Career advice

Care home role needs direction

The scope of the registered nurse role in care homes is not widely understood.

Care homes are essential for providing care to an older population with increasingly complex healthcare needs.

Picture credit: Getty

As well as providing long-term care, nursing homes prevent older people being admitted to acute hospitals and offer intermediate care to support discharge from hospital.

There are important differences in the way nursing care is provided in care homes, compared to other settings. However, understanding of the role of registered nurses (RNs) in these settings is limited.

...

Care homes are essential for providing care to an older population with increasingly complex healthcare needs.

Picture credit: Getty

As well as providing long-term care, nursing homes prevent older people being admitted to acute hospitals and offer intermediate care to support discharge from hospital.

There are important differences in the way nursing care is provided in care homes, compared to other settings. However, understanding of the role of registered nurses (RNs) in these settings is limited.

Little has been documented about the characteristics of this workforce, such as the scope of their roles, their education and training, and opportunities for career development. A recent project funded by the RCN Foundation addresses these gaps in understanding.

Employed full time 53%

Annual turnover 29%

In current role <3 years 50%

There is considerable variation in staffing levels and turnover between care home organisations and individual homes, but little information exists about the factors that influence these variations.

What is known is that the RN role in care homes is multifaceted and includes:

Managing acute illness and emergencies.

Preventing health problems.

Maintaining older people’s functioning and wellbeing.

Promoting mental health and wellbeing.

Organising complex medication regimes and therapies.

Having expertise in palliative and end of life care.

The RN supports, supervises and leads the assistant workforce in care homes. They must also fulfil many administrative, regulatory and managerial functions.

Current pre-registration programmes focus mainly on acute care nursing, with insufficient time spent on care for older people. In addition, care homes do not always provide supportive learning opportunities.

The care home sector needs to consider ways of providing rewarding career pathways for RNs. Continuing professional development opportunities are essential, but are difficult to access because of a lack of appropriate courses and funding, a lack of access to NHS courses, poor understanding by commissioners of the training needs of care home nurses, and problems identifying who is responsible for the development needs of nurses in this sector.

A post-registration specialist qualification in the care of older people, including care home nursing, would raise the profile of the sector and help attract and retain nurses. It is time for the role of the care home nurse to make its way on to political, practice, education and research agendas.


Further information

RCN Foundation report

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