Are care workers appropriate mentors for nursing students in residential aged care?

Abstract

BackgroundThe aged care sector is increasingly dominated by a less-qualified workforce at a time of increasing prevalence of complex health concerns, such as dementia. An Australian program to develop teaching aged care facilities is being undertaken to build the sector’s capacity and provide nursing students with positive experiences of engaging with vulnerable clients. This research aimed to examine care staff potential to facilitate nursing student engagement with clinically relevant knowledge in the performance of hygiene care in a residential aged care facility.MethodsThis study was designed as an action research study. A cycle of reflection, planning, action, and evaluation is described to illustrate the carer mentor capacity to engage with and contribute to the learning of nursing students. Participants were second year student nurses (n = 10) on a four-week placement in a Tasmanian aged care facility in 2013 and their nurse/carer mentors (n = 17). Mentors participated in six action research meetings, and nursing students engaged in a parallel series of four feedback meetings during the placement.ResultsAt the beginning of the placement, nursing students exhibited a disregard for the clinical value of care provision. Students considered provision of hygiene care, in particular, the preserve of care workers and an inappropriate training exercise in the context of an undergraduate nursing qualification. To assist students to make links between core nursing competencies and hygiene care as well as to engender respect for their role within the aged care facility, carer mentors developed the Carer Assessment and Reporting Guide. Once implemented during the final weeks of the placement, the Guide improved student perceptions of resident hygiene care (reframed as assessment) and the role of facility care workers, as well as reinforcing carer self-esteem.ConclusionHygiene care is replete with nursing competencies that are valuable for undergraduate learners, including assessments of skin integrity, mobility, cognitive function, bowels and urine, and basic hygiene. Nurse education programs should strive to address student misconceptions about care work in facilities to account for population level increases in care needs.

Educational needs of Japan’s dementia care workforce: results of a national online survey

“…Globally, work in aged care settings is often characterised by low pay and status, manual labour, shift work, high staff turnover and limited opportunities for professional development (Annear et al 2014;Hugo 2007;Ministry of Health, Labour & Welfare 2016). There are also persistent hierarchies within the health professions of many developed countries, which often unfairly subordinate and devalue nursing and caring roles within the health care sector and wider society (Walker & Holmes 2008).…”

The impact of an educational intervention on home support workers' ability to detect early pressure ulcer damage

“…However, in the community setting in Ireland, HSWs work within the social care division, not primary care (HSE, 2015). This division could leave the HSWs feeling that they are disconnected rather than being part of an integrated team, leading to feelings of being undervalued (Annear et al, 2014). As their level of training is seen to be of a lower standard, the risk remains that due respect is not shown to them by other healthcare workers.…”

“…Findings within the literature suggest that the HSW's caring role and tasks performed vary depending on the country or clinical area in which they are employed. This leads to role confusion (Annersten-Gershater , Annear et al, 2014and Hewko et al, 2015. Swedberg et al (2013) demonstrated that patient safeguarding and quality of care given could not be guaranteed or uniform, given the confusion regarding the exact nature of the HSW role.…”

“…This is an enhanced key aspect of their role. Adding further to differences of opinion regarding role progression, in Australia Annear et al (2014) illustrated that HSWs are involved in student nurse learning.…”

“…However, these studies do not measure patient outcomes relative to role development (Carlisle et al, 2007, Ingleton et al, 2011, Annerston-Gershater et al, 2013, and Sund-Levander, 2013 to delegate tasks to a HSW appropriately and safely, they need to have an understanding of the HSW role, and their competency to fulfil it. Annear et al (2014) stated that HSWs helped student nurses appreciate the importance of direct care, and recognise complex health issues, such as skin assessment. Skin assessment is one aspect of pressure ulcer prevention and is predominantly completed by this caring workforce (Athlin et al, 2010).…”