Aged care nurse Terri Burrell, who is in charge of 59 patients, is paid $12,000 less per year than a nurse with a similar job in a public hospital.

Ms Burrell, 49, is an experienced Registered Nurse who runs night and evening shifts at an aged care facility in Sydney’s inner west.

Late at night she must cope with just three other staff and no doctors. In the event of an emergency, Ms Burrell must decide if a doctor needs to be called or a resident needs to go to hospital.

She must also supervise the care of residents suffering from dementia and a range of physical ailments. “I don’t have a doctor there on the premises like we do in a hospital,” she said.

While hospitals and child care centres have staff-patient ratios, Ms Burrell said Australian nursing homes did not. This meant a night shift at her facility saw two nurses and two assistants overseeing 59 residents!

Compounding the problem, residents are now sicker and frailer when the reach nursing homes due to people living longer and staying at home longer with home help.

“They’re coming in so much worse off than they did before,” Ms Burrell said. “People are living longer. There’s nothing wrong with that … but when we get them their level of care is very high.”

This is the reality for Australia’s aged care nurses, who work just as hard and have just as much responsibility but are paid much less than their hospital counterparts.

The situation is putting pressure on an already stretched aged care system. A Federal Government spokesperson told Health Reporter the aged care system needed reform, but nurses like Terri Burrell say action is long overdue.

The Australian Nursing Federation recently welcomed the Federal Government’s $18.7 million plan to expand the role of Nurse Practitioners, who are qualified to treat clients in an advanced clinical role, in residential and community based care.

But the ANF’s Because We Care campaign also wants a better wage deal for all aged care workers.

Aged care nurses earn $168-$300 on average a week less than those in public hospitals – at a time Australia urgently needs 20,000 more aged care nurses.

An ANF online survey late last year found 78 per cent of aged care nurses and assistants, 90 per cent of whom are women, would leave if the wage gap wasn’t closed. Only 10 per cent wouldn’t leave.

ANF Federal Secretary Lee Thomas said the message was loud and clear. “The vast majority of low paid nursing and care staff working in aged care are very worried about the wages gap across the sector and are now prepared to leave their job because of it,” he said.

Will you leave aged care if the wages gap isn’t closed?

Source: ANF and Health Reporter

Image credit: NSWNA

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Most of the 110 nurses attending the NSWNA Annual Aged Care Nurses Forum last month were from the residential care sector and the majority were registered nurses (RNs).

The program included presentations from aged care nurses in clinical leadership roles, as well as sessions about aged care reform, industrial and campaigning matters, and regulation in aged care.

Presentations included falls prevention, nursing and medication management in people with delirium, better liaison between aged care and the acute sector, and quicker interventions to prevent unnecessary hospital admissions.

Geriatric flying squad

Amanda Klahr, a clinical nurse consultant, spoke to the forum about her award-winning Geriatric Flying Squad.

The Flying Squad is a geriatric assessment and management service that Amanda developed and manages, and which won a HESTA Australian Nursing Award for innovation in nursing.

Developed at the War Memorial Hospital in Waverly Park, the service provides comprehensive geriatric assessments, multidisciplinary care in the home, and referrals to appropriate services.

The team includes a clinical nurse specialist, a doctor specialising in geriatric care, a social worker, an occupational therapist, a physiotherapist and a clinical psychologist.

Amanda says the aim of the service is to help clients to live in their own homes while maximising their quality of life.

‘Our clients are community-dwelling elders who are failing at home for some reason.
They are referred to us by a concerned GP, neighbour, personal carer or family member, the department of housing or police,’ she said.

‘The Geriatric Flying Squad is a rapid-response service for sub-acute patients. The nurses triage the clients by researching their medical records and talking to family.

The squad typically works with a client for 12 to 15 weeks, including an intensive first month before discharge. If the client encounters difficulties again, they have the option of returning to the service.

What do you think of the geriatric assessment and management service?

Image credit: NSWNA

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The Department of Health and Ageing has recently developed a ‘What can we learn?’ report about residents who go missing from Australian Government funded aged care facilities.

The report is now available in the Industry toolkit on the Aged Care Complaints Scheme website.

Last week we talked about the risk factors that contribute to the likelihood that a resident may go missing. Today we discuss ways these risks can be addressed.

How can risks be addressed?

At entry

Close monitoring and assessment of residents following entry, especially on their first day of entry, may reduce the incidence of residents leaving a service unnoticed.

At the point of entry

An individualised, person-centred approach to the orientation and integration of a resident into a new environment may minimise the distress and disorientation associated with entering into a residential aged care service and reduce the desire for residents to leave the service.

This may involve family members or persons who are significant to the resident that can provide support to the resident and assist in ensuring that important risk factors are identified when the approved provider is developing a detailed care plan and management strategy.

Pre-assessment of permanent and respite residents entering a service

Screening new residents (including those in respite care) and assessing their care needs on the day they enter a service may assist approved providers to manage the risks factors associated with residents going missing during their initial stay in a service. This can be done in tandem with other assessments.

Ongoing monitoring

Residents’ care needs change over time. Ongoing monitoring of care needs may be beneficial in managing risks associated with residents going missing. Ongoing monitoring is particularly important when risk indicators such as a history of wandering are identified.

Caregiver and community education

Increased community and aged care staff awareness could prevent some instances of residents going missing.

Aged care staff and the community play a critical role in ensuring the safety of residents, especially those who are at risk of going missing.

Providing appropriate education to care givers and the community can: increase their understanding of behaviours that may lead to a resident going missing prevent some incidents where people have unintentionally assisted a resident to leave or have not informed the service a resident has left. In addition, education of the family or significant persons can assist in the development of effective resident care plans.

Through increased vigilance, anyone who visits a service can ensure that security measures are effective in residential aged care facilities. Care givers can accurately document resident movements out of the service and ensure they are returned to services on time.

Interventions

Aged care services can intervene in a number of ways to reduce the possibility of residents going missing without explanation. This can include environmental modifications, technology and safety monitoring, and physical and psychological activities.

The environment around a service may also pose risks to missing residents, such as a service’s proximity to bushland, bodies of water, or roads.

Interventions should be based on a case-by-case analysis of potential risk factors that apply to individuals and the service’s location.

Interventions may be particularly useful in managing the risks associated with cognitively impaired residents or residents who exhibit wandering behaviour.

Conclusion

Risk factors include cognitive impairment, a history of wandering, and residents entering an unfamiliar environment as a new entrant or for respite care.

Screening and assessment of the resident at the point of entry and education of caregivers and the community could reduce the likelihood of at-risk residents going missing.

There are a number of strategies that the industry could consider to manage and reduce the possibility a resident going missing without explanation, including environmental modifications, technology and safety monitoring, and physical and psychological activities.

We asked on our Nurse Uncut Facebook page and last blog post what your age care facilities do to reduce wandering residents – see some of the ways below.

“By having more staff”

“At our facilities we find that a plastic chain strung across the doorway can prevent some wanderers from trying to exit. Can be a useful strategy to keep them out of certain areas or rooms.”

What does your facility do to reduce wandering?

Image credit: Tom Beardshaw via Flickr

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The Department of Health and Ageing has recently developed a ‘What can we learn?’ report about residents who go missing from Australian Government funded aged care facilities.

The report is now available in the Industry toolkit on the Aged Care Complaints Scheme website.

This report is intended to be a useful resource for the aged care industry, and it:

• shares data analysis results
• highlights national trends associated with missing residents
• outlines potential risk factors that may be involved with residents going missing
• suggests interventions that may address these risk factors
• provides additional information about cognitive impairment, dementia and wandering behaviours.

The aim of the report is to provide the aged care industry with information relating to missing residents. Its contents should not be considered as instructions or advice.

What are the risk factors?

The report indicates there are multiple risk factors that contribute to the likelihood that a resident may go missing. These include where they have:

• a cognitive impairment
• a history of wandering
• recently entered a service
• been receiving respite care in a service.

The common theme of these risk factors is a behavioural element. Residents may be confused or challenged by unfamiliarity in their environment due to a change of location or a cognitive impairment.

In addition, a combination of elements can increase the likelihood a resident can go missing. These factors include:

• residents who are able to walk independently and are cognitively impaired
• residents with a history of wandering that are not in a secure environment
• residents that are new entrants and are cognitively impaired.

How does your work place prevent wandering aged care residents?

Read about how some of these risks can be addressed in Part 2 next week.

