National Nursing Week is May 7-13 and the theme is #YesThisIsNursing. This week draws attention to nurses, increasing the awareness of the public, policy-makers and governments of the many contributions of nursing to the well-being of Canadians. One of the biggest challenges in the delivery of healthcare is ensuring there are enough nurses.
The numbers of seniors are growing, with those over the age of 65 living longer than ever before and with more complex health issues, resulting in increased need for long-term care (LTC). If the increased demand for LTC wasn’t challenging enough, the nursing workforce is also growing older. Almost 50 percent of all nurses working in LTC in Ontario are nearing retirement age. This means there will be an even greater need to replace these LTC nurses just to maintain current staffing. It is likely that you or a family member will require LTC services at some time – we have a collective responsibility to ensure that the care will be there.
Nurses in long-term care provide 24-hour complex nursing care and supervision within a secure setting, including managing responsive behaviours and providing onsite palliative care. Recruitment of staff to work in long-term care (LTC) is an even bigger challenge as compared to other healthcare settings due to the many false assumptions that exist. Recruitment is further impacted as working with older adults is typically the least preferred career option among nursing students. Nursing in LTC may not result in the instant rewards as experienced, for example, in an emergency department setting. However, LTC nurses all seem to agree on the regular and meaningful rewards they receive from the relationships with the residents and their families and the sense of ‘making a difference’ because of the opportunity to apply both the art and science of their nursing skills.
“Once I started working in long-term care, I realized this is why I became a nurse,” said Patricia Voldock, Registered Nurse, Miramichi Lodge, Pembroke, Ontario.
Perhaps the biggest myth is that LTC nursing is not challenging enough. Again, when compared to the quick actions and drama such as in an intensive care unit, LTC may not appear challenging on the surface. However, LTC nursing is actually a complex and challenging practice specialty. The increased challenges have become even more apparent with shorter hospital stays, younger residents with complex diseases and constant changes in practices.
In addition to the increased challenges, what nurses learn during their education is actually more difficult to apply in the geriatric setting because these guidelines are intended for situations that are more predictable. The geriatric patient often displays signs and symptoms that are quite different from a younger adult. For example, most people know that one of the key signs of an infection is an elevated temperature. However, in the elderly, it is not uncommon for there to be no fever or even a lower temperature than normal when an infection is present. Add to this that most seniors suffer from several complex chronic conditions and it makes for a very challenging setting. The nurse in LTC has to be like a smart detective, not being swayed by the most obvious signs but rather probing deeper for the less obvious clues, and often while working with a resident who may be unable to answer direct questions. This means that nurses in LTC need to have excellent assessment skills with a sound knowledge base in order to determine when something is out of the ordinary and what actions to take.
Nurses want respect and recognition for their expertise. How we demonstrate this to LTC nurses can vary. It could be as simple as expressing our gratitude for their hard work and dedication or recognizing the complex and challenging environment in which they work.
During National Nursing Week, and every day, we salute the women and men who have chosen nursing as a career – the backbone of our healthcare system.
Bonnechere Manor (180 residents) and Miramichi Lodge (166 residents) are municipal (not-for-profit) long-term care homes owned and operated by the County of Renfrew and City of Pembroke. They have provided quality care to the frail and elderly since 1958 and 1969 respectively. A wide-range of long-term programs and services including 24-hour nursing care, accommodation, meals, as well as physiotherapy programs and a variety of social and recreational activities are provided. In addition to long-term care services, the Homes also offer a variety of community services. They are accredited with Accreditation Canada which provides the Homes with the opportunity to benchmark their programs and services to national standards and enhance continuous quality improvements.
