Clouded future of disability nursing

Gary Dunne with Ken Adderley
Gary Dunne with Ken Adderley

When Ken Adderley moved into ADHC’s Summer Hill centre he came under the care of nurses such as Gary Dunne, with his 20 years experience of nursing chronically disabled people with life-threatening illnesses.Gary learned to decipher Ken’s unique ways of communicating – a fundamental part of his job, in the absence of speech.”You have to learn to read someone with Ken’s degree of developmental disability; to know when they are happy and when they are sad, whether they are in pain or just bored – why they are acting in a particular way,” Gary told The Lamp.

“You also need a strong medical background to be able to decide on a given day whether a client is capable of doing some activity or not, and to manage ongoing issues such as pain. Our role is a combination of those nursing skills and that ability to read unique communication.

“Our clients have a difficult time when they go to a general hospital because the staff don’t know them and can’t ask them what’s going on. All they are left with is their clinical observations.”

Gary says developmental disability nursing involves a holistic approach to care that aims to deliver the maximum quality of life for every client. It requires a wide medical knowledge, particularly at centres such as Summer Hill, where Ken’s level of extreme frailty is common.

“It is a specialised area of nursing that has changed enormously over the years, due to advances in medical knowledge and technology,” Gary said. “For example, many of our clients would not be alive without the benefit of gastrostomy feeds, which barely existed 20 years ago. When I started in this area of nursing, just providing adequate nutrition was an ongoing daily challenge.

“Gastrostomy feeds have made a massive difference in that severely disabled people are now more robust and can survive something like a chest infection that once would have killed them.

“Their quality of life has greatly increased, but their health issues can multiply and worsen as they age. That means there is a growing need for this specialist area of nursing.”

Gary worries that the pay gap between general and disability nursing is turning younger nurses away from disability services, depriving clients of a wealth of nursing knowledge and experience.

“Why does a nurse who looks after someone like Ken, get $5 an hour less than a nurse who works at RPA down the road? A nurse is a nurse is a nurse, and we should all be pretty much on equal pay.”

Adding to the pay gap, the state government’s move to cut annual leave, penalty rates and other award conditions of around 1000 ADHC nurses will, while delivering only minor cost savings, make disability nursing an even less attractive career option.

“It’s ironic really. We’re a small specialist area of nursing that generally is never in the limelight. But this time, we’re the first in line. We were the very first to be affected by the cap and limits on award negotiations, which partly explains the gap between us and other nurses.

“We’re now likely to be the first New South Wales nurses to be hit with cuts to penalty rates, holidays and other conditions. If O’Farrell gets away with it, the much larger public hospital system will be next. The precedent will have been set.”