During his clinical placement in aged care, nursing student Brett received support from a specialist clinical nurse facilitator. Having a dedicated supervisor to call on gave him newfound insight into the often-complex skills required by nurses working in aged care, and the diverse career opportunities in the sector.

Brett, who has worked in aged care for more than a decade as a Personal Care Assistant (PCA), decided to upskill and become a registered nurse to fill the “gaps in care” he has witnessed on the floor. A former soldier with the Army Reserve, he initially decided to pursue a career in healthcare after a positive experience being cared for by compassionate nurses after being injured while on deployment in Afghanistan.

The Federation University nursing student suggests his understanding of the skills and responsibilities of nurses in aged care increased significantly through taking part in the Commonwealth-funded Aged Care Nursing Clinical Placements Program, established to raise student awareness of the rewarding career opportunities in the sector. Five organisations, including the Australian Primary Health Care Nurses Association (APNA), were contracted to deliver programs nationally where students work alongside clinical nurse facilitators to develop an expanded scope of practice and clinical assessment, management, and leadership skills.

“As a PCA, we see nurses in their role, but we don’t really understand what they do,” says Brett.

“We just see them do paperwork, mainly. I never actually understood the aspect of their critical thinking and clinical aspects, which we don’t really get to see that often.

“By doing this placement, I’ve actually had my eyes opened through my facilitator, and it’s broadened my horizon to actually understand more aspects of their nursing roles, as well as little things that can be improved, and gaps I’ve seen, which I would like to eventually help fill.”

Launched in June 2023, the Aged Care Nursing Clinical Placements Program was driven by recommendations made by the Aged Care Royal Commission to improve staffing levels across the sector and subsequent aged care reforms legislated by the government such as RN 24/7 and mandated care minutes.

APNA’s Aged Care Student Nurse Placement Program, which will support 1,800 second-and-third-year nursing students, includes direct supervision from an APNA-employed RN clinical facilitator, a broader scope of nursing practice and experience for students, such as dealing with chronic disease management and complex care, and access to best-practice resources via an Aged Care Knowledge hub.

APNA’s General Manager, Career Pathways, Donna Gleisner, says the program demonstrates the advanced practice required to provide high-quality care for aged care residents.

“One of the considerations was around the burden on the aged care facilities,” she explains.

“Predominantly, education providers would send students into aged care in year one of their Bachelor degree and, more often than not, they didn’t have a good experience. They’ve gone in there, they’re paired up with a personal care attendant (PCA), and they’re just being used as an extra set of hands.”

That type of scenario leaves students unable to learn complex clinical skills and, as a result, they don’t consider aged care an attractive pathway, says Donna.

“What we’re trying to do here is, number one, take the burden off the aged care facility to supervise those students, so that they’re not being paired with a PCA, they’re being paired with an RN facilitator who can actually match the learning outcomes they need based on their curriculum.

“Number two is making sure the students have a better experience and that they’re learning from a registered nurse who’s worked in aged care, who knows the gaps that need to be filled, and knows what they need to learn.”

Registered nurse Kathryn Twigg, who has worked in aged care for nearly a decade, is among APNA’s roster of Clinical Nurse Facilitators guiding students throughout the program.

Being able to closely supervise students offers her the opportunity to provide clear direction, enhanced learning, and a more tailored experience, she argues.

“A PCA will go in and shower a client and look at their personal hygiene status. Whereas, when I take a student in, I still get them to do all of those daily living activities, because they’re important, but I’m getting them during that shower, to look at their skin colour, look at their circulation, their skin turgor to see whether they’re dehydrated. I’m getting them to look at their skin to see whether there’s any pressure areas, which could be a source of infection. I am still doing that daily care that they would have done with PCAs, but my role is to teach them the clinical aspect of what we are doing.”

Kathryn’s motivation for joining the program revolves around the broader sector’s push to create a pipeline of qualified registered nurses to meet the future needs of elderly Australians living in nursing homes.

“We’re not going to have enough nurses and we haven’t got enough nurses that care about the ageing population,” she says.

“If I can encourage one kind, caring, compassionate, intelligent, motivated student to go into aged care, I’ve made a difference.”

One of the key strategies Kathryn uses to inspire nursing students to consider a career in aged care is encouraging them to adopt a different perspective.

“It’s getting them [students] to look at things differently and realising that these people [residents] actually need nursing care. We need to open up their [students] eyes to the importance of the little things and the clinical links.

“Aged care requires a higher level of intelligence, problem solving, assessment skills, knowledge, and critical thinking than you would ever require in a hospital. So if you want to be the best nurse you can be, put yourself in a challenging situation, because when you challenge yourself, you learn and you get better.”

Funded until June 2024, Kathryn says APNA’s Aged Care Student Nurse Placement Program is tracking well and that feedback from both students and facilities has been positive. Early challenges largely centred on improving communication about the aims of program for all involved, particularly frontline staff on the floor. To help counter this, a video is being sent out to participating aged care facilities, explaining the ins-and-outs of the program, and thanking them for hosting students.

Nursing student Brett’s view of aged care has changed significantly since taking part in the program. He now considers it a viable career option after he completes his degree.

“I would like to work in hospitals and acute to build up my skills first,” he says.

“I would eventually like to become a nurse educator, like my facilitator, but ultimately, at the end, I would like to go back and work in aged care, to fill these gaps with the experience I would gain.”