Why I choose to work in aged care

By Melissa Cromarty, APNA Board member and clinical manager at an aged care facility in regional New South Wales

Some of the most heartfelt and heart-warming experiences in my nursing career have occurred in aged care.

It has been a privilege to be part of 60th wedding anniversaries, 100th birthday celebrations and to be at a person’s bedside when they take their final breath.

In fact, caring for an individual at the end of life is just as special as being the midwife who helps deliver the baby. Ensuring that person is comfortable and pain-free during their palliation is deeply rewarding in its own way. Providing comfort for their extended family is also very empowering.

As a nurse in aged care, you not only support the clinical needs for each resident but also play a more social role for them and their families. This includes helping to plan and execute activities based around social, personal, nutritional, hygiene and spiritual needs. It makes the job dynamic and interesting.

I turn up every day and feel that I absolutely make a difference to the lives of those I care for.

"It is a joy having the residents as part of my life; I feel so lucky to have so many ‘grandparents’."

Of course, there are challenges when dealing with complex health problems, multiple medications, mobility and disability issues, as well as emotional disturbance relating to ageing and loss of a partner.

Finely attuned clinical skills are required, with a broad knowledge and skill base to be able to detect and action early signs of clinical decline.

In addition, a good understanding is required of best practice management for chronic conditions such as diabetes, heart disease, COPD/asthma, cancers, chronic pain syndrome and arthritis. Broad experience caring for those living with dementia and severe behavioural and complex mental health conditions is also beneficial.

The clinician is required to be ambitious and willing to work to full scope of practice as we tend to ‘do the lot’. We need to be confident and skilled to make appropriate judgement calls based on our clinical assessments so any assistance needed by our residents can be triaged, including provision of medical support in a timely manner.

As we all know, COVID-19 has brought its own challenges. Social isolation due to visiting restrictions was particularly difficult for many of our residents and their families. We tackled this by creating short video messages for the residents to send to relatives. Some were funny while others simply broke your heart. For the families, it was reassuring to hear from their loved ones and see them smiling, safe and cared for.

Sadly, we have endured loss during the lockdown period with several of our long-term residents. The impact on families has not been helped by restrictions on funeral arrangements. For some residents whose families live interstate, the palliation period for their loved one has been even more stressful from afar.

I am often asked what changes need to happen in our sector. We certainly need funding to attract more trained nurses back into this important part of the primary health care system. While our care staff do an amazing job, they could be better supported with more trained nurses.

We also need to change the funding models to better utilise the diverse skill mix of nursing staff. For example, as a Registered Nurse I am trained in cannulation and the administering of intravenous antibiotics. If I was able to do this in an aged care setting, this would help avoid patient transfers to hospitals for treatment for conditions such as acute urinary tract infections.

I would also love to see more nurse-led clinics with a proactive focus on aged care. We could absolutely change the way services are provided to our older people if the funding model was altered to support this.

Many GPs are pushed to the limit caring for the growing number of elderly people in the community. Nurse-led clinics could alleviate some of these pressures and achieve better health outcomes for the aged.

Finally, aged care is where I am meant to be. With all that has been happening lately, I am passionate about being a positive influence to guide change in a sector of care to which I am dearly attached.

With APNA Membership, aged care nurses thrive in their careers. Learn more about APNA Membership.

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