The critical shortage of young nursing talents in the elderly care industry needs to be solved
After working as a therapist in a medical and elderly care institution in Beijing for four years, Li Ahua, a girl born in Hebei Province, born in the 1990s, decided to change careers, bid farewell to her old man who had served for several years, and left her love of rehabilitation.
On the other hand, Zhang Xin, a girl from Shandong Province, blames herself for not being able to help her mother who has lost her ability to take care of herself find an affordable elderly care institution with a professional medical team.
Behind the two rather helpless young people, there is an increasingly prominent social problem: the traditional home care model has been impacted by factors such as family size miniaturization, cultural diversification, and increased family care burdens, and its functions have been gradually weakened, but elderly care services The level of socialized supply in China has not reached public expectations, especially for some disabled and semi-disabled elderly care and care needs.
In order to actively respond to the further deepening of my country’s population aging, the "14th Five-Year Plan for National Economic and Social Development of the People’s Republic of China and the Outline of Long-Term Goals for 2035" proposed that during the "14th Five-Year Plan" period, we must vigorously develop the general population. Favorable old-age care services support families to undertake the old-age care functions, and build an old-age care service system that is coordinated with home and community institutions and combines medical care and health care.
In order for the policy to be better implemented, the barriers to talents in the elderly care industry must be broken first.
How to attract more young people to join the "Silver Hair Industry" has become a top priority.
There is a huge gap in elderly nursing talents
The peaceful life of Zhang Xin's family became hectic after her mother lost her ability to take care of herself due to a sudden cerebral hemorrhage.
The father who ran the orchard in his hometown contracted out the orchard and took care of his wife full-time.
Zhang Xin gave up his original idea of going to work in other provinces, settled in Jinan, and used his vacation to "run back and forth".
Not long after, Zhang Xin's father also became ill, which made her burden suddenly increase.
She took her parents to the hospital in Jinan, and at the same time, she brought in an uncle from her hometown to take care of her.
But relying on relatives and friends is still not the answer. The doctor also expressed the suggestion that "mothers should refer to rehabilitation institutions". Zhang Xin could only ask people around and inquire about some local elderly care institutions.
The information returned is not ideal-most institutions are unwilling to accept elderly people like Zhang Xin's mother who are unable to take care of themselves. A small number of them are willing to accept, and the charges are far beyond her ability to bear.
In desperation, Zhang Xin sent his mother to a nursing home in his hometown.
"There are more than 20 elderly people living in the hospital. There is only one attending doctor, three female caregivers over the age of 40, and occasionally a young man with a disability as a helper." Zhang Xin said that she originally thought of this nursing home. There are too few staff, but just during the stay of the mother, one nurse resigned on the grounds that "work is too tiring, and I can't do it when I am too old."
This made Zhang Xin's mother's nursing situation worse. Once the nursing staff got busy, they would forget the old man who "cannot speak and move", "the feeding is not on, and the bedsores on her body have not been broken."
The experience of Zhang Xin's family is not an isolated case.
The results of the fourth sample survey of the living conditions of the elderly in urban and rural areas in China conducted by the National Office for Aging, the Ministry of Civil Affairs, and the Ministry of Finance show that there are roughly 40.63 million disabled and semi-disabled elderly people in China.
However, data from the "2018 China Civil Affairs Statistical Yearbook" shows that there are only 44,102 qualified elderly care workers in my country.
The domestic elder care service industry is facing a "employment shortage" across the board, and young nursing talents are even more scarce.
According to a report released by the China Philanthropy Research Institute of Beijing Normal University, even according to the general 1:3 ratio of care for the totally disabled population, the scale of my country’s elderly care talent gap has reached 5 million people. Related professional service talents are also lacking.
The attractiveness of the elderly care industry to high-quality labor such as college students is obviously insufficient.
In 2020, when a reporter from China Youth Daily and China Youth Daily visited a grassroots nursing home in a county in Shaanxi Province, they learned that in this institution that supports 42 disabled and semi-disabled elderly people, caregivers work in two shifts. It is very hard to ensure that the elderly are taken care of the whole process of eating and living for 24 hours.
The reporter noticed that the more than 10 caregivers in this nursing home are all middle-aged people between 40 and 50 years old, and there is no young employee.
Not long ago, the research team of the Standing Committee of the Gansu Provincial People’s Congress conducted a survey on the construction of the province’s elderly care service personnel. It also found that as of December 2020, there are only more than 5,300 employees in Gansu’s elderly care institutions, of which 2,400 are professional nursing staff. Many people can only meet 60% of actual needs, and the per capita conservation ratio of 1:6 is far lower than the national average of 1:4 per capita.
