What is professional autonomy? It means having the authority to make decisions and the freedom to act in accordance with one’s professional knowledge base. Something that most nurses understand in their careers.

No matter what kind of aged care facility a nurse works in, they have a responsibility to offer high quality care and maintain professional standards.

A better understanding of autonomy is needed to clarify and develop the nursing profession in a rapidly changing healthcare industry.

While working in aged care or any clinical setting, nurses can often work autonomously to provide care and make clinical decisions regarding the treatment of residents or their patients, especially those that have more complex conditions.

But how is this autonomy affected as the organisation grows?  

Internationally there is a concern about how the core elements of nursing are taken care of when focusing on expansion and extension of specialist nursing roles.

Australia, much like the rest of the world, are seeing a decline in the number of smaller and “not-for-profit” residential aged care facilities.

The smaller facilities were typically owned by religious or community groups, charities, private groups and local or state governments.

Larger facilities, where the industry is particularly growing, are run with shareholders, private corporations and are typically owned and operated as businesses. The reason they are growing is because they are able to take part in mergers, acquisitions and takeovers of smaller facilities.

One research, interviewing 103 registered nurses from a wide background of different aged care facilities, found that the type of organisation had a big impact on their nursing practice, autonomy and their care issues.

Results showed that there was a belief that nurses had less autonomy in the bigger “for-profit” organisations. Many felt it was due to management, while others suggested it was the stresses of staffing ratios.

Being market driven and with an increasing ageing population, there is a higher demand for efficiency and productivity. However, with an expanding industry, autonomy is threatened when management attempts to create a “one size fits all” approach to “running a business”.

But aged care is more than a business especially when there are vulnerable lives being cared for. And the mentality of looking at aged care as something as basic as a business does not do anyone justice. Every facility has a mix of different personalities – whether it be the residents or the staff.

Aged care is growing, but that doesn’t mean the autonomous nature of a nurse’s’ job needs to be sacrificed. The call here, as many would claim, is to increase the amount of staff at hand.

Autonomy is needed when caring for each resident or patient with a set of individual needs. Inherent in autonomy and control over nursing practice is nurse power—not necessary power to dominate, instead power to contribute uniquely nursing knowledge and expertise to residents and the organisation they represent.

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