Health Times December 2017

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December 2017

Regional and Remote Feature + Cultural awareness improves clinical leadership + Online pharmacy training for Remote Area Nurses + Alice Springs nurse earns top award for bringing dialysis to remote communities + RAHC sends its 5000th urban health professional to the Northern Territory

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December 2017 We hope you enjoy perusing the range of opportunities included in this Issue. If you are interested in pursuing any of these opportunities, please contact the advertiser directly via the contact details provided. If you have any queries about our publication or would like to receive our publication, please email us at contact@healthtimes.com.au

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Online pharmacy training for Remote Area Nurses By Sharon Smith

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emote Area Nurses (RANs) have been described as ‘Specialist Generalists’; meaning that RANs need to know a little bit about a lot. RANs are recognised as forming the backbone of rural and remote primary care and provide a growing volume of services, especially in relation to chronic disease management, and practise at an advanced level in a collaborative manner often with limited or distant medical. Dealing with patients with both chronic and acute conditions across the lifespan, often involving many generations of family, within the context of a culture and community that is not their own is only part of the job description. Often RANs take on other professions’ roles; finding themselves acting as the pharmacist, social worker, driver, cleaner, or even veterinarian. The Centre for Remote Health is a joint centre between Flinders University and Charles Darwin University that offers a number of courses catering to the RAN such as the Pharmacotherapeutics for Remote Area Nurses course, available online or as a two-day workshop in Alice Springs. Course facilitator Tobias Spear describes the course as being suitable for current RANs and those looking to move into the area. “While it is beneficial to have experience in primary health care, particularly in the

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remote context, it is not necessary. One of the positive and quite unexpected features that we have found with the conversation to online delivery is the significant proportion of participants who are undertaking the course in preparation for going remote. “People are using the course as a first foray into the remote space, and as such the course contributes to the orientation to how health is delivered in the remote context. The course informs participants of the distinctive features of the remote context, including scope of practice, culturally safe and responsive care, and the relevant resources.” The self-paced online course encourages clinical reasoning, knowledge development and use of recommended evidence based information sources. Participants benefit from the clarification of the parameters that dictate and regulate the scope of practice of health professionals in Australia, and learn the framework that enables RANs to determine whether an activity is within their individual scope of practice. Originally developed some 15 years ago in response to a lack of training for RANs, the face-to-face pharmacotherapeutics course was adapted into an online version


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Aboriginal colleagues. The course includes a section on cultural safety and is delivered in a way that demonstrates culturally safe and responsive practice,” says Tobias. Upon completion of the course participants are able to include up to 30 hours of self-directed learning, assessments and online activities in their CPD record with the certificate of completion as evidence of the undertaking. The course is part of a suite offered by the Remote Area Nursing stream which also includes short courses, workshops and postgraduate qualifications in remote and Indigenous health through Flinders University.

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to give greater access to participants for a range of budgets and locations. The course is continually updated incorporating participants’ feedback to ensure that it is current and meeting the needs to participants and stakeholders. The pharmacotherapeutics course covers 6 clinical modules, including hypertension, Type 2 Diabetes, respiratory disease (asthma and COPD), mental health (depression and psychosis), antibiotic use and pain management. It assists participants in developing clinical reasoning to ensure safe and appropriate medicines use. “Cultural safety is an important component of the pharmacotherapeutics course. The content, activities and assessments are guided by the Aboriginal and Torres Strait Islander Health Curriculum Framework and have been reviewed by


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Industry shortage leads to new program in grief and bereavement care

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he Australian Centre for Grief and Bereavement (ACGB) is calling on psychologists, counsellors, and allied health professionals to update their qualifications in grief and bereavement counselling following a chronic shortage of appropriately trained professionals currently working in the field. According to ACGB’s CEO, Mr Christopher Hall, there is now strong evidence to suggest that many Australian health professionals who work in the frontline of bereavement counselling and intervention are not sufficiently supported with up to date training and education on the topic. “We now know that when it comes to working with grief and bereavement, many practitioners feel that they are drawing on very old models of understanding, some of which date back to the late 1960s. As a field, the area has significantly progressed, and at ACGB we believe that Australian practitioners should have access to worldclass training and education on the topic.” he said. The ACGB’s call for updated training comes on the back of the release of its new Graduate Certificate in Bereavement

