The rhetoric and reality of nursing in aged care: views from the inside

Background: Aged care services and nursing roles are evolving in response to policy reform and increasing consumer expectations, however the nursing workforce is declining in numbers. Aims: To examine registered nurses' perceptions and experiences of working in aged care. Methods: Descriptive, exploratory study involving thematic analysis of individual interviews. Results: Key issues related to: professional role strain; workforce challenges; managing expectations, relationships and communication; balancing rights and risk in decision-making; changing models of care and impacts of policy and regulation. Conclusion: Expectations and perceptions of aged care nursing are unclear and conflicted. Nurses face significant challenges in meeting consumer, profession, organisational, and policy expectations amidst workforce instability and resource constraints. Structural barriers and aged care policy environments represent significant threats to sustaining nursing in aged care.