The education of nurses working in care homes for older people: An Appreciative Inquiry

Abstract

Aim To explore the education and developmental needs of care home nursing staff. Background With an increasing ageing population, the need for high‐quality care provision is set to rise and will require nursing staff with the desired knowledge, skills and values. However, multiple concerns have been identified when considering the development of nurses working in care homes. Moreover, challenges in the care home sector have also contributed to a situation where some nurses view care home work as being of low status and choose this work to fit around other commitments, rather than viewing it as a viable career pathway. Method A qualitative approach based on the principles of Appreciative Inquiry. Fifteen participants working in five care homes with nursing, based in England (UK), took part in this study. Data were collected during 2016–2017 and involved managerial, qualified and unqualified staff. Results Data analysis revealed three distinct themes: an effective learning environment; the care home as a nursing student placement; and the need for financial investment. These themes were found to have the most influence on the development and education of care home nursing staff. Conclusion This research provides important insights into the care home as an educational environment, not only for nursing students but also for those employees already working in such settings. Exploration of the ways in which higher education organisations and care home teams could collaborate more closely could be mutually beneficial to the quality of care and to raising the profile of care home work. Implications for practice Care homes can provide a rich learning environment for both staff and nursing students. Collaboration and appreciative ways of working enhance opportunities for developing practice and care.

Understanding the staff behaviours that promote quality for older people living in long term care facilities: A realist review

“…Role experience was a modifier of reciprocity reinforcing behaviours. Experienced staff often used reciprocal behaviours to build confidence with less experienced/confident staff ( Casey et al, 2011 ;Brown Wilson, 2009 ;Colomer and de Vries, 2016 ;Vassba et al, 2019 ;Barry et al, 2005 ;Jack et al, 2019 ;Rapaport et al, 2017 ;Zeller et al, 2014 ;Gillham et al, 2018 ;Yeatts and Cready, 2007 ). Such behaviours were nested in relationships built on open communication and respect for the less experienced ( Gillham et al, 2018 ;Cammer et al, 2014 ).…”

Capacity of nurses working in long‐term care: A systematic review qualitative synthesis

“…Data were collected via interviews ( n = 10), focus groups ( n = 7) and an open‐ended question ( n = 1). Articles investigated recruitment, resilience, employment and retention of RNs in LTC (Backhaus, Verbeek, et al, 2018; Binney, 2014; Cope et al, 2016; Knecht et al, 2015; McGilton et al, 2014; Thompson et al, 2015), how nurses perceived their professional work (Carlson et al, 2014; Eisenbraun, 2017; Eldh et al, 2016), rewards and difficulties (Gao et al, 2015) and supervision of RNs in LTC (Prentice et al, 2017), student RN preceptorship and career aspiration in LTC (Carlson, 2015; Carlson & Bengtsson, 2014), LTC nurses’ perceptions of occupational status (Thompson et al, 2016), leadership (Corazzini et al, 2015; Fiset et al, 2017), education and development needs of RNs in LTC (Jack et al, 2019) and intentions towards managing deteriorating health (O'Neill et al, 2018).…”

“…Nurses valued LTC for the opportunity to exhibit skills to build and sustain respect for personhood. A focus was on person‐centred care in building resident relationships; conveying respect, advocating for resident decisions and prioritising dignity (Carlson & Bengtsson, 2014; Corazzini et al, 2015; Eisenbraun, 2017; Eldh et al, 2016; Fiset et al, 2017; Jack et al, 2019). Nurses also saw building relationships with families as satisfying (Carlson et al, 2014; Corazzini et al, 2015; Gao et al, 2015; Jack et al, 2019).…”

“…A focus was on person‐centred care in building resident relationships; conveying respect, advocating for resident decisions and prioritising dignity (Carlson & Bengtsson, 2014; Corazzini et al, 2015; Eisenbraun, 2017; Eldh et al, 2016; Fiset et al, 2017; Jack et al, 2019). Nurses also saw building relationships with families as satisfying (Carlson et al, 2014; Corazzini et al, 2015; Gao et al, 2015; Jack et al, 2019). Studies addressed pride in relation to creating professional relationships and a passion for the nursing profession, which were the result of valuing older adult care and meaningful relationships with residents (Binney, 2014; Carlson & Bengtsson, 2014; Carlson et al, 2014; Cope et al, 2016; Eldh et al, 2016; Gao et al, 2015; McGilton et al, 2014).…”

“…Graduate nurses would have multiple learning opportunities in care homes (Jack et al, 2019; e.g. a manager said nurses would be: a leader, a friend of family members and the client, would be multiskilled; another manager said the care home worked as more ‘person centred’ compared to hospitals; another manager said the work in care homes has multiple managerial aspects, for example, the nurse would lead 150 staff, learn how to manage a budget, learn how decisions nurses made would directly affect a client's care) (refuting evidence) ‘multiple roles’ ( Moved to theme that became ‘Stretching beyond the technical’ )…”