DO you take an aged care resident in urgent need of the toilet to the bathroom? Or attend to the insistent buzzing of another who needs your help?
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These are the decisions that aged care nurses face, and since the announcement of the royal commission into the sector last October things are only getting harder.
The commission into aged care is assessing the quality of care provided in residential and home aged care to senior Australians and more than 1700 submissions have already been received.
A Central West aged care nurse would only agree to share the harsh reality of what working in the sector was really like on the condition of her anonymity.
Chronic under-staffing has always been a major issue during her eight years in the sector, and now with the commission's microscope firmly trained on aged care workers and facilities she said it was getting tougher.
Someone could miss a toilet because we have so many buzzers going off. You just can't get staff.
"Two staff can be responsible for up to 20 residents, but on a night shift staff levels are lower," she said.
"With the amount of stuff we do on a daily basis, I can see how things have slipped through the cracks, but with the number of staff we don't have time to do everything.
"Someone could miss a toilet because we have so many buzzers going off. You just can't get staff and I think that's where half the problem starts."
Also, since the commission has started, the nurse said the type of care given to residents has changed.
She said the use of bed rails and the provision of anti-psychotic medications to residents was now being phased out in the facility in which she works.
"It's [bed rails] now considered a restraint and everyone is panicking," she said.
"Anti-psychotics are considered a restraint ... a few of our residents have actually been taken off them."
The issue of other types of medication to residents has also become harder in recent months.
"It's much harder to give pain medications to the residents ... Panadol is not too bad," she said.
"You have to show the steps you've done first, such as re-positioning them, giving them a heat pack or other alternatives."
Despite the hard work and the under-staffing, this nurse said it was still a job she loved.
"When you have a resident come in you become family with them. You see them everyday, whereas their actual family might only come in for an hour or two."
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