Bullying in the aged care sector isn’t a new problem in Australia, but it’s a growing one. Just ask anyone who works in the industry. Disturbing stories of intimidated, overworked staff, cruelty to patients, worried families, poor management and substandard living conditions are becoming more frequent. As a society we need to ask: what should we be doing to make things better?
Aged care is big business in this country, generating more than $22 billion of annual revenue, the vast bulk of which is funded by the government. It serves around a million and a half Australian consumers who spend more than $5 billion per year on its various services (residential care, home support, home care, etc.)
That $5 billion doesn’t include the RAD (refundable accommodation deposit) charged to aged care residents and held in trust by providers, which currently averages around $340,000.
As of July 2019, all government-subsidized aged care services in Australia must now comply with Aged Care Quality Standards, with evidence of compliance ensured through assessments. These Quality Standards focus on consumer outcomes and reflect performance expectations for the level of care provided.
Aged care workers in the 21st century cope with a range of highly stressful situations, from patient death, overwork, understaffing and tight schedules to demanding families, difficult patients, mountains of paperwork, complex equipment and life-threatening injuries and illnesses. They must navigate an often-confusing hierarchy of skills and authority to maintain a high level of care. With older Australians making up a growing percentage of our total population, these challenges will only broaden over time.
In an increasingly market-driven industry, profit and share prices matter – but they should never take precedence over people. Elder abuse is only part of the problem. Bullying in the aged care sector is present at every level and can come from myriad directions.
Carers can bully residents/patients, or be bullied by them. Bullying between managers, staff and family members can originate from any side. Nurses, carers and other staff who genuinely want to do the right thing may be hamstrung by intimidating ‘my-way-or-the-highway’ leadership styles. And sadly, it’s often these hard-working, front-line employees who bear the brunt of vilification: they’re the handy scapegoats in the current aged care crisis.
Stressed-inducing work environments
When a workplace culture is toxic, stress and staff turnover rises, job satisfaction and productivity shrinks and the level of care suffers. It becomes harder to retain quality staff, which means replacements need extra training to be ‘brought up to speed’.
A recent National Aged Care Survey asked more than 2700 participants who work in the industry to highlight their main areas of concern, with the following results:
The same survey found that the intensity of bullying, harassment and intimidation in the aged care sector had reached new and frightening levels and that governments and aged care providers simply weren’t being held accountable for failures in the aged care system. Some of the participants’ comments make for sober reading:
The stresses present in a normal workplace are magnified in the aged care sector for several reasons. Workloads can be overwhelming and often there aren’t enough staff on hand with the right mix of skills to care for the type and volume of residents.
A large number of surveyed workers also expressed concern that some managers, executives and employers lack the requisite skills to efficiently run an aged care facility and tend to blame front-line staff for their own shortcomings. This blame can then escalate to bullying.
The health care industry – and nursing in particular – has always experienced disturbing rates of bullying. Roughly half of all Australian nursing students experience bullying/harassment during their placements, and more than three-quarters of remote-area nurses have seen colleagues leave their positions because of bullying/harassment. Other data shows that 40% of hospital-based nurses have experienced regular bullying within the previous year.
These are damning statistics that point to a range of unacceptable (and preventable) behind-the-scenes behaviours that management is failing to address – either because of unhealthy power dynamics, leadership failure or insufficient training in anti-bullying, employee well-being and organizational culture.
Another area of concern is the unprofessional, intimidating response that some family members have received from aged care staff when they complain about the treatment of their elderly loved ones. Some relatives are being told not to take photos of their family members inside the facility and others have reported being shouted down, belittled or even physically manhandled toward the exit when they raise issues about the standard of care. This highlights how bullying in this industry isn’t just an internal issue – it affects the general public too.
Solutions start from the top. Managers must be much more proactive in dealing with unacceptable workplace behaviours and lead by example. Those in charge should set the standard for patient care, customer service and employee health.
Employees in aged care who find themselves being bullied should take the following steps:
It’s also essential that the aged care industry develop working environments in which upstanders (helpful bystanders) can feel empowered. Those who witness bullying should be encouraged to speak up and take a firm stand against it – not be shamed into silence. Upstanders play a critical and often underestimated role in effective bullying prevention.
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