Study shows ‘crucial steps’ to attract graduate nurses to aged care

Supportive personal care workers are among the features of clinical placements that determine if student nurses will return to the sector after graduation.

Supportive personal care workers are among the factors in clinical placements that determine if student nurses will return to the sector after graduation.

While learning opportunities and mentoring have long been seen as important in quality clinical placements for student nurses, a new Australian study has provided the first data to verify which elements of placements are linked to nurses’ desire to work in aged care after graduation.

The study by researchers at the University of Tasmania found that the opportunity to exchange feedback with clinical mentors, a positive teaching and learning environment, and supportive personal care workers were three factors that directly related to the likelihood of graduates working in residential aged care.

The study outlined some “crucial steps” to enhance clinical placements for student nurses in residential aged care that could lead to improved recruitment in the sector.

The workforce challenge facing residential aged care was worsening, as vacancy rates for registered nurses (RNs) in aged care rose to 33 per cent in 2012, up from 26 per cent in 2003, while RNs made up just 15 per cent of the residential aged care workforce in 2012, down from 21 per cent in 2003, the researchers noted.

While previous studies had identified the key features of a quality placement, this was the first to corroborate whether they were linked to students’ perceived likelihood of working in aged care after graduation, said the study based on surveys with 71 nursing students in a clinical placement at two facilities part of the Wicking Teaching Aged Care Facilities program.

A ‘good’ placement

Under the program, facility staff formed a mentor group at each site, made up of nurses and care workers led by a senior RN as mentor leader. Mentors were provided with education, a placement program and a toolkit.

Separate feedback meetings were held with both mentors and students to discuss placement experiences, with comments relayed to the other party.

Students visited the facilities before the placement and discussed their expectations of the program. They were given an orientation and provided with information about the facility. During the placement, they were supported by the mentor group, and participated in regular education sessions as well as the feedback meetings.

Personal carers as mentors

Significantly, the study found that the supportiveness of personal care workers was a determining factor in students’ attitudes to subsequently working in residential care.

“When students feel well supported by care workers, who comprise over two-thirds of the Australian aged care workforce, they are more likely to consider working in a residential facility following graduation,” it concluded.

These findings emphasised the importance of care workers being able to effectively work with and mentor students under the supervision of an RN, according to the researchers, who said their study was the first to quantify the importance of care workers in facilitating a positive placement experience.

However, there was a lack of research on the efficacy of care workers in mentoring nursing students during clinical placements in any environment, let alone aged care, the study noted.

The researchers also said that, while placement programs often facilitated student feedback it was typically in the form of a post-placement survey, whereas the study found that students valued the ability to exchange feedback with mentors during the course of the placement.

Finally, a positive teaching and learning environment was identified as another significant factor, which referred to students’ perceptions of how well their needs were met, assessment of their skills and effectiveness of feedback.

Discussing the implications of the study, the researchers said that the teaching and learning environments within aged care needed improvement, opportunities for mentor-student feedback exchange during placements should be offered, and care workers needed support to mentor effectively.

The study, Aspects of nursing student placements associated with perceived likelihood of working in residential aged care, was published on the Journal of Clinical Nursing last week.

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Tags: registered-nurses, University of Tasmania,

7 thoughts on “Study shows ‘crucial steps’ to attract graduate nurses to aged care

  1. Honorable but misguided. Nursing students shouldn’t even be doing clinical placements in aged care facilities and new grads certainly shouldn’t be choosing one for their first job.

    Students are only sent to aged care because there’s not enough places in hospitals for them (and they charge exhorbitant fees to accept them). Sending faxes, calling GPs, participating in rampant polypharmacy and practising outdated wound management really aren’t the skills they need…and they certainly dont need to be ‘mentored’ by an unskilled care worker; if they’re smart enough to get into Uni, they’re smart enough to work out how to use lifters incorrectly, cross infect residents or inflict skin tears all by themselves.

    I encourage all my AINs doing their degree to get a few years of acute experience before they come back to aged care. They’ll be much better for it and so will aged care.

    Too often I’ve witnessed new grads with no experience be placed as the RN in charge. Its unfair to them and the residents. Unfortunately, your degree doesn’t equate to competence (exactly how many in-charge nursing shifts did you do at uni, and in how many wards?). Where’s your clinical base? Dont you know that you should be just a little bit scared (because I certainly am if you’re not!)

    How much more can we dumb-down our RNs? Instead of researching the value of a friendly Cert 3 mentor, we should be pushing for our students to receive more acute experience.

    And dont be fooled by the “New Grad Programs” promoted by some provders. The very nature of our industry precludes them being exposed to acute medical management and participation in full-circle treatment. How interesting…a 12 month program that teaches you to call an ambulance.