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Counselling and Intervention (GCBCI) which will be offered in Melbourne, Sydney and Brisbane in February 2018. The GCBCI is Australia’s first Nationally recognised post-graduate VET qualification in this field. It aims to empower psychologists, counsellors and allied health workers with practical skills and training around a number of core concepts in grief and bereavement. These skills are in constant demand in both Australia and overseas, and are especially drawn upon during times of crisis such as natural disasters and acts of terrorism. As Australia’s leading Greif and Bereavement authority, and a Registered Training Organisation, the ACGB is in the unique position of being able to run courses that are grounded in practical, applied knowledge that practitioners don’t have access to anywhere else. The result is a much more agile qualification that draws from the intimate connection between clinical services, education and evidence based research. Practitioners who are interested in updating their qualifications in this field are encouraged to visit the ACGB website at www.grief.org.au for a prospectus and enrolment application form. The Australian Centre for Grief and Bereavement offers a Graduate Certificate in Bereavement Counselling and Intervention. Further information can be found at www. grief.org.au


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Alice Springs nurse earns top award for bringing dialysis to remote communities By Nicole Madian

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aving grown up in the regional town of Maryborough in Queensland, nurse Sarah Brown was never drawn to life in the big cities. On the contrary - having developed a passion for community nursing, Ms Brown’s career quickly took her to remote Northern Territory, where her years long dedication to the region’s aboriginal communities, lead to her being named Nurse or Midwife of the Year in the 2017 HESTA Australian Nursing & Midwifery Awards. Her passion for nursing goes back to when Ms Brown was just a young girl. “When I was about 12 I started visiting a nursing home on Saturday mornings and got a bit obsessed with death and dying and good nursing care,” she says. “When I finished school I studied nursing in Armidale NSW and Sociology, Cross cultural communications, Primary Health Care and Indigenous health were the subjects that floated my boat.” After graduating, Ms Brown completed her first year at St Vincent’s hospital in Darlinghurst her first stint living in the big smoke. “After St Vinnies I moved to Adelaide and got a fantastic job working as a community nurse in the Aboriginal Medical Service - I thought all my Christmases had come at once.”

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With so much of her study focused on what was happening in the Northern Territory, Ms Brown decided to apply for a job teaching Aboriginal Health Workers based in Alice in order to experience life in the community first-hand. “This gave me the chance to visit remote communities for the first time and I fell in love! “Not long after I became a remote nurse and lived and worked in remote communities in the desert, the Top End and on Cape Barren Island in the Bass Strait for about 10 years all up. My partner and I had 3 kids along the way, so life was definitely full and challenging. While Ms Brown has worked in large teams, much of her experience as a remote nurse has been as the only nurse at the clinic. And although living in remote regions does pose challenges, Ms Brown said she loves the pace of community life. “I love the opportunity to be part of people’s lives and to help them make their communities a healthier place to be. “I guess there are a few more logistics to consider - you can’t pop down to the corner shop for some milk at 6 pm, it certainly made me value fresh fruit and vegetables and a newspaper


medicine making social enterprise, a garden with chickens and a pizza oven! “We started with one machine in Alice and one machine in Kintore and we’ve grown to 11 remote communities in the NT and WA with plans for more in the next year. Our aims are to get people home to country and help them have a good life.” Ms Brown says rates of kidney disease are much higher in remote communities, which is causing immense hardship across remote Australia. “There are many more people on dialysis now than 15 years ago, but we also got 157 people back home to their communities in the last twelve months,” Ms Brown says. “People are living longer and are able to continue living in their own homes, with their families, working in their communities rather than being health refugees. There’s hope now and great pride. The organisation also launched The Purple Truck, a mobile dialysis unit. “It can go to the places we still haven’t got dialysis and give people an opportunity to get out of the city and home for a few weeks. While Ms Brown and her team are working on building some new dialysis units in the NT and in South Australia, there are still many communities without access to dialysis. “We get some money from the government but we still do lots of fundraising, art sales, all sorts of things and communities support us where they can. “Hopefully one day there won’t be as many people who need dialysis because kidney disease is really a disease of poverty, dispossession and powerlessness. “The Purple House story is really a story of communities working really hard to make things better for themselves and their families. “I think remote communities have got a lot to teach the rest of us about determination and survival.”

