What nurses say

AiN role the beginning of a career path

Malcolm Leabon, RN at Royal North Shore Hospital.

Before getting his registration 18 months ago, Malcolm Leabon worked as an AiN for a nursing agency, mostly in aged-care facilities, residential care, mental health, and in medical/surgical wards.

Malcolm told The Lamp that having a clear career path was a big motivation for his entering the nursing profession.

‘I worked in hospitality and retail at the same time as becoming an AiN. I knew then I would want to progress up the career ladder, which meant studying to become an RN. But working as an AiN first was good preparation for that.

‘As an RN, I can really see the difference between new-grad nurses who have worked as AiNs, and those who haven’t. I recently worked with a student nurse who hadn’t ever showered a patient, whereas AiNs learn basic nursing and communication skills through practical experience,’ he said.

Malcolm says that generally there is a good understanding between RNs and AiNs with respect to their respective roles but he is concerned that an increased reliance on AiNs in the workforce will lead to a greater casualisation of the nursing workforce.

‘In an ideal world, all Registered Nurses would have some experience as an AiN and all AiNs would want to further their education, but in reality there seems to be an increased reliance on, and shift towards EENs and AiNs. I think the lack of Registered Nurses will mean agencies play a greater role in the future of nursing. At the end of the day, it all seems to be about cost cutting, not nurse training.’

More AiNs mean more responsibility for RNs

Michael Grant, RN for DADHC at Stockton Hospital.

Michael Grant has worked as RN at Stockton Hospital and says he has noticed a significant increase in the reliance on AiNs at his workplace. ‘I’m very concerned about the affects the increase has on the workloads and responsibilities of RNs,’ he said.

‘Coping is very difficult, but there no longer seems to be any choice. There was originally an understanding agreed to by all parties that AiNs should account for 15% of the workforce. The next agreement was that any increase should be made according to an appropriate skill mix, and be approved by a workloads committee. But, despite that agreement, the reliance on AiNs has increased markedly. In fact, until this year, there was a staff freeze that meant the only permanent positions advertised were AiN roles, despite the shortage of RNs, and of ENs, too.

‘AiNs are generally a willing group of people but the expectations in Disability Nursing are high. They don’t have the same levels of understanding, and at the end of the day it’s RNs who are legally responsible for patient care. That means we’re sprinting all day trying to accomplish all the clinical work, as well as supervise the increased number of AiNs we’re responsible for. Also, administratively, the workload has increased, especially since many AiNs aren’t accustomed to doing this kind of paper work nor the amount of it. And, for others, their literacy and numeracy skills aren’t that strong.’

We can’t replace experienced and skilled nurses with unlicensed minimally trained workers

Lyn Cohen, NUM of the Ambulatory Care Ward in a hospital in south west Sydney, says there is no place for the proposed Health Care Assistant workers to perform allocated nursing duties in the acute care setting. ‘People admitted to hospital are acutely unwell. They need high levels of observation and care by experienced, skilled and trained nurses. Health Care Assistants who have completed a short course (similar to the AiN Certificate III course) will not have the knowledge, background, training and experience to deal with very sick patients.

The introduction of Health Care Assistants to acute care will ultimately compromise patient care,’ said Lyn.

‘I am concerned these workers do not have nursing in their job title. They will not have nursing qualifications and they will not be part of a nursing career path.’

Lyn is also concerned the plan to introduce Health Care Assistants will be at the expense of RN positions and will put pressure on existing RNs.

‘RNs will still have their own patient load but will now be expected to also supervise Health Care Assistants. It will add stress, increase workloads and reduce skill mix on the wards.

‘The proposal undermines the traditional role of RNs,’ said Lyn.