Journal of Gerontological Nursing

Editorial 

FACING UP TO ABJECT IGNORANCE

Thelma Wells, RN, PhD

Abstract

There is a tendency to be cloistered when one specializes in any field. This may be especially true in gerontological nursing where a quest for greater knowledge and supportive networks combined with both limited funds and time directs our energies almost exclusively to gerontological/ geriatric journals and conferences. Our work relationships also tend to focus us with those who share similar beliefs. This cloistering undoubtedly helps to clarify direction, increase depth, and strengthen our efforts but it may make us unaware and ill-prepared to face the abject ignorance that still surrounds gerontological nursing.

Consider with me some dumbfounding and devastating statements about gerontological nursing that I have heard over the last month. Dumbfounding because they are so profoundly wrong that one is uncertain of where to begin to respond. Devastating because with all our progress within gerontological nursing they indicate that the real battles have not yet begun.

From a practice setting comes the remark, "gerontological nursing is just like pediatrics". This comment indicates a dearth of human development knowledge. In fact most practicing nurses have had almost no education about growth and development beyond young adulthood. Basic programs currently teaching human development typically weigh content toward the younger years and tend to include old age in a summary unit with death and dying. Continuing education programs seldom provide basic growth and development information.

The remark to me is also a probable cry for help. Faced with complex and pervasive clinical care problems, the provider limited to pediatrie knowledge can not hope to recognize and appropriately treat dysfunction amongst old people. Pretending that ignorance doesn't matter is an unsuccessful coping method. The kindest response to such a remark would explore the stress of gerontological nursing practice and direct the listener to substantive textbooks and journals in this field. A variety of sensitivity techniques such as selected films and/or role playing might indirectly challenge those with rigid defenses. Practice is still in desperate need of qualified gerontological nursing role models and clinical oriented in-service education programs.

From education comes the dismissal, "gerontological nursing is just the nursing process applied to old people". A simplistic view in the extreme, this remark negates an impressive literature on normal age changes, presentation of illness in old age, and variations in treatment specific to the elderly. Although we have a variety of commendable basic textbooks in gerontological nursing, few programs include such material in required course work and fewer teachers have actually learned the content themselves.

The issue is to educate the educator and long term, persistent strategies are needed. It may be useful to supply relevant articles with friendly cover notes to those who could but don't include gerontological nursing content. A lunchtime film program can serve as an informal teaching process as well as interesting faculty in good gerontological films. Arrange for a good guest speaker to provoke stimulating discussion about content areas. Gather support and become a member of curriculum committees where you can seek to have gerontological nursing objectives inserted in relevant classes.

From a research meeting comes the denial, 'Tm not doing gerontological nursing research; I'm just testing my instruments with older subjects". An accurate assessment, this disavowal serves no one. Reflecting a conceptualization so limited that instrument testing is prime, the remark further reveals no knowledge of the unique features of instrument utilization with older subjects. With a myriad of researchable questions, gerontological nursing needs to stimulate nurse researchers and foster more clinical studies. We should all write more, not just to each other in specialty journals, but in the broader research and clinical publications. It is important to…

There is a tendency to be cloistered when one specializes in any field. This may be especially true in gerontological nursing where a quest for greater knowledge and supportive networks combined with both limited funds and time directs our energies almost exclusively to gerontological/ geriatric journals and conferences. Our work relationships also tend to focus us with those who share similar beliefs. This cloistering undoubtedly helps to clarify direction, increase depth, and strengthen our efforts but it may make us unaware and ill-prepared to face the abject ignorance that still surrounds gerontological nursing.

Consider with me some dumbfounding and devastating statements about gerontological nursing that I have heard over the last month. Dumbfounding because they are so profoundly wrong that one is uncertain of where to begin to respond. Devastating because with all our progress within gerontological nursing they indicate that the real battles have not yet begun.

From a practice setting comes the remark, "gerontological nursing is just like pediatrics". This comment indicates a dearth of human development knowledge. In fact most practicing nurses have had almost no education about growth and development beyond young adulthood. Basic programs currently teaching human development typically weigh content toward the younger years and tend to include old age in a summary unit with death and dying. Continuing education programs seldom provide basic growth and development information.

The remark to me is also a probable cry for help. Faced with complex and pervasive clinical care problems, the provider limited to pediatrie knowledge can not hope to recognize and appropriately treat dysfunction amongst old people. Pretending that ignorance doesn't matter is an unsuccessful coping method. The kindest response to such a remark would explore the stress of gerontological nursing practice and direct the listener to substantive textbooks and journals in this field. A variety of sensitivity techniques such as selected films and/or role playing might indirectly challenge those with rigid defenses. Practice is still in desperate need of qualified gerontological nursing role models and clinical oriented in-service education programs.

From education comes the dismissal, "gerontological nursing is just the nursing process applied to old people". A simplistic view in the extreme, this remark negates an impressive literature on normal age changes, presentation of illness in old age, and variations in treatment specific to the elderly. Although we have a variety of commendable basic textbooks in gerontological nursing, few programs include such material in required course work and fewer teachers have actually learned the content themselves.

The issue is to educate the educator and long term, persistent strategies are needed. It may be useful to supply relevant articles with friendly cover notes to those who could but don't include gerontological nursing content. A lunchtime film program can serve as an informal teaching process as well as interesting faculty in good gerontological films. Arrange for a good guest speaker to provoke stimulating discussion about content areas. Gather support and become a member of curriculum committees where you can seek to have gerontological nursing objectives inserted in relevant classes.

From a research meeting comes the denial, 'Tm not doing gerontological nursing research; I'm just testing my instruments with older subjects". An accurate assessment, this disavowal serves no one. Reflecting a conceptualization so limited that instrument testing is prime, the remark further reveals no knowledge of the unique features of instrument utilization with older subjects. With a myriad of researchable questions, gerontological nursing needs to stimulate nurse researchers and foster more clinical studies. We should all write more, not just to each other in specialty journals, but in the broader research and clinical publications. It is important to join and attend groups outside of gerontological nursing. Become knowledgeable about funding for quality gerontological nursing research and challenge others to join our field.

Abject ignorance has not gone away despite the substantive progress in gerontological nursing. While we can derive great satisfaction from looking inward, we must face the reality in which gerontological nursing exists. We should neither dismiss nor be dismayed by the abject ignorance that surrounds us. But rather gird our loins and forge into the struggle to teach others what we have learned.

10.3928/0098-9134-19830901-01

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