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Nursing Workforce in Australia

Discuss about the Nursing Workforce in Australia.

The nursing profession is a major discipline in the health care sector and is principally focused on working towards taking care of all individuals, families, or communities, which are currently in  distress. The basic aim of nursing is to maintain and attain delivery of optimal health care services, thereby increasing the overall wellbeing and quality of life of the service users. In other words, nurses are most often differentiated on the basis of the approach they take to care for their patients (Chang et al., 2012). Hence, the nursing workforce is regarded as a major factor that helps in tackling problems that are continuously faced by the healthcare systems, The primary condition to establish this workforce includes establishment of optimal conditions that help the nurses to realize their potential. The report will illustrate the sustainability of nursing workforce and will further elaborate on its strengths and weakness and will also identify opportunities for retention of nurses.

Background

Australian nurses are found to work either independently or in collaboration with members of a multidisciplinary healthcare team that includes mental health facilities, remote and rural nursing regions, residential aged care facilities and indigenous communities (Health Workforce Australia, 2014). Australia is found to demonstrate two different levels of regulated nurses, such as, enrolled nurse and registered nurses (Buchan, O'may & Dussault, 2013). The role of registered nurses requires them to work at an advanced level that is facilitated by the attainment of an appropriate post-graduate qualification. This makes them eligible for seeking endorsement as nurse practitioners.


Furthermore, enrolled nurses also play an essential role in the Australian healthcare system and work in a range of settings namely, aged care facilities, rehabilitation centers and acute hospital wards. Their role requires optimal delivery of care services to all patients and also makes them responsible for responding to emergency situations (Lowe et al., 2012). The innovative role that the Australian nursing workforce aims to provide to its clients include improving access to the internet, providing cost-efficient care services, targeting and recognizing the at-risk population, and providing outreach care services in all settings (Buchan et al., 2015). Hence, the primary duty of the workforce is to make its employees work at advanced levels across a range of clinical settings. In addition, to adoring their roles in the public healthcare sector, the nurse practitioners are also responsible for providing efficient primary healthcare services either in the form of generalist or specialist nursing (Thomas, Chaperon & Federation, 2013) .

Characteristics of Enrolled and Registered Nurses

Workforce across different sectors

According to statistical reports of 2015, maximum percentage of enrolled and registered nurses are found employed in the acute sector that provides care to people suffering from a range of conditions such as, metabolic disorders, infections, and degenerative conditions. This was followed by high proportions in aged care, medical and surgical units, succeeded by peri-operative and mental health sectors. Lowest proportion of the nursing workforce was found in community nursing, rehabilitiation and paediatric units (Health Workforce Australia, 2014). Thus, variations in the nursing workforce are also governed by complexities of the different care sectors.

Geographic distribution

According to the government reports published in 2012, more than a quarter of the registered nurses worked in New South Wales (29%), and another quarter in Victoria (26%). Further data reveals a considerably low percentage of registered nurses working in Queensland (20%). Similar results were obtained in 2015 data for New South Wales (29.51%), Victoria (26.02%), and Queensland (19.95%). Thus, comparison of the aforementioned data indicates that geographic distribution plays a significant role in determining the nursing workforce with the maximum contributions from New South Wales and minimum from Queensland. Differences were observed with regards to the distribution of enrolled nurses in 2015, with 21.95% in New South Wales (23% in 2012) and 33.17% in Victoria (33.79% in 2012). Thus, regions of South Australia significantly contribute to more nursing workforce than other territories and states. Higher proportions of male workforce are contributed by Northern territory (Health Workforce Australia, 2014).

Health Workforce Data

The national board in combination with the Australian Health Practitioner Regulation Agency (AHPRA) is the sole regulatory agency that governs the registration of 14 health professionals. Data from the annual registration process contains exhaustive information on the employment and demographic information for all healthcare professionals (Health Workforce Australia, 2014). The National Registration and Accreditation Scheme (NRAS) led to the establishment of AHPRA in 2010. The nursing roles have seen great improvements in the past decades and the roles have become increasingly diverse and complex (Halcomb et al., 2014). A summary of the workforce characteristics of registered nurses, enrolled n nurses and all employed nurses are given below:

Workforce characteristics

2009

2012

2015

Headcount

225,040

238,520

253,010

FTE nurses

198,924

212,659

225,344

FTE per 100,000 population

905.9

936.4

947.6

Male proportion

9.8

10.4

11.0

Average age (years)

