0:00

[Music]

0:36

Welcome to this episode of NLN podcast

0:36

Nursing EDge Unscripted the Scholarship

0:41

track. I'm your host, Dr. Steven Palazzo,

0:41

a member of the editorial board for Nursing

0:46

Education Perspectives. Nursing EDge Unscripted

0:46

and our track entitled Scholarship celebrates the

0:53

published work of select nurse Educators from

0:53

the NLN's official journal Nursing Education

0:58

Perspectives and the NLN Nursing EDge blog.

0:58

The conversations embrace the author's unique

1:04

perspectives on teaching and learning innovations

1:04

and the implications for nursing program

1:08

development and enhancement. In this episode we

1:08

will discuss how early exposure to geriatric care

1:15

concepts improves students perceptions of older

1:15

adults. The article we will be discussing is

1:20

titled, Exposing Undergraduate Nursing Students

1:20

to Older Adults: A Qualitative Analysis." The

1:27

article can be found in the May-June issue of

1:27

Nursing Education Perspectives. The author of

1:32

the article is joining us for today's discussion.

1:32

Dr. Christine Pariseault is an assistant professor

1:38

at the Widener University School of Nursing

1:38

in Chester, Pennsylvania. Dr. Pariseault,

1:43

welcome! Thank you. I'm so pleased to be here

1:43

with you today. Well, we're happy to have you

1:47

here to discuss your article. So tell us a little

1:47

bit about what got you interested in this topic

1:53

and how this research came about. I've been really

1:53

interested in older adults and older adult health

1:59

care and I had the opportunity to take clinical

1:59

students to an older adult experience in a prior

2:06

position that I had held. We decided to do a

2:06

pilot study of students in their sophomore year

2:13

going to a monastery, which was on the campus

2:13

where I was working and having them involved in

2:19

the daily care of the friars there. This was done

2:19

at the end of a four-day practicum that they had in

2:26

hospitals or nursing facilities and then they

2:26

came to me and did this one-day practicum with

2:32

the friars in the monastery. It was really

2:32

to get them to see older adults, see how they

2:37

interact, see their daily life and the research

2:37

article dealt with it their students...

2:45

really their responses and what they were feeling

2:45

from this experience and what they got out of

2:51

it and they compared going in and coming out and

2:51

how they felt about interacting with older adults.

2:57

Great. Well it leads me to my first question so

2:57

geriatrics tends to be the least popular

3:01

clinical rotation for students. It's

3:01

not unique to where I'm at or where you're at.

3:08

It's pretty consistent. It typically occurs in the

3:08

student's first semester of the nursing program

3:14

and do you think there maybe is a better place

3:14

to put geriatric exposure to maybe get students a

3:20

little bit more interested in the topic?

3:22

I wouldn't say there's a better place.

3:22

I think it has to be throughout.

3:26

I think where it's placed early in curriculum is a good

3:26

place because a lot of students have had some

3:31

interactions with older adults. They have

3:31

grandparents, they have parents,

3:35

they have that base from their life, but

3:35

I think it can't just live in the early days

3:40

of nursing curriculum. It has to be integrated

3:40

throughout. When I say that I mean throughout

3:45

all of the med-surgs, throughout mental health nursing, community nursing, leadership

3:51

and nursing, and how health policy works with older

3:51

adults. I think it has to be introduced and grown

3:57

all the way through the curriculum. There's just

3:57

not one place for it to live. It is hard in the

4:03

beginning because I do think students will be like,

4:03

I don't know if I like it or not. Some will be like,

4:07

wow, I really like it but that little snippet

4:07

in the beginning really is just to get them in, get

4:13

them seeing it, and then work with them

4:13

through the whole curriculum.

4:18

I guess the question too is how to engage the faculty in the curriculum in a way that you develop intentional exposure,

4:26

intentional practice with geriatric population

4:26

because they tend to go right from that first

4:32

exposure, very limited exposure usually in the

4:32

first semester and then into their med-surg

4:37

and their specialty tracks and kind of even

4:37

if they had like a little exposure to it that

4:43

first semester they don't typically see it again

4:43

throughout the entire program and they get to the

4:48

end of the program and it's very difficult to

4:48

get any excitement generated about them doing a

4:53

practicum in the geriatric setting.

