Nurses working in Aged Care in Australia

joannep · Jul 15, 2008

Hi,

Well I don't work in aged care, but you've certainly given me food for thought. :wink2:

rubystar · Jul 15, 2008

Hi, carer and RN student here.

I'm not a huge fan of ACFI but maybe that's just because it is new. Firstly it cost a LOT of time for management to get it all together and my generally good workplace nearly fell down around our ears because we never saw them on the floor, they spent months trying to get this thing up and running. Then once it was up and running I find some of the tick charts they like to lump us with beyond vague, and any degree of some behaviour will fit the box. I wish I could be more specific, I just don't like it so far but overall it seems to do the exact same thing as the old system with its intent and its overall categories from what I can tell.

Computerised systems... we started using Icare a few months ago. For a lot of our RNs and care staff it was the first time they had really been forced to come to terms with computer usage. Whenever I'm there I seem to get a lot of the "how does this work?" and through some trial and error I usually iron it out but I'm 21 and have been glued to a PC for a long time. Some of the charting we decided right off the bat was a load of rubbish, a bowel chart that took 5 minutes to do everybody took forever just to do one person so we gave that up in about 2 shifts flat.

The only saving grace of icare has been that I can check up on what's been going on in the last week with the click of a button (or several) which is great because I only work 2 shifts.

pfongk · Jul 24, 2008

I'm currently working as a PCA in an aged care hostel. ACFI has definitely had some teething issues. Hopefully once we get the hang of things it will be better. We're still paper based which if we can get our way will be changing, I'm not holding my breath though (management is cheap). I think part of the problem with us is the fact that we don't actually have an RN or a night shift in the hostel, we can borrow an RN from the adjoining nursing home if we need them and the night staff do do rounds in the hostel. I haven't actually done any out of house training though which I think is not the best idea as only the hostel manager who is a PCA with her cert IV has and she is asking me all sorts of questions on it. I do like the fact though that I'm not having to write pages upon pages on the same thing every day as I had to with the RCS schedule.

MicStar · Jul 26, 2008

rubystar

we started using icare Oct 2007, it has it pit falls but if I compare it to when we were paper based, it is so much better. I have heard mixed reports about the other software programs out there, and not all good.

MicStar · Jul 26, 2008

SITE MANAGERS / D.O.C. / D.O.N. / RESIDENTIAL CARE MANAGERS

I am going to attempt to create another thread to compliment this one, a thread to allow discussion amongth aged care managers, CNs / CNCs, Residential Care Managers etc.... :caduceus: :redlight: :nuke:

Grace Oz · Aug 8, 2008

[/qens working in team leader roles, or roles traditionally done by rns, should there be an extra level created/pay point for these nursesuote]
i thought this was already in existence?
ens should have a career structure in aged care!
can you elaborate on this please? what would your proposal be?

MicStar · Aug 13, 2008

[/qens working in team leader roles, or roles traditionally done by rns, should there be an extra level created/pay point for these nursesuote]
i thought this was already in existence?
i believe in some states of australia there is a level, however not in sa - can you provide feed back from your state?
can you elaborate on this please? what would your proposal be?
ens working in independant hostels with ageing in place operate with 60% level of high care residents most of the time (of course this can vary). the ens are at times in-charge of the facility, and work at an advanced senior en level (are a resource to less experienced ens, provide guidance to care staff, administer ddas, insulin) and hence should be paid at an advanced level. these ens are doing the drug round, assessing residents and basically managing the floor.

sunnie16 · Aug 28, 2008

The ENs are at times in-charge of the facility, and work at an advanced senior EN level (are a resource to less experienced ENs, provide guidance to care staff, administer DDAs, insulin) and hence should be paid at an advanced level. These ENs are doing the drug round, assessing residents and basically managing the floor.

This is so true! In my first year out of TAFE after I finished my EEN course, I was doing all of the above. In our facility on all afternoon shifts the EENs are the senior staff managing the floor. We definanatly take alot of the traditional RNs role which I don't mind at all but at the same time, with the extra responsibility should come extra pay... Then again there are the PCs and AINs who are doing alot of the ENs traditional responisibilities and getting paid pennies! They deserve more as well...

