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Care homes all over the UK are struggling to attract nurses with some paying exorbitant agency fees to plug the gap. The level of pay and misconceptions about nursing in care homes are seen as largely to blame for nurses opting to work for the NHS instead of the care sector.
A report by the Teaching Care Home pilot found working in a care home is often seen as a "last resort" with negative views of care home nursing held by universities and other bodies seen as a barrier to attracting new nurses to the sector.
Morag MacDonald, staff nurse at Baycroft Great Baddow nursing home in Chelmsford, Essex, admits that prior to working in a care home, she also had a negative perception of care home nurses. She would like to see more nurses being open-minded and considering a job in the care sector.
“I wrongly thought that many of them wanted an ‘easy life’ and often thought to myself they would not handle a shift on a busy ward. That was too judgemental.
“Also, I have had people say to me that you become ‘de-skilled’. That depends on what kind of nurse you are.”
Experience the pleasure of residents' smiles
She admits that “if you need the adrenaline of working in A&E, then perhaps care homes aren’t for you. But if you want to experience the pleasure of your resident’s smile when they see you coming onto your shift, then please consider a career in a care home!”
Ms MacDonald took up the post of staff nurse at Baycroft at the end of last year. Before that, she worked for over 15 years in palliative care with Marie Curie Cancer Care and at St Luke’s Hospice and St Michael's Hospice.
She holds a BSc (Hons) Adult Nursing from Anglia Ruskin University in Chelmsford and has worked in a nursing home as a staff nurse caring for patients with dementia and also for the NHS as a community nurse and has a keen interest in wound care. Before her nursing career, she was a sheltered housing manager for Chelmsford Housing Partnership.
Ms MacDonald describes herself as being “passionate about holistic care” and says “if I can make a difference to the lives of people as a nurse, then I am incredibly privileged”.
'Chance to make a difference'
For her, the benefits of working in a care home, are the “chance to make a difference on a day to day basis with residents and spend more quality time with them”.
She also likes the “autonomy the position of a staff nurse gives me. I can make decisions and see them through and I love to encourage the care staff to be really involved in all aspects of life at our home.
“I enjoy getting to know the residents and their families and it feels like I have an extended family. I have a great affinity with the elderly and believe that we can all learn something from the older generation simply by listening and giving our time to them.”
Challenges to working in a care home
She admits there are challenges to working in a care home, saying: “There are always challenges, as is in life. Staffing levels are notoriously low in many care homes and this obviously impacts on the residents; lives and of the nurses and carers”.
However this is not the case at Baycroft as she adds: “We are very fortunate at Baycroft to have excellent staffing levels and this makes our jobs so much more rewarding knowing that we can spend quality time caring for our residents.”
Another challenge is caring for people at the end of their lives. “I have many years of experience working within palliative care and I hope that I give my residents the best care possible at the end of their lives,” said Ms MacDonald.
Staff will often form very close attachments to residents and so when they need palliative care, this can be very hard emotionally.
“This is always a holistic approach as we deal with grieving relatives and it is hard when you have become attached to them. It is often difficult for the younger members of staff to witness someone passing, but we always support them and encourage them to talk and be open about how they feel.”
Pay and benefits
In terms of pay and benefits, her job as a care home nurse “is much more than I earned with the NHS and there are opportunities for promotion to positions such as unit manager”.
She adds: “We have amazing chefs at Baycroft and they make sure all the staff have fab food, so much better than the soggy sandwiches I used to have!”
Her enthusiasm for the job is palpable and she says the best thing about Mondays is “seeing all the ‘family’ who are my bosses, my co-workers and of course the residents.
“I never dread Mondays like in some jobs because nursing is ultimately a seven days a week job. If anything, when I have had a few days off I can’t wait to get back to catch up with everyone.”
For Ms MacDonald, a typical day is “doing the handover from the previous shift, making sure that any relevant medical issues are addressed and to check if any residents have appointments or GP visits.
“Care staff are allocated which residents they are looking after, although all the staff take care of everyone, it's not down to just down to an individual. I start the medication round which is usually the longest med round so you have to be very focused.
“Some residents have wounds that need to be dressed, it is always a challenge I enjoy as I love doing wound care. It is so satisfying when a wound starts to heal and the resident feels better. Care plans have to be reviewed and updated regularly, that can be a bit time consuming but we have a computerised system called KareInn which makes our record keeping easier.
“Whilst on the day shift, I cover three medication rounds. Medications have to be checked and reordered in a timely manner and we have protocols on ordering. We may have an admission with a new resident and that is a busy time making sure we have covered all their needs.
“I try to sit with the residents in one of the lounges to catch up with them and I’m known to start singing (badly) if an old Dean Martin song comes on!
“I always try to lend a hand to the health care assistants as I know they have a hard job sometimes, I was a carer myself for many years. If I have any concerns or simply want a chat, my managers Nicoleta and Christine are always there to support me. That is the key to enjoying this job, having a good team who support each other.”
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