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As The 'Gap' Closes....

Updated on February 14, 2014

As a nurse's age increases, life experience is an asset, bringing with it compassion and increased quality of care.

The “gap”, refers to the degree of difference in age between patient and nurse in a healthcare situation. The younger the nurse, the more distance or space is felt by the nurse when interacting with many of his or her patients. The large age gap between a young nurse and many of his or her patients assures less of a personal connection from the perspective of the nurse.

The 'gap', between nurse and patient narrows as the nurse get older. This, often is responsible for a changing style and approach of the nurse when providing care to his or her patients. The change in style of relating to patients, as the 'gap' narrows, often manifests itself with a deeper and richer communication and genuine, empathetic concern for the patients.

I am not saying that the nurses with the wider gap are not empathetic or concerned, They are within the normal realm of what would be expected for their age. Their life experience does not in many patient scenarios give them pause to think and dig a little deeper, coming up with a question or questions that may be of significant importance to a patient.

The nurses that have narrower gap between themselves and their patients could possibly be more distant, with a lack of affect and an almost utter lack of concern for their patients. This is a situation where the nurse has become burnt out and has little left to offer. These nurses, obviously are going through the motions. Many would opt to retire if that were a possibility for them. I am not referring to that type of situation in this article.

Though some of the patients, while the nurse is in her youngest years, may remind the nurse of a grandparent or other relative, the majority of the patients will not remind the nurse of anyone that he or she knows and there will be little commonality felt by the nurse for the patients. This wide gap allows for a healthy detachment between nurse and patient.

The nurse, later, may choose to go into fields such a labor and delivery, psychiatry and other fields of nursing where the population is younger and the gap will be less, For the first couple years that likely will not be the case.

The education received by the younger nurse will be fresh and current. The nurse, being so young, will likely have a youthful mentality with lots of energy, which may lend itself to extra-special acts of kindness in the form of little 'niceties'. The older, more seasoned nurse might not have the time or energy for such 'niceties'.

The seasoned nurse, due to experience, has a stronger ability to notice ' shades of grey', which may be early indications of serious problems. Identification of these 'shades of grey' make it possible for early intervention. The shades of grey often take time away from the 'niceties'.

What is interesting, is that, in some cases, what a younger nurse might consider a ‘nicety’, an older nurse might see as a necessity. A younger nurse, with all of his or her energy and spunk, often underestimates the frailty of her patients. It is difficult, and, on occasion, downright impossible for a young nurse to understand beyond the logical level, the degree of weakness that some older patients have, making it very difficult for them to do anything for themselves. Some younger nurses are not able to quickly identify such patients.

Unless just back from surgery, or near comatose, some young nurses have a lot of trouble with this concept, especially the ones that when leaving work plan to go for a 5 mile run to blow off steam! Excuse my sarcasm, here. I can’t help but laugh at this one because this was me at the age of 22.

What used to get me were the 'water pitchers'. There was so much emphasis on keeping the water pitchers filled at all times. Granted, there was a nurse’s aide that was supposed to fill them, but often there were not enough aides, or the aides went conveniently into “hiding” and you couldn't find them.

Ultimately, it was the nurse’s responsibility to make sure that every patient that was allowed to have water, had a full water pitcher. As a young nurse, my thinking, when I was called by a patient to fill a water pitcher was “don’t they understand the important things I have to do? People need their medications; I have too many patients and a couple are bordering on unstable. How could they bother me for this”?

As an older nurse, my thinking would be more like; “oh, he’s thirsty, he must really hate that he cannot get up to get something to drink. That must be so miserable to be at the mercy of someone else for a drink of water. He shouldn't have to ask. I am going to give him extra fluids so that he is not in that position again. Also, with the medication he is on, we would not want him to get dehydrated”.

Along the same lines, a younger nurse might not think to make sure that everything the patient needs is within reach; call bell, bedside table, phone etc. The nurse might do an extra spectacular job at all her job responsibilities which may include; providing wound care, managing intravenous medications, physical assessments etc.

The younger nurse may even consider him or herself to be a perfectionist with a high regard for how they manage all the responsibilities of their job. They may have incredible documentation that outlines a patient’s medical situation to a ‘T’. They may do a fantastic job of communicating the necessary information to all the other disciplines involved with the patient. Of course, I do not even have to say how important all these things are! The nurse is new to the profession, driven to succeed, and aims to be the best they can be, which, they are!

The older, more seasoned nurse, because the gap between patient and herself has narrowed, sees the patient in a much different way. The seasoned nurse has a stronger ability to see the 'person' rather than a 'patient'. The person sitting in the hospital bed is more than an object requiring medical intervention, including his or her nursing skills.

The seasoned nurse may consciously or subconsciously be looking at his or her father, mother, sister, brother or even herself. He or she sees a person that has a life which they can't wait to get back to. The nurse, due to his or her own life experience has a stronger ability to reach possibly a small part of the soul of that patient, identifying needs that a younger nurse could not and would not be expected to recognize. To be able to see these needs would require more of a life lived.

The older nurse may not be as fast on her feet, or care to be perfect in all he or she does. At this point in time, perfection is not the priority. The seasoned nurse has proven his or her knowledge and abilities. He or she understands that in the quest to attain perfection, the focus gets shifted away from what is important, the patient.

The energy it takes to work toward perfection is replaced with an often soulful connection with the patient, even sometimes when there is nothing said. It is far more therapeutic to the patient than any task a nurse is expected to tend to. This connection is valuable important to a patient that is vulnerable and scared. It is also of great value to the seasoned nurse.

Because of the narrowed gap between nurse and patient, the seasoned nurse has acquired an extra special ability to identify and understand the needs of the patients. This is the gift that gets given to the nurse, by default, for the many years that he or she has dedicated to their profession.

Not only has the seasoned nurse been caring for patients for many years, in addition, that nurse has likely experienced being a patient themselves. The nurse has the first-hand understanding of what it means to be a patient. The nurse has 'crossed over' to the ‘other side’ and come back.

The seasoned nurse has experienced many of the same worries, disappointments and celebrations in life that their patients have. It is these elements that accentuate the multidimensional aspects of being human.

The seasoned nurse has become as dimensional as his or her patients. The job satisfaction that comes with the ability to intervene from this place of mutual understanding cannot compare to the job satisfaction attained by a young nurse.

The young nurse is eager, crisp and driven to succeed. These qualities manifest in their own special ways and are refreshing . The seasoned nurse, with his or her life experience has an overall understanding of his or her patients that only comes with a narrow 'gap' which the younger nurse does not have now, but will one day!

This understanding is comforting to many patients. The younger and more seasoned nurses both have their own special unique qualities to offer patients. What the younger nurses can’t offer today, they will tomorrow as the ‘gap’ between patient and nurse narrows.

Nurses, instead of developing adversarial relationships with each other, as a result of differences, which is often the case, should attempt to understand how the blend of newness and experience are a magic combination that serve to promote high quality care and meet the needs of patients at a higher psycho-social level.

If nurses could work on respecting each other, their differences, and work together to recognize how those difference could work in the favor of the patients, not only would the patients benefit but so would the morale, which, often leaves a lot to be desired, Morale, that is another topic for conversation!


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