Advanced Contents tor Geriatric Nursing Assistants Carolyn A McDonald; State College, PA: Venture Publishing, Inc.; 1 994; 236 pages; $28.95, softcover
This book was written for nursing assistants whose role on the geriatric health care team is not fully appreciated despite the wealth of information they hold about the resident or older client. The author, an experienced geriatric nurse and educator, intends this book to help nursing assistants better understand their role by providing them with the "whys" of their job to supplement their knowledge of the "hows". In the end they will function more effectively on the health care team and with improved morale.
There are 26 chapters divided into six sections. The first section, "The Aging Process and Options for Care" has four chapters covering the various types of facilities and services for elders, the changing clientele of skilled nursing centers and the interdisciplinary team providing care, the role and work attitudes of the nursing assistant. This section closes with a description of changes in aging philosophy and concerns about living arrangements, finances and safety.
Six chapters make up the next section, "Introduction to Anatomy and Physiology." Body systems are covered with very detailed anatomical figures to illustrate structures. Section III "Observing, Assessing and Evaluating Physical Status" has chapters on making observations count, vital signs, and fluid balance and electrolytes.
The fourth section covers "Mental Status Changes and Related Conditions." Included here are chapters on mental status and factors affecting it such as dementia, Alzheimer's disease and psychiatric problems. A chapter on strategies for creating the optimum environment is next and the section ends with a chapter on death and dying.
Section V discusses the disease states affecting body systems. Lastly, individual topics are covered in Section VI. Included are nutrition and diet, sexuality and aging, first aid and decubitus ulcers.
This book is the text used in the Geriatric Nursing Specialist Program developed by the author and marketed to geriatric facilities. The students in this program are presumably Certified Nursing Assistants who would have a different job description upon completion of this program. Staff development educators or those who provide training programs for nursing assistants would be advised to consult with the author before using this program in their practice setting. Licensing requirements and career opportunities for geriatric nursing assistants with additional skills may vary from region to region.
Educators will notice the lack of chapter objectives and an index to locate specific items. Not all chapters have summaries, and the reference list includes citations not found in the text while others are missing. Numerous typographical errors detract from the book's presentation.
The best parts of this book are those in which the author focuses on the importance of the nursing assistant-resident relationship and how to maximize the opportunities to observe and gather information, and the key role the nursing assistant plays on the geriatric health care team. The chapter on death and dying recognizes the special relationship nursing assistants have with residents, how difficult it is for nursing assistants when residents die, and their need to grieve over the loss. This personal loss may be overlooked as the required procedures are carried out.
Without a doubt, the author, a former nursing assistant, cares deeply about improving the stature of the nursing assistant. In both the foreword and the afterword the author stresses the nursing assistants' importance in long-term care and encourages them to continue to learn and grow. A changing client population with the different needs and levels of care brings new challenges to the LTC industry. It makes sense to look at ways to improve staff efficiency and effectiveness. Certification and additional training to enhance observation, communication, and interpersonal skills can improve overall morale of the nursing assistant group. But without changes in the organization of the workplace, these efforts can lead to more frustration. The author alludes to this in the preface, but doesn't provide the nursing assistant with insights and strategies they might use to implement their new skills and smooth their integration into the present workplace. Such advice would be a fitting sendoff to the nursing assistant readers.