The aged care industry is currently navigating a transition brought on by landmark legislation, including wage increases across the board, adjustments to required care minutes, and the 24/7 registered nurse (RN) responsibility, which was introduced on the 1st of July, 2023. These changes, in the wake of the Royal Commission into Aged Care Quality and Safety, aim to improve conditions while also addressing the challenges of employee retention and attraction to the sector.
Facilities will respond to this in various ways, depending on their size and scale, but the changes highlight how an industry in transition is nonetheless experiencing an intensified demand for RNs, and, as a result of the 24/7 RN requirement alongside the attraction of recent wage increases, many new nurses are entering the sector. Without dedicated attention to upskilling these new RNs, however, we risk amplifying an existing problem.
Today’s article details how facilities may respond to the 24/7 RN requirement, explores the continually evolving challenge of the experience-complexity gap and how now is our chance to close it via education, not widen it further.
3 ways facilities are responding to the 24/7 RN requirement
Facilities will have varied responses to the 24/7 RN requirement, shaped by their existing size, structure, and capabilities. The spectrum of reactions can be divided into three main categories:
Firstly, smaller facilities, particularly those in rural communities, may grapple with the 24/7 RN requirement due to resource limitations in their immediate region. It is important for facilities of this size to look towards the exemption criteria outlined by the Commission, though the application could be long and arduous. It is likely that in these circumstances, senior care workers may need to take on additional responsibilities such as liaising with GPs and clinicians in emergency situations. Nonetheless, these facilities will be some of the most vulnerable and challenged by the new legislation, due to infeasibility of having a 24/7 RN.
In the second scenario, the facility cannot meet the exemption requirements, and will require sourcing a RN for their facility. Considering the recency of the requirement’s introduction, many of these facilities may find themselves currently within a transition period, looking for or training new RN staff on the complexities of aged care. These facilities will be experiencing the strain of training new RNs the most, though will be provided additional support via the 24/7 RN supplement.
Lastly, a large proportion of facilities already have a 24/7 RN in place. For these facilities, the challenge lies in upskilling their existing staff to meet the new reporting requirements and also refocussing on the importance of the RN and ensuring adequate training is provided, particularly to those who are still relatively new to the industry.
Empowering new RNs with education
With these changes, alongside recent wage increases, there is the potential for improvement in the longer term around resource shortages across the sector. However, the persistent challenge of the ‘experience-complexity gap’ still lingers, and could potentially widen if education is not used to complement the recent 24/7 RN requirement.
The ‘experience-complexity gap’ is the problem of retaining experienced nurses and the total years of experience in the industry gradually falling, relative to the increasingly complex health conditions, comorbidities and challenges that residents are facing. These all need heightened levels of experience that is just not available readily for new nurses.
Therefore, education in aged care is now more important than ever, ensuring we can quickly and responsively build new RNs into a workforce ready to navigate the complexities of an evolving sector. And this does not just involve clinical skills, but also the ability to delegate tasks, manage nighttime supervision, correspond with doctors and pharmacists in times of clinical deterioration and delineate the boundaries of their responsibility versus that of care workers.
Here are some key ways you can upskill new RNs to take on the responsibility of the 24/7 nurse requirement:
Develop training plans tailored to new RNs in aged care, to help them both adjust to the new 24/7 schedule and also more generally up-skill.
Set up a mentoring and coaching plan. This can involve pairing your new or inexperienced RNs with highly skilled nurses or senior staff. Find one hour each fortnight for a coaching session around delegation, conflict resolution, clinical risk and handover skills.ce topics such as… delegation, conflict resolution, identifying clinical risk, handover skills.
Prepare RNs effectively for clinical deterioration including how they may co-ordinate with doctors or paramedics in overnight hours.
How Ausmed can help
Ausmed’s LMS and Learning resources are a perfect way to improve RN's learning outcomes and up-skill them for the complexities of aged care. Not only is it possible to assign tailored Training Plans to your RNs, but a variety of Learning is available that teaches valuable aged care-relevant skills, such as:
Supporting Activities of Daily Living: Ambulating and Transferring
Supporting Activities of Daily Living: Continence and Toileting
The Ausmed App can also ensure that RNs have access to learning resources and organisational policies at any opportunity. This means that learning can be immediately applied, ensuring it is learnt via action, not just in theory.
Ausmed is here to support you through the challenging times ahead for aged care. We want to ensure your workforce is not only competent, but are also building a career of continuous learning they can be proud of. Reach out to your Ausmed customer support specialist to learn more.
References
Australian Government Department of Health and Aged Care (2023a) 24/7 registered nurse responsibility, Australian Government Department of Health and Aged Care. Available at: https://www.health.gov.au/our-work/care-minutes-registered-nurses-aged-care/24-7-rns (Accessed: 19 July 2023).
Australian Government Department of Health and Aged Care (2023a) 24/7 registered nurse supplement for Residential Aged Care, Australian Government Department of Health and Aged Care. Available at: https://www.health.gov.au/topics/aged-care/providing-aged-care-services/funding-for-aged-care-service-providers/247-registered-nurse-supplement (Accessed: 19 July 2023).
Australian Government Department of Health and Aged Care (2023) Exemption from the 24/7 RN requirement, Australian Government Department of Health and Aged Care. Available at: https://www.health.gov.au/our-work/care-minutes-registered-nurses-aged-care/24-7-rns/exemption (Accessed: 19 July 2023).
Nursing Executive Centre (2019) The Experience-Complexity Gap . New York: Advisory Board. Retrieved from: https://www.advisory.com/topics/nursing-care-quality-and-service/2019/06/the-experience-complexity-gap (Accessed: 19 July 2023)
