Aged Care
Call to put nursing back into aged care
Lawyers assisting the aged care royal commission say RNs – and nurse practitioners – should make up a greater proportion of the care workforce.
Senior counsel assisting the commission, Peter Rozen QC, said an RN should be present on each shift and available to direct or provide care subject to limited exceptions.
He told the commissioners that the proportion of RNs in the residential direct care workforce fell from 21 per cent in 2003 to 14.9 per cent in 2016 – a drop of more than 25 per cent.
The proportion of enrolled nurses dropped from 14.4 per cent to 9.3 per cent over the same period.
In contrast, the proportion of “unregistered and in many cases unqualified” personal care workers increased from 56.5 per cent to 71.5 per cent over the same period.
“To be clear, the care work that was performed by qualified nurses, physiotherapists, speech pathologists, etc. is now being performed by unqualified, unregistered and in many cases untrained personal care workers,” Mr Rozen said.
“It is hardly surprising in these circumstances that the royal commissioners have received thousands of submissions by members of the public complaining about the substandard care being provided in residential aged care.”
He said it may be no coincidence that the declining role of nurses in the aged care workforce has coincided with a change in name from the “comforting and familiar ‘nursing homes’ to the impersonal ‘residential aged care facilities’”.
“Perhaps it is time to accept that the term ‘nursing home’ was the right one all along.”
Mr Rozen said the federal government should provide “practical leadership” in aged care workforce reform including providing additional funding to implement the recommendations.
He also blasted the Department of Health for an apparent “lack of leadership and expertise about aged care”.
The “highest levels of the aged care bureaucracy” appeared to be “timid, risk averse (and) more worried about political risk than making a contribution to aged care reform”.
Susan Felsch says
This lack of RNs has been an issue being brought up in NSWN & MA AGMs as far back as early to mid 1990s. Discussion then about disasters occurring or about to occur due to lack of unskilled staff. RNs would be able to call early alerts, due to their skilled training, that may otherwise develop into life threatening conditions. These complaints just fell on deaf ears whilst residents suffered and died in avoidable conditions. Funding was inadequate then and continued to be inadequate.
Society will be judged by the care if it’s aged and impoverished! To this time we are not shining our LIGHT!
Lynne says
I agree totally, when i was working in hospitals as an RN the amount of clients coming in from nursing homes for acute care was quite high, dehydration was common and the families didn’t want to return them back to their aged care facility. Some families whilst they were in hospital moved them out of the aged care facility and refused to send them back. Hence we were then faced with finding them suitable care elsewhere. sometimes these people would be in our care for months, which then costs the health budget a phenomenal amount. the reason the families did this and time and time again they mentioned their loved one was getting better care in the hospital and they were happier in themself. ome are facilities have got it right and the clients are well looked after. Their needs to be further training and education for carers as a lot of time basic issues are not reported, the minimal ratio of RN to clients doesn’t allow the RN to oversee care as closely as required i feel.just my 2 bobs worth.
Katherine Ingram says
This started before 2003 when the Howard government bowed to pressure from proprietors to change the CAM/SAM funding. CAM funding protected the funding for nursing care because outside of a very small margin funding had to be sent back if it wasn’t spent on nursing care. As soon as the funding changed the number of RNs was decreased and some nursing home were practically run by AINs. There were already fewer RNs than AINs. The RNs did dressings and medications. I found it difficult to believe that it became legal for AINs to give out the medication previously given out by RNs. Not a Word was said by the NSWNMA who were interested in recruiting the AINs from HREA. Not a word from the NRB in their new AHPRA tower.
Now I believe it is worse because of the casualisation of the nursing home staff. So they are doing shifts to get enough money. The proprietors expanded and then couldn’t fill the beds. The final thing is that RNs in nursing homes are paid less than RNs in public hospitals. New Grads who cannot get into New Grad Courses in public hospitals go to care for the most vulnerable people in nursing homes. Actually the highest paid RNs work in our jails.
I use to be. DON in a Nursing Home before this all happened. It was so heartbreaking that even in the “good” nursing homes there was always pressure to cut costs. The nursing homes already ran on a shoestring compared with public hospitals.
Claire Schoots says
It’s all about making money aged care.As a registered nurse no one has the skills except qualified nurses to have the standard of care and skills to properly care for the most vulnerable.
fiona says
OMG, I have been a care worker for many years now and I’m a bloody good one, I left the Aged care sector only this year because of all the “no care attitude from the foreign carers and RNs. and not to mention the shit money we get paid. I went from working for a loving caring facility (only a little facility) to a big money grabbing ,don’t care attitude company in which now have cut more than half the staff and still going, The facility is a night mare and is a dirty place. Am i disgruntle worker , No i am not I left simply because i could not handle the neglect from these people that now run this facility
Lina says
Mandatory staffing ratios must be implemented.
Training for non registered care staff improved.
Better infection control equipment, hand washing facilities, not just hand sanitizers
It’s simple, better trained staff, better outcomes
patricia slavin says
discovered when i finished e.n. course 1995, i worked casual at a nursing home , pittifull , experience a colleague pushed a pt into and emmediatly out of a shower recess ( not showered) without guilt just an act of lie.
staff member was almost in tears when i insisted in helping diabetics drink their night cordial as I was holding her up too busy to do this BUT plenty of time to talk and smoke before knock off time .
Staff who did care asked me what is MRSA is they were looking after pts with infection . I fed 4 pts in various room at one time moutfull here and run into another.
This has continued low wage low ijob satisfaction while some R.N. is in charge doing nothing
Had my foot run over by water chair as staff hurried almost hit a pts head on the brick wall . be cared for I left never to return but gave my reason noone cared.
low staff elderly need longer time to