I’ve recently read that when registered nurses are on duty, residents have better health outcomes, a higher quality of life and fewer hospital admissions. While this seems an obvious result – factors within the aged care industry such as nurse’s availability, financial constraints and recruitment make it a difficult task to achieve. It’s interesting to note that staffing ratios within aged care aren’t considered in the same vein as say, intensive care nursing or paediatrics where a one-to-one ration is often considered the norm.
The Productivity Commission Report Caring for Older Australians described staffing ratios as ‘a fairly blunt instrument for ensuring quality care because of the heterogeneous and ever-changing care needs of aged care recipients’. However, staffing ratios deliver results in hospitals where patients have ever ‘changing needs’. Boosting staffing ratios within the aged care sector have thus far failed – in fact, mandated nurse-to-resident ratios are opposed by Ken Wyatt, Minister for Aged Care. They argue that this would just lead to increasing costs and limit flexibility. Healthcare is a 24/7 industry and it could be argued that the current flexible staffing approach leaves the decision whether to have an RN on duty at the discretion of the provider – but do they always employ additional staff when care needs increase?
Within aged care, the needs of older people are variable where around 80% of residents have high care needs. I have read a number of articles that suggest the staffing profile of aged care homes today does not reflect the resident profile because if it did, there would be a large increase in the number of registered nurses. Instead, the number of registered nurses has decreased while there has been an increase in less skilled nursing attendants – nurses now account for less that 15% of the workforce. Dr Sarah Russell at Aged Care Matters states that ‘whether residents’ care needs are due to cognitive decline, incontinence or chronic pain, residents invariably benefit from having registered nurses on duty’.
As a supplier into a number of aged care facilities, it is interesting to read some of the questions posed within the sector. While I don’t work within a clinical setting I would suggest I probably see more nursing assistant roles advertised than registered nurses but this may be due to a number of reasons such as; retention of nurses being more effective or simply there is a greater requirement for AINs. At hospitals in New South Wales, each unit is required to publish their staffing ratios, with the state following the precedent set by Victoria with their recent legislation for nursing ratios. If aged care providers were required to publish their direct care staffing rosters, would this enable people to make an informed decision about the standard of care in each facility?
I’ve been recruiting aged care professionals across NSW, QLD and VIC so if you need any assistance with any vacancies then please give me a shout on 02 8252 1108 or drop an email to firstname.lastname@example.org. This week I have recruited some fantastic aged care nurses in Sydney and also extensively experienced facility managers in Melbourne, Sydney and the Gold Coast.