In particular, the shortage of professional talents in mental care for the elderly, rehabilitation and health care for the elderly, and operation and management of elderly care institutions is more prominent.
Even in Shanghai, where the overall level of development of the elderly care service industry is relatively high, and the standardization and standardization are good, Shanghai still has the problems of low quality of elderly care workers, serious shortage of numbers, and greater mobility.
A "Shanghai Elderly Care Institution Evaluation Report" released in 2018 showed that from the total number of caregivers, the number of caregivers employed in the surveyed elderly care institutions reached 12,918, and the ratio of caregivers to elderly beds was 1:6.48.
According to the "Requirements for Facilities and Services of Elderly Care Institutions" (DB31/T685-2013), the surveyed elderly care institutions need approximately 18,417 caregivers in total.
It can be seen that there is a big gap in the demand for elderly care workers.
In Shanghai, 91.2% of the nursing staff are women; from the perspective of age structure, the percentage of 51 years old and above is 59.88%; from the perspective of education structure, the percentage of junior high school and below is 87.27%.
Retaining young people cannot rely solely on ideals
The elderly care service industry is regarded as a sunrise industry due to the rapid growth in demand.
However, such an industry with great development potential is not only out of the scope of young people's favorite employment, but also a large number of young people have the idea of "leave" after entering the industry.
Yuan Chunyun, who worked as a nursing assistant in the Nursing Center for the Elderly in Binhu Century Community, Baohe District, Hefei, Anhui Province, was a nursing nurse. She was a nurse for 11 years and entered the aged care industry for 4 years. He is the youngest nurse in the whole institution. , Daily needs and 3 colleagues are responsible for nursing care, rehabilitation physiotherapy, and home care for 11 elderly people.
Among the 11 elderly people, there are elderly people living alone, elderly people with hemiplegia, and elderly people suffering from Alzheimer's disease and showing cognitive impairment. The oldest is 92 years old.
This requires caregivers to pay more love, care and responsibility. They should observe the actions of every elderly person, and pay attention to the spiritual needs and psychological changes of the elderly through chatting and encouragement, just like managing an "elderly kindergarten".
This made Yuan Chunyun's "biological clock" several hours earlier than others.
After arriving at work at 5:30 in the morning, she must call the elderly to get up on time, squeeze the toothpaste, take them to the bathroom to wash, and take the elderly to share meals and feed them.
After that, monitor blood oxygen and blood pressure for the elderly, and dispense and take medicines for the elderly suffering from hypertension, cerebral infarction and other diseases.
For the elderly who have difficulty swallowing, the tablets must be ground.
Then, she will take the elderly to do handicrafts, finger exercises, watch TV, and rehabilitation exercises until lunch.
After 2 o'clock in the afternoon, the elderly who had a lunch break got up, and the caregiver had to help them wash up, clean up and defecate, disinfect the room, and tidy up the sheets.
On the night shift, he has to inspect the room every two hours to supervise and help the elderly to urinate, observe the elderly’s breathing and pulse, check whether the elderly is wearing the quilt, whether the temperature of the air conditioner is appropriate, whether the elderly press the remote control indiscriminately, and check many small detail.
The complexity of the work is only one aspect. Sometimes the caregiver has to face some grievances, because some small mistakes are reprimanded by the elderly and their families.
Yuan Chunyun said frankly that the job is hard and bitter, but the salary is only more than 4,000 yuan.
At present, it may be a feeling that supports her to continue to work.
"When you put your heart and soul into it, you can also enjoy the pleasure and sense of gain in this profession. The elderly are actually very cute. You are kind to him, and he is really kind to you and treats you as his family."
However, an industry that can develop healthily in the long term cannot be supported by ideals alone.
For this reason, more young people will choose to "get out" after entering this industry.
The reporter noticed that recently, at the "dual selection meeting" for nursing care majors held by Tianjin Polytechnic University, graduates were robbed by companies.
Even the person in charge of an elderly care organization found the school and said, "I want all of you who graduated!" But at the "Tianjin Elderly Care Industry Summit Forum" held that day, some employers bluntly said, "Some young people When he came here, he had to teach from scratch, but he learned the skills and left soon."
A follow-up survey conducted by the third-party education evaluation agency Mikes on the "high attrition rate" of the industry shows that from the perspective of the development of national pension vocational education, the attrition rate of students in the first year may reach 30% in the second year. 50%, 70% or even higher in the third year.
Two factors hinder young people from entering the elderly care service industry
After graduating from Cangzhou Medical College of Rehabilitation Technology, Li Ahua was once excited about being able to work in this major.
