Care homes up and down the country struggle to recruit nurses, as the pay and status that comes with working for the NHS tends to be more attractive. Claire Phillips, who has worked as a nurse in a care home for nearly two years, has found that “working in a nursing home is seen as a job you do when you can’t get a job in a hospital or maybe when you’re close to retirement and want an ‘easier life’. It doesn’t help that fellow nurses can also belittle the care home sector as a possible career path. “I remember clearly the ‘dirty nursing home’ comments from nursing staff when I was a student,” reveals Ms Phillips.
This poor image that proliferates about working in a care home coupled with the pay generally not being as good as working for the NHS, has led to “some care homes having to close in England and in Wales because of the lack of nursing staff,” according to Clare Jacobs, employment relations adviser for the Royal College of Nursing.
Nursing recruitment crisis
She says the situation has got so bad that “there is potentially a nursing recruitment crisis” in the care home sector. “First and foremost,” she says “it is because of pay. If you look at some of the fees that local authorities pay to care homes to look after residents, it does not even cover the cost of care, let alone their accommodation and food, etc. So it is very difficult for care homes to pay their nurses the same rates as the NHS can.
“Care homes find it hard to recruit nurses because of this and even recruiting from abroad is difficult as it can take up to six months to get someone over and registered. If they are not from the EU, they will also have to go through an adaptation programme. The other problem is that it is only a stop gap as nurses from abroad can only stay in the UK for up to three years.”
There just aren’t enough nurses even for the NHS let alone care homes and in 2013, hospitals were forced to recruit nearly 6,000 nurses from overseas.
However there are plenty of benefits to working in a care home. “If you have the right resources, it can be so rewarding as you can give the residents one to one personal care. Nurses also can often find they can work more flexible hours in a care home than for the NHS and there is a real sense of team work in a care home. The job satisfaction can be a lot higher. Looking after someone with dementia and making sure they have a good quality of life can be extremely rewarding and enjoyable,” says Ms Jacobs.
What it is really like being a nurse in a care home
Certainly Claire Phillips, who writes a nursing blog called Grumbling Appendix has found this to be true and gives an inside view on what it is really like working as a nurse in a care home.
She says: “I am currently working in a medium sized nursing home that operates over three units dealing with elderly care, learning disabilities, acquired brain injuries and those with complex care needs. I’ve worked there since qualifying – nearly two years now. I remember spending the first few weeks convinced I’d made some horrible mistake (being a nurse, not working in a nursing home!) but now I wouldn’t want to work anywhere else.
“During my training, I’d had doubts that I was a ward nurse. I am rubbish with names. I would just about remember a patient’s name when it was time for them to be discharged. My favourite placement was my management placement on an acute stroke/elderly care ward where I got to spend a substantial amount of time and patients were often there for weeks rather than days. It was here I realised long term care was where I wanted to work.”
There are many myths circulating about being a nurse in a care home and one of them is that as a nurse, you don’t acquire the same range of clinical skills. Ms Phillips disputes this. “It depends on where you work of course, but I deal with catheters, tracheotomies, PEG feeds and wound dressings on a daily basis. I have residents who can deteriorate rapidly and I have to communicate effectively with GP surgeries and out-of-hours services to make sure I get appropriate treatment for them.
Have to use your own initiative
“You’ve also got to use your initiative. Every box of medication, every catheter and piece of equipment is usually individually prescribed for each resident. If a feeding pump breaks in the middle of the night or a catheter needs to be replaced twice in as many days and you don’t have a spare, then you have to sort it,” she says.
Like every nurse, she has to manage her time effectively. “On a twelve hour shift, I can spend five hours doing medications, which leaves seven hours for dressings, calls to GPs, liaising with other health care professionals (HCPs), evaluations, updating care plans and risk assessments. I have to manage my staff by – depending on their skills – allocating them to work either on the floor or with a resident who requires one-to-one care. Occasionally I have to deal with conflicts amongst staff and between residents.”
The nursing staff crisis does put staff at the home under increased pressure to work extra shifts and means Continuing Professional Development is done in her own time.
“This is an issue that affects nurses nationally and until we have the right amount of nurses working across the NHS and private sector, it is unlikely to improve and both sectors need to work together to make sure staff are keeping up to date. After all, a lack of suitable accommodation for those needing long term care delays discharges and puts pressure on the acute sector.”
Can be a 'brilliant career for so many people'
Registered nurses are also key to developing the knowledge of care workers, who often go into a care home with little experience and know-how.
“Where I work we try to do daily teaching sessions on a variety of subjects from mental capacity to infection control. For those who aspire to become nurses themselves, good nursing homes offer an excellent grounding in healthcare and help them develop many of the essential skills they will need as a registered member of staff.
“Being a nurse in a nursing home can be every bit as busy, frustrating, rewarding as working in any other healthcare environment. I like going to work and seeing the same residents every shift. It suits my skills as a nurse and my personality.
“I’m definitely never bored and I feel I have so much still to learn. It is not for everyone but nursing is diverse and that’s what makes it such a brilliant career for so many people. But in assuming nursing home staff are stupid or incompetent, we do the profession a disservice.
“And by actively discouraging nurses from considering nursing homes as a valid career option, are we by extension saying that nursing home residents don’t need or deserve the best staff?” she says.
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Article Source: http://www.carehome.co.uk/news/article.cfm/id/1567712/nurse-reveals-work-care-home-nhs