44.2

44.3

44.5

Proportion aged 50+ (%)

-

37.7

23.65

Table 1A- Workforce characteristics of employed Registered Nurses

Source- (Health Workforce Australia, 2014)

Workforce characteristics

2009

2012

2015

Headcount

51,711

51,624

55,383

FTE nurses

43,614

42,467

46,753

FTE per 100,000 population

198.2

187.0

196.6

Male proportion

8.9

9.2

9.9

Average age (years)

44.9

46.0

45.5

Proportion aged 55+ (%)

-

45.5

28.77

Table 1B- Workforce characteristics of employed Enrolled Nurses

Source- (Health Workforce Australia, 2014)

Workforce characteristics

2009

2012

2015

Headcount

276,751

290,144

331,015

FTE nurses

242,521

255,174

307,104

FTE per 100,000 population

1,104

1,123

1,077

Male proportion

9.6

10.2

10.7

Average age (years)

44.3

44.6

44.4

Proportion aged 55+ (%)

36.3

39.1

39.0

Table 1C- Workforce characteristics of all employed nurses (including Midwives)

Source- (Health Workforce Australia, 2014)

Thus, an analysis of the workforce data suggests that a significant improvement has been observed in the number of employed registered and enrolled nurses, recruited by the Australian workforce (Australian Institute of Health and Welfare, 2018). The aforementioned data suggests that women made up more than 89.3% of the nursing workforce in Australia. Similar results were also observed in its previous year (2014). Furthermore, the average age of the employees was found to be 44.4 years, which in turn indicates that the nursing workforce is made up of experienced members having years of sound clinical expertise. The tables also indicate that the proportion of registered and enrolled nurses aged higher than 50 years have considerably reduced since 2012, thereby signifying efforts taken up by the government to recruit more nursing professionals.

Analysis of Workforce Data

Workforce supply

The major aspect regarding workforce supply refers to the average age group that indicates the imminent retirement of all older nurses and workforce that in turn will create subsequent impacts on the strength of workforce (Health.gov.au, 2018). Moreover, it will result in an increase in ageing workforce in future as well. Recent researchers suggest that countries such as, Australia have been successful in maintaining an almost similar ratio of nursing professionals (Shacklock & Brunetto, 2012). Recent reports suggests that the fact that Australia avoided recession and continued to recruit more employees in the nursing and midwifery workforce from other countries significantly added to the numbers. There are a plethora of factors that help in maintaining a well-supported nursing workforce that is critical to delivery of safe and competent care services.

  • Workforce planning and education- Regular and on-going dialogue between the stakeholders involved in nursing workforce planning, the professional associations and the education planners are responsible to making each sector well informed for preparing the workforce according to the needs of the target population (Crettenden et al., 2014).
  • Education investment- The Australian government spends significant amount of money in training and providing education for all healthcare personnel who enter the nursing workforce (Health Workforce Australia, 2012).
  • Clinical placement- This acts as an essential component of education that is imperative for the nursing programs.

Strengths

The major strengths of the Australian nursing workforce are given below:

  1. It offers steady employment to a huge number of people and is also responsible for increasing education of most healthcare members.
  2. Registered nurses are found to get better compensation than most other nursing staff
  3. There is a growing body of evidence that suggests the positive contributions made by nursing care practitioners on the overall health and wellbeing of all individuals
  4. An increase in the number of Registered Nurses will be sufficient to replace the huge rates of retirement of experienced nurse (Australian Institute of Health and Welfare, 2018).
  5. Huge nursing workforce and the existing healthcare policies are imperative in influencing strong public perceptions regarding the profession.

Weakness

  1. New registered nurses are often unprepared for providing value based care that is able to meet the needs and preferences of the clients
  2. The new enrolled nursing workforce fails to ensure delivery of optimal care services in an cost-effective manner (Chang et al., 2012).
  3. Uneven growth of nursing workforce is observed across several parts of Australia
  4. Registered and enrolled nurses are more likely to face problems due to shortages of physicians, retirement of the aged workforce, implementation of new health legislation and policies and aging baby boom generations.

