Jun 05, 2019

How can we attract more nurses to work in aged care?

We must do more to attract nurses to work in aged care, a keynote speaker has told a conference in Sydney this week.

Adjunct Professor Kylie Ward FACN, Chief Executive Officer of the Australian College of Nursing, addressed Criterion’s Strengthening the Aged Care Workforce, and spoke to HelloCare about the messages she wanted to convey.

Aged care funding shortfall erodes nurse wages

Adj Prof Ward said there are several reasons nurses aren’t attracted to working in aged care.

The $3.5 billion funding shortfall identified by last year’s aged care workforce ministerial taskforce impacts the wages that nurses receive, and the funding that can be directed to their career development.

“When we’re looking at how to attract nurses, we’ve got to fix the bottom line of the overall funding shortage, because that has an impact on wages and the ability to invest in professional development,” she said.

“It is well known that a nurse earns more by going to work in a hospital than they do in an aged care facility.

“At a fundamental level, that’s got to change. We’ve got to value our nurses.”

Aged care nursing can be lonely

Adj Prof Ward said working as an aged care nurse can feel isolated.

“It’s quite lonely when you’re the only registered nurse and there’s not really any other regular clinicians. Doctors, everyone else, come and go.

“I think it’s really important that people get to be able to be professionally connected and work on policy and improvements, whether that’s end-of-life care or dementia, so they’re stimulated in different ways and get connected professionally, and then can add value in their own workplace.”

Negative media coverage erodes value of nursing in aged care

Adj Prof Ward said the aged care industry has been “slammed” by the media and “very little” has been done to promote the value of nurses in aged care.

Unregulated workforce demoralizing, devaluing

Another factor keeping nurses away from the aged care sector is the fact that the role of registered and enrolled nurses is being “diluted and replaced” by unlicensed, unregulated healthcare workers.

“I think that is demoralizing and devaluing,” Adj Prof Ward said.

Healthcare workers have an important role to play in age care, Prof Ward said, but over the last five to seven years we’ve seen nursing levels go from 21 per cent to 15 per cent of the aged care workforce.

The gradual erosion of the number of nurses in aged care is “at the core” of the values of some organisations, Prof Ward said.

“Not all of them, there are some fantastic organisations, but some of them are saying that we’d prefer to focus on money than quality of care.”

The myth: “This is a home, not a hospital”

Adj Prof Ward said the idea that a nursing home is a home, not a hospital, so you don’t need nurses, is a “myth”.

“The reality is that nursing homes and residential aged care facilities are actually semi-hospitals. The care is complex. People have lots of different condition, you’ve got dementia, confusion, cognitive impairment, issues with nutrition, skin integrity – all sorts of different conditions.

“Nursing has always looked at spiritual, emotional, physical and psychological wellbeing, but a nurse rarely has time in aged care to sit with someone and have a chat.”

Paperwork overload

The other pressure that nurses have to cope with is huge volumes of paperwork.

“There are so many requirements,” she said.

The demand for real time reporting is understandable, but it means nurses are often at the computer, unless the nursing home has a tablet-based system.

“Technology should enable us, not pull us away from the residents,” Prof Ward noted.

End of life care requires a special skillset – and time

Adj Prof Ward said one subject that doesn’t get a lot of attention is the amount of love, care and time that goes into looking after somebody as they are dying.

“You can not expect a Certificate III worker, who took a few weeks to get their certificate, to be able to deal with that complexity.

“For a registered nurse, you want to spend time with the family or a resident who’s dying, but you’re pulled in all different directions.”

“It’s getting harder and harder to be satisfied when there’s so much pressure,” Adj Prof Ward told HelloCare.

Nurses need to feel valued

Adj Prof Ward said she was 25 when she started working as a nurse in aged care.

“You don’t have to be an age or stage,” she said. “This is a wonderful career pathway for nurses.”

“The most important thing any industry provider can do now is make sure their nurses feel valued and included, and that positive messages are being sent, because we are really battling a lot of negative media.”

97% of residents and families are satisfied with their experience of aged care

“On national or commonwealth reporting, around 97 per cent of residents and their families are satisfied [with their experience of aged care].

“The incidents that aren’t right, are distressing, and no family should have to live with that, or no individual receive that type of treatment, but there is a lot of good stuff.

“We would definitely like to see the unregulated healthcare workforce regulated, under the guidance of nursing, and make sure that there’s at least one registered nurse on every shift.”

Adj Prof Ward said that operators who have a positive message for their nurses will be heard. “There are nearly 415,000 registered nurses in Australia, we all talk, and the word spreads,” she said.

Adj Prof Ward said the good providers – those paying nurses “honourable” rates and with high staff levels – need to be more visible in the industry.

“Leave us to care”

“There are meaningful career pathways for nurses caring for the elderly,” she said.

“We love our careers as nurses, we love our jobs, we chose to do nursing because we want to care.

“I think sometimes the industry forgets why we came to the table, and it’s not to be taken away from the residents. Leave use to give the care we need to give.”

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