One in five directors of nursing in Irish residential care homes are actively planning to leave their posts while a further 28 per cent have considered leaving after the stress of the pandemic, a study has found.
The survey, Experiences of Directors of Nursing in Preparing for and Managing COVID-19 in Care Homes for Older People, showed that directors of nursing homes struggled with staff shortages and the frequent changes to public health guidelines.
Many were also disappointed at the lack of understanding in the media and by politicians on the reality of the stresses of working in nursing homes – stresses which they said were further exacerbated by the pandemic.
Some 122 care homes were surveyed, with over 35 per cent of these facilities experiencing significant financial losses during the pandemic which may impact the future financial viability of the facilities. Over half – 54 per cent – experienced at least one coronavirus outbreak.
The survey recommended further investment in care homes, greater psychological support for nurses and improved governance and integration of care homes within the HSE.
In a press statement, lead investigator Prof Amanda Phelan, a professor of ageing and community nursing, in Trinity’s School of Nursing and Midwifery, said: “The pandemic highlighted a variety of pre-existing issues in the workings of private and voluntary nursing homes in Ireland. It also generated severe new challenges in the management of nursing homes as the sector was at the centre of the maelstrom.”
“The intensity of the response to COVID-19 across the nursing home sector had a major personal and professional impact on Directors of Nursing as they provided nursing and psychological care for fearful residents, managed outbreaks, and navigated staffing challenges due to attrition or staff self-isolating”, Phelan continued.
“This report asserts that a more coordinated, supportive, and integrated approach is necessary in centralising private and voluntary nursing homes within the wider Irish health systems. In crisis situations, an inclusive stakeholder approach at key decision-making forums to focus on early intervention and collaboration to safeguard citizens is fundamental.”
Tadhg Daly, the chief executive officer of Nursing Homes Ireland, said in a press statement: “Confronted directly by a pandemic, Directors of Nursing applied tremendous leadership, intensifying the application of infection, prevention and control practises that resulted in nursing homes transforming from social to more medical models. This was achieved during a period of concerted and immense pressure and strain.”
Daly continued: “Against the backdrop of COVID-19, this report emphasises nursing home care is at a critical crossroads. The pandemic must represent a defining moment for gerontological care. This entails requirement for the State to recognise the expertise entailed in providing high-standard nursing home care and ensure an appropriate framework is implemented to appropriately recognise and value the specialised care provided within our nursing homes.”
Dr Catherine Buckley, the president of the All-Ireland Gerontological Nurses Association, added: “The COVID-19 pandemic in all healthcare settings was challenging for both staff and people who required care. In nursing homes, the burden of ensuring safety of staff and residents while adhering to regulatory standards fell mainly on the shoulders of Directors of Nursing. Directors of Nursing have to be able to balance a range of competing demands, values, strategies and regulatory frameworks in order to provide effective care services for vulnerable older people.”
She said: “As someone who was also in the trenches, managing a nursing home for a short time outside of my substantive post, I can empathise with the experiences of these Directors of Nursing. It is clear that the findings of this report must inform national policy on how private and voluntary nursing home are aligned and integrated with national supports and the voices of nurses who lived this experience should be taken account of when formulating both regulatory and national standards.”
The 175-page survey, carried out by a number of Irish universities, can be viewed in full here.
