July 8, 2014
Article by Global Pre-Meds
Hospital doctor shadowing & global health experience programs.
Around five per cent of individuals in the UK, aged 65 or over, are currently having their health needs met in care homes. For those aged 85 and over that figure jumps to 20 per cent. In addition you’ll find that some care homes take on a palliative care role while others have added a rehabilitation aspect where they will form a type of half-way house for those who have recently been released from hospital but aren’t well enough to return home to care for themselves yet.
And talking of which, many of the elderly will be cared for in their own homes in the future if the government has a say in it (their current policy being to encourage more independent living). However, there will always be elderly individuals who require the specialist services (24 hour support) and companionship only a care home can provide. So what does nursing in a care home involve? Well, read on as we set out to enlighten you here at Gap Medics:
Please don’t believe for one minute that working in a care home is less stressful than a hospital. Although many of the tasks carried out in an elderly home (such as moving a resident from a bed, taking them to the toilet and helping them eat) are carried out by auxiliary nurses – also known as Health Care Assistants (HCA) – you will still have to be present in order to both supervise and monitor what’s occurring.
This is because you, as a nurse, will be accountable for that patient’s care and health while in the home and this can only be achieved if you can observe such issues as their appetite (checking they are able to swallow, for instance), whether or not they have bed sores and if they might have difficulties using the toilet because they’re perhaps constipated or have a urinary tract infection. You may even have to set up a toileting schedule and draw up a plan for care home staff to ensure the resident takes some exercise every day.
Every care home (or organisation) has its own policies and ways of working and it’s necessary to abide by these – even if you disagree with them. In some care homes for instance, it may be your responsibility to ensure that the lifting hoist is safe or that there are enough slide sheets available. In others this will be the duty of the care home manager.
-Clinical care in a nursing home. Clinical aspects of nursing care carried out in a home within the UK includes setting up intravenous infusions/syringe drivers, PEG feeding and taking blood from residents. You will also be responsible for ordering repeat prescriptions, ensuring that glucose levels are consistent and for monitoring and adjusting medicines. Other tasks include changing dressings and looking after pressure sores and other skin infections. In addition, you are the link between the resident and the doctor and have the authority to arrange for the resident to be transferred to hospital if you believe it’s necessary.
-Caring for the skin. This includes wounds and is actually a major part of nurse’s job in a care home. This is because our skin thins as we get older and doesn’t repair itself as effectively, resulting in the possibility of a serious bacterial infection and ulcers. Many elderly residents also have blood sugar difficulties and diabetes which can exacerbate skin wounds. A poor diet won’t help either (which is why it’s important to monitor the patient’s feeding). In fact, due to their age, many of the home’s residents will have several conditions and therefore complex needs.
-Pneumonia and depression. Often due to increased isolation or depersonalization, these are illnesses an elderly individual can be particularly susceptible to and the latter illness isn’t always easy to spot, therefore working as a nurse in a care home often requires acute perception in addition to medical skills. In fact, monitoring an elderly patient’s mental skills and cognitive function is another regular part of nursing in a care home.
-Because those you treat are residents in the home, it’s possible to really get to know your patients and their families rather than in a hospital setting where sometimes patients are in an out within 24 hours.
-Nursing for elderly patients can be complex because of the number of conditions experienced by an individual. Because of this it’s often necessary to write out complete care plans which take into account the individual’s nutritional and exercise needs, medication, mental health and socialisation skills. This is a lot more challenging than simply dealing with one condition at a time.
-There is not as many nursing staff in a care home as in a hospital which means that you’ll get the opportunity to use more of your nursing skills. Neither will you have a supervisor constantly checking over your shoulder but will be expected to make your own decisions about a resident’s medical care. This can prove a real confidence boost.
As we mentioned earlier in this article, there is a growing elderly population which bodes well for an increase in the number of care homes. Some of these will be specialist (ie for dementia care) but nursing duties will still be called for just as they are in general care homes.
Having said that, it’s not currently a requirement for all care homes in the UK to employ a nurse: in some facilities general nursing is carried out by community nurses. Only in the more intensive nursing homes, where 24 hour support is needed, is resident nursing a necessity
To find out more information about what it’s like to work as a nurse in a care home abroad, why not take a look through our GapMedics website today? There you’ll be able to hear from students who have nursed elderly individuals on placements while working abroad.