OPINION: Nursing the breaking point

By Jane Boag (pictured)

In less than 50 years, the Australian aged care system will be at breaking point unless we do something drastic today.

This is the key message from the recently launched campaign ‘Australians Deserve to Age Well’ (AAA, ‘Nursing homes unsustainable’, 02/02/12) – a fact that is already well known, and concerning, to many of us who work in aged care.

What is more eye-opening is that an additional 500,000 nurses are needed by this date.

The year 2050 might sound like a long time off – it’s 38 years in fact. But people are remaining independent in their homes for much longer, changing the way aged care is currently provided. So while extra nurses are needed for residential aged care, we also need a great many more to go into individual homes to provide support. With this in mind, 38 years really isn’t that far away when you need 500,000 more nurses. In 38 years, I very well may be receiving aged care support.

I look at the students studying nursing today, and I have full faith that the standard of care they will give me, when I’m ready, will be extremely high. What I’m concerned about is whether or not they will choose to provide me with that care.

Most graduate nurses do not start their career in aged care. They choose acute hospital, theatre, emergency or specialist experiences such as midwifery.

Aged care nursing isn’t seen as sexy. It isn’t seen as specialised. And it certainly isn’t seen as ‘expert’. Yet aged care nurses need to have a high level of expertise across many areas that, ironically, topped the list of preferred fields, such as chronic disease management, palliative care and wound care.

Aged care nurses need to be able to understand complex health scenarios. They need to deal with the many complexities an older person may have. They need to know when intervention is required, when to increase support, when to transition to end-of-life care. Aged care nurses must be trained in supporting people with disabilities, low vision, mental health issues, wounds and chronic diseases, 24 hours a day, seven days a week. What’s more, they must work on these issues in a highly government-regulated environment and still manage to foster meaningful relationships with the other important clients in aged care – the family and support network of the older person.

We need to change the perception of student nurses that aged care is ‘the easy option’. As Australia Day honour winner Professor Tracey McDonald AM stated recently, “I see aged care nursing as a destination career rather than something you fall back on. It has been happening but it’s picking up pace.”

The aged care industry has started to respond with graduate nurse programs and education for undergraduate students and staff. Benetas has recently partnered with Aged & Care Community Care Victoria to implement the Aged Care Graduate Nursing Program. This program offers graduate nurses 12 months work for an aged care provider, learning about a broad range of clinical and aged care industry issues, both on the floor and through seven weeks of formal education developed and run by Monash University. This week’s historical Fair Work Australia equal remuneration decision is also a big step in the right direction. Awarding social and community services workers with a 19 to 41 per cent wage increase is fantastic recognition of the work nurses do. But is this enough to get the attention of 500,000 new nurses by 2050?

Aged care nurses enjoy high levels of job satisfaction and flexibility. They work in a dynamic, changing environment that is consistently challenging and helping them to improve their skills. They work within an evidence-based practice setting, with new research and technology backing up these practices. We need to do more to market these benefits to graduate nurses. 

We need more nurses, quite simply, because as more and more people want to stay in their own home as they age, nurses will be needed to support this expectation. The next generation of people who will require aged care are media savvy, are used to having a choice about life decisions and they expect a high level of customer service – aged care is moving towards being ‘all about me’. People will expect their needs and choices to be met and respected, and won’t settle for anything less. I know I will still want my sushi and diet coke when I am in a residential aged care home! But we can’t offer this choice or these standards without more nurses.

The aged care sector needs to raise the bar in regard to people’s expectations. We need to engage, educate and support the best available registered nurses, to ensure they choose aged care as their preferred field. And when 2050 rolls around and I am eating the meal of my choice, in the home of my choice, I truly hope that I can also have the nursing support of my choice.

Jane Boag is the general manager of residential services at Benetas, a not-for-profit organisation founded by the Anglican Diocese of Melbourne, which provides residential and community aged care services, as well as day and overnight respite services in Victoria.