If ever there was a time to recognise the value of the highly skilled and dedicated aged-care nurses who expertly care for the 36,000 older Kiwis in New Zealand's 650 rest homes, then this was it. But, in Budget 2020, the Government has failed them and the older Kiwis they care for.
Aged-care nurses earn on average up to $10,000 a year less than their counterparts in a public hospital setting, reflecting years of undervaluing of aged-care nursing and indeed the care of our older people.
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Aged-care nurses tend to the most frail and vulnerable cohort of the New Zealand population in rest homes, where the average age of a resident is 85 with multiple underlying health conditions. They shoulder huge responsibility, expected to make autonomous decisions without the usual back-up of medical professionals on the floor.
They lead multi-disciplinary teams of other nurses, caregivers, activity coordinators and diversional therapists. They juggle complex clinical situations, while ensuring life in the rest home remains calm and as "normal" as possible.
Aside from their clinical prowess, aged-care nurses display an empathy, humanity and kindness that endears them to our precious older people. And alongside providing palliative and end-of-life care, they also step up to provide the significant emotional support needed to a resident when family cannot be there.
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Covid-19 has reinforced the critical and irreplaceable work of all nurses in this country, but particularly aged-care nurses who have fronted an extraordinary challenge caring for our most vulnerable New Zealanders. We have seen outstanding dedication, some even living onsite in rest homes to care for residents, taking them away from their own families. Many also stepped up to take on additional shifts to cover for sick colleagues or those unable to work because of childcare responsibilities. Such dedication while astounding, often goes unnoticed.
To add insult to injury, our nurses are poached by district health boards on an ongoing basis with attractive salary packages, a situation rest homes cannot control simply because they are not funded to match DHB rates.
Those providers that can and do pay their nurses more generally have a retirement village to cross-subsidise their care offering, but contrary to popular opinion, rest homes are not profitable businesses. They rely wholly or largely on capped Government funding and run on the smell of an oily rag. Indeed, the sector is a broad church with a range of ownership structures, from corporate and private to trust, religious, welfare-run organisations and not-for-profit entities.
Aged residential care services in New Zealand are also highly reliant on overseas nurses to keep services going. In fact, they account for more than 50 per cent of the 5000 nurses working in the country's rest homes. Like all our nurses, these overseas nurses are highly skilled and display an empathy that is so well received by our residents. So, while New Zealand does not train enough home-grown nurses, aged care will always struggle to attract and retain them with pay rates less than the DHBs.
The five clusters in New Zealand rest homes represent less than 1 per cent of aged care facilities in New Zealand, a statistic that compares favourably with overseas examples. There have been deaths and that is sad and tragic for families and all other involved, but the fact there have been so few is down to the leadership, clinical expertise, courage and empathy of aged-care nurses.
It is time New Zealand and the Government recognises their value and finally pays them what they are worth.
• Simon Wallace is CEO of the NZ Aged Care Association.