Assistants in Nursing
Provide limited patient care under the direction of nursing staff in hospitals and aged care facilities.
A morning round in the aged care home
You are an assistant in nursing on the morning shift, helping residents with personal care under the direction of the registered nurse. It is 6:45am and the home is waking up. You have ten residents on your list, breakfast is at eight, and one of your colleagues has called in sick.
Choose what you would do. Then see what happens. There are often good reasons for each choice.
I do not want a shower today. I am cold and my back hurts. Leave me be and come back later, will you?
Respect his wishes and move to the next resident, and write nothing down
Mr Papadopoulos stays in bed. By lunch the new nurse finds his back pain has worsened and nobody knew. A refusal is a choice to respect, and it is still information to share.
Gently remind him that showers are part of the routine and that everyone on the floor has one
He grumbles and agrees, but he is stiff and unhappy, and he tells his son you pushed him. Residents have a right to say no, even when it makes your list harder.
Accept his choice, offer a warm drink, and tell the nurse about his back pain and the cold
The nurse checks him and arranges something for the pain. After lunch he has his shower and is much happier. You respected his choice and made sure someone knew why.
Mrs Anh in room 6 needs two people to help her to the bathroom, but everyone is busy. Could you just take her by yourself? She is only small and she asked for you.
Go ahead on your own, since she trusts you and the delay would upset her
Mrs Anh slips slightly as you help her and you both get a fright. Lifting plans exist to protect residents and staff. Being willing is not a reason to skip them.
Tell Gwen it needs two people, and offer to wait with Mrs Anh until a colleague is free
Gwen sends someone within a few minutes, and the transfer is calm and safe. Mrs Anh is not upset, because you stayed and talked with her. Speaking up about a plan is part of the job.
Ask Mrs Anh to wait in her chair for half an hour until things are quieter
No one is hurt, but Mrs Anh is uncomfortable and anxious by the time help comes. A safe plan still needs to be quick, so say what you need and keep her company.
Mum's hair has not been washed and she is in the same cardigan as Sunday. Is this what I am paying for? I want to speak to the manager about the standard of care.
Apologise, listen to what she is worried about, and offer to get the nurse in charge to talk with her
Ms Reynolds calms a little, and Gwen meets her. You were kind, but you could have also checked your list to see whether she had a point and made a start on it.
Explain that the home is understaffed today and everyone is doing their best
It is true, but it sounds like an excuse and makes her angrier. She goes to the manager with the staffing detail. Families need to hear what is being done, not what is going wrong.
Listen, thank her for telling you, check what has been done for her mother, and get the nurse
You find the shower was planned for today and bring it forward. Ms Reynolds sees action and softens. A complaint is often a worry about someone they love, and it tells you what to look at.
How it went
By three o'clock the round is done. You are tired, your feet are sore, and a resident has squeezed your hand and said thank you. Assistants in nursing do close, practical work for people at their most personal. Would you be comfortable being trusted with that?
This is a simplified, fictional situation to help you explore. It is not professional instruction or a test of your ability.
Case study: The cup of tea that told a story
A fictional case set in a residential aged care home and hospital ward at a fictional regional health service.
The situation
At Wattle Grove Aged Care, Dang was an assistant in nursing on the morning shift. She was helping Mrs Fitzgerald, who lived in the home and had always taken two cups of tea at breakfast. On Tuesday Mrs Fitzgerald left her tea untouched and was quiet when Dang greeted her. Nothing else looked unusual, the call bell had not been rung, and the morning list was long with nine more residents waiting.
What they did
Dang stayed for a minute and asked how Mrs Fitzgerald was feeling. She said she was fine, but she winced when Dang helped her sit forward. Dang did not try to work out what it meant. She told the registered nurse right away what she had noticed, using the same words Mrs Fitzgerald had used, and wrote a short note. The nurse came and checked her.
How it turned out
Mrs Fitzgerald had an infection that would have taken longer to spot. The doctor started treatment that day and she was back to two cups of tea within the week. The nurse told the whole morning team about the untouched cup, and asked care staff to say so when someone is off their usual routine.
What would you do?
- What did Dang know about Mrs Fitzgerald that made the tea matter?
- How would you decide when a quiet morning is worth reporting?
- Why might residents say they are fine when they are not?