Risk of too many unsupported new graduates in rest homes a 'concern'

25 May 2016

A survey confirming rest homes are employing high numbers of new graduates with no guaranteed mentoring is an "ongoing concern", says the nurses union NZNO.

The latest graduate survey shows that around 90 new nurses were employed in residential aged care. But only 30 places had been approved and offered this year under the NETP (nursing entry to practice) programme that requires rest homes to provide registered nurse mentoring and structured professional development for the novice nurses.

Hilary Graham-Smith, associate professional services manager of the New Zealand Nurses Organisation (NZNO), says unfortunately it too often sees the results of new graduates going into aged care outside of the NETP programme. 

"We know what the RN staffing is like in some aged care facilities and it's probably not adequate in providing the kind of mentorship and support that new graduates need," said Graham-Smith. "So often new graduates find themselves quite quickly into positions of responsibility where they are in lead roles with a number of caregivers under their direction and delegation. There may be RN support at the end of the telephone, or at the other end of the facility, but if there is a crisis or a serious situation then that is not always adequate." 

She said the result can be new RNs getting into difficulty and ending up in front of the Nursing Council.  "Or just being so petrified about what is going, and feeling so unconfident, that they leave.  And potentially can be lost to the profession at that time as well."

Statistics from ACE, the new graduate placement system, showed the number of new nurses employed in aged residential care  (ARC) under supported NETP (nursing entry to practice) programmes remained low at 30 - despite being a targeted priority for NETP places.  But the latest graduate survey shows rest homes did take on high numbers of new graduates – just outside out of the NETP programme. 

The annual March survey by NETS (Nursing Education in the Tertiary Sector) of nurses who graduated in November showed that around 90 new graduates were working in the continuing care elderly (aged residential care) sector – just under 10 per cent of the 946 surveyed graduates who said they were working as nurses.

Jane Bodkin, the Ministry of Health's acting Chief Nursing Officer, acknowledged that the difference between the ACE data and NETS survey results showed there are graduates employed in continuing care elderly who may not be supported in a NETP programme.

She said the Ministry supported the vision that all New Zealand nursing graduates start their careers supported by a NETP programme including graduates working in continuing care of the elderly.

"We know that many DHBs support graduates employed in aged care on NETP programmes even when they do not qualify for Health Workforce New Zealand (HWNZ who fund NETP) funding because, for example, they are working less than 0.8 FTE.

She also said many DHBs are working with local aged care providers to build their capacity and to support new graduates including ensuring they have adequate trained preceptor support and, in some cases, input from clinical nurse specialists and nurse educators.

"The Nursing Workforce Programme is about to establish a working group to identify and implement actions to grow the aged care workforce this will include actions to support new graduates in this sector."  

Health Workforce New Zealand and the Office of the Chief Nursing Officer have developed a workforce forecasting model that estimates there will be 656 fewer registered nurses working in continuing care elderly by 2025, a 15 percent decline. The Office said earlier this year that building the residential aged care workforce would be a focus, including encouraging more new graduates into the sector and ensuring they are supported in their first year of practice.     


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