MIND THE GAP - the words practically leapt off the signboard on the platform in Toronto. Waiting for the subway gave rise to reflections about the words oî admonition and the potential application to other situations. In this case, gap referred to a break in continuity between the platform and the tracks for the subway. For the unwary, this break or gap could contribute to a state of disequilibrium and subsequent fall. Gaps of a different nature, it seems, also might contribute to a state of disequilibrium and disruption of progress toward stated goals.
When nurses get together, reference to such gaps as the generation gap, the communication gap, and me credibility gap often are heard. Has there ever been an older generation of nurses that has not bemoaned the fact that nursing is not what it used to be, and commented about the lack of commitment of younger nurses? Or a generation of new graduates that didn't view their elders in nursing as being a little square or stodgy?
And, has there ever been a time when these opinions were not compounded by a communication gap? Even members of cohort groups of nurses have been known to make disparaging remarks about their colleagues, with little insight into the potential for these remarks to create divisiveness among them. Moreover, nurses of all generations have been subjected to scrutiny when a credibility gap is suspected. In some instances, the license to practice has been suspended or revoked. Perhaps, in view of demographic variables, cost-effectiveness issues, and changing patterns of health care, it is time to "mind the gap" of whatever nature, and move into the 80s with a fresh perspective and more affirmative action, lest there be a loss of balance and disruption of progress toward achieving the goals of nursing.
Demographic variables point out the need for increasing nursing action designed to meet the unique health care needs and problems of an aging society and its aged members. Gaps need to be narrowed and efforts unified to achieve objectives that would contribute toward the mission of promoting health, if the nursing profession is to discharge its mandate to society and its older members. Nurses already involved in the field of gerontological nursing are in a position to press for mandatory inclusion of content on geriatrics/gerontology in curricula of schools of nursing and at all levels of nursing. They are the ones most likely to support the identified need for prepared staff in various practice settings.
While it may be a challenge to overcome resistance from nurses who are not interested in gerontological nursing, the number of gerontological nurses and their growing sense of identity should strengthen their eftorts. "Networking," a mechanism being used by these nurses, provides a sense of unity and purpose for the group. Communication among these nurses is being accomplished through various channels, formal and informal; it extends across generational lines, geographical boundaries, and time zones. Nurses are increasingly aware that they have a great deal to offer in the area of cost-effectiveness; they have an avowed intention to become involved in policy making positions and other areas where they can participate in decisions affecting the quality of care of older people. The issue of credibility is being examined from various angles, including those of communication, competency, and accountability. Perhaps the minority status of gerontological nursing is stimulating motivation to act and determination to redouble efforts to move the specialty area forward. Time will tell.
Reflections on recent experiences with nurses across the nation, and from other nations, seem to indicate an increasing impetus for meeting the challenge pointed out by demographic variables on the older segment of the population and reinforced by the unique health care needs of the elderly. One of the important issues to be dealt with in this upsurge of activity is the need for additional nursing research. At the same time, there is need to "mind the gap" lest findings such as those based on a sample size too small to allow generalization, or on areas too narrowly defined, hinder development of the knowledge base needed for substantiating tiie deliberative practice of gerontological nursing. "Minding the gap" does not negate the importance of moving forward; it does suggest moving cautiously to avoid the clanger of losing balance and delaying the benefits to be derived from nursing research.
Perhaps an effective way of "minding the gap" is to start mending gaps wherever they exist. In the mending process itself; gaps may be narrowed and progress made, which would be rewarding and serve as incentives for ongoing activities. Who would have ever thought three words - mind the gap - could trigger such a flight of ideas? Who would have ever thought so few nurses could acheive so much in such a short period of time as has been the case of nurses concerned with meeting the health care needs of older adults? Gaps can be narrowed.
Can the gap between an and science be narrowed to allow for continuing creative endeavors mat might bring even greater rewards for nurses seeking to promote a sense of well-being and a zest for living among older persons?