I began my career in 1994 , as an Enrolled Nurse (EN)working in Nursing homes. There were quite alot of us back then, we had no Personal Care Attendants(PCA) and I was one of 15 ENs over seen by 2 supervising Registered Nurses (RN). We heard of places that were utilising untrained staff, they were cheap and basically it gave the organization "flexibility".

The PCA had to do whatever role was required back then. Slowly the PCA role seeped into most areas of aged care but there was still a large Trained staff componant.  But in time, and because PCAs were cheaper and more pliable, there was more and more of them.

These people had no training and the training they had lacked the discipline and focus of Nursing. They basically took the Nurses out of Nursing homes and then people wondered why our elderly are not being "NURSED" properly anymore. Centrelink has a course, note, to train people to be "PCAs". Anyone can do it, these elderly wont complain and it keeps the unemployment numbers down.

I am now a RN in an Emergency Department and I see them arrive all the time. Elderly people who simply can not be medically managed because there is no nursing staff in their...nursing home.

Our system gets clogged up by ambulances arriving with patients from these places, dehydrated and unwell.

An ED is not the right place for these people but what else do you do with them? There are no medically trained staff to deal with their unstable conditions in the home they came from.

Heres another example...  Occasionally I would work agency and agreed to take a shift in a Care facility for Acquired Injury patients. There was myself, the only trained staff and four PCAs. The PCAs spoke little english and seemed more concerned about emptying bins so they could start their breaks without even once mentioning things like "pressure area care" or checking on your patient.

When they spoke to the residents it was demeaning and with no respect whatsoever. Then at eleven o'clock at night , they all settled down in the front lounge and slept. And slept and slept. I waked them, they simply rolled over and went back to sleep.  There were 40 residents to care for !...all immobile, all incontinent.

At 5am there was a rush - they grabbed a linen skip, flew into rooms, tore patients bed clothes off with no explanation to the patient, tore their pad off, smacked a dry one on without even washing them, and, without so much as washing their hands, moved onto the next poor soul.

These patients were not even regarded in any way. They were slabs of meat to these People, that was all. It was, disgusting.

Nursing doesnt teach that, that is not the kind of behaviour Nursing tolerates. We were taught patient focus and discipline, respect and compassion.

What I have witnessed after the introduction of Untrained staff is a drop in standards and a problem that is being white washed by insitutions and governments. The sad thing is, its the resident in a care facility, totally powerless and voice less who suffers this outrage quietly and alone.

Sadly, I think its only going to get worse. But don't blame the Nursing profession for this, we told you this would happen the moment it started years ago.

9 April 2009: Mark C.