Spring 2008
Volume VI, Issue I

Cover illustration by
Robert Neubecker

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Geriatrics offers surprises to those who associate it exclusively with nursing homes. Today, except for maternity and pediatrics, approximately 50 percent of hospital patients are 60 or older. As a result, according to Johns Hopkins University School of Nursing Assistant Professor Elizabeth (Ibby) Tanner, PhD, RN, "every nurse should be prepared to care for older adults in hospital settings." Unfortunately, most providers, including nurses, have not been trained to do so, but that's changing.

"Issues in Aging" is now a required first semester course at JHUSON. "We're pioneers in this field," said Tanner, who is also teaching a multidisciplinary seminar on the care of the complex older adult, another first for the school. She notes that what's paramount for nursing students to learn about this population is the need to collaborate with multiple disciplines. "Most patients don't have just one illness; they have multiple complex problems and may be taking a dozen different medications. Tanner adds, "A myocardial infarction does not manifest the same in a 50 year old as it does in an 85 year old." To differentiate, nurses must develop a high level of problem solving, communication and assessment skills in addition to old-fashioned compassion, and then offer solutions that fit the patient's social, physical and economic resources. That's a tall order.

A mitigating factor: "The goal is not necessarily to resolve all of the geriatric patient's medical problems," Tanner said. "An important goal is to improve quality of life while focusing your attention on each individual's social and emotional well being, as well as the physical care." Among the many satisfactions that come from caring for older adults: "We can learn so much from them."

Kitty Poon '06, who is pursuing her graduate degree in nursing, agreed. "I'm amazed by their resilience," she said. Since 2004, Poon has been a volunteer in the Service Awareness through Geriatric Education (SAGE), a community service program which matches students from the Schools of Medicine, Public Health and Nursing with seniors living independently. The goals are to reduce elder loneliness by fostering friendships between the generations and to broaden the students' perspective of older adults outside of a medical setting. Volunteers, usually in teams of two and from different schools, are expected to visit seniors in their homes and share a meal.

A solid foundation in the care of older adults also has practical advantages. "Nurses who are prepared for this work are highly sought after in a myriad of settings, including acute care, emergency room, psychiatry, oncology, etc.," Tanner said.

Megan Tyler '07 is a good example. She credits her nursing school leadership experience with the JHU-wide multidisciplinary Geriatric Interest Group organized by Tanner as instrumental in being selected for her job as a staff nurse in the special care unit at Anne Arundel Medical Center. As a student, she also participated in Grand Rounds at Bayview Medical Center and one of her clinical experiences was with the Baltimore City Health Department's Commission on Aging and Retirement Education (CARE). Most of the patients she works with now have dementia. "I knew what to expect," Tyler said. "That makes it easier clinically. Professor Tanner is a great mentor."

Tanner, along with Dean Martha N. Hill, PhD, RN, FAAN, has been publicly recognized by the John A. Hartford Foundation Institute for Geriatric Nursing for her work in content mapping and including strategies for teaching the core competencies of geriatric nursing. She is also the first nursing faculty to be affiliated with the Johns Hopkins Center on Aging and Health, which now includes faculty from the Schools of Medicine, Public Health, and Nursing, all working together on the forefront of aging research.

 

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