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The sky’s the limit

Darragh O Keeffe reports on how a university and leading providers are working to bolster aged care education.

How universities can best prepare registered nurses for the realities of working in residential aged care, and how providers can best support student nurses during placements are among the central themes of an ongoing research project.

The Partnership in Aged Care Project (PACE) is being undertaken by the School of Nursing at Flinders University, in collaboration with five industry partners.

Also under the microscope in the three year action research project is how service providers can best provide an “educational trajectory” for their nursing staff. From the university perspective, the researchers are identifying the issues around creating relevant curriculum.

The study has involved a wide ranging literature review, which identified core barriers to graduate nurses entering aged care, such as ageist views among some nursing students; viewing aged care work as ‘low status’.

“The rationale behind the project was that our university hadn’t put students into aged care placements before and we decided if we were to, it would make sense to do it in partnership with industry. For these to be quality, meaningful placements, it had to be a collaboration between university and providers,” explains Jan Paterson, professor in Nursing (Aged Care) at Flinders University.

Paterson began by meeting with the CEOs of the providers to gage interest and got a “wonderfully supportive reaction”. Next, an advisory committee with representatives from each of the providers was established. This group met regularly and was important in facilitating a series of 20 focus groups in the facilities, canvassing opinions from staff.

“Another step was having a communication strategy. The research fellow working on the project, Dr Lily Xiao, produced a quarterly newsletter, which carried articles written by people in the industry.

We also provided feedback on the project.

“The students have been in the facilities on placements and evaluation from the perspective of the resident, clinician, academic, and student suggests the placements have been effective, with the initial results showing good learning outcomes.”

“A core goal for us was to look at education from the undergraduate level right up to the postgraduate level in aged care and investigate how industry and individual facilities could better support nurses,” says Megan Corlis, director of research and development at Helping Hand Aged Care, one of the industry partners.

“A significant aspect for us was evaluating our graduate nurse program; looking at how supportive our environment was for registered nurses coming to work in our facilities.

“What struck me is that aged care is very autonomous. When you come to work in aged care you can be on your own, with little support, except maybe a phone call. A big element was critically reflecting on what we do; our behaviours around how we deal and interact with graduate nurses. There’s not a lot of research on this area in aged care,” says Corlis.

For this reason, Paterson says that developing a clinical venue takes about three years.

“You have to work with the staff, get them used to having the student on site and ensure they’ll support the student.”

In residential aged care, the lack of registered nurses is an issue. The literature review showed that in the absence of registered nurses, students tend to take on carer roles instead of working with, and learning from, nurses.

“You’ve also got to have an academic facilitator coming into the facility to interact with the student. They’re important in terms of communications lines for students while they’re on placement. The venues need to have a clear idea of the objective behind the placement,” says Paterson.

One strategy for preparing the facilities was running workshops for all staff, facilitating their learning about what the experience for the student on placement would be like and providing strategies around communication.

“The importance of good clinical placements for nurse recruitment in aged care is obvious. If they have a positive experience, and see residential aged care as a vibrant place, full of learning and career advancement opportunities, they’re more likely to return to it after graduating,” says Paterson.

“Often, providers, and the industry generally, haven’t been in a position where they could have an input on the curriculum nurses study in university,” says Corlis.

“That is something Jan and her colleagues are striving to change. It’s about making people job ready and enabling aged care providers to look at themselves and their role in that.

“When you start working in partnerships, you begin to see how siloed you are from each other. You begin to see what the experience is like for the student, and the student gets to see what is happening in aged care. It’s about developing sensitivity for aged care in the student, and indeed in the university,” she says.

With regards to supporting the educational opportunities of existing staff, Paterson says the providers had good policies in place.

“When we conducted the focus groups we got a clear idea of what the staff’s educational needs were. They wanted continuous education around areas relevant to their daily practice – such as continence, wound care, assessment. Regarding tertiary study, it became apparent that so much of what RNs require is skills around administration, as many move into management roles.”

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