Reflection on Photographs: Exploring First-Year Nursing Students' Perceptions of Older Adults

Abstract

Nursing students' exposure to clinical placements with older adults is instrumental in helping them adopt positive attitudes toward care of that population. This qualitative pilot study analyzed perceptions and expectations of a group of first-year students prior to a clinical placement with older adults. A photo-elicitation technique, involving viewing of realistic photographs of older adults being cared for, was used to help students clarify expectations. This was followed by thematic analysis of their perceptions and expectations. Analysis revealed five main themes: Dissecting What It Means to Be a Nurse, Revisioning Therapeutic Relationships in Terms of Dignity, Youthful Reflection on the Differences Between Young and Old, Feeling Challenged and Confronted, and Experiencing Sensitivity and Awkwardness Toward Older Adults' Nakedness. Engagement with images of older adults encouraged students to anticipate their clinical placement in an aged care setting in a more meaningful, reflective way than they may have done without prior exposure, suggesting a need for realistic pre-practice education.

Clinical placements engage nursing students to think, behave, and feel like nurses. During clinical placements, the culture and ethos of nursing with its complexities and challenges are discovered, often for the first time. Anecdotal evidence suggests this can be both terrific and terrifying, with students reporting that it can change the way they view the world (Levett-Jones & Bourgeois, 2007). This exploration of nursing students' perceptions and expectations of nursing care of older adults prior to their first clinical placement was intended to facilitate a personal exploration of what it means to be a nurse in the context of older adult care.

An increase in the older adult population and a demand for nurses to care for them has prompted a growth in research exploring why nurses are not choosing aged care as a career (Abbey et al., 2006). Happell and Brooker's (2001) Australian study investigated the career preferences of Year 1 nursing students from nine undergraduate nursing education programs and found that caring for older adults was the least popular career choice. Students explained it as boring and unpleasant work and described being frustrated from a lack of ability to cope with this specialized area of practice. Ensuring positive attitudes in nursing students is a major challenge for those involved in preparing students for their first clinical placement with older adults. One way of responding to this challenge is to use creative teaching strategies; for example, maximizing personal and aesthetic ways of knowing to help students develop a more reflective approach to caring for older adults. Aesthetic knowing involves perception, empathy, insight, and understanding the lived experience of people.