Stop the cuts: Why Enrolled Nurses are an essential part of the aged care sector

Compassion, Integrity and Respect. These are the core values Southern Cross Care state that they uphold for their residents and employees, and which they also expect their employees to follow.


Compassion

Where was the compassion shown by Southern Cross Care when they informed staff of their proposed redundancies and job loss over a Microsoft Teams meeting, only notifying staff affected of this meeting via a text message to their personal phones a day prior?

Where was the compassion shown to the residents by leaving letters of the proposed change to the structure and ‘Household Model of Care’,  which would impact them significantly, on their bedside tables without providing explanation or discussion? Leaving residents then to their own devices to read and interpret content not provided in terms and language that could be easily understood.

Where was the compassion shown to residents and families by Southern Cross Care by not providing and offering those who are finding the proposed changes difficult and emotional, with the offer of counselling with Baptcare as they had for staff?

Integrity

Where is the integrity of Southern Cross Care in changing care workers job descriptions and classification without providing them notification, unless it is simply to suit their own agenda and then expect the care workers to administer medications even if they do not feel confident, or do not want to?

Where is the integrity shown to care workers by not increasing their rate of pay to reflect the greater workload and increased responsibility of medication administration that they will have?

Where is the integrity shown to staff who have lost their jobs when Southern Cross Care are still unable to provide an exact end date of their current roles finishing, and impending redundancy?

Respect

Where was the respect shown to GP’s who provide medical care to the residents at the facilities when they have not even been consulted about the proposed changes and remain integral to the person-centred care approach spruiked by Southern Cross Care?

Where was the respect shown to residents and their families, the key stakeholders, by Southern Cross Care not consulting with them months ago about the substantial proposed changes to the way that their care would be provided in the future?

Where was the respect shown to many highly qualified and clinically experienced long term enrolled nurses by offering them re-deployment options within the organisation such as care worker roles, and Leisure and Wellness co-ordinators?

Aged Care is a specialised industry that is not for the faint-hearted. It requires staff that are hard working and passionate. To these people, choosing to work in aged care is a vocation; it requires well trained staff in their specialised fields to come together as a team so they are able to provide optimum person-centred care for each individual resident.

People choosing to work in aged care, as you know, are some of the lowest paid workers in the country. Therefore, it is not the pay rate that attracts staff to work in the industry but a passion to care for some of the most vulnerable people in our communities, as highlighted in the recent Royal Commission into Aged Care.

As an Enrolled Nurse I provide clinical care for my residents and support the registered nurse continually throughout the day.

Many registered nurses are new graduates or have not had a lot of experience working in the aged care sector, whereby clinical support is so important and, unlike other health industries that may have GPs or doctors on site to liaise with, rely heavily on Enrolled Nurses to support and assist them with clinical care and monitoring of a resident’s health status.

Registered nurses are voicing their concerns, as GP’s are, that care workers will not have the same clinical skills and competency as an enrolled nurse to administer medications to a resident and provide other clinical skills necessary for residents to retain optimum health and health outcomes.

Care workers at Southern Cross Care have had eight hours medication training and two shifts with a registered nurse delivering medications to residents to be classified as medication endorsed and competent. Care workers are not required to have personal indemnity insurance or hold any form of registration. It is expected that registered nurses will be held accountable for medication management and errors that may be made by care workers.

As an Enrolled Nurse, like my counterparts, I have had extensive medication management and clinical training. We are medication endorsed and hold personal indemnity insurance and registration with the Nursing and Midwifery Board. We are accountable for our own practice, unlike care workers.

In an industry where retaining staff is increasingly difficult, facilities often work short of nurses and care workers on a daily basis. How then does Southern Cross Care believe that they will be able to retain registered nurses and care workers, under increased pressures and workloads, under this proposed ‘Household model of Care’, without the ongoing support that Enrolled Nurses provide.

Aged care

What Southern Cross Care plans to do with their staff was not what the Royal Commission into Aged Care envisaged.

The Royal Commission was about providing the best person-centred care for residents and in doing so facilities would retain a highly qualified skilled staff mix to provide that care.

It may be too late for myself and colleagues at Southern Cross Care to retain the roles we love and are passionate about, providing care to residents we call “family”, however, it is not too late for the Government to ensure that what Southern Cross Care is proposing does not set a precedent for other aged care facilities around the country.

It is vital therefore that legislation of a minimum mandated skill mix of Registered Nurses, Enrolled Nurses and Care workers is implemented to stop any future greedy aged care providers from taking the same course of action, as Southern Cross Care currently proposes.

Ultimately, it is the resident who is the most affected by Southern Cross Care’s proposed changes within the aged care sector, and the way that care is provided to them.

We need to uphold the Australian values of freedom, honesty and dignity, mutual respect, equality, compassion and giving people a “fair go”.  Residents in aged care helped build and shape our country, fought for our freedom and paid their taxes. Why then would we not want to place their care into the hands of people who are passionate and have the best qualifications and skills to look after them? I ask our Government to support Enrolled Nurses to ensure that they continue to remain as integral workers within Aged Care.

Thank you.

The author is a Tasmanian Enrolled Nurse who asked to remain anonymous 

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