A passion for aged care: after nearly three decades working in aged care, Rave Wilkes is still nursing in an area she loves.

There's an ebullience, an energy and an enthusiasm about NZNO's 2004 Gerontology Nurse of the Year Raye Wilkes that 27 years in the same aged-care workplace has not dimmed.

She began working casual night shifts at Whareama in Nelson in 1978, when her children were young. After a variety of roles, including community liaison worker and charge nurse, she is now manager of the 76-bed (soon to be 81-bed) facility, which includes 43 continuing care beds. She pays tribute to former Whareama general manager Terri Potroz, for "helping me fly". Wilkes' passion for her work and her workplace is obvious and infectious. She is constantly paying tribute to her "fantastic" caregivers, her "fabulous" enrolled nurses and her "passionate" charge nurses. She speaks of the residents with a genuine warmth and affection. "I refuse to call them clients. They are not clients. This is their home and we must always remember that. We are co-workers whose role is to add value to each person's day."

A focus on individual care

In her 27 years at Whareama, Wilkes has witnessed the shift from routine, task-orientated care to a much stronger focus on individual care. Ten years ago Wilkes, then a charge nurse, went to Australia to learn more about validation therapy as a way of caring for older people. That way of care stilt strongly informs the care at Whareama. How is that philosophy of individual care reflected in the daily life of the residents? "It's all about choices--about what food they want to eat; about what time they want to get up; about what time they go to bed. If they've been out for the evening they can come home at any time they want. If they can't sleep, the night staff are there to have a cup of tea and a chat with them, or to watch a video, if that's what they'd like to do."

There are residents' meetings where they can raise issues of concern or suggest changes. "There is always room for improvement in individual care," Wilkes says. "Each resident is uniquely and beautifully individual and we must always nurture that."

The keys to providing such care is trusted staff "who have to have an affinity with older people" and constant caregiver education. Caregivers are encouraged to work towards gaining the national certificate in the care of the older person and a small celebration is held whenever someone completes the certificate. "We really value caregivers as part of the team." She thinks life experience is important for a caregiver and notes that those "steadfast and committed caregivers" are normally older women. But she loves the energy young caregivers bring. "One of the young caregivers recently had her belly button pierced and the residents were delighted."

She also pays tribute to Whareama's two part-time recreation officers, partly funded by trust funds left by residents. "They do an incredible job and their role is important in our commitment to normalisation. There are both group and one-on-one activities but there is no pressure on residents to join in."

A recent highlight was the Whareama Ball, complete with gowns, live music, ballroom dancing, including fall-safe chairs, and supper. "It was fantastic and so many residents commented that they hadn't danced for so long."

Wilkes has experienced work at Whareama under the not-for-profit regime of the Anglican Church and now under New Zealand Life Care who bought the 48-year-old facility in 2002. "I have found New Zealand Life Care to be a good employer. Obviously they run it as a business and want to make a profit. I run a good business as Whareama is always full."

She became manager in 2002 and admits that she has not enjoyed all aspects of the role. "I wondered at first if, when disciplinary issues arose, I would be able to separate my role as manager from the emotional bonds I've built with staff over the years. But I've found I can do that. There are some frustrations--there's too much paper work and I've been asking to have the carpet replaced for a long time. But I believe New Zealand Life Care's focus is in the right direction and we have learnt a lot from each other."

Long-serving staff

She would love staff to be paid more but says that valuing staff "is not all about money". Clearly a number of staff feel valued as they have worked at Whareama for many years. One registered nurse, Joan Aldridge, has worked there for 30 years and Wilkes names a number of caregivers and ancillary staff who have worked there for more than 15 years. "We have such good staff but I put a lot of effort into that."

There has been increased turnover in the last couple of years and where once ten or more people would apply for a caregiver position, now just one or two are applying. Two of her daughters began their nursing careers as caregivers at Whareama.

She is active in an action group of Nelson aged-care providers lobbying the Nelson Marlborough District Health Board for more money for aged care. At one meeting, a Whareama caregiver invited DHB members to come and work with her for a day and one took up the invitation. "It hasn't meant more money but she was impressed with the caregiver's work and now has more understanding of what quality aged care involves," Wilkes said.

If she had the chance to tell Health Minister Annette King her priorities for the sector they would be "more funding, more funding and more funding".

Wilkes said receiving the Gerontology Nurse of the Year Award was "very humbling" and a reflection on the whole team. "I'm not an academic whiz kid kind of a nurse; I'm just Raye Wilkes and everybody here helps me fly in my job. I have a passion for aged care and people see that that passion is catching."