Interview: Muscling Up
Unions: Thinking Pink
Bad Boss: Global Bully
Unions: National Focus
Economics: Friend or Flunkey?
History: Young Blood
Industrial: Living For Work?
International: Fighting Together
Poetry: Medicare Plus Blues
Review: Human Racing
The Locker Room
A New Mark for Labor
Bob Gould On Kicking The Liberals Out
How would you feel about putting a dependent relative, Mum or Dad perhaps, into long-term care if you knew there wasn't a nurse in sight?
Think about it, one of Sydney's most experienced Nursing Home directors warns, there's a crisis brewing and boiling point is not far away.
"We are moving towards a situation of unregulated workers under some sort of health care manager," Lucille McKenna warns. "It's not what I want and it's not what our elderly people deserve but I do think it is what's coming.
"I don't think the Commonwealth sees a future for aged care with nurses in it."
So what? you might ask, why do aged care facilities need trained nurses anyway?
Follow McKenna into Narraweena Nursing Home, near Dee Why on Sydney's prosperous northern beaches, and there's a rude awakening in store if you haven't got your head around the difference between a retirement home and a nursing home.
This isn't the sort of place where people while away their golden years playing lawn bowls or ticking over the TAB account in front of the television. This is a hospital - in all but designation and pay rates.
Narraweena is home to 54 Australians who are doing it tough and they aren't all old, not by any stretch of the imagination. The youngest is 36, others are in their 40s, although the majority won't see 60 again.
What they share is an inability to look after themselves. The dementing diseases, principally Alzheimer's, is the biggest culprit, but strokes, emphysema and a range of other maladies have all taken their tolls.
"We don't have one person to whom we can just say, go to the dining room or go to the toilet," McKenna says. "Not one person, there are a few who could manage it, but there would be no guarantee where they would end up.
"Sixty percent of our residents come directly from a catastrophic incident, via a public hospital. The workload, on everyone, is intense."
More and more the service provided is palliative care. Palm Grove's figures show the average length of stay is shortening and that those who depart do so in more ways than one.
Since the Howard Government changed the Aged Care Act in 1997 the degree of resident dependence has escalated but funding for the sector, despite the protestations of Ministers like Bronwyn Bishop, hasn't moved with it.
In that sense, at least, Palm Grove is typical of thousands of nursing homes dotted around every state in Australia.
Sharyn Lunn was the boss at a central coast nursing home until she threw her arms up in despair, and walked. Another fully qualified nursing director, she is looking to return to the public system.
She will not, she insists, return to aged care until wages and conditions improve.
The pressures, from Federal Government, Lunn argues, are intolerable.
The final straw, for her, was being told to chop another 56 hours out of the weekly nursing roster.
"When I started there were 969 hours a week allocated for assistants in nursing," Lunn explains. "I was asked to reduce this when I arrived and did so by 56 hours a week, bringing AIN hours to 75 percent of income. To get to 65 percent would have required another cut of about 56 hours, down to 857 a week. These cuts are not being done in response to resident profile changes.
"It would mean roughly five fulltime AINs looking after 16 residents each. I believed I needed eight to ten to provide the level of care these people were entitled to."
Another Central Coast establishment has lost eight enrolled nurses and 12 registered nurses in the past year and only been able to fill two of the 20 positions. Manager, Julie Miller, says the home has 10 beds it cannot fill because of the shortage of qualified staff.
She calls the situation "disastrous".
"This is not a facility problem, it's an industry problem," she says. "Since the Aged Care Act changed we have gone backwards. Nursing staff cannot maintain the workloads being expected of them."
It's an analysis the Nurses Association agrees with wholeheartedly. It has been running an Aged Care campaign for two years now, highlighted by "pink" days of action. So widespread is concern that even bus drivers, rail and construction workers have donned the unlikely colour in solidarity.
The Association has a special 27 percent wage claim pending before the IRC.
Back at Palm Grove where they turn over more than $2.5 million a year for a profit around the $300,000 mark, there is no secretarial support whatsoever. McKenna and her offsider, deputy nursing director, Linda Hyson, divvy up receptionist, telephonist and typist duties between them.
McKenna says under-funding has made recruitment and retention of trained staff next to impossible. She points out of 12 registered nurses at Palm Grove, fully half are over 60 years of age. And there is no likelihood of younger nurses filling their places, because ...
- aged care nurses are paid 12.75 percent less than their colleagues in public and private hospitals
- their workloads are extreme
- the 1997 Act has introduced a mountain of complicated paperwork, on which funding is based, that nurses find "wholly unattractive"
- that Act has brought with it a system of unannounced spot checks, complete with aggressive interviews, that intimidate workers. The last at Palm Grove was conducted by two inspectors who spent six hours grilling already-busy nurses about procedures.
But, at least Palm Grove still calls itself a Nursing Home, defying a trend spearheaded by big, for-profit operators that tag themselves Aged Care Facilities.
The difference is significant, especially as an ageing population leaves a growing number of Australians in need of specialist, intensive care.
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