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Removing the stigma attached to nursing in aged care

on Wednesday, April 30, 2014

Nursing students in Queensland are among the first to trial a new placement program that promotes a holistic approach to aged care.

Around 60 First year Bachelor of Nursing students have piloted the Positive Placement Program (+PPP), an initiative set out under Griffith University’s Centre for Health Practice Innovation and the School of Nursing and Midwifery.

In groups of 15, the students have completed two week cycles at RSL Care Carrington Retirement Community and RSL Care Cazna Gardens Retirement Community, where they have been assigned to work directly with residents, rather than shadowing the steps of a personal care worker (PCW).

Griffith University senior research fellow Lorraine Venturato said this model for placements has given students a greater understanding of the leading role that the registered nurse (RN) should play in aged care.

“In the past I’ve asked students feedback about what they think RNs do and they’ve given responses like: ‘nothing,’ ‘they sit in an office,’ and ‘I don’t know what they do because I never see them.’  

“Part of the impetus of this program is to change that perception. A good RN should bring a degree of oversight, be able to work with families and provide direction to other staff,” Ms Venturato said.

Students are assigned a small group of residents to work with closely, usually two from low care and one from high care. They are required to access and update their personal profile and interact with the range of health care professionals and staff that contribute to the care of the individual, which may include their family or social contacts as well.

“It’s important for students to be able to place residents in a social setting –They are no longer the frail older member of an institution but a part of a family,” Ms Venturato said.

“One of the positive changes of the program was not only their perception of working with older people, but their attitudes towards older people in general."

Ms Venturato said the motivation behind achieving good quality nursing in aged care is not the cure, which gives the satisfaction of "fixing" people, as in the acute setting, but rather rewards from the care itself.

“You need to know people - the better you know the person, the better quality the care,” she said.

“It’s not about having the biggest MMR machine or the latest drugs, it’s about personal interactions," she said.

“If we send our students out to do as many showers and stick as many needles in as possible, we’re marginalising the idea of aged care.”

Ms Venturato said students are attracted to the adrenaline of crisis they experience in acute care.

“You never see TV shows about nurses in a nursing home. It’s always acute-focused. There’s a whole interdisciplinary team and it’s a matter of life and death.

“In aged care it just moves at a different pace, but there is a degree of autonomy that is not evident in acute care.”

“I love that as a clinician in residential care I might have to deal with a fractured neck of femur, congestive cardiac failure and urinary tract infection in one day, as well as the family issues that may go with that.

“I may also make someone’s day by stopping for a chat while I do a dressing.”

Residential staff worked in conjunction with clinical practice coordinators to develop the program, so when the time came to begin placements students entered a collaborative environment with a clear idea of where to go if they have a question or initiative.

Ms Venturato said that RNs and PCWs from RSL Care underwent the same 12 month training program as the university facilitators, resulting in a wholly congruent learning experience for students.

“The staff were much more excited to have the students come through because they had a clear idea of their role. In previous programs they have been unaware what students were and weren’t allowed to do.”

Ms Venturato said person-centred care is recognized as the gold standard in aged care, but in reality students are largely assessed on skills and task performance.

“This model offers one way of starting to transform the culture of aged care to one that is more person-centred.”

Image: Dr Lorraine Venturato. CONTRIBUTED.

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