Vital Views

Joe Gaccione 0:00
Greetings, you're listening to Vital Views, UNLV School of Nursing podcast. I'm Joe Gaccione, communications director for UNLV Nursing. If you name all the different kinds of nursing specialties, chances are gerontology isn't the first or maybe even second field that comes to mind. But gero nursing, which revolves around care and study of older patients, is a necessary specialization that aids an often misunderstood population. Quality care for older adults isn't just physical; gero nurses are providing a mental and emotional check on their patients’ wellbeing to make them feel connected and part of the community, rather than holed up in a room alone. To talk more on gero nursing, we welcome back a returning podcast guest, Dr. Kayla Sullivan, UNLV assistant professor and registered nurse here in Las Vegas. She actually teaches gero nursing here at UNLV. Dr. Sullivan, thanks for coming back. What goes into gerontology nursing?

Kayla Sullivan 0:52
So, gero nursing is really just the study of older people and aging. It encompasses a lot of different things as we age. Most people think that, you know, we get older and it's just like, disease and comorbidities, but we're really dealing with the person as a whole, different, you know, socioeconomic changes, different family structure changes, emotional changes, death of loved ones that have been with their life, you know, in their life for a very long time. When we think about gero nursing, there's just a variety of different topics and aspects about a person's life that we look into.

Joe Gaccione 1:36
And you teach gero at UNLV nursing, correct?

Kayla Sullivan 1:39
I do. When I actually started with UNLV, what seemed like many moons ago, I started teaching gero in the clinical setting, so I did that for many years, and then in the last few years, I started doing the lecture for it, both in the our second bach accelerated program as well as our traditional program, and I really enjoy it.

Joe Gaccione 2:01
When we look at gero in the clinical setting, I'm curious, is that in specific places like hospice facilities, nursing homes, not to, not to stereotype where old, older populations might be, but just that's, those are the most common places that I think of. Is there, are they specific?

Kayla Sullivan 2:17
So, I will say that that's funny that you say that about stereotyping because a huge reason that a lot of nurses are like, “I don't wanna be a, a gero nurse,” is because they think that gero nursing is only in a nursing home or a long-term care facility, but when we think about UNLV clinical, pre-COVID, unfortunately, a lot of things have changed since COVID, we were able to go into the hospital. So, we would see our sicker elder population, you know, with multiple comorbidities, but we'd also be able to go and look at the well elder. So, we'd go and see the older population, for example, like at OLLI, which is here at UNLV, right across the street, part of, part of campus, but it's where older adults, 65 and up, get to come and they take classes, you know, it's not structured like college is, but for a semester they’re, you know, taking different history classes, art classes, and we would be able to interact with this well elder and really show the students that just because you're getting old doesn't mean you're old and sick and you're dying, but they're really living a fulfilled life. We'd also look at different areas, you know, we'd go to an assisted living facility, we would go to memory care clinics and help out with screening for dementia, we would go to adult daycare services. So, there was a lot of different options that we exposed the students to so they were able to see an older person on like, a continuum versus, “They're just sick and they're gonna die.”

Joe Gaccione 3:58
And that's a great point about life fulfillment because, I'm gonna use a cliche, so I apologize in advance, the phrase that you're only as, as old as you, you feel, or only as old as you think you are, but I believe that to be true because you could be young but not have any purpose and you, versus you could be older, but have a fulfilling life to be able to say, “I've done so much, my,” your, your mood, your demeanor, and sure, it's all situationally based, you know, you could have, you know, depending on what you're going through, circumstances notwithstanding. Going into COVID, we, we spoke with another UNLV nursing professor, Dr. Nirmala Lekhak, and she was doing COVID research about older people that were basically stuck, I mean, they're stuck in their homes, they're stuck because they can't go out. They're more at risk and there's that isolation feel. What are some misconceptions about gero?

Kayla Sullivan 4:45
So, the very first day of class, I usually will pull up some questions that I just want the students to think about and answer, and one of them is like, “What, what did you expect from this class? What do you think you're gonna get in this class?” It's usually like your myths or misconceptions about gero. Typically they say, “Oh, they're all older. They're all really sick. They have multiple comorbidities. They're all in the hospital, you know, they have all these different problems and their life just really sucks,” is kind of the gist of what they get. And at the end of the class, we do something called a health promotion project. So, they go out and they actually find an older adult in the community and they assess them and create an intervention, an educational intervention. So, it could be on anything like, for example, a lot of them do like a grandma or grandparent because they’re easily accessible and it will be something like, “They wanna be more physically active,” so they assess that, and they assess barriers, and then they create an educational intervention on how to get grandma or grandpa more physically active and actually educate them, and then they present on the entire, you know, to the entire class on what they found. And after this, they usually are like, “You know, we didn't really realize that older people are living fulfilled and full lives.” So, I think that that is kind of a huge misconception of older people, is that everyone just thinks that they're sick and dying, but they're really not. They're living just like anyone else at any age. If you talk to a lot of older people that are, you know, in the well elder, what we say, they'll be like, “My life started at 65,” right? “Things really started getting better and I started to explore different things,” and they really started living in, in their older age.

Joe Gaccione 6:38
Old age also comes wisdom and you're also realizing mastery of, of anything isn't truly complete, I, I think, until your final day, because there's so much to learn, and even in your older age, you can learn more about yourself and more of what you like and don't like. And you might be at a point where you feel more adventurous to say, “I'm gonna do this, I'm gonna do something different.” Along those lines, based on the, the feedback I, I'm hearing from your students, do you think more nursing students generally shy away from this field as they start to look at the specialty they want to be in?

