Nurses' Attitudes to Working with Older People in Acute Care

Wednesday, 1 August 2012: 8:30 AM

Anne-Marie Mahoney, RN, BN, GradDipAdltEd, MTD
Clinical Education Unit, Austin Health, Heidelberg, Australia
David Beckett, BA (Hons), MA, MEd, PhD
Graduate School of Education, University of Melbourne, Carlton, Australia

Learning Objective 1: The learner will be able to identify the concept of immersion in practice - from clinical and policy in relation to impact on attitude.

Learning Objective 2: The learner will be able to see the value of creating space in the world of work for learning through relational reflection .

Purpose: There is little evidence that factors influencing attitudes to older persons have been investigated (Moyle 2003). Changes to service delivery models within acute health have meant that there has been an increase in Day of Surgery Admissions (DOSA) and a decrease in length of stay. Many younger patients are cared for in the community supported with funded programs. Therefore, in-patient populations in acute care are generally older, with greater acuity and increasing co-morbidities. Australia expects an increase from 4.3 million older persons in 2021 to around 6.8million in 2051 (Australian Bureau of Statistics (ABS, 2008).Aim: The aim of this study is to build on existing research (Courtney, Tong and Walsh 2000; McLafferty 2005; Wray and McCall 2007; Poole 2009), with a particular focus on immersion in practice and the impact of experience through immersion in practice on nurses' attitudes to working with older people.

 Methods: This study is ethnographic and utilized individual semi-structured interviews with 15 nurses. Four nurses agreed to be interviewed again to more fully explore their experiences of working with older people. The interviews were transcribed verbatim and thematically analysed. Analysis continued until saturation when no further themes were emerging from the data.

 Results: Three themes emerged from the analysis: Role-modelling, Dependence and Relationality. These themes are consistent with the existing literature and have been used to inform a professional development program for nurses.

 Conclusion: Immersion in clinical practice and socially constructed reflection impact nurses' attitudes to working with older people in acute care.The themes have informed the design of a professional development program that utilises a reflective practice paradigm.  I have called the program Achieving Relational Reflection: improving care of older people.  This program will be implemented in 2012.