4:53

Right. That's a great point and with all of the mapping

4:59

that we're doing to the AACN Essentials, I think faculty

4:59

could really embrace this in that element and

5:05

map their courses with key things that carry the

5:05

older adult care through. So I think as we as all

5:14

faculty are spending countless hours looking

5:14

at our curriculum and mapping them out in our

5:18

syllabi and linking courses together that would be

5:18

a great thing to put in. It could be an unfolding case

5:23

study. I think that's kind of a great doorway

5:23

for faculty to really take a good look.

5:30

You make a great point there. In our new curriculum,

5:30

which starts this Fall, we've integrated geriatric

5:34

concepts throughout the curriculum in all areas

5:34

of the curriculum and we are talking about

5:39

building in a case study like that throughout the

5:39

curriculum, a standardized patient or a a simulated

5:44

patient that we can take through the entire

5:44

program. So that leads us to the next question.

5:48

What strategies do you suggest to better

5:48

engage students in geriatric care concepts?

5:54

Oh, I think there's a lot of strategies. First,

5:54

I would talk about research. I have had the

5:59

honor of being the honors program director for

5:59

a few years at Widener University and it was

6:04

really good to teach students research and if

6:04

we could get students involved in older adult

6:09

research I think that would be a great place

6:09

to kind of connect some students. I say that, but

6:15

I also want to say I think within our nursing

6:15

faculties we need to know who our older adult

6:20

specially people are on our faculty and really

6:20

use them and tap into them just like we have our

6:25

peds people and we tap into them. I think we

6:25

need to know who our older adult people are

6:30

and really tap into them, get these students

6:30

looking at research topics that they can pull

6:36

into this faculty you know whether it's in their

6:36

evidence-based practice course or a nursing

6:39

research course, I think that's a great place to

6:39

start that scholarship going. Other places like

6:46

innovative type things, vSim is good that we've

6:46

been using or the virtual reality. You know,

6:53

the can't the name of it but the virtual reality

6:53

and kind of giving them an older adult patient or

6:58

letting them see what it's like to be an older adult.

6:58

I know when Covid hit we tried to do some of

7:03

that really creative stuff online with blurry

7:03

screens and things so that they could see what

7:08

it's like to be visually impaired but I think

7:08

virtual reality could be a really great way

7:14

to keep that engagement with students and older

7:14

adults throughout. When they get to pop

7:20

senior centers, churches, wherever the older adult

7:25

community is. The research that we're talking about

7:25

today really showed the students fellowship

7:32

among the friars that we were dealing with, whether

7:32

it was at a time of saying mass or it was

7:39

a time of lunch and breakfast where they all

7:39

kind of came together and talked so getting

7:45

students to see seniors interacting with each

7:45

other rather than just isolated med-surg rooms

7:50

would be good. Every curriculum is different but

7:50

a lot of curriculums might have a specialized

7:57

senior elective. I know we do where seniors can

7:57

choose an elective. I would love to see an older

8:02

adult elective that gets the students out there

8:02

and working with older adults and letting

8:08

them see the reward of working with older adults

8:08

so that it kind of keeps their interest going. I

8:12

think if they could see the reward of it and get

8:12

those moments of collaboration with them, hear the

8:18

wisdom from our our older population and

8:18

their take on the world, that's what I heard a lot

8:23

of when I took this pilot study group out.

8:23

I think we just need to bring that to more

8:28

students. They were really enthralled with the

8:28

wisdom that the friars told them from their life.

8:34

Do you think they see a lack of opportunity

8:34

for career pathways or employment

8:40

in the geriatric care kind of setting? I know we've

8:40

talked about that before with some of my students

8:45

here and their concern really was - we don't see

8:45

ourselves really in the role, we're not exposed

8:52

to any roles, and the roles we see are typically

8:52

the the RN that's kind of behind the scenes.

9:00

You may have one or two RNs in a care facility.

9:00

The majority of the RNs or maybe LPNs and CNAs

9:06

working so they have a hard time imagining what

9:06

that role for the RN would look like and still

9:11

providing active interaction and care to the the

9:11

clients that they're serving. Can you speak to that

9:16

at all or have any experience with that?

