Nurse Insights: What Are the Challenges of Geriatric Nursing?
Geriatric nursing is a challenging yet rewarding field that requires specialized skills and knowledge. In this article, we explore the physical and mental challenges geriatric nurses face, including managing physical health conditions, assisting with mobility, and addressing mental and emotional health issues such as dementia, depression, and anxiety. We also provide strategies for providing quality care while maintaining personal physical and emotional well-being.
Nurse Insights
What Are the Challenges of Geriatric Nursing?
In our Nurse Insights series, experienced nurses offer an insider’s perspective on the nursing profession by addressing common questions, challenges, and triumphs of their careers.
Understanding the Physical Challenges in Geriatric Nursing
A significant aspect of geriatric nursing is ensuring our patients’ mobility needs are met. As individuals age, they often face challenges with mobility, such as struggling with walking, moving from a sitting to a standing position, and maintaining balance. As nurses, we assist with these daily physical needs, sometimes requiring us to lift or reposition patients, which demands not only proper techniques but physical strength as well. Safe patient handling methods are important to prevent injury, both to the patient and the nurse.
Assisting With Mobility
Assisting an elderly patient with their mobility needs may involve moving them in bed, helping them stand from a seated position, or supporting them as they walk or navigate their surroundings. Safe handling methods, such as using a hoist or slide board, can reduce the physical strain and the risk of injury to both you and your patient.
Managing Physical Health Conditions
Management of chronic physical conditions, such as arthritis, heart disease, or diabetes, requires constant monitoring by nurses. Regular assessments, medication administration, and wound care are just a few tasks in geriatric nursing that demand physical stamina and precision. Many geriatric conditions require detailed, hands-on care and an acute understanding of the condition’s intricacies.
Maintaining Personal Physical Stamina
The physical care provided in geriatric nursing is as much about maintaining your physical condition as the nurse, as it is about caring for the patient. Your day may comprise long hours on your feet, lifting and moving patients, and several other physically demanding tasks. Regular exercise, proper rest, and appropriate body mechanics are essential to avoid injuries and maintain physical health and stamina.
Difficulties in Addressing Mental and Emotional Health
As a geriatric nurse, it’s common to encounter patients with mental and emotional health issues such as dementia, depression, and anxiety. These conditions demand a certain level of patience and understanding, in addition to the basic physical care you are trained to provide.
Dementia
Dementia, often manifested in conditions like Alzheimer’s, is not a simple condition to handle. Patients may experience memory loss, difficulties with thinking and problem-solving, and challenges with language and understanding. Therefore, communicating with them can be difficult. They may forget who you are, where they are, or what they were doing, which could lead to agitation or confusion. It’s crucial to remember that these responses are not purposeful or spiteful, but a result of their condition.
Depression
Depression in elderly patients is often linked with physical health issues, loneliness, and grief. As healthcare providers, it’s essential to provide emotional support in addition to the necessary medical care. However, this ongoing emotional support could drain your emotional reserves, frequently referred to as “compassion fatigue.”
Anxiety
Anxiety in elderly patients might present differently from younger counterparts, with more physical symptoms or fear of falling. Ensuring the patient’s physical safety is important, but also addressing anxiety can be delicate and require strategic communication.
With the high prevalence of these mental health issues in elderly patients, geriatric nurses often regularly face emotionally taxing situations, urgent medical situations, and the potential for patient aggression. This constant reality can contribute to a high level of stress, potentially leading to burnout or compassion fatigue.
One way to mitigate the draining effects of dealing with these complex mental health issues is to engage in self-care practices, like regular exercise, a healthy balanced diet, and adequate sleep, coupled with support from colleagues and professional mentors. Additionally, it can be valuable to seek formal counseling or psychological support, particularly if feelings of burnout or compassion fatigue persist.
Communication Barriers in Geriatric Nursing
Three primary types of communication obstacles can occur with geriatric patients: hearing loss, speech difficulties, and cognitive impairments.
Hearing Loss
With aging, many older adults experience hearing loss to some degree. Hearing loss makes it challenging for patients to understand spoken instructions or questions asked by you. When a patient struggles to hear clearly, they may miss essential details about their care or medication instructions. This scenario can lead to a treatment plan failure, a decline in their health status, or an increase in medication errors. To overcome this barrier, consider utilizing visual aids and written communications to reinforce key points. Also, always ensure your patient’s hearing aids are working correctly if they use them.
Speech Difficulties
Speech difficulties, often due to stroke or other neurological conditions, can equally hamper communication with elderly patients. They may struggle to articulate their needs, symptoms, or pain level, often leading to frustration or anxiety. Clear, patient, and empathetic communication is especially crucial in these scenarios. You could also introduce alternative communication methods such as communication boards or electronic devices.
