As Australia grapples with an aging population and a rise in chronic health conditions, the demand for nurses is rising so much there’s now a nurse shortage. Research by Health Workforce Australia (HWA) shows that, due to the aging population and many other factors, there could be a shortfall of more than 100,000 nurses by 2025, and by 2030 it will be 123,000.
This nurse shortage is not just an Australian issue – it’s worldwide. WHO estimates there will be a shortage of 4.5 million nurses globally by 2030. It doesn’t help the Australian situation that some current travel restrictions are making it more difficult for overseas nurses to work in Australia on skilled migration visas. Since 2019, there’s been an 18% surge in nurse registrations, translating to an average of 3,000 fresh faces entering healthcare every month but with the growing aging population, even this increase is not enough to allay the nurse shortage.
The nurse shortage is felt particularly hard in the aged care sector. In its latest report, the Department of Health and Aged Care estimated Australia is facing a shortage of 5918 registered nurses to meet 2024-2025 aged care staffing requirements.
We asked Kate Alexander, CEO of aged care company – NurseWatch – what she felt are the reasons behind this current nurse shortage?
“Certainly right now, there’s a nursing workforce shortage,” answered Kate. “This could be because workers want more out of their careers. When I started my career, we didn’t have nurse practitioners but now we have nurse practitioners and GPs had a different place in the medical system. So, I think now we’ve got to look a bit broader and ask what do the people who’ll be over 65 want in 15 to 20 years time? What would they want their nurses to be like?”
“I think the traditional model of nursing has changed and evolved,” answered Kate. “I think a lot of that data has been taken from the present models of care. I think the future models of care – which is fundamentally where NurseWatch has positioned itself – is going to be a lot different for this next cohort of older persons who are aging. I predict that because we’re a lot more aware of our health now, that we’re going to have a different type of chronic illness – or more manageable chronic illness. Our skill sets will be different and our models of care will be reflective of technology. We will still require the human touch, but technology will be a lot different. So clinical wearables will evolve a lot more and play a bigger role.”
Kate added that while we have wearables now, these will evolve a lot more and people will take a lot more ownership of their health. “We’ve got wearables now that can tell us what our blood sugar is and we’re a lot more knowledgeable on nutrition. There’s a great deal more evidence-based knowledge available – and our models need to reflect the medical care that people want now. So, for us at NurseWatch, we don’t have issues in employing nurses because our model of care is reflective of what the workforce is wanting and what our clients are wanting.”
When you say nurse practitioners, is that different to a registered nurse?
“Yes, nurse practitioners is another level up. You do a Master’s so it’s basically just underneath the GP. Nurse practitioners have been very, very helpful and positive in nursing homes because they can write scripts for certain medications for someone who’s impaired, they can do complex work management- basically they can do a lot more than a registered nurse. And I think those people considering nursing are now getting ready to take on the nurse practitioner level because people do a lot more training these days.”
As a nurse yourself, did you see this shortage coming? Did you feel that as a country, we haven’t really been encouraging young people to train as nurses?
“I think this area is multi-factorial. My mum was a nurse. She trained at The Royal Melbourne, and if she was alive today, she’d be nearly 90. In those days, nursing and teaching were done by the religious orders. Then, my mum’s age group was the first group to do nursing out of the religious orders, generally. And then in my age group, many of us did nursing, teaching or secretarial work,” said Kate.
“But now, my daughter – who’s in her late 20s – has a lot more options. So many different degrees are now an option and you almost need a Master’s now. It’s all a part of a bigger picture. And I think that’s why we’ve got to be innovative and we’ve got to look at nursing. What will nursing look like in 20 years time? It’s certainly going to be a lot different. We rely on immigration a lot in Australia so we need to train our assistants in nursing with a higher skill set.,” she added.
“I think we need to encourage enrolled nurses and give them a greater skill set. I think registered nurses need to start looking at being nurse practitioners, to support the GPs. And GPs are another medical cohort which really has a shortage. In my era, the GP did everything and there were no specialists – or very few specialists. Now there are specialists for everything,” Kate said.
“So, I think there’s a lot happening in our medical ecosystem. I don’t think we’re isolated and we’ve got to be a lot more integrated. That’s why at NurseWatch, we integrate our nurses with our wellness care social model. This means we have the capacity with our client’s medical team, to log on and see the whole picture at the present time,” she added.
I noticed as well that 67% of nurses globally – and it’s probably fairly similar in Australia – are women. Do you think we’re doing enough to encourage younger men to go into the nursing field?
“Yes, 67% out of 100 are women – it used to be more like 100% in my day. And yes, I think again it’s about looking at the traditional model of care and certainly wages. Men historically have been the breadwinner but this is obviously changing now. I think nursing will evolve and we’ll have more men but also transgender people. I think there’s not the data about this available yet, but people from the LGBTIQ+ community will come into nursing more,” said Kate.
