But last year it was predicted by the Ministry of Health that the aged care registered nurse workforce would fail to meet the projected need in 2025. The New Zealand Nurses Organisation (NZNO) also points out that many aged care nurses are at retirement age and the nursing needs of aged care facility residents keep getting more complex and demanding.
Yesterday Wagner released Nursing Council annual practising certificate data which showed that the number of registered nurses (RN) who said they were working in a continuing care (elderly) setting had grown 22 per cent between 2011 and 2016 from 3405 to 4142 – a higher proportion than the 13 per cent growth in the general RN workforce. Of these nurses 82 per cent were employed in rest homes or residential care settings, another 7 per cent in private hospitals and 11 per cent were employed by District Health Boards.
A new nursing workforce forecast model released last year, developed by the Office of the Chief Nursing Officer and Health Workforce New Zealand predicted a “significant decline” by 2025 in the proportion of aged care registered nurses required to meet the projected need of the ageing population. Plus a steep decline in the number of enrolled nurses, dropping by 28 per cent, which would impact particularly on the aged care sector where many of them worked.
Wagner said the Nursing Council statistics showed the number of RNs working in rest homes and aged care facilities had increased significantly since 2011 and was “more than keeping pace with New Zealand’s growing need for dementia, hospital and psychogeriatric care”.
“The number of people receiving longer-term hospital level care — where most registered nurses are employed — increased by 17 per cent, while the total number of people receiving aged residential care increased by just 5 per cent,” said Wagner. “This tell us we’re staying ahead of population growth and the rising demand for these types of services.”
Lorraine Ritchie, NZNO professional nursing advisor, said statistics are hollow and meaningless without context and if there had been an increase in RN numbers in the past six years there had also been an increase in acuity. “Residents are sicker, older, frailer, require more complex nursing and medical attention such as palliative care, dialysis and challenging situations with residents with dementia.”
The recently published New Zealand Aged Care Workforce Survey also showed that the most common age group of aged care nurses was between 55 and 64 (31.1), a further 5.4 per cent were over 65 and nearly a quarter were between 45-54 – so in total just under 60 per cent were aged over 45. Ritchie said NZNO advisors and nurses in the sector were concerned about what would happen when this nursing workforce started retiring from the physically demanding and hard work as new graduates generally did not choose to enter residential aged care and the setting may even be less attractive now that their pay may end up relatively the same or less than some caregivers.
Last year’s workforce model predicted that while the overall RN workforce was predicted to “almost keep pace” with population growth the ratio of registered nurses in continuing care elderly per 100,000 people would decline by 24 per cent. The impact was predicted to be even more significant when compared to the ratio of RNs for the population aged sixty plus where the ratio would decline by 38 per cent. Also impacting on continuing care elderly services, was the decline in enrolled nurses which impact not only on continuing care (elderly) but also assessment treatment and rehabilitation (ATR) and district nursing services.
At the time of the release of the Nursing Workforce Forecasting Model, Chief Nursing Office Jane O’Malley said the Model showed that further work was particularly needed in the area of aged care and the Ministry’s Nursing Workforce Programme has submitted a paper to the HWNZ Board on beginning specific work related to the aged care sector.
Wagner said District Health Boards spend more than 40 per cent of their $12 billion budget on providing health and disability services to people aged 65 years and older. This age group makes up around 15 per cent of the population.
“Based on the forecast growth of this age group, this spend is expected to rise to 50 per cent of DHB expenditure by 2025/26,” Ms Wagner said.
“In the last six years, the total spent by DHBs for older people’s support services, including aged residential care, home support and hospital rehabilitation, has increased by 23 per cent or $302 million.”
NB article updated May 26 to include NZNO comment