Image credit: Tom Beardshaw via Flickr

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The NSWNA is surveying nurses working in the “for-profit” Aged Care sector to ensure we are well informed before we commence bargaining for new agreements Fill out the survey and you could win an Ipad2

The NSWNA has engaged a company called Essential Research to undertake the survey and to conduct an online focus group.

Nurses who complete the survey that is being mailed out or who complete the online version will have a chance to win an ipad2. For terms and conditions see below.

To complete the survey online please click here.

Terms and conditions for ‘for profit’ Aged Care survey, iPad2 draw

Key things you need to take note of:

1. The prize is an Apple iPad2TM (32GB, 3G).
2. The prize will be drawn on 14 December 2011.
3. The winner will be notified by telephone and/or e-mail and/or post.
4. Only one survey entry per person.
5. To be eligible to be in the draw your completed survey must be received by the Association prior to 7 December 2011 (via website or post).

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More than 90 employers, covering 176 facilities in the not-for-profit aged care sector have signed up to a new template agreement that delivers an average 9.2% pay increase to nurses over three years. For some the pay increase will be as much as 12.38%.

More than 1400 NSWNA members will benefit from a new agreement with employers in the not-for-profit aged care sector. Over 92 per cent of members have voted in support of the agreement.

RN Judith Nicholas (centre) wore her traditional nursing uniform to symbolise the importance of nurses in aged care

The three year agreement includes a 3 per cent pay increase in the first year (from 1 July 2011), 2.8 per cent in the second year and 3 per cent in its final year.

Wage increases are even higher for AiNs, with their wages to be at least 3.5 per cent above the Nurses’ Award minimum rate.

‘This is a big win for AiNs,’ said NSWNA General Secretary Brett Holmes.

‘In the past AiN wages have been very close to the minimum wage. There is now a clear increase above the minimum wage. This is well-earned recognition for the valuable work that AiNs contribute to the aged care sector.

‘The wage increase, along with salary packaging, now makes the not-for-profit sector more attractive than other parts of the aged care sector.’

‘Some RN classifications are getting close to public sector rates. This will make the not-for-profit aged care sector a more appealing place to work for many nurses.’

The first pay increase will be backdated to the first pay period on or after 1 July 2011, and paid after the agreement is approved by Fair Work Australia.

The employers have agreed that, if the Productivity Commission Report results in more funding for aged care, discussions about further wage increases will be held.

What has been won

Wage increases

• 3% first pay period on or after 1 July 2011
• 2.8% first pay period on or after 1 July 2012
• 3% first pay period on or after 1 July 2013

Other important conditions

• existing conditions, including penalty rates and leave entitlements, are protected
• overtime applies for part-timers and casuals after 10 hours
• under-18 AiN rates removed
• employer pays for cost of criminal checks
• casuals can request permanent employment after six months
• casual loading increases to 21.5% from
July 2011; 22.67% from July 2012; and 23.83% from July 2013.

Do you think this will make the not-for-profit aged care sector a more appealing place to work?

Image credit: NSWNA

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A new survey has revealed low paid nursing and care workers will leave the aged care workforce unless the Gillard Government urgently addresses the wages gap.

The Australian Nursing Federation (ANF) launched the on-line survey of aged care workers as part of its national “Because We Care” campaign aimed at fixing Australia’s under-resourced aged care sector.

Hundreds of aged care nursing and care staff are continuing to respond to the survey, which poses the question “Will you leave the aged care workforce if the Gillard Government does not close the wages gap?”

So far, results are showing:

• A majority 77 per cent of aged care workers responded they would leave.
• 12 per cent were unsure if they would leave.
• 10 per cent said wouldn’t leave.

“Although, the survey commenced only last week, there’s an emerging pattern showing that low paid nursing and care staff in aged care are extremely concerned about the wages gap they’re experiencing and are prepared to leave the workforce unless the Gillard Government steps-in and rectifies it,” ANF Federal Secretary, Lee Thomas said.

“How can the sector possibly expect to recruit the 20,000 extra nursing staff needed to meet the growing demand of Australia’s ageing population if aged care nursing and care staff are being paid significantly less than what they would earn in other health settings?

“The ANF and its growing membership are now seriously concerned that unless the Gillard Government acts, we will simply have no workforce left to deliver quality care for the elderly Australians living in nursing homes.”

