The numbers simply don’t add up when it comes to the current aged care nursing workforce, the Australian College of Nursing warned the Royal Commission in Melbourne yesterday.
“Our population is ageing. Today, 15 per cent of Australians are aged over 65. This is about one million more people than there were in 2001-02, yet the number of Registered and Enrolled Nurses in full time equivalent positions in residential aged care facilities (RACF) has fallen by 13 per cent since 2003,” Australian College of Nursing CEO, Adjunct Professor Kylie Ward FACN said.
Between 2003 and 2015, the number of residential aged care places increased by 30 per cent and dependency levels of residents rose from 64.4 per cent assessed as high care to 89 per cent.
“Aged care residents have complex and chronic conditions and deserve to be cared for by trained and licensed health professionals. Yet unregulated health care workers (UHCW) make up 70 per cent of the aged care workforce and the number of Registered Nurses working in aged care is decreasing,” Adjunct Professor Ward explained.
Challenges facing the aged care sector include disparity in pay rates between aged care nursing and acute setting positions; limited availability of clinical supervision for training of nurses in RACFs; perception of aged care nursing; and lack of support from some RACFs for staff professional development.
“Aged care nurses can earn as much as $200 less than their counterparts in other parts of the health care system,” Adjunct Professor Ward revealed.
“Clinical placements provide on the job training to nurses before they enter the workforce, yet the limited number of aged care nurses mean providing quality supervision to trainees is increasingly difficult and future nurses are not being exposed to this speciality.”
The Australian College of Nursing has called for a minimum of one Registered Nurse to be on shift at every RACF 24 hours a day, seven days a week.
“The impact nurses and advanced practice nurses can have in aged care is significant,” Adjunct Professor Ward said. “So, it is exceptionally concerning we are not doing more to build, rather than diminish the aged care nursing workforce.
“A case study review of nurse practitioners in aged care indicates that an additional 10 nurse practitioners in aged care would cost approximately $1.5 million per year, but conservatively result in 5,000 avoided emergency department visits and annual savings of over $5.7 million due to reductions in ED, hospitalisation and ambulance costs.”
The Australian College of Nursing would like a nurse practitioner employed in every RACF.
“Inadequate nurse staffing, the ratio of RNs to UHCW, has been shown to increase health care costs by 40 per cent and contribute to adverse events which cost approximately $4 billion per year. We need to better understand the skills-mix needed to provide best practice care to aged care residents and strive to develop the required workforce.”
ACN supported the establishment of the Royal Commission and welcomes the opportunity to contribute to its vital work.