9:16

I think that's a great point. They do tend to only

9:21

see this little tiny snippet of an RN maybe in a

9:21

skilled nursing facility and they call that their

9:27

geriatric experience and they're not seeing you

9:27

know nurse practitioners finely trained in

9:34

older adults, especially those really older adults.

9:34

I don't think they're seeing a lot of that. I did

9:40

actually have one student of mine recently come

9:40

to me who took a position on an older adult floor

9:47

in a Philadelphia city hospital and I was really

9:47

excited about that opportunity for that population.

9:53

Unfortunately I think it just gets blended

9:53

into every other med-surg or every room and they

9:59

I have a, you know,

9:59

such and such age patient, but I think we do need a

10:04

little bit more mentoring and role modeling

10:04

of people who are experts in the field.

10:09

Right. Well, just talk briefly about your findings.

10:09

You talked about the students had some areas

10:14

of concepts they looked at like acceptance, age

10:14

related changes, desire for independence, importance

10:20

of social networks, and enhanced perceptions of

10:20

geriatric and gerontology in general. So if you

10:27

can just briefly ... what were the

10:27

findings you had in those areas?

10:31

My favorite was the social networking that they really

10:31

just took off on the students. That was one of

10:36

the first things they told me was how the friars

10:36

interacted with each other at the dinner table,

10:42

we brought them downstairs for a mass where they

10:42

celebrated together, at the different events

10:49

throughout the day, that they really felt the

10:49

social interaction was key with them knowing

10:54

each other and that was their first big

10:54

takeaway. I think it was really valuable

10:59

for them to see older adults interacting because

10:59

they're so used to their college interacting so

11:04

that was a big one. A lot of students felt very

11:04

moved by the older adult telling them this is

11:11

how I adapted. I might not be able to walk down

11:11

the hall by myself but I'm allowed to roll down

11:17

the hall by myself or I use this device and it

11:17

keeps me still going. Or I have the

11:23

paper, they were sharing the newspaper a lot so

11:23

they were very moved by the resilience the older

11:29

adult to adapt to their physical changing bodies

11:29

and I think it really opened a lot of their

11:35

eyes to see like, oh, this is how the human keeps

11:35

adapting. Right. They really, really liked that

11:43

and they just came to me, a couple of them, they're

11:43

like, wow. I really thought I wanted to be a labor

11:47

and delivery nurse. I didn't realize that this

11:47

was such a satisfying place to be with their

11:52

older adults. They were like -

11:52

this is great. They know each other. They were so

11:57

happy to be with us. There's so much to share, so it

11:57

was really a very big awakening for many of them

12:04

and I hope that they carried that through their

12:04

curriculum. I never did get to follow up like,

12:08

hey, where you going now the end of the curriculum

12:08

because Covid kind of hit us, but I think it just

12:13

really kind of opened a lot of eyes for them to say

12:13

this is something I really might want to look at.

12:19

What future work do you have in your plans for this area?

12:24

I would like to bring it to more collaboration and work

12:24

in our curriculum. I teach advanced med-surg so

12:32

in that curriculum I like to have discussions

12:32

about the concepts like what does sepsis look

12:36

like in a med-surg way and then

12:36

I like to bring it into our older adults

12:41

or different safety needs. I'm working it in my

12:41

curriculum. I teach a lot of patient safety,

12:47

which is a great place to put it, so I like to

12:47

build that into my scenarios and case studies

12:54

and as I'm mapping my courses personally I'm

12:54

definitely putting it more into the interactive

12:59

classroom experiences.

12:59

That's great. Well, Dr. Pariseault, thank you so much

13:04

for joining us for this interesting and insightful discussion

13:04

today. I really appreciate your time and expertise

13:09

and broadening our understanding of this topic. And

13:09

to our listeners, if you haven't have opportunity

13:14

yet, please take a look at Dr. Pariseault and

13:14

colleagues article, "Exposing Undergraduate

13:19

A Qualitative

13:19

Analysis," and again, it can be found in the

13:24

May-June issue of Nursing Education Perspectives.

13:24

Thank you so much again for joining us. Thank you.

13:30

[Music]