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australian ageing agenda

Study ignites debate over ratios

Published on Tue, 01/12/2009, 11:36:25

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The debate about nurse to resident ratios has surfaced again following the release of a report from the University of Melbourne.

The second phase in a longitudinal study on the aged care workforce in Victoria found that staffing levels have fallen significantly in the past two years.

In 2007 the ratio of registered nurses to residents in the state’s homes ranged from one to six to one 39. But this year the ratios range from one nurse to nine residents, to one nurse to 47.

According to the Victorian Branch of the Australian Nursing Federation (ANF) which commissioned the study, the  increasing workload is leading to stress and depression among its members.

“What we hear on a daily basis from our members is that the workloads are too heavy,” said assistant secretary Yvonne Chaperon. “They ring up and say they feel that they can’t fulfill their duty of care and that frustrates them greatly.

“We have got ratios in public aged care here in Victoria and our members report that that works really well.

“We have tried to get ratios introduced through the EBA [enterprise bargaining agreement] process but the [non-government] providers won’t negotiate around that.”

But the industry believes the imposition of ratios could possibly act as another impediment to quality of care.

The CEO of Aged and Community Services Australia (ACSA), Greg Mundy described staff ratios as a “very old-fashioned” approach which had not delivered significant benefits in the past.

“The reason it doesn’t work is that it tries to reduce a number of complex factors down to a simple number,” said Mr Mundy. “It runs counter to the whole thrust of consumer focused and less institutional models of care.

“In residential care, you need whole range of support. Some of that is best supplied by nurses, some by personal care workers and some by allied health workers.

“The range of interests is actually quite diverse so to say that you need to have 1.9 hours of this and 3.6 hours of that is too prescriptive.”

Mr Mundy added that the international shortage of nurses made ratios an unrealistic solution.

The President of Nurses in Management Aged Care (NIMAC), Pam Bridges agreed that nurse ratios were too simplistic.

The former director of nursing and registered nurse said instead that it was critical to develop new models of care.

“We need better systems to support and retain managers who are consumed by unrealistic expectations often at the expense of optimum care for residents,” said Mrs Bridges.

“But nothing will change without realistic funding and real understanding of older people and aged care.”

The study also found that more nurses and personal care workers wanted to leave their jobs than two years ago.

The most common reason that staff members continued to work in aged care was a strong belief in the importance of providing high quality care to the elderly.

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