Li Ahua hopes to use her own technology to help more people. Faced with boring and heavy work, she has never retreated.
Some units and communities contact their institutions to provide home rehabilitation services for the elderly, and she often takes the initiative to sign up.
However, the small monthly salary and the career development plan from "junior therapist" to "chief therapist" formulated in the hospital still make this young man often feel that the future is bleak.
In the end, it was the inflammation and pain caused by the frequent flexion of the wrist that gave Li Ahua the idea of changing careers.
Although she was a little bit ashamed of her grandparents who were only halfway through individual treatments, she still "lowered her head in front of reality."
During the interview, the reporter found that low income, difficult working conditions, heavy work content, easy to feel wronged, and lack of upward channels are the main reasons why young people leave the elderly care service industry.
The "Survey Report on Employment Willingness of Chinese College Students in Elderly Care Services (2019)" released by the China Philanthropy Research Institute of Beijing Normal University is the first survey conducted specifically for college students in senior care related majors in my country.
Among the 3189 college students who participated in the survey, 40.41% expected the salary to be between 5001 yuan and 7000 yuan, and 568 expected the salary to be more than 7000 yuan.
Not long ago, a special survey conducted by the Shanghai Elderly Service Industry Association showed that the monitoring values of the after-tax salary income of elderly care workers in 2020 are: high digits 7735 yuan/month, median 4846 yuan/month, low digits 2,854 yuan/month, The average is 4985 yuan/month.
In 2019, the average annual salary of skilled talents in Shanghai reached 127,900 yuan. In contrast, the income of elderly care workers is a bit low.
This is one of the important factors that make it difficult for the industry to attract young people.
The unclear career path is another "bottleneck" that is difficult to break through in the elderly care service industry.
Yang Lei, dean of the School of Health of Shanghai Urban Construction Vocational College, believes that, first of all, the professional qualifications of elderly care workers in our country are insufficient.
In Japan, elderly care workers can take the first, second, and third level guardianship certificate. This certificate is very professional and can be recognized all over the world.
In contrast, my country's senior care worker certificate examination is not very professional, and many contents are borrowed from the nurse qualification certificate examination, which does not reflect the characteristics of the elderly care industry.
Secondly, the imperfect title system also restricts the development of graduates. It is difficult for them to obtain the establishment of a public institution by virtue of the senior care qualification certificate, so there is no way to climb the title.
Although private institutions account for more than half of the elderly care industry, the establishment is the industry's "vane", which will affect the income of employees, promotion channels, and social recognition.
For example, she said that a student in the college won the second prize in a national vocational skills competition. The school recommended him to a senior care institution sponsored by the Shanghai government for employment, and hoped that the unit could set aside a career establishment.
Although the unit welcomes this student to work, the final problem is still stuck in the establishment.
"If the Human Resources and Social Security Department does not release the establishment, even if the graduates work in some public pension institutions, they will switch to private institutions after two or three years of training, and public institutions will become a springboard for cultivating talents." Yang Lei said.
Lack of talents will restrict the development of the industry for a long time, and put most social elderly care institutions in an awkward situation-as long as they can maintain their own homes, they are not willing to go to elderly care institutions; and there is a real need for elderly care institutions. , The semi-disabled elderly will be excluded because of the lack of professional talents in the elderly care institutions, who can only provide general living care and cannot meet their own rehabilitation and nursing needs.
The mismatch between supply and demand affects the operation and operation of elderly care institutions, resulting in insufficient service funds, imperfect facilities, limited elderly care functions of institutions, and low-level operation of an aging society. It has discouraged young people who wanted to engage in the elderly care service industry, causing the entire industry to stay away. In a vicious circle.
How to let young people see the upside and hope of the silver hair industry
Although the development of the elderly care service industry faces many difficulties, some constructive ideas and pioneering practices have begun to appear in various places.
At present, more than 200 colleges and universities in my country have opened nursing service and management majors, and gradually established a three-dimensional professional education system from technical colleges, vocational schools, vocational schools to undergraduate schools.
In 2020, the country's first independently established undergraduate major in elderly care service management was approved by Shanghai University of Engineering and Technology, and 33 students were enrolled in the first batch.
Here, students will receive a full-cycle industry-university-research practical education, extending classrooms from classrooms to enterprises, nursing homes and communities.
In recent years, relevant government departments have retained high-educated and high-quality talents for the elderly care service industry by improving remuneration, strengthening training, and holding vocational skills competitions.
