Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Experiences of Graduate Registered Nurses in Aged Care: A Case Study

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Experiences of Graduate Registered Nurses in Aged Care: A Case Study

Article excerpt

INTRODUCTION

This study responds to the impending lack of Registered Nurses (RNs, referred to as RN Division One in Victoria) to care for the nation's elderly. The shortage of qualifi ed aged care nurses has occurred at a time when the demand for aged care services is increasing. Previous studies have identifi ed that the majority of new graduate RNs choose not to work in aged care (Happell, 1999; Moyle, 2003). However, little is known about the experiences of new graduate RNs who accept a position in the aged care setting in their graduate year. This study was conducted to gain insight into the experiences of new graduate RNs from a diverse range of aged care settings in metropolitan and regional Victoria in order to better inform future recruitment and retention strategies. Semi-structured interviews, using questions derived from the literature, were used to elicit the new graduate RNs' experiences of aged care nursing. Comparative analysis of participants' responses provides a deeper understanding of the issues impacting on their experiences.

BACKGROUND

Demographic and policy changes have impacted heavily on both service providers and consumers of residential aged care facilities (RACFs) in Australia. The national introduction of the 'Ageing in Place' policy, an objective of the Commonwealth's Aged Care Act, 1997, encouraged and enabled older people to be supported with services to assist them to remain in the community for as long as possible (Aged Care Act, 1997 cited in Commonwealth Department of Health and Ageing, 2002). Consequently, those who live in RACFs have a higher degree of dependency and frailty than previously, with 86% of such residents assessed as being high-care status in 2006 (Australian Institute of Health and Welfare, 2007).

The need for an increased number of RNs with specialised aged care training and nurse specialist entitlement has been emphasised in several papers (Ford & McCormick, 2000; Illefe & Kennerson, 1995; King, 1995; Moyle & Kellett, 1996; Stolley, Buckwatelter, & Harper, 1995 cited in Pearson et al., 2001). The importance of recognition of qualifi cations, provision of opportunities for professional development, and structured career progression within the aged care sector is essential in retaining qualifi ed staff and recruiting new nurses to the fi eld (Pearson et al., 2001). To this end, the Aged Care Nursing Scholarship Scheme, an Australian Government initiative, was initiated to encourage people to enter aged care nursing and increase the skills of nurses working in the aged care sector, by the provision of undergraduate aged care nursing scholarships and post graduate education support (Senate Community Affairs References Committee, 2005). The effects of such fi nancial incentives are yet to be seen.

The overall number of RNs working in aged care is declining (Senate Community Affairs References Committee, 2005). A review of the aged care nursing work force revealed that only 18% of RNs working in this area were permanent full-time employees (Richardson & Martin, 2004). Additionally, inferred retirement rates found that 37% of the 2002 aged care nursing workforce would retire over the next ten years, compared with 26% in other spheres of nursing (Australian Health Workforce Advisory Committee, 2004). Finally, the Australian Nursing Federation (ANF) (Victoria) commented that '[in] Victoria the skills mix of RNs to residents had fallen from an average of 1 RN to 30 residents across all shifts in 1997 to 1 RN to 60 residents during the day, out to 1 RN to 90 or 120 at the evening and night shift' (Senate Community Affairs References Committee, 2005, s.2.13).

These workforce issues persist in the context of an increasing acuity of older people in RACFs and there is concern that it will become increasingly diffi cult to fi nd the number and quality of staff required to care for a growing number of increasingly dependant elders. In 2007, as part of a national response to current needs and projected increases in demand for RN graduates by the Australian Government (Karmel & Li, 2002), 5100 new undergraduate nursing places were offered over fi ve years. …

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