind set of people. Over the years government worked towards improvement of facilities, infrastructure, development of standards and state of the art medical care facilities in aged care home, but no emphasis was made on improving their image in common population. They are still considered as a place where people put their elderly in condition when they don’t want to take care of them, this image created a barrier for people who actually needed specialized and professional care. It is because of this image still people avoid taking facilities of aged care in Australia who actually need it and it is filled by many elderly people who don’t need aged care but they are staying there on pre text of being homeless and jobless (Kardamanidis, et al. 2007).
Strategies to improve nursing shortage 1. Education
Number of institutes should be increases which provide education on nursing.
Promote more equitable compensation for both nursing and education levels.
2 Work Environments
More flexibility requires in Structure and scheduling of work environment.
Reward experienced nurses for serving as mentors for the junior nurses and new recruitment.
Salaries and other benefit to the nursing staff should be enhanced.
3. Regulation
Nursing education funding must be increased.
Better identification of registered nurse who work within Medicare, Medicaid, and other reimbursement systems.
4. Research and Technology
To enhance the capacity of hospital, new and upgraded technologies should be used.
To improve delivery of nursing services, more workforce models should be developed.
As per international studies, it has been found that better use of nursing professional can bring more benefits to the general practice, which includes increase in workforce capacities, understanding of care and outcomes of diseases. Nurses are providing information to the general practitioners about the benefits of nursing professional. Now a day's government of Australia trying to introduced more and more institute which provide the education on nursing. Hospital management are providing training facilities to the new recruitments, improving staffs stability. Hospitals are well equipped with new and upgraded technologies, so that nurses can use this technology which saves their time, so that they can look after the other patients also. Government of Australia has introduced a Public Health Program which promotes health in the community and prevents from diseases before it occurs and managing the risk. In Australia there are lots of career opportunities for nurses and they can also works on permanent or temporary basis. The Australian Government issue visa to skilled and experience nursing staff and also organizing various training and research programs. For registered nurses it is important to have a degree in Master of Science in Nursing or Doctor of Nursing (Reed, 2009).
Conclusion In conclusion it can be said that registered nurses must pay attention on interpersonal relationships with their patient. Nurses should maintained good relationship and coordination with the physicians, therapists, patients and their families and also develop health care system. The educational background is varies widely for nurses in various part of the world. The acute hospital care of older person has to provide some environment adjustment, core knowledge and skills staff. In order to conduct a holistic assessment the nurse need to communicate effectively with the old age patient and their family members. Nurse’s role should include educating the patient’s family and modifying their behavior to ensure that their behavior should be positive and encouraging (Funnell, et al. 2009).
References
Wong, C. A., & Laschinger, H. K. (2013). Authentic leadership, performance, and job satisfaction: the mediating role of empowerment. Journal of Advanced Nursing, 69(4), 947-959
Stanley, D and Sherrat , A. (2010) Lamp light on leadership: clinical leadership and Florence Nightingale. Journal of Nursing Management 18, 115–121
Kardamanidis K, Da Cunha C, Taylor L, Jorm L. (2007) Hospital costs of older people in New South Wales in the last year of life. MJA; 187 (7): 383-386.
Australian Government Department of Health and Ageing (2015) (Westwood Spice) Activity Implementation Report: National Palliative Care Strategy’ 19-456
Reed, P. (2009) Inspired knowing in nursing. Pg 63 in Loscin & Purnell (Eds) (2009) Contemporary Nursing Process, Springer Publication, p.189-237
Funnell, R. et al. (2009) Tabbner's Nursing Care (5th Edition), page 72, Elsevier Publication, Australia. P.145-217
Byrne, D. Et al. (2014) A Solution to the Shortage of Nursing Faculty Awareness and Understanding of the Leadership Style of the Nursing Department Head, Nurse Educator Vol. 39, No. 3, pp. 107-112.
Wilson, L. Et al. (2012) Leadership needed to address the global nursing and midwifery workforce shortage, Nurs Outlook 60 (2012) 51
Ewart, L., (2014), Patient- and family-centred care on an acute adult cardiac ward, British Journal of Nursing, vol.23, no.4, pp.213-218
Nolan, M., Davies, S., Brown, J., Keady, J., & Nolan, J. (2004). “Beyond person centred care: a new vision for gerontological nursing.” Journal of Clinical Nursing. 13(3): 45-53