Cognitive Impairments
Cognitive impairments can pose significant communication barriers, especially in patients with dementia or Alzheimer’s disease. Issues with memory, attention, and thinking can make it hard for these patients to understand and recall instructions or to articulate their experiences. When communicating with patients facing cognitive impairment, it’s crucial to keep your language simple and straightforward. Repeat your key points if necessary and give them time to process the information.
It’s essential to recognize these communication obstacles early and adapt your communication style to ensure effective patient care. Remember, the goal is to facilitate better understanding and collaboration between you and your patients.
Importance of Long-Term Care Planning
Registered nurses (RNs) play a crucial role in long-term care planning for aging patients. However, predicting their progress and setting realistic expectations for them and their families can be challenging. Nurses need to consider various factors, such as the patient’s health status, living arrangements, and financial resources, when developing a long-term care plan.
The Role of Nurses in Long-Term Care Planning
Nurses collaborate with other healthcare professionals to ensure the continuity of care for aging patients. They conduct comprehensive health assessments, interpret medical data, and contribute to individualized, patient-centered care plans. This role extends beyond the clinical realm into the space of emotional and psychological support, as nurses often act as advocates, educators, and facilitators for patients and their families.
They assist in making decisions about care, coordinating resources, and planning for potential changes in patients’ health conditions. They act as a bridge linking the patient’s home, community, and acute care settings, making them indispensable in the process of long-term care planning.
Challenges Encountered by Nurses
One of the most challenging aspects of long-term care planning is predicting progress and setting realistic expectations. The complexity of aging patients’ needs, variance in disease trajectories, and uncertainty around life expectancy can make it difficult to predict how an individual’s health status will progress over time.
Determining the right level of support and how that might need to change is a challenging balancing act. It involves maintaining the patient’s independence while ensuring adequate care is in place to manage physical and cognitive decline, avoid complications, and control symptoms.
Nurses also face the challenge of communicating these complexities to patients and their families, managing expectations, and addressing fear or anxiety related to long-term care. Balancing hope with realism can be particularly difficult, especially when emotional and psychological factors come into play.
These complexities underscore the importance of skill, empathy, communication, and a comprehensive understanding of patients’ needs and expectations in nursing. They highlight the critical role that nursing education plays in preparing nurses to take on these monumental responsibilities in the context of long-term care planning.
Managing Advanced Life-Decisions and End-of-Life Care
Assisting geriatric patients in making complex medical decisions can be emotionally demanding. As a nurse, it’s your role to facilitate these discussions and offer guidance while respecting the patient’s autonomy and values. Watching patients struggle with difficult decisions, fearing the unknown, and experiencing sadness can be grueling. Make sure to couple compassion with professional detachment to maintain emotional balance.
Empathic Distress
When a patient vents their fear or grief, it’s natural to feel empathic distress. This emotional response can lead to feelings of sadness or even burnout. Remaining attentive to your own emotional health and seeking support from colleagues or mental health professionals when necessary is critical for managing these difficult encounters.
Navigating End-of-Life Discussions
Initiating end-of-life discussions can be challenging. It tugs at the heartstrings when a patient faces their mortality. Keeping an open mind, listening to the patient’s fears and wishes, and offering sensitive responses can help navigate these discussions. While dealing with your own emotional reactions, remember that these conversations are an integral part of providing compassionate care.
Crucial Role in Hospice Care
If you are working as a hospice nurse, you will play a crucial role in managing a patient’s end-of-life journey. The heartache of seeing a patient’s decline, coupled with the responsibility of ensuring their comfort, can sometimes be overwhelming. Be prepared for emotional rollercoasters, and don’t hesitate to seek support from your nursing team.
Challenges in Geriatric Nursing Related to the Healthcare System
Understaffing is one of the most prevalent issues affecting geriatric nursing today. As a nurse, you may often find yourself in situations where the number of elderly patients significantly outnumbers the available nursing staff. This can lead to increased workload, stress, and risks of errors, significantly affecting the quality of patient care provided.
Largely tied to understaffing is the lack of sufficient resources. You will likely experience situations where vital resources for effective elderly care are simply not at hand. This could range from simple supplies like gloves and bed sheets to crucial elements like medications and up-to-date medical equipment, severely hindering effective patient management.
Constant Policy Changes
One other major challenge is the ever-evolving nature of health policies, which may often result in confusion or inconsistent care processes. Policies often change depending on factors like government actions, healthcare evaluations, and even changes in technology. These constant shifts require you to continuously reorient your procedures, making it hard to stay updated.
Moreover, all these challenges in the healthcare system contribute to an overarching issue: compromised quality of geriatric care. When you’re understaffed or lack necessary resources, or when you’re struggling to keep up with policy changes, it’s the elderly patients who suffer most.
Remember: your role is often the bridge between your elderly patients and the healthcare system. Being aware of these challenges can prepare you to navigate these obstacles more effectively, leading to improved patient care and outcomes.
