In 2020, after nearly a decade working in ED, NSW registered nurse Emma McSeveny pivoted into aged care, believing that her broad experience and skillset could bring value to the sector.
Within just three years, however, overwhelmed by not enough staff and poor working conditions and wages, she reluctantly made the decision to stop working in aged care last November.
“I felt unsafe,” she tells the ANMJ.
“I felt that my registration was at risk, and I had no support from my manager. Due to the workload and lack of staff, there are huge responsibilities placed on a registered nurse in aged care.”
In the sector, Emma predominantly worked night shifts, where she was typically in charge of 120 residents. This included the support of a handful of care workers, yet, zero enrolled nurses.
The biggest challenges?
“It was the lack of staff and poor ratios. Having come from the public health sector, there just wasn’t enough people to meet basic care needs effectively,” she laments.
“There were nights where I’d have three or four palliative residents and it became unmanageable. Throw in a fall on top of that, and an unwell resident and it’s incredibly difficult to manage it as the only RN.”
Despite the obstacles, Emma says she enjoyed working in the sector and making a difference.
“I loved building a relationship with the residents that I cared for and tried to have those non-clinical moments, particularly through the pandemic, so that they felt like they were not just a resident but an actual person,” she says.
In recent years, the aged care sector has been put under the microscope, with the landmark Aged Care Royal Commission exposing systemic problems, including inadequate staffing levels and poor skills mix, and finding that the sector is failing to meet the needs of older, vulnerable Australians.
Emma suggests one of the sector’s issues, the inability to attract quality staff, unsurprisingly remains problematic given that care-workers “can get paid more stacking shelves at Coles or Woolies” than carrying out such an essential job. The reliance on agency staff, too, often affects the delivery of quality care, she adds.
“The lack of consistency, the lack of good care staff, really impacted on the basic healthcare of residents [in my experience]. It was taking longer to pick up illnesses and changes in condition because they [residents] weren’t that well known to staff, or staff just didn’t have the time to spend that extra two minutes with them.”
Emma began working in aged care just after the global COVID-19 pandemic hit Australia. Adapting to new infection control measures and visitor restrictions, she helped her nursing home navigate much of the turbulence, including several outbreaks and, sadly, watched on at the bedside as several residents passed away without family to give them comfort.
“I could have done a double shift seven days a week had I wanted to, we were that short-staffed,” Emma recalls.
“And it wasn’t just the RNs that were short-staffed, care staff members were short-staffed on a shift-by-shift basis and that made it really hard because we were all picking up extra shifts and doing extra work. Yes we got paid, but we didn’t get a lot of thanks from management for picking up the extra slack.”
Like many aged care workers, Emma admits the difficult period left her burnt out and exhausted, eventually tipping her over the edge and forcing her to leave the sector.
“Myself, and I would say every other colleague that I worked with, was burnt out,” Emma says.
“Nobody was feeling fresh and supported. We all continued to rock up because we had a strong sense of duty to care for the people that were in our facilities.
“It was one of the easiest decisions that I’ve ever made because at the end of the day, I had to protect and look after myself. I couldn’t keep working the way I was and give effective care to the people that I was looking after.”
Encouragingly, long-overdue reform to fix the aged care crisis has begun under the new Albanese Government. This includes legislation mandating registered nurses 24/7 in nursing homes from July, and a 15% pay rise for the workforce, set to come into effect next month.
This week, the Government flagged $11.3 billion in next week’s federal budget to fully-fund the wage increases across the sector. While the Australian Nursing and Midwifery Federation (ANMF) welcomed the commitment, it said it was disappointed that the Government has failed to impose a mechanism on how aged care providers actually use the taxpayer money to ensure it goes directly to nurses and care workers, not into their pockets.
The uncertainty fuels increasing media reports featuring aged care providers spreading misinformation that there are not enough nurses to meet the requirement of at least one RN on site 24/7 in every nursing home, and, similarly, that there are not enough nurses in Australia who want to work in the sector.
According to an ANMF Fact Sheet on ‘Registered Nurses 24/7 in Nursing Homes’, evidence shows many nursing homes already have at least one nurse on site 24/7, with Tasmania already having the requirement, and the vast majority of Victoria’s 600 private aged care facilities having the requirement within current enterprise agreements.
The Government estimates 90% of aged care homes are already meeting the requirement and the ANMF believes more RNs, including graduates unable to find secure meaningful employment each year, would want in the sector if conditions improved.
Debunking another myth that there are not enough nurses in Australia who want to work in aged care, the ANMF says many nurses only left the sector because the crisis simply became too much to bear, and would readily return if there were safer workloads, decent wages and support for them to provide quality care. Tellingly, members surveyed cared most about minimum staffing levels and skill mix, and implementing RN 24/7.
It is a sentiment that resonates powerfully with Emma, who says she, too, would consider coming back if the crisis was fixed.
“I would if there were better conditions, better ratios, and better support from management,” she says.
“And not just better ratios for the registered nurse, or enrolled nurse, but better ratios for the care staff as well, because some of the care staff I had the honour of working with are the hardest working people that I’ve ever met and went above and beyond what I felt was the basics of their job. They really cared for those that they were entrusted to look after but got paid terribly and their ratios were horrid.”
While Emma is content with her new role in mental health, she does miss the unique rapport she had built up with residents and hopes to one day to return to aged care and make a difference.
“I’ve cried on more than one occasion when they’ve passed away and I haven’t been ashamed of that because you’re working in somebody else’s home and it’s lovely to have that kind of relationship with them,” she recalls.
“I strongly believe aged care needs to be fixed for the sake of the resident. A lot of them don’t know how to, or are unable to advocate for themselves and it’s just a shame that the system’s failed them and it’s gotten to the point that good people are leaving the sector.”