Developing nursing competencies in aging
The development of competencies for nurses working with geriatric populations is important on several levels. Competencies help the individual nurse develop needed skill sets to care for this fast-growing population. Nursing competencies give an organization's staff the knowledge of what is expected of them in the delivery of care.
Problems faced by the elderly
The elderly face a myriad of medical conditions that require attention and care. Chronic conditions combined with functional impairment present a challenge to the caregiver. Common chronic medical conditions faced by the geriatric population include the following:
- Cancer
- Hypertension
- Cataracts
- Pneumonia
- Cardiovascular disease
- Dementia
- Depression
- Diabetes
- Stroke
- Osteoporosis
- Urinary incontinence
Emergency situations common in the elderly population include:
- Adverse reactions to medications and overmedication
- An increase in trauma-related injuries due to comorbid medical conditions
- An increase in long bone and pelvic fractures due to osteoporosis and other conditions related to calcium loss
- Falls
- Suicide
- Mental and emotional problems
Importance of the development of nursing competencies
Whether a new graduate from a nursing program or an experienced clinician, nursing competencies provide a standard base of knowledge that can be implemented across the organization. Legal and financial considerations have made competency-based education and testing of nurses the norm. Simulations can give new nurses the ability to function skillfully and confidently in clinical situations. Competency testing and education can also help reinforce an organization's expected clinical skills in experienced nurses. Competencies can help develop a culture of caring and competent nursing practices. The Joint Commission for Accreditation of Health Care Organizations (JCACO) addresses the competence of a hospital’s staff, holding the organization responsible for the initial training and ongoing development of nursing skills.
Empathy toward and communication with the elderly patient
When dealing with an elderly patient, a nurse must keep in mind that the cares, concerns and feelings of well-being are different than those of the younger demographic. The elderly have concerns about their perceived or potential loss of control of their day-to-day lives. Their fears are grounded in the thought that if they open up to their caregiver about their health problems, they might be sent to a facility where they will lose their ability to make personal choices about their day-to-day life. There are feelings of loneliness and isolation. A sense of not being valued and marginalized is also common. These feelings should be a primary consideration when developing competencies. Role playing is an excellent way that nursing educators can help develop these skills in their staff. A culture of caring and compassion along with clinical excellence needs to be the main goal.
Delivery of competencies
Competency education has been found to be effective whether a didactic or a self-learning delivery method is used. Whatever the delivery method, a competency should be based on a measure of what a competent practitioner should know. The criteria for testing needs to be clear so that both the student and instructor have an understanding of baseline skills. Competencies must be centered on the learner to be effective, and the end goal must be clear.