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on the day it was printed when I came to town!” Whilst working in the remote towns of the Northern Territory, Ms Brown felt a particular pull towards the region’s aboriginal communities. “No two Aboriginal communities are the same,” says Ms Brown. “All have different cultural differences, languages and histories. “There is a lot of poverty and ill health in remote communities, but there are also a lot of strengths, such as looking after family and country, teaching their children and grandchildren. “They are people who have mountains of compassion and love despite really hard lives. “I have learnt what is important in life is not how much money you earn or what sort of car you drive but how you treat the people around you and the friendships you make.” It was Ms Brown’s association with the Pintupi people from the Western Desert, with whom she launched The Purple House, that lead to the project that would earn her her recent award. “The Pintupi people wanted to get a dialysis machine in Kintore so they could get their family members home to country and look after them themselves. “Dialysis is usually 3 days a week, so if you are from a remote community you really had to move to Alice Springs as there was no dialysis out bush at the time. “So they had an auction at the Art gallery of NSW and raised a million dollars! They knew what they wanted to do, but they had to work out how they were going to do it.” Ms Brown began helping the ‘kidney committee’ in 2003 to set up the organisation and to make plans. “The Purple house is our base in Alice Springs and it’s a real hub of activity - people coming for dialysis, to see a nurse or to ring their family. “There’s a kitchen and a fire pit, a bush


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Cultural awareness improves clinical leadership By Sharon Smith

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he Indigenous Allied Health Australia 2017 conference was focused on the integration of care, culture, connection and collaboration in the delivery of allied health care to Aboriginal and Torres Strait Islander patients across the Australian healthcare system. We spoke to workplace training facilitator Duane Vickery who presented at the conference on using these elements to get the best out of our workforce in order to provide better patient care. Reasons for developing our leadership skills in a cultural context are one and the same according to Duane, who presents the concept of leadership not as an instructive role but instead as an adaptive role, responsive to the needs and backgrounds of those you are supporting. This relies on embracing the adaptive leadership theory, which is a practical method of learning. It uses the individual’s technical (knowledge and skills) and adaptive (relationships, attitudes, behaviours) resources to build a foundation of learning, experimenting and then designing interventions to the challenges encountered. Duane explains the four-step process that adaptive learners must progress through in order to understand what it is to lead cultural responsiveness in a clinical setting. Cultural Awareness – being able and willing to recognise cultural differences; being aware

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of one’s own culture; and accepting the cultural differences within a population. Cultural Sensitivity – going beyond acknowledging cultural difference to respecting the other parties’ background, knowledge and customs, which may be uniquely different within their culture. Cultural Competence – having the attitude and knowledge how to empower one’s clients in regard to their own culture; and adapting one’s delivery of services to meet the differing needs of the population (by way of social, cultural and linguistic customs or norms). Cultural Safety – having a health delivery system that understands the power differential between cultures; has the barriers removed from policy, procedure and practices; and services are clientcentred so that behaviours of service providers are in response to the actions of the patient. We want to treat our patients with respect so they not just feel safe for that visit, but for return visits, and when talking to family and friends about the health service. Things as simple as gaining trust through learning how the locals say ‘hello’, or the respectful way of introducing yourself can be a


the adaptive leadership theory is important for mentors to be able to provide guidance and non-judgemental support to their mentee, and to help them clarify their own goals and be true to their own experiences and background. Everyone has a different experience and different background – black, white, woman, disabled, queer, old, young, immigrant – and we can all benefit from this kind of thinking. It’s really quite simple, Duane says. We have a diverse base of patients already, we just need to trust our guts as clinicians in building our awareness of sensitivity for the individual. “It’s not all about the clinician’s own outcome. What do I as the practitioner need to do to adjust to make the relationship more effective? I need to do the work! To look at the patient’s background, our difference, and my own cultural bias.” “By being adaptive we improve the diversity of our industry, and with this comes emotional intelligence as we care for people.” The Indigenous Allied Health Association has a Mentoring Program workbook and webinar that is accessible on their website. Duane is Managing Director of Education Training & Management Perspectives Pty Ltd (ETMP), a consultancy company specialising in leadership development and governance facilitation, education, training and research. He is an adjunct lecturer in Multicultural Studies at Avondale College, NSW and is a former Director of Worawa Aboriginal College in Victoria.

