Assistants in nursing: Their emergence, roles and utilisation in aged care

The care of frail elderly people in nursing homes has become accepted as a necessary, but often not welcomed, aspect of aging and longevity within western society. Citizens of modern society can expect that as they age and become frail then transition to a nursing home may well occur. General debility, increasing age and the perceived need for specialised twenty four hour nursing care often precipitate this transition. Older people and their families accept a nursing home bed when it arises and pay their daily care fees with the expectation that qualified nursing care is at hand to take care of them in this vulnerable part of their lives. This expectation of 'qualified nursing care' by consumers is becoming less defined as care by the registered nurse but moreover as the utilisation of other tiers of nursing and/or support workers within the framework of aged care structural reform in Australia. The reduction of registered nursing staff both in numbers and hours spent on direct care and the increase in numbers of support workers such as assistants in nursing (AINs) who provide the majority of day-to-day care in nursing homes is of particular interest. This paper examines the issue of increasing numbers of AINs, their role and utilisation within nursing homes, and discusses the implications this trend has for nursing practice within the aged care sector