The ANF is calling on the Government to inject $500 million to close the wages gap in aged care by making Budget 2012 the “aged care Budget”.

Will you leave the age care sector if the wages gap is not fixed?

Image credit: NSWNA

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Nurses in aged care facilities who care for younger people with disabilities will welcome a joint Federal-State plan to relocate these residents.

The Federal and State governments have allocated $190 million over five years to move young people with disabilities from nursing homes and into appropriate care.

Approximately 6,500 Australians under 65 currently live in aged care facilities because, under the current system, they have nowhere else to go.  In what is largely an unknown phenomenon, young people with a variety of disabilities regularly fall through the health-care and compensation safety net and often end up in nursing homes, where staff do not have the facilities or resources to properly care for them.

According to the Young People In Nursing Homes National Alliance, many of these people have sustained catastrophic injuries in situations where compensation is not available. Others, often without health insurance, have developed degenerative neurological diseases such as multiple sclerosis, muscular dystrophy or Parkinson’s disease.

Aged care facilities are simply not designed to cater for the very different and often intensive needs of these younger residents.

We whole heartedly support this move! How about you?

Where you surprised to hear 6,500 (!) young disabled Australians live in aged care facilities because there is simply nowhere else for them to go?

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Image credit: Kimba via Flickr

A research project is currently underway on the experiences of women aged 45+ who are carers or nurses in the Australian aged care sector.

You are invited to participate in this project by completing an online survey, which can be accessed HERE

You could win an iPad 2 just for completing the survey!

This survey is being undertaken by researchers at Curtin University and the University of South Australia. The research is funded by the Australian Research Council and the survey has been approved by the Human Research Ethics Committee at Curtin University.

The survey contains questions about your work in aged care and should take you about 30 minutes to complete. Further instructions and information about the survey are included at the beginning of the survey.

Please take the time to share your experiences of work in the Australian aged care sector by completing this survey. This is your opportunity to contribute your thoughts on working conditions in the sector – and suggest changes that will be beneficial for you and the many other women who work in aged care.

Image credit: NSWNA.

The wages gap between aged care and hospital care continues to grow each year. We need the federal government to fix the shortage of nursing staff in aged care by closing the wages gap, so we can deliver quality care.

We need the federal Government to fix the shortage of nursing staff in aged care by closing the wages gap between aged and hospital care.

Public sector nurses doing a similar job make between $168 and $390 on average more each week.

• Investment of $494 million delivered in the 2012 Federal Budget can close the wages gap between aged and hospital care. Additional investment to maintain competitive wages would require additional funding of $97.9 million per annum indexed.
• Aged care falls through the cracks — only the Australian Government can close the wages gap in aged care.

The cost of closing the wages gap between aged and hospital care for nursing staff would cost $494 million in 2012. This investment would deliver competitive wages to aged care, and address the nursing staff shortages, putting aged care on firm foundations ahead of sector reform.

Aged care falls through the cracks.

Only the federal Government can close the wages gap in aged care. This is because competition for nursing staff in aged care comes from hospitals where nurses doing a similar job make between $168 and $390 on average more each week.

We can close the wages gap now through a National Framework agreement between government, aged care providers and nursing staff.

• A National Framework agreement providing additional funding to close the wages gap and implemented through enterprise bargaining is the best mechanism to deliver competitive wages in aged care.
• This mechanism remedies the failures of the past, by making sure additional funding goes to wages and delivering competitive wages quickly and with minimal disruption.

Closing the wages gap requires immediate action and the provision of additional tied funding.

A National Framework agreement between government, aged care providers and nursing staff would be delivered through enterprise bargaining and would:

• Enable aged care providers to access additional funding to pay competitive wages to nursing and care staff while maintaining care standards and enterprise flexibility;
• Guarantee that additional funding flowed through to wages through an enforceable industrial instrument that preserves existing sector industrial arrangements; and
• Deliver competitive wages to the sector quickly and effectively, complementing proposed reforms, and addressing existing staffing shortages.

‘The care of aged care residents would be improved with the right number of staff, the right mix of staff, improved stability of staff and proper pay. Aged care facilities are run on a shoestring.’ — Patricia Kun, Aged Care Resident

What are your thoughts on the wages gap?

Source and image credit: ANF

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