DaisyDoodle · Aug 31, 2008

I'm from the U.S. and I work in a nursing home. I am wondering how different we are from what you have. We call it Elder Care. There is a big push now in the United States to make the image of nursing homes seem more like a home and not an institution. I was wondering if you have heard of the Eden Alternative.... it is bringing the outdoors in to the facility. Bringing life in to the facility. For example, we can bring out pets into the facility. I bring my dog to work everyday. This is just very basic. If you have some time, I would really like to have some discussion about how nursing, especially geriatric nursing works in your country. Do you have LPN's? Licensed practical nurses or only RN's. We have both. The LPN's have less school and are limited by the duties that they can perform. The biggest difference is that they are not able to document that they "assess" it is only the nurse that can do assessments. Well, if you have time, I'd like to chat and share exchange information about our countries.

MicStar · Sep 1, 2008

I'm from the U.S. and I work in a nursing home. I am wondering how different we are from what you have. We call it Elder Care. There is a big push now in the United States to make the image of nursing homes seem more like a home and not an institution. I was wondering if you have heard of the Eden Alternative.... it is bringing the outdoors in to the facility. Bringing life in to the facility. For example, we can bring out pets into the facility. I bring my dog to work everyday. This is just very basic. If you have some time, I would really like to have some discussion about how nursing, especially geriatric nursing works in your country. Do you have LPN's? Licensed practical nurses or only RN's. We have both. The LPN's have less school and are limited by the duties that they can perform. The biggest difference is that they are not able to document that they "assess" it is only the nurse that can do assessments. Well, if you have time, I'd like to chat and share exchange information about our countries.

Hi DaisyDoodle

We are regulated for 44 Standards this regulation is monitored by the Aged Care Accreditation Agency, which is an organisation set out to monitor homes; the emphasis is on residents lifestyles, continuous quality improvement and when audited they want to see REAL results for residents. Yes the atmosphere is to make the environment home like, most facilities built these days look like modern apartments...

We have ENs (Enrolled Nurses) who are equivalent to your LPN, RNs assess, very similar roles it would seem. We prodominantly have ENs working in low level care facilities and RNs working in high level care facilities (2 sorts of facilities HIGH CARE or LOW CARE). THe site manger of a low level care facility is usually the only RN on site. But these day low level care facilities having 'ageing in place' approval which means the resident can stay at this site if they proceed to high care; in the past low care residents who 'for example' had a stroke and required high care, couldnt go back to their home and needed to be moved to a high care facility..this is not the case anyone with the agine in place concept.

Let me know how this compares to you facility in the US

DaisyDoodle · Sep 1, 2008

Hi DaisyDoodle
We are regulated for 44 Standards this regulation is monitored by the Aged Care Accreditation Agency, which is an organisation set out to monitor homes; the emphasis is on residents lifestyles, continuous quality improvement and when audited they want to see REAL results for residents. Yes the atmosphere is to make the environment home like, most facilities built these days look like modern apartments...
We have ENs (Enrolled Nurses) who are equivalent to your LPN, RNs assess, very similar roles it would seem. We prodominantly have ENs working in low level care facilities and RNs working in high level care facilities (2 sorts of facilities HIGH CARE or LOW CARE). THe site manger of a low level care facility is usually the only RN on site. But these day low level care facilities having 'ageing in place' approval which means the resident can stay at this site if they proceed to high care; in the past low care residents who 'for example' had a stroke and required high care, couldnt go back to their home and needed to be moved to a high care facility..this is not the case anyone with the agine in place concept.
Let me know how this compares to you facility in the US

It sounds like where we eventually want to be. We are regulated by state and federal agencies. The age in place concept is something that has been done in our country I would say over the last 10 years and still has not been perfected because of the regulations. We are getting better at assessing people to see if they are able to stay in their current environment or move them to a different environment with a higher skill level. For example, in the community that I work at we have independent living cottages where people live on the campus independently but have everything taken care of such as painting and lawn work, etc. Then we have assisted living where the residents need little things done such as medication reminders, laundry, help with ADL;s. There is no real clear tool until recently that our facility could use to move the people that cognitively were no longer able to stay at the assisted living. We would get resident with multiple falls that would be transferred to us with a fracture and then have to stay with us. I always questioned, why are we waiting for the fracture? There has to be a tool. Now, we use a whats called Lifesteps and it is recognized in our line of business. It tests different areas such as cognition, balance, etc. I wish we could have a true age in place where the resident could actually stay in their own place till they expired but we don't. We have facilities that usually have 3 levels of care like mine, independent, assisted, then skilled and we move people along. As you can imagine, no one wants to wind up at the skilled... because that means it's the last stop. :no: