BlueCare plans to reduce up to 60% of its ENs, union claims

The Queensland Nurses and Midwives’ Union (QNMU) has said it has been advised that BlueCare “plan to reduce up to 60% of their Enrolled Nurses (ENs) from this week”.

“BlueCare are planning on sacking up to 84 of an estimated 130 Enrolled Nurses across 21 Queensland facilities,” QNMU Secretary Sarah Beaman said. “That’s up to 60% of BlueCare’s Enrolled Nurses in aged care.

“The loss of such an experienced and important part of the workforce will have swift and widespread ramifications. We hold serious concerns for the ongoing wellbeing of BlueCare’s aged care residents.

“In addition, BlueCare nurses have been advised they cannot discuss the changes with residents or their families. The QNMU is urging friends and family members to visit loved ones with BlueCare to check their wellbeing, seek an updated roster and demand answers from management as a matter of urgency.”

QNMU said it has referred UnitingCare Queensland and BlueCare’s “mass care reduction” to Australia’s Minister for Aged Care and Seniors Sam Rae, the Australian Government’s Aged Care Quality and Safety Commission, Australia’s Inspector-General of Aged Care, the Australian Health Practitioner Regulation Authority and the Australian Human Rights Commission Age Discrimination Commissioner.

“UnitingCare Queensland and BlueCare have a long tradition of cutting nurse numbers and hours,” Beaman said. “They cut care during COVID-19, the Aged Care Royal Commission and clearly this continues. Queensland’s elderly, and those who care for them, deserve better.”

In a statement this week, QNMU said that the move to reduce EN numbers follows the 2023 Australian Government introduction of the requirement that a minimum of one registered nurse (RN) be onsite at a private aged care facility 24/7. “Previously, there was no requirement even one RN be onsite at all times to oversee care,” QNMU said. “It’s touted some private aged care providers are reducing EN numbers to meet the cost of the federally mandated minimum one RN requirement.

“Currently, ENs work under a minimum one RN to deliver care for large numbers of residents. It is not uncommon to have one RN providing high-level advice and oversight to one or two ENs, who then provide care for large numbers of elderly residents. Many facilities have up to or exceeding 100 residents.”

QNMU also said that, in the absence of ENs, it’s “feared” complex roles such as medication management will be handed to Personal Care Workers (PCWs) — who provide valuable support, with duties including bathing and assistance with feeding, but who must do so under the guidance of RNs and ENs.

“It’s understood this practice is already being rolled out by a number of private aged care providers. The QNMU has repeatedly raised concerns with relevant agencies regarding this practice over many years,” the union said.

“An enrolled nurse can detect the deterioration of residents’ health and has the skills to respond accordingly to save lives,” Beaman said. “Removing large numbers of enrolled nurses from 21 BlueCare facilities will have serious and swift impacts. We are deeply concerned Personal Care Workers will be tasked with roles formally carried out by enrolled nurses.

“This is dangerous and cannot be allowed. UnitingCare Queensland and BlueCare must be held to account.”

In a comparison between RNs and PCWs, QNMU said:

“RNs have a minimum three-year nursing degree and 800 hours of clinical placement. ENs have a minimum 18-month Diploma of Nursing and 400 clinical placement hours. PCWs enter aged care with little to no experience. PCWs should not be asked, or expected to, replace ENs in monitoring residents’ symptoms, responding accordingly, administering complex and potentially life-threatening medications and other important daily care.

“Common conditions detected by aged care ENs include infections, wounds, sepsis, urinary tract infections (UTIs), dehydration, malnutrition, adverse medication reactions and responding to emergencies such as resident falls, injuries or emergent medical conditions such as heart issues. In the absence of ENs, PCWs simply do not have equivalent training or skills.”

QNMU noted that, under existing federal aged care requirements, it is not illegal for private aged care providers to reduce or remove EN hours or numbers. “The QNMU is deeply concerned UnitingCare Queensland and BlueCare’s mass removal of ENs, and associated care, will set a precedent for other aged care providers,” the union said, adding: “The QNMU continues to monitor the situation closely. Media will be advised of any announcements or developments. Next steps are pending.”

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