“I do think there’ll be a lot more interest in nursing when the model for this career is interesting and innovative. I think if you have more nurse practitioners, this will encourage more men to train up and more workforce flexibility will help as well. I think this will encourage diversification in the nursing workforce,” she added.
You’re now the CEO of an aged care company called NurseWatch where the majority of the staff are nurses. Why did you set it up this way?
“Well, nurses are the most trusted profession. We’re at the front line. We are very knowledgeable and we’re very practical. Our profession has evolved to a really high level of care where our patients are in the centre of our clients. The nurse is the link between all of the allied health professions and the doctor. We decipher information and we value add to what’s going on,” Kate said.
Kate Alexander, CEO of NurseWatch
“So, at NurseWatch, our nurses project manage people’s health. Everyone in the health ecosystem doesn’t have that ability. They’re not in the front line, so they rely on us to give that information. So you need those skill sets and I wanted nurses to be elevated – and I wanted us to be valued,” Kate added.
“You go to a lawyer to do your legal work. So, you should go to your nurse for older person care. And our nurses specialise in that,” Kate said.
Kate Alexander, CEO of NurseWatch.
Was it always important to you to have trained nurses at NurseWatch?
“Yes, it’s always been important and that’s why we called it NurseWatch. And when I did my nursing training 40 years ago, we watched over our patients and we made sure they got the best care. For nurses who are registered, this is one of our domains of practice. So, with NurseWatch, I consciously made sure we had trained nurses looking after our clients right from the beginning. Our logo has a nurse’s hat on it. So, very much so – that’s why I wanted nurses,” Kate said.
And this brings me to my next question. There’s a big increase in the aging population in Australia at the moment. And so there’s a lot more people who need aged care but these days, there are many who want to stay in their own home. So NurseWatch fills that niche doesn’t it? Because it can help them do that?
“It does and it does it well,” said Kate. “And now we’ve got an infrastructure around it as another layer, to ensure people receive the best possible care. So at NurseWatch we’ve got our own software system and our client’s homes are all set up digitally so they link in with their specialists. We also have a whole lot of consent and safety measures in place. With our team to support our client’s health, we have the capacity to get the broad view of what’s going on with our clients holistically and clinically. This is a major advantage for us and means our clients are getting the best level of care.”
The stats are saying that at the moment one in six people in Australia are aged 65 or over, and more people are suffering from chronic conditions. But on average, we’re still living longer in full health. So, does this mean there’s an increase in demand for nurses who can step in, as you say, into areas of specialisation such as aged care, mental health or critical care – these types of areas?
“Yes, nurses are very capable. We can do it all… And we can all do it in the home. Hospitals are bricks and mortar. There’s no reason why we can’t do most of our specialised work in the home,” said Kate.
Yes, and also, going forward with what you mentioned about technology and the advances in healthcare – will these new technology systems mean patients will need less assistance from a nurse in the future?
“While these wearable technologies and these time-saving devices do remove some of the pressure, they also require staff who know really how to use the technology properly,” said Kate. “So, this means there’ll always still be a big need for nurses. We’re not going to be able to rely on technology totally.”
“But I think our nurses will effectively be able to project manage the care of our clients. So the technology gives us accurate and up-to-date data which really just supports the clinical knowledge we have already. But this new technology is beneficial for everyone and that’s good news,” she added.
“People are a lot more knowledgeable about their own health and interested in their own health these days. There’s a lot of information encouraging us to be interested in our own health and even public health. You know – look at dental care and the advancements in immunisation such as the polio vaccine. The next layer is mammograms, pap smears, bowel checks – none of this ever existed before,” Kate said.
“Even the invention of penicillin – all of this is really having a cumulative effect on all of us living longer. And now my generation is going into the next level and looking into our spirituality and our health and wellbeing as well. This will then elevate our healthcare into longevity. And we might have the level of chronic illness that we had say with my dad’s generation. Dental care didn’t exist then, but most clients had dentures,” said Kate.
“So, it’s a bigger picture and there are many variables. We’ve got the wellness care social model at NurseWatch. So the wellness model is also taking into account our patient’s spirituality and they join our service at that level. This means we can actually follow our patients through their whole health journey and set up their health passport. Then, in 20 years time, we can look back and start collecting data by joining our health services in the wellness part of the model. What that might look like in 20 or 30 years will hopefully be little or no chronic illness. So, that’s what we’re aiming for,” Kate added.
Is this because NurseWatch is founded on a model which actually takes into account a lot of the variables and the way the demographics are changing?
“That’s right,” Kate answered. “It’s for the future and we are looking at that right now.”
For more information about what NurseWatch does, visit here.
Or call the NurseWatch team for more information on (02) 9167 8129.
