Igniting a focus on mentorship

Despite the complex and growing number of older adults requiring specialized nursing care,1 gerontological nursing is too often perceived as less prestigious than other areas of nursing.2 Similar to many practicing nurses,3 students do not always appreciate gerontology as a highly skilled area of practice.2 Nursing faculty and staff of residential aged care facilities (RACFs) hold a critical and influential role in disrupting these preconceived notions during students’ clinical placements. The results of our systematic review in this issue of JBI Evidence Synthesis reveal that clinical experiences in RACFs are not always sufficient to provide faculty and staff “a voice to lead”4; that is to say, placements alone are not enough to ignite enthusiasm for aged care or an appreciation for the learning opportunities available in RACFs.5 Faculty and staff must be prepared to share their unique expertise in this setting, confront students’ negativity about aged care, and invest considerable effort into highlighting learning opportunities available in the setting. The need to invest in faculty who have passion and expertise in gerontological nursing is evident, along with the need to prepare staff in RACFs for student placements. The latter is particularly true because staff are largely unregulated and not always considered ideal role models for students.6 The importance of investing in student placements in RACFs is more important than ever. Residential aged care has shouldered much of the impact of COVID-19 and the negative publicity associated with it.7 The public focus on residents’ “social isolation crisis”8(p.460) and chronic understaffing in long-term care make it difficult to advocate for a rewarding and fulfilling career in RACFs. Residents and staff are increasingly experiencing mental health challenges related to the pandemic that have not ameliorated the atmosphere in RACFs.8 In their recent policy brief on the global nursing shortage and necessity of nurse retention, the International Council of Nurses draw attention to the current and potentially long-term effects that the pandemic will have on the nursing workforce in general.9 Their concern is that, as more and more nurses reach the point of burnout from direct and vicarious traumas, there will be severe attrition from the profession.9 The long-term sequalae and attrition rates in RACFs attributable to the pandemic are not yet known, and impacts on student placements are likely to be felt for many years to come. Given that the findings in our review show that staff in RACFs were already feeling undervalued and under-recognized before the pandemic,5 the importance of promoting RACFs as a desirable place to learn and work cannot be overstated. Now more than ever, faculty and staff need to present a united front for new learners and collectively invest in igniting a passion for gerontological nursing and long-term care. Without immediate action at institutional and public policy levels,10 valuable staff may be lost in RACFs, and with them opportunities for strong mentorship to bolster the appeal of nursing in aged care settings. In spite of the many challenges that COVID-19 has highlighted, staff in RACFs have also proved to be incredibly resilient and willing to assume additional responsibilities for residents who were cut off from community supports and families. The need for capacity building and professionalization in RACFs is clear.1 While not disputing the many challenges in making the RACF environment an attractive place to work and in cultivating students’ interest in aged care, the positive impact students can have on the setting should not be overlooked. To this point, another synthesized finding of our review is that staff perceive students as enhancing the RACF environment.5 Students inspire faculty and staff to grow and develop as professionals, offer a reciprocal exchange of knowledge and experiences, and contribute to improved resident care. The value of having students in RACFs must remain a focal point in the ongoing conversation around how to address staffing shortages and recruit nurses to work in aged care environments. Academic institutions have a social responsibility to meet the growing demand for nurses who specialize in the care of older adults, and to provide high-quality clinical placements that ignite students’ passion for this specialty field. In line with the World Health Organization's call for nursing education programs to move away from producing generalist practitioners,11 it is necessary for schools of nursing to embrace gerontology as a specialized and demanding area of nursing practice. Investment in staff is critical as they provide mentorship to students, assist clinical instructors, and can become role models for students to aspire to work alongside.11 Investment in clinical instructors is essential as they nurture the development of future nurse leaders in gerontology and much-needed clinical-academic partnerships.11 Overall, igniting a focus on mentors who share their passion for gerontological nursing with the next generation of nurses will be critical to ensuring the longevity of this important and highly skilled workforce.

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