Dr Darren Kilroy - Medical Director (International) , RLDatix
I still vividly remember a particular night when, working as a junior doctor in a Sydney Emergency Room, a very elderly man came into the department accompanied by his wife and their carer. He’d had a fairly minor fall but had been very shaken by the circumstances, and his visit was more one of reassurance than anything else. And yet, as I finished and chatted to them, having organised some painkillers and ensured they had transport arranged back to the residential home that he and his wife now both lived in, he gripped my hand and fixed me with a look which I can see even now. “Thanks doctor,” he said to me “for all that you’ve done. It’s no fun being this old and I was scared when I fell. I thought it might be the last time I saw my wife, you see, and we’ve been together 52 years.” Quick as a flash the carer cut in. “Don’t be daft Raymond,” she admonished him. “You two have got years together yet”. And the three of them laughed infectiously. I found myself joining in. As I left the cubicle, the carer was handing them biscuits and they were talking animatedly.
I share this anecdote because it was one of the very first occasions on which my subsequent lifelong passion for aged care – the need for a safe and high-quality experience for the older and more vulnerable amongst us – first took hold. Over the many years that followed in my career as an Emergency Physician, the particular challenges but, moreover, the unique rewards of helping to care for old and frail people became prominent and important in everything that I did. The nurses I saw around me who had given their professional lives to this specialty never failed to impress me with their kind pragmatism, their ability to overlook any number of obstacles and their stoicism in the face of meagre resources and, so often, equally meagre respect and interest from other colleagues.
And that last problem – the place of aged care in the professional landscape as our older population grows and we all place additional demands on the capacity we have at hand – is now a wicked and frustrating one, fuelled by an inadequately-sized workforce leading to a scrabble between organisations for staff, the grass-is-greener temptations of an alternative career outside of health, and the global context of far more elderly patients needing help than we can ever hope to accommodate based on the current recruitment position we see around us. So what’s to be done right here and how?
Simplistic as it may seem, we can only do what is within our gift to do. We’re through with admiring the problem. We can start by reaffirming aged care nursing as the thing it always was and always should have been – the most privileged of careers, a career to aspire to, to develop within, to grow into and to celebrate.
There’s simply not enough of that going on.
Are we thanking aged care staff enough for what they do? Are we promoting the superb work they do, in whatever way we can? This isn’t about awards ceremonies or prizes, it’s about quietly but consistently promoting aged care as a career choice, one that holds promise, fulfilment and reward.
Where we see attrition to non-healthcare sectors we need to be attuned to the reasons why and deal with them. Better conditions of work and rostering governance in the local supermarket or online delivery company? Let’s see those conditions and work through those rostering attractions and match them. If we can’t, let’s articulate the differences and advocate for change.
Competition between aged care providers for what resources there are? Let’s collaborate. It’s not easy. Nobody pretends it is. But head-to-head bunfights for workforce never end well for anyone and are often a race to the bottom in terms of sustainable workforce models, that utterly fail to put the aged patient at the centre of any of it.
Let’s see what we can do with real-terms incentives to join the superb professional collective that is aged care nursing. Staff development. Properly planned, meaningfully executed training and recognition for career progression. A sense of pride in the job. Our nursing community needs this help. We can do it. It needs effort and can seem frustrating when the narrative is stuffed full of inexorable demand and endless queues for care. But we have to be determined and tenacious.
It’s a call-to-arms to support aged care and get it onto the pedestal it deserves. But I don’t suggest we do it for publicity, for remuneration nor even for the satisfaction I know I would bring. I think we should do it for Raymond.