The author of this article, Joanne Bryant, is an Endorsed Enrolled Nurse who works in various city based hospitals in Australia, as well as travelling and working in rural hospitals. Joanne is passionate about her profession, and concerned about the neglect of patients like Tom, and to point the finger at the deficiencies in nurse education which is compounding neglect.

“I also write this for a personal reason…to give a voice and to be an advocate for the patients like old Tom that I have had the privilege of looking after. Maybe this story will invoke some debate which will return dignity and respect to the many aged care patients who at present are being denied that which is their right.”

By: Joanne Bryant (based on true events)

"I hate aged care", snapped the graduate nurse as we stood at the bedside of an elderly man in a busy acute hospital ward.

"The elderly probably don't enjoy it much either", was my abrupt reply.

"Bud I didn't get my nursing degree to look after old people", she added.

Her response to my next question shocked me even more. "So what were you taught at university about how to settle an elderly bedfast patient for the night?"

She looked at me, seemingly surprised by my question, "We are told that it is not our job".

A wave of sadness washed over me as I felt the very core of our profession being diminished. That core being care, compassion and integrity. The fundamental nature of nursing was changing dramatically before my eyes and I was powerless to stop it.

I pursued in with my line of questioning however, determined to glean some understanding of what she meant. "So whose job is it?"

"That is never explained, it is just accepted that all that stuff will be done by someone else", she continued, unaware the impact her admissions were having on me.

"So if you are not taught basic nursing care, what are you taught?" I persisted.

"The sciences, there is a big emphasis on all the science subjects", was her proud reply.

This was not the first conversation like this I had had during my placement at this busy hospital. Other graduates and students had responded to my questions with very similar answers. The patient in question was an 83 year old gentleman by the name of Tom.

I had cared for old Tom since he had been admitted to hospital several weeks before. He had had a fall, fracturing his femur, and with his blindness and confusion he was a patient that needed full nursing care. No high tech requirements, just general nursing care, patience and TLC.

I had watched him deteriorate as many of the staff found it distasteful to look after him with his care being time consuming and I guess mundane to some, he was also easily startled because of his blindness and would often react loudly if not approached in a mindful manner.

With several of the staff being new graduates and students, to them this was definitely not what they had signed up for.

Tom was not a difficult patient to those of us who understood holistic nursing. When time was taken to explain to Tom what we were doing and to encourage him to participate in his own care, he was compliant and very witty. Those were good days for Tom, he was continent with pre-empt toileting, would feed himself when set up, required little pain relief as he was not left sitting for too long, and was mobilized regularly as per physiotherapy guidelines.

Then there were the other days. When I was allocated other patients instead of him I still prempted to keep an eye out for old Tom. I would watch his meal trays come and go untouched, as no-one set him up so he could eat. I would see him sitting in a hard chair for hours with a grimace of pain on his face. His futile calls to be taken to the toilet would go unheeded, leaving him no choice but to be incontinent because no-one could be bothered to walk him to the toilet. He would go for days without anyone bothering to give him a shave, or as I was to discover, even clean his teeth.

Tom was being neglected, and for no other reasons that ignorance, laziness, and a lack of human compassion.

Compassion and empathy do not even make it to the nursing curriculum, unlike the abundance of science subjects. None of those subjects were going to prevent the neglect occurring to Tom on a daily basis.

"On a night shift, I was checking on Tom and noticed he still had his teeth in. I asked him to pass his teeth to me as I knew he preferred not to sleep with them in.

Imagine my horror when he handed them to me, and they were green with slime. My heart sunk yet again."

Holism in nursing seems to be a thing of the past. Where is the dignity Tom deserves? It is his right. This man was once someone's father, brother, husband, friend, and is deserving of the best of care that we could provide, not this distant, thoughtless, neglectful farce that portrays itself as nursing today.

We are educating our nurses away from the basics, it seems there is no importance placed on the simple needs of patients such as Tom.

The eternal optimist in me has tried to ignore the ongoing trend of neglect that appears to be worsening, hoping they were random cases. They are not.

We are leaving the care of these frail patients to staff that have no raining in aged care, we expect miracles from them, and new graduates who have been taught elitist, irrelevant subjects, with no mention of incontinence and dementia. They have been given a foundation in basic skills, and are inadequate to provide the standard of care our elderly patients deserve. Then we ridicule and vilify them when things go wrong.