Conclusion

Thus, it can be concluded that nurses form one of the major components of the Australian healthcare workforce and are responsible for providing care to all people, across their entire lifespan. One major aspect of the Australian nursing workforce can be related to imminent retirement of older nurses who from a major proportion of the entire workforce. Thus, efforts are taken by the government to retain the nursing workforce, which in turn is facilitated by recruitment of more registered and enrolled nurses. Major recommendations for the Australian nursing workforce identified in the sustainability report involve bringing about efficient leadership for building workforce capacity that will facilitate the nursing managers to lead innovation in their workplace. Increased efforts for improving career preparation during the early years and providing necessary support at the workplace are major changes that have been identified by the Australian Health Workforce. There is also a need to enable innovations in the workplace related to staff arrangements and optimization of nursing roles. These recommendations will also prove effective in increasing retention of registered and enrolled nurses in 2018 due to the fact that these recommendations will help in improving provisions for implementation of evidence-based nursing that would facilitate decision making skills. Upon implementation in current scenario, the nurses would receive encouragement to innovate upon their roles and duties. These innovations would also make the registered and enrolled nurses aware of their importance in the organisations, thereby facilitating efficient delivery of care services and resource allocation. Acquisition of management and leadership skills would also motivate them towards career progression.

References

Australian Institute of Health and Welfare. (2018). Workforce Reports - Australian Institute of Health and Welfare. Retrieved 4 April 2018, from https://www.aihw.gov.au/reports-statistics/health-welfare-services/workforce/reports

Buchan, J., O'may, F., & Dussault, G. (2013). Nursing workforce policy and the economic crisis: a global overview. Journal of Nursing Scholarship, 45(3), 298-307.

Buchan, J., Twigg, D., Dussault, G., Duffield, C., & Stone, P. W. (2015). Policies to sustain the nursing workforce: an international perspective. International nursing review, 62(2), 162-170.

Chang, A. M., Gardner, G. E., Duffield, C., & Ramis, M. A. (2012). Advanced practice nursing role development: factor analysis of a modified role delineation tool. Journal of advanced nursing, 68(6), 1369-1379.

Crettenden, I. F., McCarty, M. V., Fenech, B. J., Heywood, T., Taitz, M. C., & Tudman, S. (2014). How evidence-based workforce planning in Australia is informing policy development in the retention and distribution of the health workforce. Human resources for health, 12(1), 7.

Halcomb, E. J., Salamonson, Y., Davidson, P. M., Kaur, R., & Young, S. A. (2014). The evolution of nursing in Australian general practice: a comparative analysis of workforce surveys ten years on. BMC family practice, 15(1), 52.

Health Workforce Australia. (2012). Health Workforce 2025 Doctors, Nurses and Midwives. Retrieved from https://submissions.education.gov.au/forms/archive/2015_16_sol/documents/Attachments/Australian%20Nursing%20and%20Midwifery%20Accreditation%20Council%20(ANMAC).pdf.

Health Workforce Australia. (2014). AUSTRALIA’S FUTURE HEALTH WORKFORCE – Nurses Detailed Report (August 2014). Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/content/34AA7E6FDB8C16AACA257D9500112F25/$File/AFHW%20-%20Nurses%20detailed%20report.pdf.

Health Workforce Australia. (2014). Nursing Workforce Sustainability: Improving Nurse Retention and Productivity (August 2014). Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/29418BA17E67ABC0CA257D9B00757D08/$File/Nursing%20Workforce%20Sustainability%20-%20Improving%20Nurse%20Retention%20and%20Productivity%20report.pdf.

Health.gov.au. (2018). Department of Health | Health Workforce Data. Retrieved 4 April 2018, from https://www.health.gov.au/internet/main/publishing.nsf/content/health_workforce_data

Lowe, G., Plummer, V., O’Brien, A. P., & Boyd, L. (2012). Time to clarify–the value of advanced practice nursing roles in health care. Journal of advanced nursing, 68(3), 677-685.

Shacklock, K., & Brunetto, Y. (2012). The intention to continue nursing: work variables affecting three nurse generations in Australia. Journal of Advanced Nursing, 68(1), 36-46.

Thomas, I., Chaperon, Y., & Federation, A. N. (2013). Submission to the health workforce Australia consultation paper on nursing workforce retention and productivity. Australian Nursing Federation. Retrieved from: https://anf.org.au/documents/submissions/ANF_submission_HWA_Retention_Productivity_May_2013.pd

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