Responding to the growth of the U.S. senior citizen population, the MSN Adult-Gerontology Primary Care Nurse Practitioner Program at The George Washington University School of Nursing in Washington, D.C., has added a geriatric component to provide nursing students with specialized skills to better meet the needs of elderly patients.
The school received a three-year, $790,000 grant from the U.S. Department of Health and Human Services in 2012 that gave the faculty time to develop a curriculum to teach students how to treat older adults.
The impetus for that is the changing demographics, said Sandra Davis, PhD, DPM, ACNP-BC, the programs director. Its important that we prepare nurse practitioners who have the specialized body of knowledge.
In 2050, 20.2% of Americans will be age 65 or older, up from 13.0% in 2010, according to the U.S. Administration on Aging.
Rather than slipping in something about older adults here and there, we could actually do a more integrated program, said Beverly Lunsford, PhD, RN, CNS-BC, assistant professor, GW SON, and director of the Center for Aging, Health and Humanities.
Diverse student perspectives
The online program attracts about one-third of its students from the Washington, D.C. area and the rest from rural and urban areas in the U.S. as well as some students from Canada and South Africa, Lunsford said. The variety of students brings totally different perspectives sometimes to the table about what some of the issues are and the different ways that they provide healthcare, she said.
Victoria Stabinski, MSN, BSN, RN, came to the program after a year-long clinical rotation with a large internal medicine practice that had a large geriatric population.
Had I not done the geriatric program, I wouldnt have been exposed to so many different physicians and different people in the area who have pushed me and helped me excel in my studies, Stabinski said.
Students complete the coursework online via distance education and the clinical practicum rotations in their local community with faculty mentoring. The students participate in weekly discussion boards about what theyre learning and come to campus to participate in role-playing scenarios.
Its a safe place to learn before you actually go out there and do it on a patient, Davis said. Its an opportunity for them to really learn those critical diagnostic and reasoning skills.
It really helped us prepare for the real-world experience and really make sure we would be good practitioners, said Stabinski, who recently completed the program and took a job with an adult and geriatric hemotology/oncology practice.
Focus on older adult needs
While the healthcare system is designed to provide acute care, the program focuses on helping students learn to care for and manage older adults chronic illnesses.
Were really good when people have a stroke or heart attack or doing immediate rescue, but with older adults, it tends to be chronic illness, Lunsford said. These are things were not going to cure, but we can treat very effectively.
The program integrates patient engagement to counteract a common feeling by healthcare professionals that they know what’s best in prescribing treatments and medications without seeking patient input. Instead, the older adult should be treated as a person with potential, someone who can understand and relate to what’s happening to them to make good decisions, Lunsford said.
Treating patients as individuals is key. What one person may want, another person may not want, she said.
For example, medications for elderly patients with chronic obstructive pulmonary disease may control the illness but make them more likely to fall. For a patient who wants to be out golfing, the practitioner may reduce medications and adapt the treatment in other ways; for a patient who is in a wheelchair, the focus may be on controlling breathing with medicine, Lunsford said.
There are many options now for how we treat different chronic illnesses or problems people have, she said.
Karen Long is a freelance writer.