title: The Influence of the Constructs of Ageing on Gerontic Nursing Practice and Education: Reviewing the Past and Suggesting the Future
Creators: name: Brooker, Jennifer Anne
Publisher: name: Griffith University
Year: 2005
Subjects: subject: Gerontic nursing
subject: Aged healthcare
subject: Registered nurses

description: This narrative inquiry traces and recounts an epiphaffic experience of a registered nurse on entering gerontic nursing, and her subsequent three-decade journey through the complexities and mazes of this nurse specialty. Such inquiry seeks to enable a better understanding of the realities of ageing and caring for older adults by opening up thinking and beliefs underpinning gerontic nursing work. Modern aged healthcare involves complex gerontic nursing actions, requiring highly skilled nursing personnel, but on the whole, gerontic nursing is dimly perceived and misunderstood by professional colleagues and the general public. Much of this misunderstanding is a legacy of an outdated ideology of gerontic nursing; yet these public beliefs, attitudes and interpretations are extremely powerful in determining aged care policy. As the population ages and more elderly people access healthcare services, society will be faced with an array of complex political and socioeconomic factors. This thesis aims to untangle such choices by pursuing the questions of: How have the constructs of ageing impacted on gerontic nursing practice and education?, What type of gerontic nurse will be required to provide future elderly care? and How will these people be educationally prepared for their new roles? Many of the constructs explored are dialectical in nature; that is, they have developed by inner conflict, the scheme of which is thesis and antithesis, or an original tendency and its opposing tendency. Such dialectical thinking has underpinned much of this thesis and in many instances, particularly in chapter 7, has taken the next step to the unification of these opposing tendencies; that is, synthesis, to create new understanding or meaning. Issues explored relate to: the ontology of ageing; the meaning of life; gerontophobia; Australia's changing population profile; changing aged healthcare systems; gerontic nursing cultural dilemmas; workforce planning; elder health in the future and gerontic nursing practice and education shifts. In a theoretical and methodological context, increasing difficulty with conventional epistemologies and the science founded on them is leading nurse theorists ever nearer to a postmodernist position. Narrative becomes a means through which gerontic nursing can accumulate and express cultural knowledge and critique procedure. The thesis exemplifies narrative's profound potential for underpinning the reconceptualisation of gerontic nursing practice and education. It is narrative's capacity to foreground the relationship between daily practice and knowledge that makes it a critical tool for the future of gerontic nursing inquiry. Narrative facilitates the paradigm, or more ontological shift from the dominant medical model of aged healthcare and 'tender loving care' rhetoric, to a therapeutic, caring-healing approach which has been in the margins in gerontic nursing practice. In the context of gerontic nurse education, narrative pedagogy offers new ways of thinking even in the midst of oppressive practices. Many issues remain unresolved about how gerontic nurses can be educated for future gerontic nursing practice. It would seem that aged care in Australia is a site of such organisational and cultural change, it threatens to undermine knowledge, care and understanding and shift care to untrained staff. The thesis illustrates how such approaches cloak much of gerontic nursing practice and devalue the intimate work of caring intelligently, emotionally and physically for frail older adults. However, while such tensions abound in gerontic nursing practice, the 2l~ century offers skilled gerontic nurses the opportunity to become key components in the refigured and redesigned aged healthcare delivery system. Research indicates that because few know enough about the sum of the future to impede well-constructed attempts at engaging in any new model design, taking any action is infinitely better than none. It is on this premise that Chapter seven posits a new model design for residential long-term aged care for older adults, believing that by imagining a different future, it can then be created and become a reality.