By what authority do you practice gerontologie nursing? Authority is a term often used with reference to an individual who is regarded as an expert. The authority of the person is based upon such things as an in-depth, substantive knowledge of a given area or competence in an area of specialty, such as gerontologie nursing. Continuing attention to updating knowledge and improving competency is required for maintaining authority. Because of the individual's expertise, she or he has the power to influence the thoughts and behavior of others. This can be an awesome responsibility. In any case, the source of the individual's authority or power can be validated with objective data.
In view of the rapidly increasing number of older people and such factors as technologic advancement, social change, and limited resources, issues affecting gerontologie nursing practice are being raised. These issues include questions about the education needed to prepare gerontologie nurses, the type of care needed to satisfy the basic human needs of older adults, and the client outcomes of gerontologie nursing interventions. These issues may be explored by considering the question: By what authority do you practice gerontologie nursing?
By what authority have you assumed the title and role of a gerontologie nurse and the concomitant responsibility for the nursing care of older adults? What is the knowledge base used for making judgments and decisions affecting the well-being of older people from a holistic perspective? On what basis do you determine whether to give or withhold a medication, whether to continue tube feeding a comatose older adult, or whether to initiate resuscitation on an elderly adult? What is your crede ntialing?
What knowledge and skills are requisite to responsible gerontologie nursing practice? By what means has essential preparation been acquired? Updated? What ethical and moral issues are confronted by nurses assuming the title of gerontologie nurse? What are the legal implications for nurses assuming this title, if they lack the requisite knowledge and skills for the specialty of gerontologie nursing?
Answers to these questions must be provided by the nursing profession and its individual members in their daily practice. Standards of Gerontological Nursing Practice have been formulated by the American Nurses* Association to guide gerontologie nursing practice and to provide a means of evaluating that practice. A description of gerontologie nursing also is included. How do these standards affect your nursing practice?
By what criteria do you evaluate your performance? Is your performance effective in terms of client outcomes? How do you determine this? Do you consider your performance cost effective? Jf you were the recipient, would you buy the service you provide? On what basis would you make this determination? How would you document cost effectiveness? If your performance was under the scrutiny of others - client/ family, nurse auditors, accreditation visitors, lawyers - what data would you use to show the action taken and the rationale for the action?
By what authority do you practice gerontologie nursing? For what purpose? Who benefits?
Socrates once said, "Know thyself." The admonition is apropos today for nurses who would be accountable to themselves, to their profession, and to those for whom they provide care.