Aged Care
Veteran aged care campaigner bows out
For the past 16 years, the NSWNMA state council has benefited from Lucille McKenna’s strong advocacy for the aged care sector.
Lucille McKenna steps down from state council – the union’s highest administrative body – this month and will soon retire from the workforce after 58 years as a nurse.
Lucille trained at Concord Repatriation Hospital and worked as a district nurse for Ashfield Council. After a further stint at Concord she embarked on a 50-year career in aged care including continuous service as a director of nursing since 1979.
She has played a prominent part in vital aged care campaigns run by the NSWNMA and its federal body, the Australian Nursing and Midwifery Federation.
They include the RN 24/7 campaign to convince the NSW government to keep the legal requirement that a registered nurse be on duty in nursing homes at all times.
“Our level of engagement with politicians has been high and I note the government still hasn’t removed the RN 24/7 requirement from the Act, which it said it would do.”
“I have lost count of the number of inquiries I’ve given evidence to over the years. They expose problems but don’t always fix them.
“I gave evidence to a Productivity Commission inquiry and talked about the dodgy trainers of Certificate 3 care workers but nothing changed. There are still people offering to provide training over two weekends.”
Government aged care reforms have amounted to little more than bureaucratic reorganisation in recent years, she says.
“They change the deckchairs all the time but conditions inside nursing homes will never improve until they are required to employ enough staff.”
The Hawke Labor government reforms of the 1980s gave aged care its “golden years”, Lucille says.
“Those reforms effectively gave us mandated staffing hours under the care aggregated module (CAM) system.
“Residents were assigned a level of funding to be spent exclusively on direct nursing and personal care. A facility was funded for the total number of hours needed by all residents and managers had the freedom to spread the hours across whatever staff were needed.
“If you didn’t use the money on direct care staff – RNs, AiNs, activities staff, physios and the like – you had to pay it back.
“It was more generous than the current system and gave us the ability to employ more RNs.
“I was running 84-bed Berkeley Village nursing home on the central coast at that time. We had a DON, deputy DON, a full time educator, three RNs on the floor on morning shift plus a part-time RN in pharmacy.
“Now in a facility of that size you’ll probably have someone called a care manager and just one or two RNs.
“The CAM system couldn’t be undermined because staffing records were audited by the Department of Health.
“People actually went to jail for fudging the books – for example, by using CAM money to pay builders instead of nurses.”
Lucille says aged care has been on a “downhill slide” ever since the Howard Liberal government’s Aged Care Act of 1997.
“The Howard legislation removed the requirement for a provider to be a person rather than a corporation. It opened the door for big companies to buy nursing homes and float them on the stock exchange.
“Until the Howard period I could always speak to the owner even if they owned a group of homes. Howard’s changes put a distance between the financial controllers of the business and the operators of the nursing home.
“They reduced official oversight of the management of facilities and allowed facilities to replace RNs with personal care staff.
“We now have a general requirement to provide adequate staff but no requirement to spend allocated money on staffing.”
Lucille says her most important task as a DON was to build a relationship of trust with residents, families and staff.
“Engaging with all stakeholders and always being available to talk through issues with them is the key to running a good aged care facility.
“The average nursing home stay is two years and families need to feel confident and know that their loved one is getting the care they need.
“I always spent a lot of time with families to make sure they felt that the staff and I would look after their family member and that I would make sure it all worked for them.”
Lucille says the NSWNMA leadership has strived to improve union governance since the early 2000s.
“The state council understands its responsibilities better, we are better educated and more informed and our union’s governance is very good.
“The union is financially sound and membership has risen from around 39,000 when I came onto council to more than 66,000 now.
“Our campaigns have mostly been effective; we engage with the community more now and we have made sure that politicians are better informed about the issues.
“We started the Nurse Power fund which gives us the money to do effective campaigning.”
Lucille’s involvement in community life has not been limited to the NSWNMA and the battle for better aged care.
She served as Mayor of Ashfield from 2013-16 and remains a councillor on the recently created Inner West Council.
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