Nov 30, 2018

Do Nurses Working in Hospitals Look Down on Aged Care Nurses?

What you do on a daily basis, eventually becomes part of who you are as a person.

And while personal aspirations can vary, there’s no denying the fact that having a fulfilling career is an achievement that lends itself to personal happiness and feeling valued.

While there are a number of career paths that seem to attract society’s praise, there are very few that garner a level of respect like those in the field of medicine and health.

Nurses hold a special place in the hearts and minds of Australian society.

These are the people that we turn to when we are at some of the lowest points in our lives, and decades worth of positive experiences have allowed us to confidently put our trust in them.

For the most part, you would think that if a person’s occupation becomes part of their identity, then being a nurse would definitely be something you would be proud to call yourself.

Unfortunately though, it appears that a select group of nurses are currently experiencing a level of negative stereotyping that is not generally reserved for those that choose this career path, and sadly this criticism is coming from their cohorts and peers.

Tracey Peterson is a long time nurse who plied her trade in both hospital and aged care facility settings, and believes that a large number of nurses within the Australian hospital system look down on the nurses that choose to go into aged care.

“The stigma that aged care nurses face is very real. We are seen as not being ‘real’ nurses,” said Tracey.

“We have the same qualifications, but we also have training in dementia, client directed care, ACFI funding, continence, wound care, and legal training in respect to legislation that governs our industry. Plus, we have to do our 20 CPD points just like everyone else.”

While some may view this type of opinion to be rare, our very own CEO Lauren Todorovic who spent many years working as a nurse in a hospital environment, also felt the weight of negative stereotyping when she chose to take her skills into residential aged care.

In fact, Lauren felt so strongly about the negativity from other nurses about her decision, that she actually felt compelled to articulate them in an article of her own a number of years ago.

And judging by the opinion of Tracey and a number of our other readers, this stigma still exists today, and may be worse than ever before.

What Is the Reason Behind the Stereotype?

There is no denying the fact that the elderly are not held in high regard in terms of value within Australian society.

They are barely represented in mainstream news and media, and the lack of coverage and importance that is placed on aged care issues fortifies the stereotype that these people have little to offer.

Society doesn’t care about the elderly, because they rarely hear about the elderly. And this has the ability to shape attitudes.

These attitudes begin at youth, who coincidentally, will be the people that we will look to, in order to accommodate the countries needs for a larger aged care workforce.

This thought process can make it extremely difficult to find young willing nurses who wish to use their skill-set in an aged care environment.

Young nurses often believe aged care to be a less glamorous and slower paced environment to start their careers, which illustrates the indoctrinated ill-informed viewpoints and lack of value being placed on the welfare of the older members of society.

Tracey Peterson believes that a number of other nurses perceive nursing in aged care as a sign of poor education and don’t recognise caring for the elderly as a respectable specialty.

“There is the perception that we are poorly educated, or didn’t do well at university. Most RN/CN’s in residential aged care have post graduate qualifications. I have a bachelor of nursing, a graduate diploma in palliative care, and masters in clinical nursing (gerontology.)”

“Aged care nurses are not seen to work in a specialty field, unlike our colleagues in the acute sector. But we do work in a specialty area. Working with the over 85’s is a delicate balance of what it enough and what is too much,” she said.

What Are The Realities?

While there is always a large responsibility involved with administering care, there is no greater responsibility than being asked to care for society’s most vulnerable human beings. The sheer weight of this responsibility seems to be something that has become lost on nurses that share this negative view of aged care nurses.

And according to Tracey Peterson, aged care nurses are asked to address these nuanced requirements without the benefit of mandated ratios. This can see their workloads increase to astronomical figures.

“Registered Nurses in aged care don’t take a patient load, they carry the whole load. They also don’t have the luxury of a ratio dictating a maximum amount of patients that they can have. They need to know the needs (health and social) of up to 100 people, run a team of staff, and problem solve anything that goes wrong.

“We work without a doctor on hand 24/7, we make decisions, and use our critical thinking the same as every other nurse. We need to be have a good relationship with our GP’s the same way the nurses in hospitals do with their Medical Officers.”

Working closely with people who rely heavily on assistance is a quickfire way to forge strong friendship and bonds. Quality aged care is only available when a nurse invests in a resident to the point where they can notice the small changes that may indicate problems.

Unlike hospitals, the bulk of people who reside in aged care facilities are not going there to get better and eventually go home. This means that  nurses relationships with residents are ongoing and required a much deeper emotional investment than the majority of healthcare professionals.

Sadly though, the vast majority of residents are nearing the end of their lives, so when the inevitable happens, nurses are required to take stock of the treasured relationship they had with that resident, and quickly move on.

“We do person centred care. We assist people to live and die as they want, and on their terms. The nursing we provide is as important as the role any other nurse plays,” said Tracey.

“ We don’t do the type of palliative care seen in hospitals, we do comfort care. We work with our residents and their families to make sure that our residents are able to pass with their loved ones (family and staff) around them.”

“Staff attend their funerals and ensure that fellow residents can if they wish. In effect they die at home,” she said.

While the majority of careers and life paths come with their own built in negative connotations, it’s upsetting that people who have made the selfless choice to look after our elderly are receiving backlash from industry peers.

There are a number of priceless moments that are exclusive to those who dedicate their career to the care and betterment of elderly people.

Everyone has a story, but there are very few people that boast the wealth of knowledge and sense of adventure that our elderly possess, and thankfully those working in aged care get a chance to listen to a lifetime of informative and unbelievable stories.

“I met a lady who was there when they opened the harbour bridge, a WWII pilot who landed a plane on a beach in PNG, scientists, dressmakers, fellow nurses, nuns and house makers, each one an individual and each one very special,” said Tracey.

Providing medical care to anyone should demand high levels of respect, but choosing to look after the people who require the most assistance deserves the highest praise imaginable.

It’s time for all nurses and healthcare professionals to come together and ensure that those who choose to dedicate their lives to our country’s most vulnerable, don’t feel any lesser for doing so.

It’s time our nurses and carers started caring for eachother.

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  1. I can only conclude that any hospital nurse who holds this view is locked into some old fashioned snobbish prejudice.in fact all nurses nowadays deal largely with an aged population due to the statistical breakdown of population.iI have the highest regard for nurses but one meets the occasional unsuitable candidate in all walks of life.Thanfully most nurses see human beings not age statistics.i can only hope that remuneration is equitable for all nurses.

    1. From a nurse in aged care, I thank you for your positive view in relation to our work. Unfortunately though, the old fashioned snobbish prejudice still applies, maybe not all nurses, but certainly there is a great number of them that can impede their point of view and make us look inferior. However, from one person who has also transpired from working as a nurse in a hospital to aged care, I can certainly put forward the fact that we have to think twice as hard as our counterpart nurses in the hospital. Our frail old people can often deteriorate in a split second, and whilst all nurses believe that people are not statistics, nurses based in a hospital are not able to cope with a person who has dementia, struggling with new surroundings and new people, and is not feeling well. I sincerely hope that the Royal Commission will address the fact that nurses are nurses and should be equally paid across the whole health system. Personally I have not only a degree in nursing, but also a masters degree in palliation and dementia, as well as numerous other specialised certificates in order to adequately look after our ageing population. In a hospital I would be well compensated for my continuing efforts in Best Practice, gaining knowledge in specialised field, all this is above and beyond my CPD points of 20, but this is not so in Aged Care – wage remuneration is dictated by the Federal Government who, in my eyes are the ones that are wearing blinkers and have the snobbish prejudice of not knowing what we do. However, my hospital counterparts are on twice my hourly rate, for less stress, less ratio per person not to mention being a leader, a conflict resolver, counsellor and just a person to talk to when in need.

    2. Josie that is a great comment . I went through my whole Nursing career “ chosen path” of working with older people which I truly loved. I was subjected to a lot of comments “ You will never be a real Nurse as you just work with old people “. Despite my ongoing training and education and enthusiasm to have some impact on an older persons life and that of the family , carer or friend of that person …… I now know the word for it “ Ageism “. Our hospitals “ Acute” as the term was always used (the old fashioned way) is now caring for more older people than ever before .The discrimination and lack of respect for an older person and those involved in their care within the industry has been very visible in my career path . 😢I say thank you for stating this is an old fashioned view, love hearing those words . I also believe that every health professional ,PCA ,AIN ,cleaner, kitchen staff all play very important roles in the lives of older people with what they do everyday in delivering care and service . We are all part of a team . “ We do it best when we all work together with respect and kindness towards each other “ . It flows through to the older person we are providing the care and service for.

  2. Having spent time working in Aged Care and the hospital system my experience is that bullying is common not just amongst Nurses but between Doctors and staff in general. I have not heard anybody make a negative comment about Aged Care Nurses but I have heard staff make numerous comments about the nursing care in Aged Care. It is not uncommon to receive admissions from nursing homes of people who have clearly been neglected. People with pressure sores, avoidable infections, malnutrition and/or dehydration, hearing aides that are blocked with wax, no glasses or hearing aides, hearing aides with flat batteries, malodorous due to lack of basic hygiene, etc. Nurses in Aged Care need to demand proper staffing so that people can receive basic care. If you can’t do this my view is that you should find another job. Nursing is not about you it is about the patient and my view is that if you put patients first everything else follows. Don’t expect your colleagues to applaud your care when they are routinely presented with your work.

    1. LOL demand proper staffing. Don’t you think we have tried this? Don’t you think we find it frustrating management don’t listen to us and ignore our requests for more RNS and PCA’s? You clearly have no idea what you’re talking about and probably have never worked in an aged care home otherwise you would NEVER think so negatively.
      Please get off your high horse 🙂

    2. This goes both ways. As a RN in aged care we have sent our beautiful and well loved residents to Hospital due to an acute problem only to have them return with pressure sores (that they have no history of) , catheterised for convenience and consequently returned with a UTI, bruising and traumatised. I will only ever send a resident if their acute condition is poor and only because Doctors won’t visit the residential aged care facility in the first place to assess and treat the problem.

  3. I totally agree as a personal carer the prejudices are there but with nurses who decide to take on the role in aged care, it is often worse. It is a great pity but snobbery is quite evident within the Health care network.

  4. I am an RN and work in Disability. I have the utmost respect for Aged Care RN’s who work under sometimes horrendous conditions.
    My field is disappearing as nursing has been judged as unnecessary. Time will tell.
    In the same way aged care has been diminished in it’s importance of needing proper (professional) care.
    As always we see money Sad as the motivator 🙁 Sad

  5. I feel that this is slowly changing but we have to do it together.We have finally started challenging the Hospitals with help from our Go’s and will continue to do it

  6. I am an EN working in aged care and I must say that I enjoying working at a facility more than the hospital. I can build a rapport with my residents and their families.

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