1. More people need nursing More people need complex nursing More chronic disease, less cash

2. NURSING ISSUES Profession is rapidly becoming mature Student nurse numbers are down Newly qualified nurses cannot always find suitable employment 28% of student nurses do not qualify Can new nurses nurse? Modernising Nursing Careers and care homes?

3. NURSES AND CARE HOMES Care homes are nursing organisations Senior, expert, prescribing clinical nurses need to be attracted to care homes Prevent hospital admissions, GP visits through nursing excellence and confidence Why are expert nurses not attracted to care homes? Confront the reality, in order to succeed What is affordable?

4. MORE CARE HOME NURSING Demography Fewer informal carers – maybe Excellent end of life care More rehabilitation Additional skills required, eg care of tracheostomy care, IV therapies etc Traditional hospital care Huge implications for skill mix – and cost!

5. PREPARING NURSES TO CARE Compassion is the icing on the cake Where are the role models? Exhaustion and hostile organisations do not relate well to enhancing compassionate care Compassion cannot be regulated Good manners and kindness should be the norm Zero tolerance policy Dig down to find the reason behind the lack of care The challenge of diverse cultures within the team

6. THE NEW NURSE Will be caring for older people A number of mature people with a range of disabilities May never work in a hospital Likely to work in the independent sector Will have experienced a care home as a student May be mature and on her 3 rd career Will have debts And, also family commitments

7. THE ADVANCED NURSE PRACTITIONER A rarity in the care home world Consider the benefits to residents Would reduce the need for medical intervention Better care, leadership, an exemplar to other nurses Relatively expensive, but wonderful value Would ANP become bored? Passion is a wonderful thing and should be cherished

8. INTERNATIONAL SHORTAGE OF NURSES Even Ireland is recruiting from overseas Skill mix needs to be tackled with intelligence Train, train, train and more training for HCSWs A culture of education, rather then regulation Care homes versus care at home. Respite care provision can be a wonderful thing Flexibility is precious How do our young people see care homes?

9. CHALLENGING TIMES The speed of change Technology, technology, technology But modern times demand the ‘old ways’ too The constants – care, compassion, continuity, coherence and the cash Scotland provides free personal care and is running out of money – change post election expected

10. IT DOES NOT COST, IT CANNOT BE BOUGHT, BUT IT CAN BE ENCOURAGED, REWARDED AND ENHANCED THROUGH SUPPORT, CULTURE AND THE RIGHT ETHICAL FRAMEWORK.