In the autumn of 1993, a new system of nursing education started in Sweden. A questionnaire was sent to the presidents of all the colleges of nursing, health and the caring sciences, and questions were asked about the part played by gerontology and geriatrics in the new curricula. The responses showed a considerable variety in the amounts of theoretical and clinical education given at the colleges. During the first or second week of their education, the students admitted to three colleges in the Mälaren area answered a questionnaire containing questions about their educational backgrounds, their working experiences in the health care system, why they chose nursing education, their ideas of the tasks that a registered nurse primarily carries out, and their preferences for work after graduation. The result shows a correlation between working experience and the reasons for studies. The students stated a preference for working in emergency care rather than in geriatric care after graduation from college.
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.