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With her John A Hartford Foundation funding, Dr. Karen Marek,
the University of Missouri's first project manager, assembled
a team of dedicated gerontology nursing professionals, and
produced this stand-alone course. Dr. Myra A. Aud, PhD, RN,
assistant professor at the University of Missouri, who began
her relationship with Gerontological Nursing Care as
a guest lecturer in the spring of 2003, has had primary teaching
responsibility for it since the fall of 2003. This mandatory,
three credit, second semester junior year course continues
to be well received by its students. Dr. Aud, with her 25
year work history in long term care, brings passion and commitment
to teaching gerontology. To date, almost 500 juniors have
benefited from her gerontological nursing wisdom both in the
classroom and in the course's clinical settings.
Dr. Aud acknowledges that her biggest challenge takes place
on the first day of class: capturing her students' interest
and persuading them that learning its content will enhance
the work they are already doing. She makes her sales pitch
by telling her students that her course is "the icing
on the med-surg cake." After all, adult medical-surgical
nursing is the heart of nursing, and geriatric patients make
up a significant chunk of this population. She discusses symptom
presentation among the average adult population vs. the 80+
set, and then explains that picking up on these subtleties
is the essence of gerontological nursing. She also shows them
the videotape, "A Century of Living," featuring
seventeen men and women who were born in 1900 or earlier,
who share memories of their long lives, including how it feels
to have lived through the entire twentieth century. She reports
that the videotape leaves her students spellbound.
The course runs for fourteen weeks, featuring two seven week
clinical experiences. These sites include a home health care
agency (Dr. Marek was its executive director), a skilled nursing
facility, dementia units in a nursing home and an assisted
living facility and an Alzheimer's day care center. In the
skilled nursing facility, each student follows one resident
in depth for three consecutive weeks, taking a life history
and doing a structured assessment. For the home health agency
clinical, the student partners with a senior care nurse whose
duties range from admitting patients to providing follow-up
care. The students practice their therapeutic listening skills
in the Alzheimer's adult day care center, and learn a great
deal as staff model respect for these elderly folk. Drs. Aud
and Marek have worked hard to make these clinical experiences
positive learning experiences.
Recently, during the last two semesters of the nursing home
component, and with involvement from supportive administration,
nursing students conducted a quality assurance project. They
match their patients' medication orders with the "Beers
Criteria," an outline of explicit criteria for potentially
inappropriate medication use in the elderly. The students
report their findings to administration. Dr. Aud reports that
such a process encourages students to think about polypharmacy
issues among the elderly, including medications that are inadvisable
with various diagnoses.
Re: instilling long lasting student interest in gerontological
nursing, Dr. Aud reports that in spite of her best efforts,
about half of the students who pass through the course have
no interest in caring for older adults. She points out that
these students are not resistant, but instead simply "do
not have gerontology in their hearts." They feel, "This
is nice, but I've already chosen pediatrics, NICU or anesthesiology."
The other half of the student body remains open to learning
gerontological nursing, largely because of personal interest-they
have grandparents and great grandparents. Four of the 30 accelerated
students who have taken the class to date, have expressed
serious interest in pursuing gerontological nursing as a specialty.
Gerontological Nursing Care emerges as a superb synthesis
course for junior level students. Both the didactic and clinical
components reflect incorporation of the combined expertise
of its creators, whose interests range from elder community
based care to dementia care. The course is improving student
attitudes about caring for the elderly population, encouraging
students to become critical thinkers relative to gerontology
nursing issues, and is attracting new recruits to the field.
Course Syllabi
Student Evaluations
Lessons Learned/Advice to Schools
Principal Investigator Contact Information:
Myra A. Aud, PhD, RN
Assistant Professor
Sinclair School of Nursing
573-884-9539
audm@missouri.edu
Karen Dorman Marek, PhD, MBA, RN, FAAN
Associate Professor
School of Nursing
University of Wisconsin-Milwaukee
414-229-5071
kmarek@uwm.edu
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