Our hospital is about to begin a trial of Assistants in Nursing (AIN’s).
AIN’s are currently being injected into the health system in response to the impending desiccation of the nursing workforce.
The Australian Health Workforce Institute published a paper titled “Australian Nursing Workforce Research October 2008“, in which they cited Schofield (2007) who predicted “that during 2006 – 2026, Australia is projected to lose almost 60% of the current nursing workforce … an average of 14% of the nursing workforce every 5 years, and a total of around 90,000 nurses”.
The fact is that Universities are hard pressed to educate and train enough new graduate nurses to replace this exodus. And even if they could, many of those leaving the workforce are in senior clinical and administrative positions who will be pulling the plug from a deep vessel of accumulated knowledge, skills and experience.
AINs may be recruited as a Certificate III unregistered health service assistant or a student enrolled as an undergraduate nurse.
It is a great opportunity to expose undergraduates to a clinical environment whilst allowing them to financially support themselves during their studies.
AIN’s work under the supervision of a registered nurse and are able to deliver patient care under a prescriptive duty statement.
The Australian Nurses Federation position statement on AIN’s states:
Assistants in nursing or midwifery and other unlicensed workers (however titled) assist nurses and midwives in the provision of nursing and midwifery care where clinically appropriate. All aspects of nursing and midwifery care undertaken by assistants in nursing or midwifery or other unlicensed workers (however titled) are determined, delegated and supervised by a registered nurse or midwife. Supervision may be direct or indirect.
AIN’s can assist with many patient centered tasks including: patient showering, assisting with mobility and toileting, feeding of patients, answering callbells, providing a patient escort, and even recording patient observations1.
All very helpful, and potentially freeing up nurses for other more complex duties2.
My big problem lays in two small letters: Assistants in Nursing.
Call them assistants TO nursing and all is well and welcome. Send us a bus load ASAP.
But call them assistants IN nursing and you are very close to calling them them nurses.
For example, take a look at this paragraph from the NSW nurses association policy on Assistants in Nursing relating to non-undergaduate AIN’s:
Nursing care is provided by registered nurses and enrolled nurses. Assistants in nursing assist registered nurses and enrolled nurses in the provision of nursing care. All persons who provide or assist in the provision of nursing care to any individual or group are performing nursing work.
To me this sounds pretty close to calling even non-undergraduate AIN’s nurses.
Once AIN’s are counted as nurses, you can use them to replace registered nurses and enrolled nurses to fill rostering shortfalls. They could be used to replace the existing nursing workforce rather than augmenting it.
“Well, all our wards are fully staffed with nurses.”
Nurses that are cheap to employ, and can be churned out onto the wards in a very short period of time (that is weeks rather than years).Â A very cost-effective proposition for staffing our over budget, understaffed hospitals.
This would put a tremendous clinical pressure, not to mention exceptional workloads on the registered nurses remaining on the wards.
The resulting long term effect on staff morale and patient care might also result in a very negative experience for the very undergraduaes we are trying to nurture.
What do you think?
Is this going to improve or degrade the provision of quality nursing care to our patients?
Are AIN’s the answer to some of our problems….or one giant leap backwards for the future of our profession?
I would love to hear of the experiences of anyone who currently works with AIN’s.
Or anyone who is working as one.
Lets get a bit of a conversation going about this one …….