Administrators/Directors of Nursing in Long-term Care Facilities (Phase 1), Lodge, MP. Kansas City, MO, American Nurses' Foundation, Inc, 1985, 137 pages, $15.50, paperback.
Professional Practice for Nursing Administrators/Directors of Nursing in Long-Term Care Facilities, a project jointly sponsored by the American Nurses' Foundation and the Foundation of the American College of Health Care Administration, and partially funded by the W. K. Kellogg Foundation, has released a report detailing an applied research effort. This report focuses on the improvement in the quality of care for the aged through more definitive professional education and development of nursing administrators in longterm care. Those of us who have been in nursing administration over the past 20 years congratulate Mary P. Lodge, project director for American Nurses' Foundation, her project staff, and participants in the development of a comprehensive review of present and future needs for the preparation of nursing leadership in long-term care.
As a former nursing administrator in a multilevel, long-term care facility for a penod of 12 years, I was pleased to review this report that develops the four main objectives of the project in five chapters that are readable and provide stimuli for both short- and long-term planning.
Chapter 1 develops profiles of longterm care nursing today and the longterm care nursing administrator, and analyzes the various problems and policies of long-term care in the past. These evaluations clearly point to the necessity for a concerted, systematic, planned effort by an inter-organizational group to enhance and reorganize the quality of nursing care for the consumers of long-term care.
The national survey, described in Chapter 2, provides information on the current status of nursing administrators, directors of nursing, characteristics of the workplace, and activities of the nurse administrator. This information becomes the foundation for the work of the nursing task force to develop a new statement of roles, responsibilities, and qualifications for the nursing administrator/director of nursing in long-term care including curriculum implications. The potential for analyzing and implementing the statement of roles, responsibilities, and qualifications (found on pages 35 to 40) are vast and should be strongly supported by professional nurse organizations.
The one negative point made in the section entitled Problem for Nurse Administrators/Directors of Nursing in Long-Term Care is that, in many instances, this population of nurses has been outside the mainstream of the profession. It is true that a large number of RNs in long-term care have a hospital diploma as their only educational preparation. Many, however, have tried to avail themselves of continuing education programs or have participated in certification programs such as those developed by the ANA. Some have also participated in seminars and annual meetings sponsored by the two national associations for long-term care: American Health Care Association and American Association of Homes for Aging. It is well-known among present nursing administrators that there has been a dearth of specialized educational programs for those in active practice.
The third and fourth chapters deal with issues related to planning, developing, and implementing a continuing education program. These chapters present many challenges to the present nursing educational system. As noted by Lord, school of nursing curricula have not developed sufficiently apace with the practice in this specialized area. The critical need for redressing this omission begins at the baccalaureate level in nursing.
The challenge to all schools of nursing is to continue to respond to the continuing education pmgram needs of present nursing administrators thmugh the development of three processes: self-assessment, career counseling, and self-instructional curriculum clusters/ modules. The series of conferences held during 1983 for the purpose of pilot testing the special modules demonstrate the need for more adequate funding for this most critical part of the development process.
The last chapter, and the one that should be the prime motivating factor for all all involved with long-term care, is entitled Project Recommendations and Strategies for Implementation. The 11 recommendations and the corresponding strategies should be used as guidelines for all organizations involved in long-term care. There is a definite need for networking and the enhancing collaboration among all the organizations involved in long-term care. As Lord so aptly noted, the nursing profession and the future of longterm care are facing years of change. New directions in long-term care will require greater awareness in planning and reorganization of priorities. Only through coordinated, collaborative, and systematic planning with nursing and other health professionals can this be accomplished.