Prevailng Issues in Nursing Homes

The need for skilled and educated nurses in the nursing home industry is more prevalent than ever before. As the average age of our population is increasing and baby-boomers are closely approaching the “golden age” (Foner, 1994), more focus and attention should be placed on the importance of going into the field of nursing home care as a specialization.

Interaction is Invaluable for Elders
(Ad Care Health Systems, Inc., 2007)

One of the biggest issues related to nursing home care, according to Harrington (2000), is that the average nurse to patient ratio in nursing homes is too low to offer an adequate level of medical care, creating a more stressful situation for the nurses responsible for so many patients. Caregiving must be improved in order to guarantee the best quality of care to their patients (Harrington et al., 2000). In addition, Foner (1994) claims that these nurses do not feel appropriately compensated and therefore are often less motivated to perform at their optimal ability. Snow (2007) claims that insufficient salary, lack of recognition, and heavy workload result in a high attrition rate amongst nurses. According to Knight (1994), when the nurses are paid less than they would in other care facilities, they often do not feel as important and are not motivated to put as much effort into their job. According to deontology, this situation causes a conflict of ethics, for example if each patient does not get the care they deserve based on the rightness or wrongness of the act of how he or she is treated, and this is compromising the patient’s integrity (Burkhardt & Nathaniel, 2008).

An unattended senior citizen
(Today's Seniors Network, 2008)

Many nurses in nursing homes receive less training and preparation for their jobs than is necessary for proper patient care. According to Bates (2007), some nurses receive only seventy-five hours of training for complex tasks that require them to observe, feed, and transport frail patients with little assistance. This lack of training results in many mistakes due to trial and error by nurses. Increasing the minimum requirement of education and training of the nursing home staff is recommended to improve the quality of care and keep nursing staff levels high for longer periods (Harrington et al., 2000).

In addition, nurses in this setting must deal with death, which can be a very traumatizing experience without proper training (Lynn, 1986). The patients are increasingly more sick and older than they were decades ago (Foner, 1994) and need even more advanced and acute care. To learn more about gerontology overall, there's an entire journal dedicated to gerontology. 

When working with elderly patients who often have chronic diseases, there is no room for error and inexperience. Sometimes the patients do not have decision-making capability due to mental illness (Foner, 1994), so nurses must make the difficult decision to exercise paternalism and make the decision for them (Burkhardt & Nathaniel, 2008). If they are not trained appropriately to make important decisions, it could put the patient in a dangerous position. Nurses could help this situation by receiving better education on encouraging advance directives, and understanding moral and legal considerations surrounding important decisions and the deaths of their patients (Lynn, 1986). Different families deal differently and nurses could benefit by reading about other families because insight is always helpful.

Positive Interactions of Senior Citizens: Hope for the Future
(National Institute on Aging, 2008)

Hopefully nurses reading this blog will stop the negative trend in nursing homes by contributing their own dedicated and educated minds to the nursing home care profession. Nurses reading this blog will hopefully become more aware of the desperate need for better nursing care for this vulnerable under served population of elderly patients. The intent is to create sensitivity and awareness amongst the nurses who could respond to this critical shortage of high quality nursing staff in nursing homes, a problematic situation that will only further deteriorate without adequate nursing coverage.

References

Bates, E. (2007).“The Aging Are Treated Poorly in Nursing Homes.” Los Amigos Medical Center. Opposing Viewpoints Resource Center. Retrieved on Thomson Gale. 19 Jan. 2008 from .

Burkhardt, M. A. & Nathaniel A.K. (2008). Ethics Issues in Contemporary Nursing, Third Edition. Thomson Delmar Learning: Canada.

Foner, N. (1994). The Caregiving Dilemma: Work in an American Nursing Home. University of California Press: Los Angeles.

Harrington, C., Kovner, C., Mezey, M., Kayser-Jones, J., Burger, S., Mohler, M., Burke, R., & Zimmerman, D. (2000). Experts Recommend Minimum Nurse Staffing Standards for Nursing Facilities in the United States. The Gerontologist, 40, 15-16.

Knight, J. (1994). Ethics of care and caring for the elderly. Southern Medical Journal, 909-917.

Lynn, J (1986). Ethical issues in caring for elderly residents of nursing homes. Prim Care, 13, 295-306.

Snow, M. (2007). What Do CNA’s Want? The Gerontologist. [Electronic Version].