In 2020, the Beijing Municipal Bureau of Civil Affairs and many other departments jointly issued the "Beijing Implementation Measures for the Training and Training of Elderly Service Talents", with a total of 18 contents, among which for the first time job subsidies are linked to the professional skill level of caregivers, and incentives and allowances for senior care positions are established. According to junior workers, intermediate workers, senior workers, technicians, and senior technicians, rewards and allowances of 500 yuan, 800 yuan, 1,000 yuan, 1,200 yuan, and 1,500 yuan are given to each person per month.
In order to guide more new forces to join the elderly care service industry, the "Measures" also set up graduate entry rewards, which are distributed in three years according to the standard of 60,000 yuan for undergraduate and above, 50,000 yuan for junior college (higher vocational), and 40,000 yuan for secondary vocational education. Onboarding rewards.
Not long ago, the Anhui Provincial Civil Affairs Department jointly issued the "Notice on the Selection of Training Bases for Elderly Care Service Practitioners", clarifying the selection of 10 provincial-level training bases for elderly care service professionals in the province and the selection of 5 elderly care workers. Provincial-level training bases, intensify the cultivation and cultivation of composite professional talents for elderly care services.
In 2019 and 2020, the Lanzhou Civil Affairs Bureau of Gansu Province, the United City Federation of Trade Unions held two consecutive senior care workers vocational skill competitions, and 6 contestants were awarded the title of "Gansu Province Technical Models" by the Provincial Federation of Trade Unions.
In addition to the guidance of government departments, what is even more gratifying is that some practitioners are actively looking for ways to solve the talent problem.
For example, more and more elderly care institutions have started various forms of contract cooperation with surrounding medical and health institutions.
This not only attracted a group of high-quality medical talents to participate in the elderly care business, but also expanded the scope of elderly care services to health care diagnosis and treatment, nursing and rehabilitation, tranquillity care, psychological and spiritual support, etc., creating greater opportunities for young practitioners. Room for improvement.
"High-quality medical and nursing services are inseparable from high-level medical rehabilitation and nursing personnel." Ma Qinghua, deputy dean of the Third People's Hospital of Xiangcheng District (Xiangcheng District Weitang Town Health Center), Suzhou City, Jiangsu Province, said. Community health institutions have ensured the operation of elderly care institutions within their jurisdiction by providing basic medical care and health management services.
However, in the long run, the primary health personnel resources are weak, the income level is low, and the professional geriatric knowledge is especially lacking.
He suggested that relevant departments such as health and health can set up special funds for old-age medicine to reward grassroots health talents, especially young talents, to join medical and elderly care services, and create more training and learning opportunities to help grassroots medical institutions cultivate more senior citizens. Medical comprehensive talents.
The application of the Internet of Things, big data, and artificial intelligence technology in the field of health care and elderly care has also increased young people's attention to the elderly care industry, giving this "sunset career" its own "sunrise temperament".
In the virtual nursing home in Chengguan District, Lanzhou City, Gansu Province, the reporter saw that the operators of the dispatching command center can dispatch orders based on the information and service items for the elderly displayed on the screen. The old man's nostalgia for home has realized his desire to provide for the aged at home.
The heroes behind the creation of this "nursing home without walls" are the post-80s.
Liu Mingzhe, the person in charge of the software developer, said while operating the mobile app that the mobile client includes functions such as housekeeping, restaurant service, one-key communication, policy guidelines, and electronic malls for the elderly, benefiting more than 120 franchised companies.
"To help the elderly of today is to help tomorrow's self" has gradually become the consensus of contemporary youth.
A new type of old-age care model in which young people first help the elderly and save these volunteer service time in the "time bank", and then "take it out" when they are old, is also taking root in many places, forming an old-age care that the whole society participates in." New cycle".
However, there is still a long way to go for the elderly care service industry to completely solve the problems of difficulty in recruiting and retaining people.
During the interview, Shao Zihong, founder of Anhui Lu’an Lotte Elderly Service Co., Ltd. and Secretary-General of Lu’an Elderly Service Association, suggested that the public should have more understanding and support for the position of nursing staff; enterprises and vocational colleges should develop more schools and enterprises Cooperative, order-based training, and establish normal and dynamic connections to solve the problems of insufficient staff and overage; the school should strengthen the purpose of students’ learning at school and let them clarify their professional positioning; local nursing care industry associations should give full play to The role of the government, academies, and enterprises to conduct special job fairs, skills competitions, and training sessions, and form a joint effort to find common problems in the industry, submit reports to government Recognition, departmental permission, and college support" talent training pattern.
China Youth Daily·China Youth Daily reporter Wang Hao, Wang Haihan and Wei Qimeng Source: China Youth Daily