seanandmaria

Before i embarked on my career in nursing i knew i only wanted to work in the aged care sector, (please no negativity i know it's not for everyone!)

I got through my training (Dip HE, Bsc), and did exactly what i wanted to do.
The quality of care given in the places i worked (back in the UK) was mostly excellent, it wasn't perfect by any means BUT the clients needs were tantamount, staff worked as a team, (including RN's doing HANDS on care ) Moral was usually good, there was open communication, training and development for ALL staff, a good skill mix (usually) and management weren't above helping out if/when needed.

Since arriving in aus and working in aged care my enthusiasm for work has dwindled, it's got to the stage where i'm considering a complete change of career.

Care standards here are given lip service (in my experience) Clients are treat like they're an inconvenience, it's not about what best suits the clients, it's about how easy can we make the working day for the staff, Holistic, individualised care isn't something i've really seen here in aged care, most facilities i've worked at insist on suppositories after 3 days for all clients, regardless of their habits of a life time (yes yes i'm well aware of the factors that increase constipation in older people) it's just completely standardised and intrusive. I've suggested things like movicol as an alternative, but it's fallen on deaf ears, Supps are so much more effective!!!

Accountability doesn't seem to be a major factor, informed consent seems to be unheard of, i've been told on more than one occassion not to ask if someone would like a suppository, just to give it to them..... yeah right whatever !!!!

sorry, this seems to be more of a vent/rant than anything else, just wondered if any others felt the care for older people is different in other countries?

Maria

PS I love life in australia and wouldn't consider going back to the UK at this point in my life.

hollykimalan

Are you sure you actually flew to Australia...and didn't, in reality, travel in
some kind of crazy time machine back to 1940's UK!
That all sounds truly terrible.
I hope you find an area of nursing where you feel happier out there.
We have not left the UK yet but I would be interested in lack of nurse
autonomy/ not being listened to type stuff that you alluded to. Is that quite
prevalent in Oz? I am beginning to wonder where nurses fit in, in healthcare.
I work in A/E and we frequently tell the doctors what to do...and yes they do listen!
I wonder if anyone else out in OZ has had similar 'disempowerment' experiences.
Having said all that I am quite looking forward to taking a back seat instead of making SHO's decisions for them on half the salary!
HKA
x

kitty4

I have experience in various areas working in Australia and none of it is particularly good. Was a practice nurse in the UK before coming to Australia permanently and that is the only thing I miss about the UK. Have not found any work here yet that makes me truly happy - even considering a career change - but other than that, life is better and would not go back to UK. Practice nursing here is so limited in duties, less autonomy than health care support workers have in the UK - and community nursing wages are disgusting - at least one third less than hospital pay in my experience. When I first came I worked in aged care as I had done that for many years in the UK (by choice) and thoroughly enjoyed it there, but what I found here was truly shocking in terms of working conditions, skill mix and attitude towards residents (this was in various nursing homes). Every time I was on duty I was the only RN for 50 - 60 bed nursing home, the rest care assistants trying their best (some of them), having to rely on them to check controlled drugs and much worse things were observed. Some homes were better than others but that is true anywhere. I did this work on agency, so obviously didn't have time to ''fit in'' anywhere, but it did give me a very objective look at it. There are some great RN's out there too who are passionate about aged care which is just as well as I don't see any other advocates to try and keep up standards. Have worked in hospitals (medical, surgical, psych) and find that the work is mostly personal care, very little use of advanced skills. What amazes me the most, is that the level of training is quite intensive (I did my Masters degree at an Australian Uni) but it seems you don't actually get to put your advanced skills into practice in reality. I am aware it's different in more rural and remote areas (where there are not so many doctors). There are so many doctors here on the sunshine coast and I still find that traditional culture of pandering to the doctors needs, although many younger ones now seem more modern in their outlooks. Saying all this, the care (in hospitals) is generally quite good (there are always things that could be better). I currently work casual in a private hospital on psych ward, which is fine and the staff are great and have all been there for many years which says a lot about the working conditions there. Pay is good, which is now the only thing that keeps me doing it, which saddens me to say as I have always loved nursing. I feel tremendously disempowered and deskilled since moving here - maybe I just haven't found the right niche for me yet! Maybe I need a career break. I miss the teamworking that I ''grew up'' with in my 20 year nursing career. This is just my experience and current feelings, so sorry if it offends and I'm not out to put anyone off who is yet to get out here. There are obviously many who have positive experiences and I have had some too, but on the whole it isn't fulfilling me at the moment

seanandmaria

Thanks both, makes me feel like im not going mad for thinking im in a time warp, or just being a typical whinging pom
Autonomy isn't something i've actually come across since being here, i no longer 'do' blood, SPC, Doplars, ect, for some weird reason they buy that service from others *shakes head as i think about continuity/cost*

I too work for an agency, i've worked in some facilities on night duty, with 150 residents, one RN (me) and some care assistants, some good, some bloody aweful

As for attitudes to aged care, it's shocking, labelling residents as 'naughty' makes my blood boil!!! hth can someone with dementia be labelled as naughty, attention seeking or anything else,

The RSC documentation here makes me laugh (well if i didn't laugh i'd cry) residents are admitted to high care becuase they have 'behaviours' ....... these beahviours go from the sublime to the ridiculous: verbally agressive means they declined the offer of assistance to go to the toilet, and became upset when staff *insisted*
physical agression means, demented man who was POW in WW2 gets upset when staff insist on taking him to bed at 5 in the afternoon!!!
These types of behaviours make the difference between high/low care and funding for them, i've worked in high care units where residents have had mild dementia, can do absolutly everything with minimal assistace, but their assessments claim they have behaviours, madness!!! and yet in the hostel *residential home* across the way, they have a wonderful concept of "Ageing in Place"....... they might have any number of residents who need high care, but there are still only minimum staff on and rarely qualified to deal with the care required. Dont be silly of course there aren't extra staff to assist with there worsening health care needs.........