Kayla Sullivan 7:09
I think so, yes, because I think that a lot of these students want to go into those flashy and popular, you know, nursing areas, surgery, ER, ICU, because it’s, you know, kind of cool. It's really cool to be like, you know, “I take care of the sickest of the sick patients and I can keep people alive,” or, “I get to bring babies into this world,” so I think that people shy away from general nursing because they don't think it's as fun or that it's gonna be boring and that “Everyone's just gonna be sick and dying, so why would I want to do that?” But I think something that we don't realize or, you know, a new nurse might not realize, is that if you're working in an adult setting, whether it be med-surg, ICU, IMC, ER, whatever it is, surgical setting, a huge portion of your patient population is going to be in that gero age. You know, we have our baby boomer population that is starting to reach that 65 and up, and that age population is going to double in the coming years. So, we're gonna have a huge, huge population of gero patients and we're gonna need nurses to be taking care of them.

Joe Gaccione 8:21
It almost is a shame that you could look at one field and say, “That's where I want to be,” but also not knowing, maybe like, all the variables. Like we hear a lot of, young nurses will say, “I like pediatrics because I like working with babies.” Well, sure, and that's understandable, and yeah, babies are cute and kids are cute, but you're assuming that every day is gonna be like that, where it's gonna be sunshine and rainbows, but unfortunately, it's not like that, like with any health field, any, any nursing field. I mean, I think the inverse of that goes with, with gero is that just because you're taking care of someone who's older, doesn't mean every day is gonna be miserable. The stories they might have, I mean, they might be happy, they just need extra care. So, it's like it goes both ways.

Kayla Sullivan 8:57
Yes. And I will say that some of my gero hospice nurses that I've worked with and known have been some of the most fulfilled with their jobs and sure, that they might be in this gero field of where they are dying, right, because it's hospice, but they're so fulfilled with their careers and the care that they get to provide, and not only are they caring for a patient, they're really caring for a family as well. So, I think that that's something just for new nurses to think about.

Joe Gaccione 9:28
We spoke recently with a UNLV nursing alum about her role in a nonprofit, Dream Catchers Foundation, where they do, like basically they fulfill the, the, the wishes of hospice patients, and we started talking about end-of-life doulas. And it's interesting because even in that role, when you're getting to that stage, as we're all gonna be at some point, and you talk about fulfillment, you're almost like, like you're recording their history, you're, you're taking note of their lives, their stories, and it's not necessarily have to be fulfilling just on a personal level, but just to be able to talk to someone and hear their, what they've been through, their experiences, I can imagine what that's like to be able to look at your life and go, “Wow, I, maybe I need to do more,” or, “I didn't realize that from that perspective.” Like you're, you're truly learning about other people in those scenarios, and you have that ability to talk to someone who's reached the end. I mean, they've, you know, 60, 70, 80, maybe, you know, longer, and to hear those, those tales, I imagine it has to be, it has to be deep.

Kayla Sullivan 10:29
Yeah. I really enjoy it. Not that, I haven't worked in like, a specific gero like, unit, but my experience being an ER nurse, ICU nurse, like I said, a huge portion of my patients have been at this gero age, and they bring a lot to the table and offer, like you said, a lot of wisdom that, it may not be medical wisdom, but it's just life, life wisdom that they can offer to those that are caring for them.

Joe Gaccione 10:59
Were there any stories that you remember that stood out to you the most? Any patients that had a bigger impact on you than you thought?

Kayla Sullivan 11:05
I would say that yes, I've had quite a few, and a lot of them are more so related to the families. So, when those patients, just because of where I have worked, a lot, I didn't take care of a lot of well elders, right? They're very sick, and taking care of someone in their, in their dying moments, and then it's their families that give you, that leave that impact on you because they thank you for what you did and how you handled the situation, how you helped them, how they're gonna remember that you helped and made their family member really comfortable. So, I think I have a lot of those memories that kind of impacted me, that you think like, “Oh, I'm just doing my job,” right? Like, “I'm just here, I'm taking care of you, and then I'm gonna go home.” But realizing that we really impact people as well, and then they're gonna remember us, too, for the rest of their lives, and they're gonna remember the care that they got for their grandma or grandpa or sister, you know, whatever the situation is, they're gonna remember that for the rest of their lives, too.

Joe Gaccione 12:12
It feels like there's a dignity to it, as well. If you have someone who's treating you well, especially in those, you know, if it's end-of-life care, then at least you know, the family knows, like you said, that they were treated well, but you have that knowledge of going, “Okay, I made their moments, their final moments,” not to sound morbid, but “their final moments, maybe not special, but just as, as good as I could have done.”

Kayla Sullivan 12:34
Yeah, as comfortable as you can in a very sad situation, yeah.

Joe Gaccione 12:39
What would be the biggest trait a nurse should have if they want to be in gero, if there was one? Is there something that you tell your students, maybe as like a sum up, like your, your pitch for gero?

Kayla Sullivan 12:50
I would say patience. Yeah, a lot of patience because these older populations, like we've mentioned, have vast life, you know, experiences and they have a lot to bring to the table to tell us. So, really just being patient with communicating and listening to what they're telling you. You know, of course, they move a little bit slower and those things, so you have to be patient with that as well, but just really taking your time to care for these patients.

Joe Gaccione 13:18
That is all the time we have today. Thank you, Dr. Sullivan for coming in again.

Kayla Sullivan 13:20
Thank you for having me.

Joe Gaccione 13:22
Thanks for listening out there. Hope everyone has a great day.