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Bittersweet: the highs and lows of aged care nursing

Photo: Bittersweet: the highs and lows of aged care nursing
Like any nursing position, working as an aged care nurse comes with both rewards and challenges - the closeness often developed between client and nurse resulting in two of the strongest outcomes on either side.

While the rewards associated with the building of strong relationships is obvious, the nature of the role means that clients are generally living out their final years, months or days, and are often unwell, meaning loss of life or disease progression is common.

And this is where the difficulty lies.

“It is not possible to have a meaningful caring relationship with a client, patient or resident without an emotional element,” says Registered Nurse and Professional Services Leader at New Direction Care Dr Gillian Stockwell-Smith.

“As in any job there are some people you get on with very well.
“I got to know my clients and their families very well.”

Aged care nursing is provided in hospital, home and in residential aged care, and in all cases, nurses often find themselves spending time with the same clients regularly, and often playing a role that extends beyond the nuts and bolts of actual nursing.

“In the community our clients tended to stay on the package for some time and I tried to maintain continuity for clients and staff so they got to know each other’s preferences.

“There is always a social element to community care, sitting down to have a cup of tea or lunch was always a pleasure but time constraints made it difficult to do often or with all clients.

“Over time conversations had whilst providing care meant that we learnt a lot about their previous and current lifestyles.

“We saw a lot of each other and got to know them well.”

For many clients, loneliness is a significant factor, and often, nurses will attempt to fill the void.

Recent research shows that almost half of residents living in aged care facilities receive no visitors throughout the year - so for some, staff are their only meaningful personal connections.

Even those that receive in-home care can be left feeling lonely and isolated for a variety of reasons.

“Particularly for those that had moved from other areas to retire or whose family members had moved away.

“I worked in an area that was attractive to retirees so some of our clients had moved from interstate and did not have a good social network.

“A lot of them were no longer able to drive which also limited their ability to get out to visit friends or family.”

But it’s not just clients who benefit from the forging of these relationships and bonds.

“I consider one of the most rewarding aspects of being an aged care nurse is getting to know about my older clients and their life,”

But of course, these unique bonds can also lead to emotional distress, even grief, for nurses when a client’s illness progresses, or they pass away.

“It is very difficult,” says Dr Stockwell-Smith.

“There is little I can do to stop the ageing or disease process so in those circumstances my aim is to make the client as comfortable as possible both physically and emotionally and support their family members through what is a very distressing period.

“This included attending the funeral where possible.”

Unfortunately, working with older people means that death and dying are common experiences for Aged Care Nurses, so it’s important to develop strategies to manage the emotions that result. 

“Death and dying are part of growing older and for a lot of older people requiring care they occur as a release from frustrating and often painful limitations from which they are glad to be free.

“I consider it a privilege not a challenge to be with or to have supported them and their families during such an emotional period. 

“There is always support from colleagues, and the organisations I worked for all had staff counselling services I could access if needed.”

Dr Stockwell-Smith says it’s crucial for employers of aged care nurses to offer counselling services to both staff and residents to cope with loss, and the varying degrees of grief that may result.

She says most nurses also develop their own strategies over time to help them cope.

“When I worked in a nursing home in the UK, we would plant a rose in the garden area within sight of the residents’ lounge for remembrance, which both staff and residents appreciated.”

According to Dr Stockwell-Smith, while the special connections formed between nurse and client can indeed make their final days, and eventual passing, emotional, it’s not always in a negative way.

“There is always sadness but it is also a time to reflect on a life well lived and - hopefully - a comfortable and pain free death.

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Nicole Madigan

Nicole Madigan is a widely published journalist with more than 15 years experience in the media and communications industries.

Specialising in health, business, property and finance, Nicole writes regularly for numerous high-profile newspapers, magazines and online publications.

Before moving into freelance writing almost a decade ago, Nicole was an on-air reporter with Channel Nine and a newspaper journalist with News Limited.

Nicole is also the Director of content and communications agency Stella Communications (www.stellacomms.com) and a children's author.