Searching for value: The influence of policy and reform on nurses’ sense of value in long‐term aged care in Australia

Abstract

Contemporary literature on long-term aged care focuses heavily on issues associated with the recruitment and retention of nursing staff, such as job satisfaction and attitudes towards caring for older people. This paper aims to highlight one aspect of a larger study of registered nurses' experiences in long-term aged care in Australia and the influence that government policy and reform has in shaping that experience. This insight into aspects of nurses' everyday experience also contributes to a broader understanding of job satisfaction in long-term care. Findings from this study suggest that registered nurses experience tension in their search for value in their practice, which incorporates professional, political and social mediators of value and worth. These issues are discussed in relation to the impact of policy and reform on nurses' sense of value in long-term aged care and highlight the need for sensitive policy initiatives that support issues of value in nursing practice.

Reducing Staff Isolation and Developing Evidence-Informed Practice in the Aged Care Environment Through an Action Research Approach to Falls Prevention

“…7 The importance of having contextually specific, tailored interventions to promote the uptake of evidence into practice is well documented within the knowledge translation literature. [22][23][24][25][26] For example, there have been reports of limited information sharing, fragmented communication, and support between and within different levels of staff in the aged care environment. 10,11 Action research has been successfully utilized by researchers in a range of settings to facilitate the development of evidence-informed practice and has been reported as a method that is efficacious in promoting the translation of evidence into practice.…”

“…9 The existing literature suggests that deploying an action research approach may assist facility staff to tailor evidence-based falls prevention strategies to meet local needs and preferences. [23][24][25][26] Registered nurses (RNs) have been identified as having limited opportunities to collaborate with peers due to shift work and generally being the only RN working on the shift. 12,13 It has a focus on "changing people's practices, their understandings of their practices and the conditions under which they practice."…”

“…12,13 It has a focus on "changing people's practices, their understandings of their practices and the conditions under which they practice." [23][24][25][26][27][28][29] Therefore, in the context of this multisite project, a decision was made to include an action research component to enhance the implementation of best practice for falls prevention in a cohort of Australian RACFs. Its use in RACFs has been demonstrated to promote the professional engagement of nursing staff to address ongoing problems with professional isolation 20 and the development of networks.…”

Bottom lines: the influence of government funding on 20th century district nursing practice in Australia

“…Consistent cutting and rationalising the work of district nurses as occurred during the 1970s and early 1980s as a result of increased workloads meant nurses could no longer carry out ‘total care’ (HDNA Annual Report 1982), a concept that allowed nurses to address the emotional and social issues associated with their clients’ illnesses and disabilities (HDNA monthly minutes 12/6/75). This issue of not funding the time spent on developing and maintaining relationships within nursing was not isolated to district nursing, and Venturato et al. (2006) lament the lack of fiscal value placed on nursing the ‘whole’ person within aged care settings in the 1990s, noting the linking of reimbursement to only certain aspects of nursing practice ‘creates tension between nurses’ professional and personal values and politically mediated financial values’ (Venturato et al.…”

Sykepleieres erfaringer med samhandlingsreformen ved korttidsavdelinger på sykehjem

“…Denne verdikonflikten har fått konsekvenser for sykepleierne som ofte føler utbrenthet og maktesløshet, slik noen utenlandske studier viser (Keddy et al 1999;Peter et al 2004;Venturato et al 2006). Det er en utfordring å tilpasse seg disse endringene i sin arbeidshverdag.…”