Nurses demand: fund aged care
Victorian nurses working in aged care were organising for a rally outside the Melbourne office of the Commonwealth Department of Health and Aged Care, this Wednesday, November 7 as The Guardian went to press. Nurses will be calling on the Howard Government to protect elderly nursing home residents by resolving the critical nurse shortage in the Commonwealth-funded private and not-for-profit aged care sector. The community rally was organised by the Aged Care Nurses Special Interest Group (SIG). "There are not enough aged care nurses working in private and not-for-profit nursing homes to provide elderly residents with the nursing care they require", said Christine Crofton, the convenor of SIG. (SIG is provided with resources and support by the Australian Nursing Federation. There is no requirement for SIG members to be members of the Federation), "Since we held our first rally last August, the situation has worsened and the Federal Government has continued to ignore the crisis — so we are speaking out again." Victoria's aged care nurses last month took unprecedented industrial action, refusing to work overtime, undertake non-nursing tasks or take any new admissions unless a full roster of nurses was guaranteed in advance. Ms Crofton said nursing homes cannot fill their nurse rosters because of the shortage. "It's a disaster for the chronically and terminally ill people who depend on nurses to care for them. Nurses are working double, triple and sometimes quadruple shifts to ensure there is a minimum nursing presence to protect residents' health and safety." SIG says these hours are acceptable "once in a blue moon" for emergencies. But they stress that such hours are dangerous and compromise the level of clinical care: that the long hours have become standard in a system Federal Aged Care Minister, Bronwyn Bishop continues to allow to operate at crisis level. Why there is a shortage Lack of funding: The Howard Government is responsible for aged care funding. In its Aged Care Act 1997 the Government removed the provision that quarantined a certain percentage of funding that was to be spent on the direct care of residents. This means proprietors are no longer obliged to spend any particular amount of Commonwealth funding on direct nursing care. Of concern is the fact that there is not enough funding for nurses to deliver good nursing care. This lack of funding accountability has seen a reduction in skilled nursing staff. The solution is the reintroduction of legislation requiring that a certain percentage of funding must be spent on direct care. This quarantined funding should be based on a minimum nursing ratio and Victorian nursing salary costs. Lack of staff guidelines: There is a critical shortage of Registered Nurses, Divisions 1 and 2, willing to work in private aged care because they will not compromise care by working in understaffed nursing homes. Division 1 nurses are accountable for nursing care during their shifts and are the only nurses qualified to administer medicines. Under the current shortage, a Division 1 nurse in a 60-bed nursing home may have to work double shifts. No matter how good their intentions, non-nurses cannot administer potent pain relief medicine, assess a resident's pain, prevent pressure sores and so on. The solution is for the Government to mandate a minimum number of nurses required each shift to care for residents to ensure nurses can meet their duty of care obligations. The State Government-funded public sector nursing homes have implemented nurse-patient ratios. And nurses who had been refusing to practice are returning to work. Nurses will return to private aged care nursing homes if they know they will be working with adequate staffing levels. Wage gap: Aged care providers are unable to recruit nurses or keep nurses because they pay up to 20 per cent less than the State Government public sector. This gap will widen as the Public Sector Agreement's wage increases are implemented over the next two years. The aged care sector cannot compete with the wages and minimum staffing levels offered in the State funded sector. The solution is for the Federal Government to quarantine and increase the amount of funding aged care providers are required to spend on nursing and direct care which would result in wages increasing. "We haven't even got to the first step yet", said Christine Crofton. "The Federal Government must admit there is a crisis in aged care for the sake of the residents. Then we can improve the way Australia cares for its elderly residents."