You are probably aware of the Royal Commission into Aged Care Quality and Safety, there are occasional media reports on the progress of the hearings. Like most Royal Commissions this one was triggered by an outcry. The horrors of the abuses at Oakden Nursing Home (now closed) were behind it.
The legislation governing Aged Care is Commonwealth law and Commonwealth funded services are controlled in a number of ways. It is an absolute requirement that assaults are reported: A reportable assault is where there’s an allegation or suspicions of what is generally known as an assault — physical, mental assaults on either residents or staff.
At one of the first hearings the Commission was informed (February 2019) there were more than 3,700 assaults in Australian nursing homes in the past financial year. Reading this (ABC News, 18 February) I was stunned.
These reported assaults excluded incidents when residents attacked each other, there is no mandatory reporting obligation when residents assault other residents, unless an aged care provider did not respond adequately.
The review of course will also focus on legislation to improve services, regulation and protection of consumers. There have been promises for tighter controls and awareness of rorts to attract greater funding with clients assessed as more dependent than they actually are.
Complaints management is another area of interest as there is evidence that complaints have been ignored or poorly investigated. For those of us who currently or in the past worked in Aged Care the fact that there are problems is not news. Put two nurses together and they can list and report a litany of miseries and experience.
What I was surprised with was the number of reported assaults. Over the years I have observed staff becoming stressed and irritated with clients. Part of our work is to recognise and prevent reactions and responses that are provoked and dangerous. Every person in aged care knows the sound of a colleague getting to that point. Shrill voice, aggressive sounds, frustrated comments. We know to move into preventive mode. Quietly step in and suggest someone else take over and give the stressed staff and client some time and space. We are all human and we can all be pushed over the edge.
That is why there is so much pressure for improved staffing and education.
There are reported hearings from the Nursing and Midwifery Board where staff have been accused of assault. Not many to my knowledge but these allegations are investigated and if found proven sanctions are applied.
Looking at the number of assaults reported to the Royal Commission though, the problem is far greater than I had ever imagined. Of course the reported assaults would include regulated and unregulated health staff and one would hope very, very few regulated (registered and enrolled) staff were involved.
What it does tell us though there is a serious problem and while we can’t change the system we can be active in monitoring and protecting our clients and colleagues. We can take action to prevent. We can be responsible for providing support and intervention. Any one of us can snap so all of us need to be alert and proactive. Rather than judging or ignoring signs of stress and known provocation we need to actively manage these. Staff are not often “bad”, although yes there have been criminal and disciplinary hearings that exposed “bad and cruel” behaviour. Stressed, tired and anxious staff can reach limits and react badly. The consequences are obvious. Patient injury, family distress, condemnation of facility and staff and the individual wrongdoer faces charges of loss of career.
Work together and be active in addressing “bad” situations, staff or systems. None of us want to find ourselves named in an inquiry. Remember one can be judged not just for an action but we can be judged for an omission. Evidence of failing to take steps and prevent problems is as dangerous as committing acts that cause problems.
There are some fabulous webinar recordings by Pam Savage regarding Nurses and the Law at the Nursing CPD Institute. The Nursing CPD Institute provides good information and CPD on an array of nursing topics in a range of easy learning ways including webinars and quizzes on the latest information that Nurses need to know – remember the Nursing CPD Institute was created by Australian Nurses for Nurses! https://www.ncpdi.com.au