How Benevolent Living is meeting new registered nurse requirements

Here’s how this Rockhampton facility is trying to fulfil new legislation for registered nurses, including $10,000 sign-on bonuses and recruiting workers from Fiji.

Benevolent Living CEO Alison Moss.

Sponsoring nurses from overseas, recruitment of workers from Fiji, temporary agency nurses and $10,000 sign-on bonuses are just some of the ways one Rockhampton aged care provider are trying to fill the new 24/7 registered nurse requirements and mandated care minutes.

Under the new changes introduced by the Australian Government and effective from October 1, 2023, residential aged care homes are required to deliver at least 200 care minutes per resident per day, including 40 minutes with a registered nurse.

Care minutes are defined as direct care time delivered by registered nurses, enrolled nurses and personal care workers, including nursing assistants.

These figures are mandated to increase from October 1, 2024, to 215 care minutes per resident per day and 44 minutes of registered nurse time per day.

The 24/7 registered nurse requirement, effective from July 1, 2023, mandates at least one registered nurse must be available to care for residents at all times.

All aged care homes need to report monthly on how they are meeting the requirements and if they haven’t, they need to show that they can still meet the clinical care needs of their residents.

Most aged care homes across the country are struggling to fulfil the new requirements as there is a mass shortage of nurses.

CEO of Benevolent Living on West Street in the Range, Alison Moss, said it feels like the government has set them up for failure.

“I think anything that increases staffing numbers is a good thing for the industry - it’s good for residents, the more staff you have, the better the care, staff aren’t so rushed, they can spend more time one-on-one,” she said.

“In principle, I am totally in favour of the care minutes … I think the issue is, and where we are falling down, is we just don’t have the numbers, I think they’ve set the targets without closely examining where we are and what is actually achievable.”

It’s also yet to be established whether the care minutes are delivering on a quality of care, Ms Moss explained.

“Measuring care minutes is only one measure … if people are meeting these care minutes by temporary contract staff but it doesn’t necessarily say the care is better, you have a whole range of clinical indicators, infection rates, falls, skin integrity … that is the real measure,” she said.

The acute sector in hospitals are also crying out for registered nurses, so what little staff there are in the pool are quickly snatched up, Ms Moss said.

“It’s not to say we haven’t made gains, all aged care providers are working very hard, but we aren’t the only sector chasing nurses and you’ll find it’s almost like a bidding war,” she said.

As the pressure on the industry increases and nurses have higher workloads, a lot are opting to leave the industry because “it’s too hard”.

“There are nurses that aren’t working in other roles that are using their nursing qualifications,” Ms Moss said.

The human resources team at Benevolent Living, which has more than 120 aged care beds, are “pulling out all stops” when it comes to ways to attract staff.

They are offering $5 an hour above the award for registered nurses, along with a $10,000 sign-on bonuses, sponsoring nurses from overseas under visa arrangements and filling roster gaps with temporary agency nurses.

“They are only filling gaps … they may only be here eight to ten weeks, it’s not a long-term sustainable solution for the industry,” Ms Moss said.

“They don’t know your facilities well or the systems, they don’t have as much ownership than a permanent employee that has been working for you for several years.”

A new program is also being piloted, the Pacific Australia Labour Mobility scheme, which contracts workers out of Fiji for a minimum two year tenure.

Benevolent Living hopes to have six workers commence in March.

“This is our first try at it, we are working with a company and they assist with the recruitment, the training, find accommodation, help the workers settle in,” Ms Moss said.

While Benevolent Living haven’t had to close beds, they have pulled back on their respite services.

“That is 70 less admissions a year, there is a lot of paperwork around an admission and risk management and changing of rooms, so we are dialling back our respite services,” Ms Moss said.

“So that’s unfortunate because I’m not sure of how many age care providers are offering respite.”

Part of the issue comes back right to the beginning, Ms Moss said, attracting staff to the aged care industry and for people to study nursing in the first place.

“The image of the industry needs to change,” she said.

“There’s an old-fashioned perception this is where nurses go to retire, you are going to lose your clinical skill sets, it’s seen as a lesser role than working in an emergency department, it’s not as glamorous … but I would argue you have to be an extremely high-skilled competent nurse to do gerontology nursing, which has its own expertise in like chronic health disease management, in dementia care, palliative care.

“That perception, in the nursing industry about how they view themselves, that needs to change … There are amazing career pathways that need to be promoted.”

More pay increases, funded by the government, will also go a long way.

“Even though we have had some pay increases, it needs to go further and the government needs to fund that, these are professional people with degrees and the type of work people are doing … if we can pay people well, that’s also going to help but we need to get more people choosing the career pathway, choosing to study nursing,” Ms Moss said.