Nursing students' attitudes toward elderly people have frequently been found to be negative. This study's aim was to describe the experiences of first-year nursing students with elderly people. Thirty students from 3 Swedish nursing colleges, interviewed during the last weeks of their first year, were asked to describe a memorable event that had occurred when they were caring for an elderly patient. The narratives were analyzed phenomenologically. Three perspectives emerged: the students' perceptions of the patients, the staff's roles, and their own roles. From these, two phenomena were identified: patients' helplessness and students' identification/nonidentification of the individual patient. Students described difficult situations for elderly patients; patients with difficult diseases, anxiety, pride; and conflicting views of how to treat patients.
The overall aim of this longitudinal research project was to elucidate and reach an understanding of influencing aspects on nursing students' choice of future work area as newly graduated nurses. The influencing aspects should be affiliated with the three-year education, the students' transition into nursing and the care of the elderly. The first study (I) concerned the amount of projected education in gerontology and geriatrics in 30 colleges of nursing and health, and the result showed a variety between colleges. Newly admitted nursing students in three colleges responded to a questionnaire. A majority of the students preferred to work in the emergency care, rather than elder care, after graduation. Phenomenological analyses of one interview theme, after one year (II), gave two phenomena; patients' helplessness and identification/nonidentification of the individual patient. Phenomenological hermeneutic analyses were carried out on all interviews and diaries provided from the three years (III-V). The findings (III) show that the rneaning of caring for elderly patients was a process from naive caring via deeper relationships with patients to an organizational perspective. The transition into nursing (IV) meant for the students a process from a natural interest in caring to the perspective of an RN, where co-operation with team members had a strong influence. The students' experiences of theoretical and clinical elder care were not positive, which meant that their reluctance to work there was reinforced (V). Content analyses about students' reasoning regarding two fictitious elderly patient cases (Vl) showed a development in reasoning in a more acute oriented case but not in a case with a confused elderly patient. Conclusions drawn imply that both the theoretical and the clinical education in gerontology and geriatrics need to be strengthened.