Nov 09, 2018

Nurses call for mandated staff ratios

Kim Barwise and Honorine Dowie met more than 20 years ago at an aged care training course. United by their passion for caring for seniors, the two became firm friends.

Fast-forward to today, and the couple are united by their despair for the poor standard of care being delivered in some aged care facilities, where they say profit is being put before care, and not enough staff are available to care for residents who have increasingly complex needs.

Ms Barwise and Ms Dowie have joined forces, calling for staff ratios to be introduced in aged care facilities. Passionately delivering their simple message, the couple is gaining support around the Country.

Passionate about caring for seniors

Ms Barwise has been a nurse for nearly 20 years.

“I always wanted to work in aged care,” she told HelloCare.

In primary school, Ms Barwise performed dances for nursing home residents, and at the age of 16, she did her work experience in aged care.

Ms Dowie also wanted to be a nurse from childhood. After visiting her grandmother in hospital every day for the last eight months of her grandmother’s life, Ms Dowie promised her that one day she would become a nurse so that she could help older people.

After leaving school at 15, Ms Dowie’s life initially took a different path, but after having children and spending time caring for both her parents in-law and her mother, she began working in aged care.

Ms Barwise and Ms Dowie met at an Adult Education aged care course in Colac.

The decline in the quality of care

Over their careers, the couple have watched the quality of care in aged care decline, and they are now calling for staff ratios to be introduced to improve conditions.

Ms Barwise cared for her great grandmother when she was in a nursing home, and even though her grandmother shared a room and eight residents shared one bathroom, residents were happy and enjoyed the atmosphere.

Ms Barwise has worked all over the world in aged care. One facility had a ratio of 1 to 5, she said, which was fantastic.

“We could meet the residents needs and take the time to talk, and have a laugh, while meeting their holistic needs, even to take them outside,” she said.

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Eyes opened to what was happening in the industry

Ms Barwise eventually became a personal care worker, and says it was only then that her eyes were opened to the reality of what was happening in the industry.

“Sometimes I think it was fate for me to become a personal care worker. It made me want to fight for change!”’ she said.

“Personal care workers could hand out medication! There was no ratios. One nurse to 60 or more residents, one carer to 16 or more residents – crazy!” she said.

Ms Barwise listed some of the many incidents that have inspired her to call for staff ratios in aged care.

“Having to apologise to residents for not getting to them in a timely manner – it could be 45 minutes or more! Watching residents cry because they were wet or soiled themselves. Residents lying on the floor because they tried to take themselves to the toilet as they couldn’t hold on any longer. Residents missing out on an activity because I couldn’t get them ready on time.”

She said she felt as though she was working on a “production line”

“There have been incidents where residents told me how much they don’t like being in the home and they want to kill themselves,” she said. Even then, with buzzers going off all around her, Ms Barwise didn’t have the time to sit and talk to them.  

Ms Barwise said she could go on and on: ”hair not done, hearing aids not in or the batteries are flat, teeth not cleaned or not even in the resident’s mouth. Simple mistakes or things overlooked as carers are simply run off their feet!”

Higher needs not matched with increases in staff

Ms Dowie initially worked in a low-care residence, and said she was able to provide the assistance that was needed.

However, the facility began to take in high-care residents with no extra staff or equipment, and her hours were cut back.

Ms Dower spent four years working four nights a week as a carer, with no RNs in charge.

She began asking about staff ratios in Aged Care, but was told there aren’t any.

“I couldn’t fathom why are they allowed to increase the high care and not provide sufficient staff numbers to accommodate them,” she said.

Staff began to notice that the falls rate was going up, and it was obvious that this was because of how long it took staff to answer call bells.

“Residents were trying to do more for themselves as they had a dire need to go to the toilet and couldn’t wait,” she said.

Sometimes residents were having to wait for 45 minutes for help because all carers were with someone else in need, and that person couldn’t be left to go to someone else.

“I also noted we had less and less time to spend with the residents. We were lucky to be able to say hello, let alone have a decent conversation,” she said.

“Residents were getting sad and depressed, I even saw attempted suicides,” she said.

“They are old, but not stupid. They could see how busy we are and becoming busie. Their own self worth was becoming jeopardised.”

She saw more falls, the number of premature deaths increasing, higher rates of depression and attempted suicides, and medication errors.

Care better where ratios are in place

Ms Dowie said, “I now work in the public sector [in a facility with ratios] and it’s wonderful.

“I have time to attend to my residents in a timely and safe manner. I get to have conversations with them without feeling pushed by management. I laugh with them and we get to socialise with them as well. We also get to take them to regular toilet visits. I am able to document their daily events and note any care changes that may be required.

“We have RNs to report to that listen to us and take action if required. The call bells get answered straight away, as there is enough staff to attend. I have found the residents to be happy and comfortable in their surroundings and best of all, it’s a home to them.”

“All of the statistics speak for themselves. There are less incidents in a facility that has staff ratios.”

The friends united in a call for staff ratios

Ms Dowie and Ms Barwise joined forces and began contacting local government, asking questions about staff ratios, and also informing them about what it going on in the aged care facilities where they were working.

They want to ensure that our loved ones in the elderly community are looked after in the safest possible way. After decades of experience in the industry, they say ratios are “the first step” in enabling this to happen.

Reactions to their calls for changes have been mixed.

“Overall they’ve been fantastic, but some very frustrating too,” said Ms Barwise.

Labelled “trouble makers” by some former colleagues, others have expressed their support but said they don’t want to get involved because they’re scared of losing their job.

“Others openly come straight out and congratulate Honorine and I,” she said.

Residents and their families have told the two women they support what they are doing, but are afraid to comment publicly themselves for fear of retribution.

We “are here to touch people’s hearts”

Many of those who speak to Ms Barwise and Ms Dowie about their calls for staff ratios to be introduced in aged care tell their own stories of sub-standard care.

It’s “very sad and frustrating” said Ms Barwise.

“Honorine and I are here to touch people’s hearts, and ask anyone who has the power to try to bring in change for residents in nursing homes.”

“The public deserves to know what these companies are about money, not people or care,” Ms Dowie said.

“We have joined forces with others across the nation and the support is getting bigger and bigger. The Government really needs to listen. We know it has to be done.”


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