RACHEL BROWNE
March 28, 2010

Mounting workloads, high stress and low pay are forcing aged-care nurses from the sector with an increasing number of less qualified workers taking up the slack.
Nurses working in aged care can expect to earn 10 per cent less than nurses working in public hospitals.

Their workloads are also increasing, an Access Economics report showing the ratio of 6.7 residents per nurse in 2007 is expected to almost double to 12.1 in a decade.

As nurses leave the profession, they are replaced by personal care workers with certificate III or IV qualifications, which can be awarded after a six-month course.

Aged Care Crisis spokeswoman Lynda Saltarelli believes personal care workers do not have the skills to manage patients with complex medical needs.

”One of the problems is in the employment of poorly qualified, poorly trained ‘hands-on’ staff who are responsible for the day-to-day care of residents with very high support and nursing needs,” she says. ”Often the English language skills of these staff members are inadequate, either to communicate effectively with patients or their families, and raises concerns as to whether they can competently read and interpret written case notes and care plans.”

A registered nurse with 30 years’ experience in aged care told The Sun-Herald of concerns about personal care workers with little supervision having ”easy access’ to strong medication such as morphine, pethidine and fentanyl.

Personal care workers make up more than 60 per cent of the aged-care workforce.

Australian Nursing Federation federal secretary Ged Kearney described them as the ”backbone” of the system but agreed they did not have the training to deal with complex patient care.

”About 70 per cent of the people in aged care have high care needs,” Ms Kearney said. ”They have complex medical problems ranging from diabetes to dementia, which affects about half the residents in care. They need highly qualified staff.

”A certificate III personal care worker does not have the qualifications to manage those needs. It does put a lot of pressure on them.”

The ANF and Aged Care Crisis are lobbying for mandated staff ratios.

Aged Care Crisis has been told of nursing homes where there is one person on duty for 80 residents.

”There are mandated staffing levels in childcare centres, kindergartens, schools and hospitals,” Ms Saltarelli said. ”They, too, cater for people with different levels of need in different locations. Why are vulnerable, frail, older people discriminated against and missing out on this protection?”

The Access Economics report into residential aged care, released in November, found a higher number of nurses meant better care.

”In acute care and residential aged care, the evidence shows that a higher nurse ratio in the staffing mix contributes to better quality outcomes.”

A spokeswoman for the Department of Health and Ageing agreed that residential aged care was suffering a staff shortage.

”The government is taking a dual track approach of providing more funding for services and for training for today while investing in training to help build the aged-care workforce of the future,” she said.

”A skilled aged-care workforce is important in providing high-quality care to frail, elderly Australians.”