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Long-term care settings in need of nurses
Berenice Pomerenke, 94, remains alert and retains her sense of humor, even though she has slowed down after a heart attack on Easter Monday. She was in her apartment at Adelaide Retirement Apartments, Normal, with her daughter, Paula. (Pantagraph/STEVE SMEDLEY)

NORMAL - Marie Deffner grew up around older adults. She knew all four of her grandparents and had a special bond with her paternal grandfather. She helped him around the house. He taught her German.

Deffner visited her great-grandfather in the nursing home. She helped "Opa" (grandfather in German) get around and visited and played checkers with other residents as well.

"I just loved spending time with that age group," recalled Deffner, 21, a Normal native.

"The moment I knew I wanted to be a nurse, I knew I wanted to be a geriatric nurse," meaning a nurse who works with older adults, said the 2004 Normal Community High School graduate who just completed her junior year at Mennonite College of Nursing at Illinois State University, Normal.

But Deffner is a rarity.

"When I got into nursing school, I was the only one interested in geriatrics," said Deffner, who said pediatrics, obstetrics and gynecology, and neonatal intensive care were popular areas for nursing students.

Mennonite-ISU and Heritage Enterprises, the Bloomington-based owner and manager of nursing homes around the state, know there's a need for nurses in long-term care settings. The two organizations are trying to do something about it.

Mennonite-ISU and Heritage are in the second year of their Expanding Teaching Nursing Home Project. The project, funded by a $1.4 million state grant, is an effort to improve and standardize the quality of care to older adults by attracting and retaining good nurses, and keeping them educated on the "best practices" in the care of older adults.

The effort remains at an early stage but there's been some progress. For example, Heritage Manor in Bloomington and Heritage Manor in Normal each recently hired Mennonite nursing graduates, said Rose Stadel, a member of the project's advisory council and director of operations for the Central Region of Heritage Enterprises.

"We're very excited," Stadel said.

More nursing students are considering geriatric nursing, said project coordinator Charlene Aaron of Mennonite.

"They are intrigued by it," Aaron said. "In a long-term care setting, they have an opportunity to work with residents and develop relationships. That's different from working in a hospital."

The project was built upon Mennonite-Heritage older adult initiatives of the past six years, especially its pilot, the Joe Warner Teaching Nursing Home. Named for the former chief executive officer of Heritage Enterprises, the 2004 pilot project reinforced the nursing school-nursing home collaboration by increasing long-term care clinical work of nursing students to get more of them to work in nursing homes.

The Expanding Teaching Nursing Home project is an effort to expand upon the pilot project statewide. The project's advisory council includes 13 people involved in long-term care throughout Illinois.

One way the project hopes to improve the professional attractiveness of nursing homes and other long-term care settings is by having mentors for new nurses.

Mentors can brief new hires on how shifts run, when to call the doctor and the director of nursing, and how to know what families want, Aaron said.

"If new nurses are adequately trained, they are more apt to stay," Aaron said.

The project also allows nurses at nursing homes access to a Hartford Institute at New York University School of Nursing Web site that is designed to have nurses type in a problem and get information on possible interventions, Aaron said.

"The goal is to try behavioral things without calling the doctor to increase the meds," Aaron said.

The site is being used successfully at several Heritage nursing homes, Stadel said.

"It's a nice collaboration," said Sara Campbell, principal investigator of the project and a Mennonite associate dean.

Two other project initiatives are urging nursing colleges to offer a gerontology specialty, and working with community colleges to encourage their nursing graduates to go on to bachelor's and master's degrees, then to work in long-term care settings or to become nursing school teachers.

"Geriatrics is a specialty and we want nurses to be certified in geriatric nursing" so they're all operating on the same level and providing the same quality of care, Aaron said.

The project also is offering continuing education; organizing long-term care career fairs for nursing students; attracting national speakers focused on issues of the elderly; allowing several students and faculty to travel to a geriatric nursing center in Portland, Ore., to learn about the latest research; and assisting nursing homes in developing plans to attract nursing schools into partnerships.

Members of the project team and advisory council are motivated, knowing that the number of older adults will only increase as Baby Boomers age and live longer than their parents, thanks to improvements in health care and medicine.

Just having nursing students in nursing homes energizes the staff, Stadel said.

"Whenever the students are here (at Heritage Manor in Normal), they inject energy," she said. "And the families are pleased with the association and that the students are there."

Deffner smiled. "Older people like to share their stories with you. And I enjoy hearing their stories."

Deffner said she's enjoyed all of her clinical rotations, but especially those in nursing homes.

"You have to learn about each individual to know how they will respond to you," she said. "It takes a lot of patience."

After she gets her degree, Deffner plans to work in a nursing home for a few years, then get a master's degree in geriatric nursing and work with patients with dementia, such as Alzheimer's disease.

She likes that the Expanded Teaching Nursing Home project is drawing more people to geriatric nursing. But she didn't need the extra push.

"The moments when you get to see their (residents') flame flicker - the elation it gives you," Deffner said. "Knowing that you're making a difference is absolutely beautiful."


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