I feel it has to be said.
I’m sure I’m not the only nurse to work in aged care that has felt this way. Perhaps this is something I have felt and observed as I continued to work in aged care and hospitals at the same time.
When I made the decision to leave my job working in the hospital, I still recall my colleagues saying “why do you want to work in aged care?”, “isn’t that something you do when you’re close to retirement or return to work after having children?”
Well not for me, and I hope by opening up the conversation and talking about the stigma that exists, that people can start to see another side to working in aged care that extends beyond cleaning dentures and bed pans.
Working in aged care, or should I say doing something that involves surrounding myself with elderly people, is where I wanted to be. It made me happy. I felt, and I still do, that I could make a difference in their lives.
I’m still trying to work out what exactly it that creates a stigma not only in the healthcare system but within the general public. Some of the possible thoughts I’ve considered over the years are:
1. Is it not glamorous or fast paced enough?
Like other areas of healthcare. Is this stigma preventing our youth as seeing this as a viable career path or aspire to work in one day? How do we change these preconceived views and make it a more attractive option to work in?
The television shows ER portrayed nurses and doctors working in a fast paced work environment where lives were in the balance and much of the job was life or death.
While, contrastingly, aged care generally gets portrayed differently; more often than not these films are comedies where the carer/nurses accidentally ends up in the job of caring for quirky personalities. Which probably adds to the thoughts around what a perceived ‘typical nursing home’ is like to work in.
2. Is working as a nurse in aged care perceived as “lower skilled role”?
Does a perceived ‘lower acuity’ of residents in aged care facilities automatically assume a “lower skilled” nurse? I suspect people working in rehabilitation at some stage feel a similar element of stigma.
Working in aged care isn’t just about taking care of old people who can’t simply take care of themselves – many people I have cared for are palliative, advanced dementia, or chronic diseases and can be very fragile and very sick.
The majority of residents I’ve cared for do want to be transferred to hospital if they become unwell and therefore making sure their wishes are upheld means a nurses clinical skills need to be sound.
A resident that deteriorates rapidly requires a quick thinking nurse to assess the situation and determine exactly what the resident needs. Often with little backup. There is no MET call. There is no luxury of calling the Local Medical Officer or getting the specialist in as soon as possible. The options available are calling the ambulance, phoning the GP and hoping the answer or assessing is the resident is stable enough to stay in the nursing home.
Sure, nurses in aged care may not need to undertake as many clinical tasks as hospital nurses but it comes close. A nurse in aged care is in charge of making clinical decisions at any one time for 60 to 130 residents.
Other clinical task that are similar to what ward nurses would be expected to do and often more. Sure there are no doubt less Intravenous Therapies (IV medication). But everything else is: inserting catheters, medications,
drugs of dependence, insulin, In some nursing homes intravenous medications, complex wounds and palliative care.
3. Is it due to the way our elderly are perceived in society?
They talk about the “elderly as disposable”, where there is an image that the elderly are a low-value demographic costing the taxpayer millions in health care, particularly as people live longer and diseases like dementia become increasingly common. Do we as society overall not value our older generation?
Being an aged care nurse can be just as demanding as the nurses you seen in hospital ERs, it’s just a different kind of demand. By no means is the job easier or more relaxed.
I’m certain I’m not the only nurse that has felt this at some point in their career.