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Daniel O'Neal, R.N.

Photograph of Daniel O'Neal

...the world view that aging is increasing in diversity and complexity, to me represents that aging is not necessarily something to be avoided, and in fact something even to be desired.

Interview conducted by: Jeffrey Light on 9 July 1997 at 11:40 AM EDT
Q: Can you describe exactly what is your profession and some of the different jobs that you have?
A: I am a registered nurse and I have a Master’s degree in nursing and certification as a clinical specialist in gerontologic nursing. That’s been available in our field, that certification, since 1989 I believe. And certification in gerontologic nursing as a generalist, as opposed to a specialist has been available since 1975. I have three main jobs, one is full time at the American Nurses Association where I am a principle staff person to the Congress of Nursing Practice—that’s the volunteer entity which focuses on the development of standards of practice, guidelines for practice, ethics, issues that relate from other professions that are not economic that speak to the nursing knowledge base which nurses implement and practice. Another job I have is that every other weekend, and actually it’s probably more maybe even three weekends a month, I work as a staff nurse and that’s been for seven years in a large university hospital here in Washington. The unit, the ward, or the nursing care unit where I work is a general medical unit. I picked that because in the old days general medicine was mostly older people. Nowadays, this being Washington, like many other towns and cities, about a quarter to a third of the population on the unit are AIDS patients, but there are still very many older adults there. The third job that I am a colonel in the Army Reserve, Army Nurse Corps and I am a special consultant to the Assistant Chief of the Army Nurse Corps. So those two latter titles and jobs are part-time.
Q: What is the range of salaries that is available in this profession?
A: I am going to focus on the staff nurse piece since that appears to be the one that’s different for you. Staff nurses, typically in the urban areas start at about $30,000. There are regional variations: less in the South and higher in the Northeast and upper Midwest. And as a staff nurse which means without extra credentials or qualifications, typically would top out at $40-$45,000/year, I think. For other categories of nurses, of course, the ranges are much greater, since they usually have extra qualifications, Master’s or Doctoral degrees and different titles. But for staff nurse I think that’s the general norm and we have pretty good data on that from a national survey and that data was just collected in ’96.
Q: How much and what type of education have you received to get to this point in your profession? And what’s typical for a nurse?
A: Myself, I have a Bachelor’s in nursing, a Master’s in nursing and I’m working on a Dissertation for a Ph.D. in nursing, I also have a certificate as a nurse practitioner. In the old days when nurse practitioner programs started, they were not degree programs, they were certificate programs. The type and how much education is desirable, I do believe what the American Nurses Association has since 1965, namely that a Bachelor’s degree in nursing is the desirable route for a career as a registered nurse. There are multiple pathways to achieve a Bachelor’s, there are many programs that are accelerated Bachelor’s for those who already have Bachelor’s degrees in other fields. There is even a generic Master’s program which bypasses the Bachelor’s degree and ends up with a Master’s degree in nursing. In terms of the most common credential, however, is an Associate degree in Nursing. They started in the late 40’s and have proliferated a great deal. So most of the 1450 nursing education programs in the country are Associate degree programs and the percent of graduate is approximately 60% of all graduations each year are Associate degree graduates.
Q: What are some of the technologies that you frequently work with at your job?
A: As a staff nurse, I work with, and am also credentialed in the 6-bed intensive care unit step-down area, which means I use cardiac noninvasive and invasive monitoring devices, meaning those that measure blood pressure, pulse oxygenation, cardiac function, and sometimes even electro and cephelographic function. I use a lot of servo technology that measures body chemistry and body function, production of certain fluids or electrolytes or functions of the body in various ways—neurologic and urologic and many other ways. The other technologies are more related to keeping people’s everyday body function that which is necessary to help them stay clean—to prevent bedsores, there are special beds that are quite frequently used, those devices which infuses substances into veins, IV pumps, there are even that measures temperature. Ventilators and respirators are frequently used, by me. And then, that which relates to feeding and moving and mobility, weighing people, moving them from bed to chair, chair to bed, and so on.
Q: One of the goals of the ThinkQuest contest is to encourage internationalism. Do you have a lot of opportunities in your job to engage in international cooperation?
A: With respect to aging? There is an International Association on Aging. Most of my contact with the organization is through Dr. Mary Harper, a nurse-psychologist who recently retired from NIMH after many years. Through my full-time job at American Nurses Association, we are the national nursing organization and we’re linked with an entity called the International Council of Nursing, whose the annual meeting was just last month. So we do have frequent connections by correspondence and visitors here since we are the national nursing organization. Much of what we write, what we produce is of interest to the international nursing community. It’s less true maybe for my military role and less true for the staff nurse role, except that in an international city such as Washington, D.C., we do have quite a few patients who come from the international community and have that interaction, that opportunity to interact with them.
Q: How have your opinions about older adults changed since you began your career in aging?
A: I think the biggest change came about in graduate school in the early 70’s. The world view that I developed then which was common within the division of nursing in New York University is a world view which shows aging as an increase in complexity and a speeding up, an increase in diversity, so that it isn’t represented as a decline in function. In other words, much of our view of aging may be related to our current ways of measuring physical function, reflexes and a host of physiology, all of which seem to show declines in function from the peak at 15-20 years of age. If we had other instruments or other devices, we might be able to find other avenues and other parameters to measure that might show aging as an increased complexity way of viewing. So that perspective, that world view that aging is an increasing in diversity and complexity for me represents that aging is not necessarily something to be avoided, and in fact even to be desired.
Q: One final question, what words of encouragement would you have to young people who are interested in starting a career in this field?
A: That which comes to mind first is that there is no such thing as normal when it relates to older people. The range of diversity, and therefore the range of uniqueness encompasses the whole spectrum of values in any given thing that you’re measuring. Whether it’s something simple that you’re measuring like blood pressure, where the range of blood pressures from very high to very low is still considered normal. To measures of personality function, social function, even psychological function. The range of activities are very varied and that diversity and that richness is unique among people you deal with in the world.

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