Until we give aged care nursing the profile it deserves, and recruit people who understand the importance of kindness, empathy and patience, those people who really want to work in the industry, stories of neglect will continue.

There are many already working in the industry that have a natural affinity for aged care, but they are overworked and unsupported.

So let's start supporting them by giving them colleagues with the same work ethic and propensity for this specialised vocation.


#5 Admin 2017-07-31 12:48
We can assure you as per the veracity of the article that Joanne Bryant wrote. Joanne has been outspoken in her efforts in speaking out about what is occurring in aged care, as have many other staff working in the sector. She is not alone.

I also provide a link to one of Joanne's submissions to the Productivity Commission’s Inquiry “Caring for Older People” that provides further insight into her experience working in aged care []

She is one of the very few prepared to speak out and publish her name - many fear retribution (for good reason) and provide “anonymous” accounts to us and through media.

Aged Care in Australia is undergoing many changes due to reforms that are focusing on exposing aged care to an open market, whilst simultaneously cutting red tape and reducing regulation. We have looked and compared accreditation / data collection and regulatory frameworks in both the US and the UK, and are familiar with the way they work. Australia unfortunately, has one of the most opaque systems in the western world when it comes to the regulatory framework.
#4 karen 2017-07-31 01:23
As a nurse of 25 years I find this article very hard to believe. Did a student really say 'it's not my job' I doubt it very much. As a general rule EN's have a very difficult time with RN's in my opinion so are often very negative towards them. EN's have a huge 'chip' on their shoulder. Don't get me wrong I could write a book about the disgraceful 'care homes' in Australia. Just have a look at the Quality Care Commission website in the UK of how are homes should be inspected etc.
#3 Helen Williams 2017-03-20 00:15
Thank you Joanne for your honesty and speaking up for the elderly in our hospital system and thank you for your care of Tom and of many others and for your perspective on nursing.

I felt quite emotional reading your story as I have had experience with what you are talking about and I know it is true and rife in the system.

My Father had a stroke and was in hospital for a long time I had to fight every step of the way to get anything near decent patient care. I have a lot to say and many stories about the neglect in the hospital and aged care system. I encountered nurses as you have mentioned that don't think it is their job or who don't care. It is shocking to hear that they are not taught patient care and are told they are not expected to do it.

There are many issues and attitudes towards the elderly in the hospital system that I found shocking. Created by Management, doctors and nurses. My Father nearly died due to the lack of care.

Tom maybe someone's father, brother, husband, uncle and he is also most of us when we are elderly. If you asked any one of us would we like to be treated this way how could anyone answer yes then why do we treat others this way?
#2 David Curtain 2016-01-02 20:16
Hear Hear Joanne.

Having supported my father as he travelled through the hospital & Aged Care system in 2013, I can only say that the powers that be think that dignity costs too much, and is not something that fits with KPI's.

Additionally, as I attempted to also care for my elderly mother, I was hospitalised against my will due to the stress of being a carer & receiving no support, and didn't have my role recognised or respected by NSW Health staff.

With an increasingly global world, I can only feel that it will only become harder for everyone to maintain or improve the standards that have seen Australia rank highly in respective fields. People such as mining magnates argue that they only have to pay $2 per hour in another country, so why can't they here?

User pays seems to be the way of the future. If people want dignity, then they will be forced to pay for it, unless everyone stands up, and say enough is enough. I hope through this website we can get enough people moving towards that goal.

I hope there are still people like yourself in the Aged Care system when I get there.
#1 Llyle 2014-12-03 15:26
I am an educator for PCA's, and have been a nurse for many years. It saddens me that when my students go on placements they witness everything that I teach them that should not happen. Many of my students are disheartened when they experience 'task orientated' nursing instead of client focused nursing. I am trying to educate them to advocate for their clients', engage with their clients' etc., but unfortunately, there are far too many workers that see their role as completing tasks in a set amount of time, not performing a caring service to make someone's quality of life better for them. They need clear direction, which is consistent and quality focused, and they are just not getting it. I think we should bring nursing back to the hospitals and learn it like it was before a degree, nurses should do their first year as an PCA/AIN and learn the basics just as we did - forget the degree - they need the hands-on caring and empathy to truly understand the service they are supposed to be providing.