Submitted by Anonymous

The single most important issue facing aged care residents and care workers looking after the elderly is without a doubt, resident to staff ratios.

Having been employed in the industry over the past 5 years as a residential care worker on night shift and seeing more complex nursing needs of residents admitted into care, the one over riding factor that hasn’t kept pace is the staffing levels and mix to make the job easier.

If anything the “for profit providers” are making it more difficult by trying to find ways of reducing hours of care per resident.

I have observed it happening at my workplace my co workers on the different shifts often comment now that it’s just becoming to hard to achieve the daily activities that they are required to preform on a daily basis.

An important sign of workplace stress is absenteeism, which currently at my facility is quite high and at times is quite difficult to replace absent staff.

I know casual staff that when asked to fill in a night shift in my unit decline the shift if it’s the unit I work in due to the workload if they have done previous shifts in the unit.

Even regular staff decline fill in shifts and it’s all down to the workload.

Team Leaders often complain about the agency budget blowing out, but it is happening due to workload stress that is being put on the regular staff.

I dread a night when I work with an agency, and it’s not t fault but not only I have to heir organise the night with all the duties required to perform but then all the computer work as well so the workload doubles.

It’s hard sometimes seeing the am staff come in for handover before they start and already looking tired knowing what’s in front of them.

It is a hard unit to work in given the number of dementia residents with all sorts of behaviours to manage and we do need more support from management in a practical sense but has never and nor likely to happen.

And talking to others working in the industry it is happening right across the board, which considering the funding they receive is disgraceful.

More than once we have been asked to document behaviour whether it happens or not or embellish progress notes so more funding can be applied for under ACFI, but we never see that funding helping us in a practical sense in terms of staffing.

I am often asked why do I continue to work, why not find something easier, and my response is always if we all gave it away because it was too hard who would do the job.

I am always very protective of the residents I care for and we do have little victories and wonderful moments albeit not often but really enjoy them when they happen and that’s what keeps me going

Residents who are now being admitted to care are coming in with higher and more complex cognitive and medical issues due largely to the government’s in-home care packages.

This, in turn, is placing more strain on staff. Staffing ratios and training has not kept pace with the more complex needs of the residents.

Training for PCA’s does not appear to have changed in the past 10 years. In my experience working night shift, I care for 38 residents in a dementia dedicated unit with one other PCA.

On a typical night, a shift includes 40 plus pad changes (all needing 2 staff assist), approximately 7 residents who need assistance with toileting (with 2 staff, 10-15 times a night), 38 jugs filled with either water or thickened fluids and put into rooms for the following day.

Other issues may include a quick decline in residents health which require prompt attention from div1 but unable to attend when needed due to her quota of residents they are responsible for.

And the falls, wanderings, verbal and physical assaults that occur. We have long advocated for one extra staff member to ease workload and give residents more care time but always been denied or not raised due to not wanting to cause problems with management.

It’s been a long time since I did my course to qualify as a PCA but one component I believe that is missing is dementia training which is such a critical component of care now with increasing dementia clients coming into care.

The funding successive governments have provided for aged care facilities is great but we must question the level of accountability of where and how this funding is allocated.

There seems to be an increasing inability to attract new staff and encourage them to continue long term, the main reason for giving it away is the workload, “ so much harder than I thought” or “too heavy”.

The residents need consistency and familiarity with staff who know how to manage them to get the best and safest outcome.

Anecdotally working with staff working at multiple facilities, stories of pads being locked up at nights, a memo being circulated asking staff to bring in used plastic shopping bags, residents not being checked for incontinence overnight, no staff being on duty certain times of night – these are of course unconfirmed anecdotes.

In summary, ratios need to be addressed as a matter of urgency to give our elderly residents and their families the care and dignity they have rightfully earned giving a lifetime to our country.

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