Survey highlights aged-care issues

1 February 2010

Unregulated caregivers are frequently being called on in residential aged-care facilities to do registered nurse tasks, a caregiver survey has found.

The New Zealand Nurses Organisation survey gained responses from nearly 300 of the union’s 1000 caregiver members invited to take part in the snapshot survey.

NZNO researcher Leonie Walker said the survey focused on the nature and extent of training, the work undertaken and their perceptions of the role and issues they face.

She said in spite of previous reports highlighting low levels of literacy and training in aged-care, the survey results show that many caregivers had undertaken a number of modules and courses related to their work. But there was unease over the “variable quality of training” and the confusion around “routine clinical tasks requiring the expertise of a RN and those relating to personal care”.

Walker said unregulated caregivers were frequently being called upon to undertake RN tasks.

“Medication is ‘very frequently’ given out without clinical supervision, and both blood glucose monitoring and catheterisation are ‘frequently undertaken’.”

Many caregivers reported anxiety about doing work they felt they were neither trained nor paid to take responsibility for, but often there was no alternative. Walker said without the right mix of staff – with appropriate clinical training and professional oversight and accountability – the quality of care was compromised and that put both staff and residents at risk.

Walker said there had been sector-agreed standards for achieving the right mix of staffing and resources since 2005, when the voluntary New Zealand Standards handbook Minimum Indicators for Safe Aged-care and Dementia-care for New Zealand Consumers, was published. Two NZNO surveys since had indicated that staffing levels in the majority of aged-care facilities fell well below the minimum levels indicated for safety. “NZNO has repeatedly called for the Standards New Zealand handbook to be updated and made mandatory, to ensure safe aged-care. We are hopeful that now is the right time.”

Respondents did report good access to, support from, and relationships with RNs at their worksites. Also, despite poor pay and the challenges of working in the sector many of the respondents loved their work.

The survey respondents were 94 per cent female and aged 20 to over 65 but with the most common age group being 51-60 – which is slightly older than the registered nurse workforce.

NZNO industrial adviser Rob Haultain said it was vital that the government support quality care in the sector through prioritising training for caregiving work, pay being linked to training and skills development, clear role definition and rigorous auditing.