Australia’s residential aged care staff are renowned for their dedication and resilience, often going above and beyond to ensure the well-being of their residents. However, this level of commitment can sometimes lead to working long shifts that exceed the standard 38-hour (76 hours per fortnight) workweek.
Exceeding average working hours can be seen as beneficial for aged care staff as it sometimes yields higher pay. Some staff even receive increased pay rates for extra hours, particularly those covered under specific awards or enterprise agreements stipulating overtime rates.
While staff can refuse overtime work, many feel obliged not through financial incentives, but a want and need to ensure that residents are receiving the care that they need.
Regardless of the motivation, one critical question that is rarely asked remains: do staff who exceed the standard 38-hour workweek compromise the quality of care being provided, and does it also put aged care staff at risk?
The Current Landscape
The current aged care regulatory framework has no limit on the number of hours that residential aged care staff can work.
Aged care facilities often experience staff shortages, and workers feel obliged to work longer hours to ensure the safety and well-being of their residents. This sense of duty is compounded by the fact that facilities prefer their regular staff to work overtime rather than hiring agency staff, which can be more expensive due to agency fees.
The continuity of care provided by regular staff is also a critical factor in this preference, as it ensures consistency and familiarity for the residents.
Although mandatory rest periods are stipulated, the reality on the ground is far from ideal. Some workers have also reported feeling unable to refuse additional hours due to fears of retribution or job insecurity.
A care worker who wished to remain anonymous told HelloCare that she was regularly working more than 80 hours per fortnight and being begged by management to work double shifts due to staffing shortages. Understandably, this eventually took a toll on her mental health.
“The day I stopped (doing double shifts) I just sat in my car and cried between shifts,” she said. “I was so incredibly exhausted and drained.”
Impact on Care Quality and Worker Health
While research conducted in residential aged care settings is scarce and mostly focused on conditions during the height of the Covid-19 pandemic, analysis of the effects of working excessive hours in hospital settings provides probable insights into the impact on aged care staff and those in their care.
Research consistently shows that excessive working hours lead to diminished care quality. Aged care workers are tasked with physically and emotionally demanding duties, and when they are overworked, their ability to perform these tasks effectively decreases.
A study published in BMC Nursing highlighted that extended shifts are linked with higher instances of missed care activities, such as delayed medication administration and insufficient monitoring of residents. This directly impacts the health and safety of elderly residents, who rely on consistent and attentive care.
The same study found that nurses working shifts longer than 12.5 hours were up to three times more likely to make mistakes compared to those working shorter shifts.
Additionally, the Agency for Healthcare Research and Quality (AHRQ) reported that nurses who work more than 40 hours per week are 50% more likely to make patient care errors and at a higher risk of workplace injuries and accidents.
Fatigue not only compromises their ability to provide care but also endangers their own health. The likelihood of making critical errors increases, which can have dire consequences in an aged care environment given the frailty of residents.
The Case for a Cap
Given the evidence, it is imperative to consider implementing a cap on the working hours of aged care staff. Such a measure would not only protect the health of the workers but also ensure a higher standard of care for the residents.
By capping the working hours, the aged care sector can prevent burnout and reduce the high turnover rates that plague it.
Nurses and personal care workers would be more satisfied and less likely to leave the profession if they had reasonable working conditions. This, in turn, would lead to more stable and experienced staff providing consistent care to residents.
When asked if she believes there should be a limit to the amount of hours that can be worked in a residential aged care setting, the anonymous aged care worker was adamant in her response.
“Absolutely. When I was working more hours I was exhausted all the time and found myself starting to snap at my co-workers and even some the residents because I was so tired and irritated,” she revealed.
“My residents were cared for, but it wasn’t quality care.”
And there are those carers and nurses who hold multiple jobs across RACFs and hospitals and work upwards of 100 hours a fortnight. This became evident during the pandemic when single site rules came into play. The WHS risks are unacceptable but employers can’t prohibit multiple job holding and get pushback from the unions when enquiring about numbers of hours worked elsewhere. Two sides to this story.