The Guardian November 7, 2001


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."

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