workforce they don ’ t have the kitchen , they don ’ t have the freedom , they don ’ t have the ability to welcome anyone anytime . They don ’ t have the familiar things around them . They can ’ t get up whenever they want . They can ’ t eat whenever they want , whatever they want , as much as they want . There are so many differences .”
Bernoth says the COVID-19 pandemic has shown that the lack of qualified staff in the sector is a critical issue and that government , and just as importantly the aged care industry itself , must act to remedy the problem they created .
“ The government ’ s worried about the employment rate . What a fantastic opportunity to open up some more courses for care workers , more refresher courses for registered nurses , and make working in aged care something that ’ s attractive and something people want to do , and provide the courses to enable them to go in there ,” she tells me .
“ But it ’ s not just the government . It ’ s the industry . Industry ’ s got to pick up , you know ? Industry ’ s depleted this system to a criminal extent . Industry ’ s got to play a part . They ’ ve got to stop with the spin , start looking at what ’ s gone wrong , and make genuine attempts to improve the system . That ’ s attractive then to people coming to work there .”
Why would anyone want to work in aged
“
Registered nurses working in aged care need to be role models and encourage people into aged care . care at the minute ? I ask her . And she agrees . The lack of pay parity for nurses in aged care versus hospitals is a hurdle and the scrutiny the aged care industry is currently experiencing is enough to put anyone off . But it ’ s a good challenge , she says , and a good career path for school leavers . We just need to remind people of that fact again .
“[ Nursing students ] don ’ t always see the best of aged care . Often , they ’ re working as assistants in nursing and don ’ t get to see the registered nurse ’ s role . The registered nurses working in aged care need to be role models and encourage people into aged care , as well . But also , there ’ s not a career pathway .
“ There ’ s not a transition to practise pathway for graduate students going into aged care . And then when they ’ re in there , skilled , unless they want to go into management , there ’ s not a clinical nurse specialist or nurse educator or that sort of role for them to move to ,” she says .
Mandated staff ratios would be a good start in fixing the issue , she says , as would some government intervention , making it easier for nurses to pursue post-grad qualifications . Industry , too , should provide good career advancement options .
Everything Bernoth says makes total sense and she , along with a group of aged care academics and advocates , have been signing the same tune for a while now , but successive governments don ’ t seem to be music fans .
I don ’ t mean to be a cynic , I tell her , but we ’ ve known about these issues for a while now , so is she confident anything will change post-royal commission ? “ No ,” she says before I can finish my sentence . “ I ’ ve been talking about abuse and neglect in aged care since about 2006 . I published my first paper about older people dying from malnutrition in about 2012 . I took that to the bureaucrats in Canberra . I took it to the federal government , and nothing happened ,” she says .
“ I presented it at a conference to aged care providers , thinking that would make a difference . At the end of me talking about how older people are dying of malnutrition , one of the CEOs of an aged care organisation said to me , ‘ What a shame you can ’ t say something positive about aged care ?’
“ So , no one ’ s listening . It ’ s caused me a huge amount of stress …” Her voice starts to break and is now strained as she struggles to hold back tears . “ To know people are dying . And no one will listen , and then this happens , COVID happens .”
There is a heavy silence on the other end of the line . I manage to break it with an awkward : ‘ Are you okay Maree ?’ and tell her I understand her frustration . “ It ’ s not frustration . It ’ s anger . And a terrible sadness ,” she tells me . I try and empathise . It can be hard to write about aged care sometimes , I say , listening to the same conversations and seeing the same outcomes , the same horror stories of neglect can , at times , feel like the very definition of insanity .
“ Australia as a society has been aware of it , there ’ s been publications about it in the press . But there ’ s been no huge outcry . We have Black Lives Matter and certainly black lives do matter , yes , but we have a huge outcry . There ’ s public out in the street , we have demonstrations , but when older people die , it doesn ’ t seem to quite resonate with people as much . “ Maybe it goes along with what Mr Abbott was saying , maybe we should sacrifice some older people for the benefit of the younger people . Is that how society feels ?”
And now I ’ m angry too , and I feel like giving up . So why would anyone keep pursing this , keep banging on the door ? “ Because I worked in aged care when it was fabulous . I ’ ve worked in aged care since 1985 and I ’ ve seen the difference that skilled registered nurses in aged care can make . I ’ ve also worked in the community and it ’ s amazing the difference you can make to people ’ s lives , but the driving force for me is that I can ’ t get the images out of my head of what I ’ ve seen , and then with my research , what I ’ ve heard ,” she says , again , with no hesitation .
“ So , to live with myself I have to ... I want to , as long as the research tells me that it ’ s going on , I want to be an advocate for older people .”
Bernoth feels strongly . She feels strongly about aged care , and takes her job , teaching the next crop of nurses , seriously .
“ It ’ s about changing their attitudes . It ’ s getting them to think differently about working with older people . It ’ s about building that level of excitement and letting them know just how sophisticated it is to be a registered nurse in aged care .
“ That ’ s a privilege for me , to be able to influence them like that . It ’ s not about talking about all the negative things that are happening . It ’ s trying to encourage them to think about the positives and those skillsets , and if the young students want to , or if any student wants to make a difference , aged care ’ s certainly a place to go .
“ A registered nurse working in aged care has so much opportunity to use their assessment skills , really sophisticated assessment skills , and make a difference in people ’ s lives .
“ A small thing in aged care can make a huge difference to the older person ’ s life , but you have to know what that thing is . That thing comes through assessment skills .” ■
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