My experiences as an aged care worker.. the good, the bad and the terrifying! - Part 3

The above picture is similar to how most facilities like to portray themselves. The reality is that you'll be lucky to be attended to by a worker with an average IQ who speaks your language proficiently. Your mum or dad will likely be "looked after" by grumpy, overworked foreigners who really don't give a shit. You may go into the facility during the day and find a greater percentage of quality staff.. but don't let this fool you! At night, the standard of care diminishes.  Another thing to remember is that as a family member, when you come in the staff are on their best behaviour! They show extra concern and care because they understand that this is where the threat to their job lies. Many of the residents aren't cognisant enough to stand up for themselves.
This kind of prioritisation according to the ability of the resident/family to complain becomes obvious (but hard to prove) throughout my workplace. A good example is that it is well known and acknowledged even by management that there are two main sections to my workplace: The low care section and the high care section. The Low Care section is considered to have far more permanent, long term workers who happen to be Australian while the High Care section has a larger majority of foreign workers with less experience. In the low-care section all the pads, biscuits, extra supplies (creams, toothpaste etc) are readily available (not locked up from carers) and for the most-part fully stocked, while in the High Care section you basically have to steal what you need from low care. If staff are to be cut, they're always cut from the High Care section first. If a worker in the low care section calls in sick, rather than call in an agency worker they'll often just get someone from High Care. My theory is that the differences in the quality of care between low and high care are intentional, and that management know that for the most part, those in high care are far less capable of complaining. It's not that the foreign workers are more likely to steal, or "do their shopping" as management claims, but that with everything locked the stocks last far longer. Of concern with managements claim that staff "do their shopping" is that they trust the staff enough to look after the residents, but suspect staff of stealing biscuits and sanitary pads? 

Staff illness.
Another issue which comes up perhaps on a third of all my shifts is that we'll be further short-staffed due to people who have taken leave or called in sick. Rather than call in an agency worker, they'll often not replace the shift to save money. If they're generous, they'll cut the hours of the shift they have to replace by about 50%. The manager has said at staff meetings that this is to discourage people from calling in sick, as they'll be letting the team down. As a result, many people will come to work when they're sick. On the few occasions I've been sick the manager has asked me "are you sure you're sick?" or told me "you sound like you have what I have", implying that if she's able to work I should be able to also. I once came down with a cold quickly while on a shift, sneezing consistently and unable to stop my nose from running. I suggested to the manager that I should go home to avoid spreading infection (ask for replacement staff). She told me to wear a mask.

The "no lift" policy.
Recently I've been in trouble with management over progress notes (electronic notes on information of concern). I wrote notes which were critical of the facilities unwillingness to act on several issues which I'd raised on multiple occasions. The issues raised were in relation to significant hazards to both the residents and  the workers. One issue related to the manual handling of a resident. In Australia we have a "no lift" policy which is supposedly in place to protect us from injury. I believe it's more in place to cover the employers and take some burden out of paying for so much WorkCover (WorkCover pays you if you injure yourself at work) which is inevitable from this occupation. The problem with the no-lift policy that it is basically impossible to do your job without lifting to some extent. It should be possible but the facilities also have to weigh up resident rehabilitation/mobility/wishes which basically require the carers to take more risks. For example, the facility physiotherapists aim to keep the residents walking for as long as possible, so they often push the barrier which results in carers eventually carrying/catching residents before they hit the ground when they ultimately fall over. Now, we're strongly discouraged from catching these residents. We're meant to let them fall and teachers/management of any facility will tell you this. We're human though and have a heart, so will ultimately try to protect the resident. I suspect that if we were  to get injured trying to save a resident we'd have no grounds to stand on with WorkCover.
The main problem with the no-lift policy is that if we were to do every task in terms of manual handling by the book, we would not finish. That is the issue with the industry in general... there isn't time to do much at all by the book. The residents of concern might take twice as long and that's time we simply don't have. The physiotherapists also don't consider all the ways in which you ultimately end up lifting residents. For example, they might assess a large resident as capable of walking but not think about or test whether that resident can lift their legs up into bed at night. There are too many examples where you're essentially left with a choice of either refusing care due to manual handling risks, or getting it done because you know no matter how many times you might report such, there are no real solutions to specific manual handling problems. The blanket rule of "no lift" may sound ideal in theory but in practice it's unrealistic. They haven't accounted for so many scenarios, such as the threat of violence and the need to perhaps lift quickly rather than risk getting hit in the face. In numerous manual handling training sessions the physio's have actually admitted that it's bullshit. They don't cover the day to day movements/risks of residents or give examples of how best to solve issues we face.

...to be continued.