Some gerontological nursing educators have been more successful than others in implementing specific, new gerontological nursing content in their respective educational programs. Although more nursing schools are including separate, specific, required courses in gerontological nursing in their curricula, the majority of schools still attempt to integrate this specialized content into several different courses in their programs (for example, courses in adult growth and development, medical-surgical nursing, psychiatric nursing, and community health nursing). Some of these schools also offer nursing electives in gerontological nursing (I enjoyed the personal rewards of teaching such an elective course in the spring of 1 990).
Those gerontological nursing educators seeking integration of more content specifically related to older adults often find several common obstacles. For example, most curricula are already packed with content, and gerontological nurses must compete with the goals of other faculty members who want to add more content on ethics, legal aspects, sub\ stance abuse, community mental health, research, computers, health economics, and home health care, to name just a few current issues. Most faculty members agree that there is limited time in 2-, 3-, or J 4-year programs, and essential content needs to have priority.
Another obstacle is the fact that integrated content is often difficult tc plan, implement, track, and evaluate. When new or different faculty members teach different courses each semester, integrated content is sometimes deleted, possibly because of preferred emphasis on other kinds of content or patient examples. Also, some schools do not have enough faculty members prepared or interested in gerontological nursing to plan, integrate, teach, and evaluate the content needed. Lastly, some faculty members mistakenly believe that all of the necessary gerontological nursing content is already in the curriculum, not recognizing the deficiencies.
With current predictions for a greatly expanding aging population, the high percentage of older patients in most health-care facilities, the increasing expectations of older consumers for quality health care, and the exploding amount of new gerontological nursing content and research, nursing can no longer afford to have new graduates with limited or haphazard preparation, knowledge, and skills in the specialized needs and care of older adults.
More and more students are recognizing the need for an increased amount of such content in their curricula. After having taken the recent state board examination for licensure, graduates reported that there were multiple questions related to gerontological nursing on the test. Also, in their future practice, more graduates will be caring for older patients than children. So why do we continue to require specific courses in pediatric nursing and not in gerontological nursing? Every nursing school should, therefore, have a specific course in gerontological nursing required of all its students.
One specific new regional project that will help to improve the amount and quality of gerontological nursing in educational programs will be implemented in 1990 and continue through 1992. It is the Faculty Preparation to Teach Gerontological Nursing project sponsored by the Southern Regional Education Board. They have received a 3-year grant of $447,683 from the Division of Nursing, US Department of Health and Human Services, to provide three 1 - week workshops to help nursing faculty learn how to improve the teaching of gerontological nursing.
These workshops will be held each summer for 3 years at sites across the southern region. It is encouraging to note that there is so much interest in this project thataU faculty slots have been filled for the 1990 session.
Gerontological nurses in institutional and private practice, education, research, and consultation need to take action now and use their energy and influence by writing or speaking to the members of curriculum committees of schools of nursing, state boards of nurse examiners, and state nurses' associations; state governors and legislators; members of local chapters of the American Association of Retired Persons and Gray Panthers (they are large in number, politically influential, and should have an interest in the issue); boards of home health and nursing home organizations; and other individuals and groups who could possibly influence curriculum requirements. Recommendations regarding changes in the state boards of nursing guidelines and criteria for on-site evaluation of nursing schools should be revised, and legislation, if needed, should be proposed to include this requirement.
Some readers may remember that a course in psychiatric nursing was not required in some states in the early 1950s. We have already waited longer than most of the other clinical specialties. Let's work for a required course in gerontological nursing in all types of nursing education programs in all states by 1995.