    Far from being altruistic, these programs only exist to secure low cost RNs, equipping them with low-end skills that lock them into the system that produced them. Surely we can do better?

  2. Dave I agree with your comments. I have told RNs who started as PCA’s with my organisation to leave age care and get acute experience ,especially around wounds, infection control and mental health .
    The problem is that ENs and PCA’s are becoming the regular workforce ,whilst RNs are being excluded once they get their registration, The ANMF is pushing for RNs to be back in Aged care,but there has to be substantial paradigmatic shifts if this were to occur.
    I also agree regarding Graduate programs.One that I was associated with through a umbrella body folded due to Federal government cutbacks as well as it seemed a co-ordinator from the Industry body not understanding specific learning needs and being a poor communicator with the students and their respective organisations

  3. Attention New Grads …. bring it & don’t be scared ! We NEED and WANT you.

    I respectfully comment that I think your making gross generalisations.
    (Although a very small part did resonate with me) – not this part –

    “Sending faxes, calling GPs, participating in rampant polypharmacy and practising outdated wound management really aren’t the skills they need…and they certainly dont need to be ‘mentored’ by an unskilled care worker;

    I find this offensive and a gross generalisation of a typical aged care residentialwork environment.
    I am an experienced aged care RN (residential/hacc/ my whole working life).
    I am university trained nurse (direct from school) and have had little hospital based experience AND
    I am now a teacher/trainer of cert 3/4 workers. (my experience and therefore my opinion is vastly differs to yours)
    I have also had the privilege of working closely with ITRACS. (google it)
    This program supported students from nursing/dietetics/psychology/physio/exercisePhysiology at residential care centres.
    They would have your argument down in flames within seconds.

    Really it is your view (and possibly your workplace) that is out dated.

    “we should be pushing for our students to receive more acute experience”

    there is a lot wrong with this comment in my opinion. my advice for you would be
    visit a variety of age care settings.
    consult your ABS for some demographics on ageing populations and carer stats &
    inform your self on chronic disease management and perhaps you can make a more informed comment.
    The aged care sector isnt perfect but then health care delivery in hospitals is also far from perfect.

    New Grads …. bring it & don’t be scared ! We NEED and WANT you.

  4. Fair enough. But If you’ve had zero acute experience you’re not really in a position to comment.

    While you’re buried in 5 year old ABS data, aged care continues to send too many lovely old people on hospital holidays…up to 60% of transfers deemed unnecessary or inappropriate…because there’s nobody with the skills to detect and pre-empt their deterioration or effectively manage acute changes.

    I’ve ‘visited’ more than a few aged care settings over the years, Jill; your indignation belies your misunderstanding of contemporary aged care’s clinical demands (or should we just call a dietitian or an exercise physiologist next time Ethel crashes unexpectedly?) Shoot us all down in flames.We dont need a debating team, we need skilled clinicians.

    Embracing mediochrity is better left for unscrupulous providers looking to reduce their wage costs…or new grads with no experience undertaking a masters degree.

    Nurses would be better served by promoting higher skills, not being apologists for the lack of them.

    Them that can, do. Those that cant, teach.

  5. Aged Australians deserve the best care we as a work force can deliver.
    I have worked in both acute and aged care for many years, regularly switching between roles. In the acute sector it can be very frustrating to listen to those who think the interim care we provide is a waste of time, but finding a facility to place each individual takes time.
    Then we regularly have to admit patients from nursing homes that could and should have remained where they were, but the staff have no choice when the family or the GP says transfer them to the hospital. More education of all staff and the public is very necessary.
    As the population ages, more resources will be needed, at this time, if a resident requires IVAB or intraveneous fluids they must go to hospital, Aging in place is a goal of the government, but equipment and Medical officers who would be willing to oversee RNs administering these in aged care setting are not going to happen.

  6. Ageing is being medicalised…
    I take offense at… comments around “dumbing” down the RN role (my previous role) in RACF by stating: Sending faxes, calling GPs, participating in rampant polypharmacy and practising outdated wound management.
    Broad generalisations help no one including nurses…all designations!

  7. Medicalised? Of course it is. At least it should be, if we can get RNs that know what they’re doing.

    Better management of chronic conditions and the push to keep folks home for as long as possible has seen much higher acuity admisssions entering residential care. Their needs demand a higher set of clinical skills to ensure resident safety and dignified care.

    Surely you’re not suggesting that old people don’t deserve the best possible care?

    Highly skilled nursing staff are able to manage their residents onsite, rather than send them to hospital at the drop of a hat, preventing inappropriate intervention and thereby actually reducing the ‘medicalisation’ of ageing.

    I don’t see why anyone would want anything less than the best?

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