I've had some intersting discussions with doctors, how can a man with a diagnosis of liver cancer be completely unaware of it because his family have decided they dont want him to know..... ok i know that it's not that long ago that it was happening back in the UK, but it's been more than a few years since it became the exception rather than the norm.

I've always been passionate about my job and older people, now im thinking perhaps a mindless job answering phones or something is the answer

Maria

kitty4

I thought that too (take a mindless job answering phones etc) - but you just can't do it if you feel and think like you and I !!!
The urge is too stong to try and do something about it. I haven't got the answer yet and maybe never will here aside from voicing my opinion and being snubbed. Must go to sleep on this and post when I'm more awake. However, how you say what you feel and what you have expeienced - I totally empathise with. I specialized in dementia care in the UK for some time and loved it. Here they are mixed among the nursing home general residents - not ideal for either parties if severe dementia is involved - and have seen people tied to chairs with sheets to prevent them wandering around (going back 8 years here) in a couple of nursing homes.
Wish I could come up with something to revolutionise things quickly but we know ingrained cultures take time to alter

augigi

Perhaps you could stop working agency and start working permanently in a place where you can make some changes?

There are good and bad places of every type. I've worked in awful aged care places, and I've worked in lovely ones. Sometimes it's the DON/nursing staff who make the difference.

If you don't like them, why not change them?

kitty4

That's a fair opinion.
Although the experiences that have been posted seem to be quite widespread here and nursing is generally seen as much less autonomous in relation to medicine - changing that culture needs changes in policy and all sorts, which takes time.
I agree it's the DON and staff that can make all the difference in any particular place and that can be said whatever country you are in.
I don't work agency any more, the unit I work on has a new NUM who is questioning, forward thinking and inclusive of her staff, compared to the one who left, who only had her own agenda in mind and looked after herself only, didn't try to change any ritualistic practices etc. Things are looking up there and there are new level 2's as well with similar outlooks. If I come up with ideas or questions, they are always considered and debated - that never happended before. Is difficult if the DON/NUM/staff are not forward looking and are there to stay though and are content in their comfort zones - difficult to join a team like that and make changes.

purple rain

Hi There, the time warp is not only in aged care unfortunately!!!!!!
I have been in Adelaide just over 2 years now and have am still shocked by the attitude to health care.
I decided a while ago that I would do something about it, yes I know it is hard but small steps and all that. It took 18 months to get a change in tracheostomy management, it would make you toes curl if I told you what they were doing before:curse:
Seriously, it can really wear you down so my advice is smile sweetly and stick to best/evidence based practice yourself and gently nudge others in the right direction. Having someone to sound off is also good it stops you going bonkers
Jacqui

seanandmaria

Thanks for your replies, i really do feel better knowing its not just me.
I also know there are some pretty good places out there too, and its a matter of time before i find something suitable, i'll just plod on until then, doing the best i can whilst im there.
I've also had my NVQ3 in training and support recognised here as cert 4 in workplace training, so going to look at that option, perhaps even changing a couple of attitudes along the way.
Fingers crossed
Maria

tiredwithtwins

read lots of posts like this over the years ... so no, you definately arent alone maria!
while we were in adelaide last may we spent some time with an elderly relative who was in an aged care facility, and i have to say i spent most of my time biting my lip about the way staff 'cared' for the residents - many had mild dementia but it was only mild! they were shouted at as if they were kids! and i had a chuckle when i saw the reclining wheelchairs with restraints!. but saying that, our aunty was happy and her husband who visited her all day every day was happy too ... if i could think of its name id tell you!

many nurses have said that aus is like the uk 30/40 years ago ... but with an influx of highly skilled and motivated nurses, aus will catch up - you have to be the catalysts that move nursing forward, kicking and screaming into the 21st century!!

purple rain

"many nurses have said that aus is like the uk 30/40 years ago ... but with an influx of highly skilled and motivated nurses, aus will catch up - you have to be the catalysts that move nursing forward, kicking and screaming into the 21st century!![/QUOTE]"


Absolutely
jacqui

augigi

God, that's so insulting to Australian-trained RNs who frequent this board!

Most of whom even *gasp* perform evidence-based practice.

purple rain

No one is trying to insult 'Australian' nurses. I work with different various nationalities, including nurses from the UK. Some 'good' some 'bad', my job is to educate and motivate all the nurses where I work to use best practice all of the time.
Personally I have a real problem with people paying lip service to Infection Control and Communication. Both areas, I believe, are in need of vast improvement.
jacqui

augigi

Trying or not, it was insulting.

Saying our standards are like another country's "30 or 40 years ago", and that it will only improve with "an influx of highly skilled and motivated" nurses (from where?) ... is insulting.

purple rain

Have you nursed anywhere other than Australia?
I am not saying it is excellent elsewhere.
I have experienced working in a number of countries, as well as here in Adelaide and have regular discussions regarding clinical practice with Educators in various hospitals across Australia, my conclusion Australia is behind in a lot of areas.
sorry
jacqui