Call for aged care to reflect “pivotal” role of nurses to deliver quality care
Nurses are pivotal to the delivery of care in aged care and the sector needs to better support them to use their full scope of practice, the head of the national professional organisation for nurses in health and aged care has said.
Nurses are pivotal to the delivery of care in aged care and the sector needs to better support them to use their full scope of practice, the head of the national professional organisation for nurses in health and aged care has said.
Australian College of Nursing CEO Kylie Ward said she was “extremely concerned at the diluting of the standards of care and the fact that registered nurses are not seen as pivotal to the delivery of exceptional care.”
Older people entered residential aged care facilities because they provided nursing-led care that addressed their needs from a holistic perspective, Professor Ward told Australian Ageing Agenda.
“With the acuity and complexity of residents it is really important that there is a registered nurse and enrolled nurse in governance in the delivery of care,” she said.
Professor Ward, who has a background in aged care nursing and management, said that aged care nursing offered dynamic, exciting and rewarding work with exceptional career opportunities.
But many challenges came with the role and aged care organisations needed to offer more career development pathways and to attract more nurses, she said.
“It is getting harder and harder on registered nurses as quite often they are the highest level and only professional on a shift. We don’t have the multi-disciplinary team that we do in other areas so the doctors and allied health professionals rely on us to govern and oversee a holistic approach to care,” she said.
“It can get very demanding and potentially a little lonely when you don’t have your colleagues to bounce ideas around, so aged care facilities need to do more and attract more.”
Aged care nurses have to be competent, capable and professional clinicians and use all of their clinical skills because of the diversity of residents and their care needs, Professor Ward told AAA ahead of her upcoming address at the The Future of Aged Care Summit.
Models of care and staffing needed to adapt to the increasing acuity of residents, while more work was required with nurse practitioners and the interface between hospitals and facilities, she said.
One strategy to address the predicted shortfall in nursing clinicians in coming years is to ensure that all nurses are working to their full scope of practice, she said.
A key issue around scope of practice was that even though there was national registration, nurses were quite often bound by policies, procedures and competencies at the local level.
“We should be able to work to our full capacity as a licensed professional. I know if I can put a catheter in or not. I know if I have those skills. I don’t need to be checked every time I go somewhere,” she said.
The Future of Aged Care Summit takes place 30 August – 1 September in Sydney.
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This also applies to enrolled nurses whose scope has grown considerably and could be a major assets to aged care facilities and the RNs. But they continue to be overlooked and we deskill them, as we do RNs, hence aged care is losing a lot of talented nurse and aged care experience. We need to move forward. We are all nurses with a great deal of knowledge and clinical skills which make a difference to the care of the elderly.
I agree with Kylie, we have RNs in aged care with advanced nursing skills who are bound by policies that prohibit them from working to their full capability.
Why is it when a resident needs IV antibiotic treatment we have to send them to hospital, or engage hospital in the nursing home, so that other nurses can come and deliver the treatment? What makes them better nurses than the ones we already have? Also why do we subject the resident to dealing with a stranger?
It is time RNs in aged care got the recognition they deserve. When I told my colleagues a few years ago that I was going into aged care, after working in acute for many years, they asked why? “That’s where you go to retire.”
I consider it a new career in nursing, and we never stop learning. I am in the second half of a Masters in Advanced Nursing Practice and hope to use the knowledge I have gained in aged care.
The problem is caused by poor staff to resident ratios, due to poor funding. This situation will get worse unless funding is fixed up. Many experienced carers and nurses are leaving the aged care industry due to burn out caused by an overload of work and frustration keeping up a high level of care. New aged care workers who are coming through are doing “crash courses” by inexperienced educators and online so many are receiving a certificate and treat it as a job with no passion or conscience. This also put pressure on experienced workers picking up their slack or trying to retrain them.
Regulation of educators, better aged care funding and better wages and conditions will be the only way to fix up this problem that at this point is getting worse.
I fear the future of the aged care industry.
Mr Turnbull appears to not care for the aged!
Julie Baker raises some really good points. Why would we subject frail, ill and often dementing residents to an ambulance journey to a frantically busy hospital when we have RNs on site. Makes no sense to me. Of course this assumes that facilities can afford to have RNs on duty 24/7 …..
Take note…”Aged care nurses have to be competent, capable and professional clinicians…” Aged care nurses will never be a pivotal part of the team if they don’t understand what that really means.
It’s no surprise that providers think RNs are superfluous when (all too often) the first response to any situation is ‘call the ambulance’ or ‘call the GP’? When did a general duties ambo become a more credible clinician than an experienced RN? (answer: when we rolled over and let them) It’s becoming increasingly rare to see an RN perform a comprehensive and appropriate clinical assessment or see the results of that assessment professionally recorded in the progress notes.
What you will see is someone grab an auto sphygmo with near dead batteries and an ill-fitting cuff and press a button. (or just ask the AIN to do the BP), believe the heart rate that’s displayed on the screen (AF? What AF?) fumble a dodgy thermometer (dead batteries again) into an ear canal full of wax and describe someone with an expiratory wheeze or productive cough as being ‘chesty’. Hands up all those with their very own ‘grown-up’ stethoscope? (There’s a reason why the ones you’re using only cost $5)
And breaking out the pulse oximeter doesn’t make you professional; unless you can explain the oxygen-haemoglobin dissociation curve to me you shouldn’t even be using one.
Nurses have always been quick to give away their tasks. After all, we’re soooo busy… dont you realise we’ve got to give out THE PILLS. Its time to stop hiding in the medication trolley (Guess what? Monkeys could do that job) and lift your game. C’mon colleagues, if you want to be recognised as a professional, you first have to act like one.
Do you think the one RN on shift who has responsibility for 100+ residents is able to work to their full scope of practice?
They’re barely keeping their head above water and are a walking liability time-bomb.
What we need is RN ratios in aged care so that MORE nurses can work to their full scope and provide the quality of care that is so desperately needed.
Dave, nursing skill, judgment and pharmacology knowledge is used in every administration of a drug. Don’t diminish the profession. Monkeys don’t give out the pills in an acute public hospital, so tell me why, when the pills are the same, our residents deserve a lower standard of nursing care?
Aged Care needs competence, not complacency, from it’s nurse clinicians and managers
You’re right. In acute public hospitals monkeys get the nurses to do it for them.
I’m on your side Alan. But being busy doesn’t preclude being capable. So we shouldn’t hold our breath waiting for ratios to come to the rescue when we’re battling to have any RNs at all.
Residents most definitely deserve a high standard of care…and you cant deliver that care when your head’s stuck in a pill trolley all day.
Good luck with trying to sell the idea that we apply pharmacological expertise and skilled nursing judgement to every spoonful of crushed Panadol and jam. It’s monkey work, let it go. I’m sure we’re capable of so much more.
I object to term .” monkey work” I work in Aged Community Care ..we are the ground workers who deal with clients on a very personal level..In years past nurses were nurses ..doctors were as described..ambos I take my hat off too..they also are ground workers..I love my job and know I’m good at it ..certainly not “monkey work” all health care givers deserve respect ..no matter how “lowly” their position maybe.. Thanks for reading..