The practice of nurses working with older people in long term care: an Australian perspective

Aims and objectives. To provide a contemporary description of the practice of nurses caring for older people in long term care. Background. The increasing size and morbidity of the population of older persons is driving the requirement for nurses who work in long term care to have appropriate educational qualifications and expertise. Design. A mixed method research design was used in this study. Method. The perceptions from clinical registered nurses (n = 48) and nurse managers (n = 16), working in six long term aged care facilities were elicited. Data were collected via purposive questionnaires, document analysis and semi‐structured interviews. Results. There was considerable agreement among the data and from the two groups of nurses about registered nurses’ practice. The most frequently performed nursing activities revealed in the questionnaire were ‘Organising their own workload’ and ‘Devising an individualised plan of care’ whilst the lowest were ‘Developing policies in response to changes in legislation or clinical practice’ and ‘Introducing appropriate research findings into practice’. Categories from the interviews included, ‘It is a team effort’, ‘We manage’ and ‘Clinical skills and responsibilities’. Overall the data revealed a picture of nurses managing the care of older persons in a specialised context. Conclusion. The findings confirm that the practice of nurses working with older persons in long term care has expanded to the role of specialised care facilitator. Registered nurses’ practice in this study is consistent with current descriptions of gerontological nursing. However, some elements of practice require further development: person‐centred care and evidence‐based practice. Relevance to clinical practice. It remains a challenge for registered nurses working with older people to deliver person‐centred care and to engage with evidence and integrate evidence into policy and practice. Strategies are required for registered nurses to develop these elements of practice.