Issues impacting on registered nurses providing care to older people in an acute care setting

Abstract

The worldwide phenomenon of ageing populations in developed countries has led to an increased emphasis on how best to meet the healthcare needs of people aged 65 years and older. One area identified as requiring particular attention is the care provided to older people in acute settings. This paper reports on the findings of an exploratory qualitative study that investigated issues having an impact on registered nurses' ability to care for older people in a publicly funded teaching hospital in Australia. Issues identified pertain to the complexity of managing the healthcare needs of the older person with an acute illness; the acute care environment as being problematic for the older person, and maintaining continuity of care in an often fragmented and under-resourced healthcare system.

It is clear from the study findings that registered nurses in the acute setting play a central and pivotal role in the multidisciplinary team caring for older people with regard to the management and coordination of care as well as in the provision of direct care. However, tensions arise from the curative focus dominant in acute care settings, which privileges and resources technically focused acute care skills and does not place as high a priority on developing appropriate knowledge, attitudes and skills specific to the care of older people.

The findings provide a base from which to progress further research as well as a challenge to those working in acute settings to develop systems of care that maximise the role of the registered nurse in improving outcomes for hospitalised older people.