Last year RN Irene McInerney swapped to working nights in the residential aged care facility where she works. She felt she was no longer able to do the job properly on the day shift.
“There had been a change in staffing. We had eight carers to 84 residents, where we used to have at least nine. Everyone was running ragged. Call bells were being left unanswered for who knows how long. People were left incontinent in their beds until we could get to them – that’s the sad reality.”
However while somewhat better working nights Irene says the stress and pressure due to skeleton staffing and demanding workloads is relentless.
“Every night shift I dread going in, hoping there’s going to be four staff on, not three. We need a full pairing up – we pair up and do rounds of turns and pad changes, it takes four hours.
You just hope nothing out of the ordinary happens.
“I had two palliative care residents last week. I was giving them sub cut morph and thinking I hope this lasts them because I don’t think I’ll have time to come back for the whole shift. It’s incredibly stressful.”
There is a lack of continuity of care, rostering is inconsistent and staff numbers are unpredictable. It’s the residents who suffer, Irene says.
“We don’t want to provide care that’s factory fashioned but we have to be systematic if we’re to get through the work. We start our rounds at 3.30am, waking people to do their pads so that four staff can get through 84 residents. There’s mixture of low and high care but two thirds would need some care at least whether that’s toileting or other care.”
Irene has worked in aged care for 30 years. She says the problems plaguing the sector have gone from bad to worse.
“My passion is aged care but it’s hard to enjoy it when it’s that stressful. It’s no longer about doing the job because you enjoy it, it’s about money and survival.
“There is low morale, people feel unappreciated, let alone underpaid. Facilities are crying poor to pay us, yet making multimillion dollar profits and building brand new facilities.”
Irene says staff don’t feel supported from management who are directed by a profit- driven Board. “We are made to feel that we can’t manage our time. We’re all in the same boat. And no one wants to rock the boat.”
Irene came down to Tasmania from Queensland to be her father’s carer more than four years ago.
She says the conditions are comparable across states and territories.
“It’s no better across those corporate private facilities. I am in contact with others I worked with in Queensland and they say it’s no better up there either.”
She says staff in residential aged care are working in a climate of risk.
“Our staffing is inadequate, there are not enough pairs of hands to go around.
We leave residents unattended hoping they’ll wait long enough. There is increasing falls and pressure sores because we cannot do things in a timely manner.
“They talk about preventative care but we are at the bottom of the cliff day in day out. My worst fear is people dying alone. We had a resident who died, we didn’t know who last saw him alive.”
Irene says it’s going to take federal government commitment to fix the crisis in aged care. “Staffing ratios are what we need to fix this. It’s not going to be right until we have mandated ratios at the federal level.”
Not only has there been increased casualisation of staff, but shorter shifts introduced to pare down staffing to an absolute minimum, says Irene.
“I HAD TWO PALLIATIVE CARE RESIDENTS LAST WEEK. I WAS GIVING THEM SUB CUT MORPH AND THINKING I HOPE THIS LASTS THEM BECAUSE I DON’T THINK I’LL HAVE TIME TO COME BACK FOR THE WHOLE SHIFT. IT’S INCREDIBLY STRESSFUL.”
“They’ve reduced the hours of shifts so that we are down to skeleton staffing. ENs on the afternoon shifts help with the medication rounds but they don’t do full shifts – four hours or so and finish at 1pm.
“People are leaving because of job insecurity or to find other work because they don’t have enough hours. Then people call in sick and there’s no one to replace them.
“Staff are having mental health days, some are off on compo. We do our best but we are exhausted. People are leaving in droves, staff are tired.”
Irene says many staff have worked in aged care for 20-30 years and are passionate about their work.
“The residents make up for it, if we leave who cares for them? We’re talking about people’s lives here. Aged care residents deserve better. So we do our best even though it’s not enough.”