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big step forward in gaining your patient’s trust, and it can mean that patient who was forced to see you by their GP will actually come back and you will end up building a relationship with them. And quite possibly their family too. Inspiring a shift to cultural adaptiveness in a practice, be it a small privately-owned clinic or a large-scale publicly-funded institution takes action from the inside and not just talk. He has seen some response to his training with Private Health Networks moving away from Key Performance Indicators as a measurement and more towards Quality of Life indexes. That’s why Duane believes it needs to be the leaders implementing this change, of which mentoring is an important part. Mentoring can be a formal or informal relationship for a short or long-term period which is oriented to achieve clearly defined goals, either for a broader vision or life purpose. Both parties benefit from the relationship – as it should be focused on supporting the person, their career and support for their individual growth. This is where cultural sensitivity and growth through self-reflection can be beneficial for even the more traditionally ‘experienced’ mentor, who can learn from the mentee – each have the responsibility to bring their knowledge and experiences to the relationship. “It’s easy to be seduced into a place where you as the mentor are giving them [the mentee] all the answers, but you have to ask yourself – ‘am I building capacity or dependency?’. I don’t want to give them all the answers, I want to teach them to think for themselves, to navigate with curiosity,” Duane says. This is where having an understanding of


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RAHC sends its 5000th urban health professional to the Northern Territory

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he Remote Area Health Corps (RAHC) has placed its 5000th health professional into a remote Indigenous community in the Northern Territory (NT), since the program began in late 2008. The milestone was marked today at Parliament House with the Hon Ken Wyatt AM MP, Minister for Indigenous Health and Minister for Aged Care, presenting a certificate of recognition to Dr Vikki Tselepis, an Audiologist from Melbourne. Dr Tselepis has completed 17 placements since 2011 in both Top End and Central communities such as Galiwinku, Gapuwiak, and Santa Teresa amongst others and RAHC’s 5000th placement was at Mutitjulu and Papunya in Central Australia. RAHC is funded by the Australian Government Department of Health under the Indigenous Australians’ Health Programme: Stronger Futures Northern Territory. The stated aim of the program is to “address persistent challenges to accessing primary healthcare services for Aboriginal and Torres Strait people in the Northern Territory”. Tanya Brunt, National Manager – RAHC, said, “The 5000th placement is a significant milestone for RAHC. We have been successful in encouraging dedicated and skilled health professionals like Dr Tselepis to be part of the effort to close the gap in Indigenous health outcomes in the NT. RAHC has achieved a very high repeat rate of 80% of urban-based health professionals returning to undertake additional placements. Moreover, we are delighted that over the years some of the RAHC health professionals have taken the step of joining the permanent workforce in the Territory following their RAHC experience.”

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“At RAHC we endeavour to ensure successful placements and hence we provide the essential support and training to all our health professionals’ pre and during their placements. We offer a suite of free eLearning modules that meet criteria for Continuing Professional Development, a cultural and clinical orientation program and on-going support for new-toremote health professionals to make a smooth transition.” Minister for Indigenous Health, Ken Wyatt AM, said programs like RAHC were making a big difference to the lives of Aboriginal people. “I congratulate RAHC on its outstanding record of providing high-calibre, clinically competent and culturally sensitive health workers for the Northern Territory,” Minister Wyatt said. “Without this initiative, and dedicated professionals like Dr Tselepis, many people would have to go without, or delay health care attendance or have to travel long distances to access care. “While health is its highest priority, the program is also fostering lasting friendships and strengthening links between urban and remote Australia,” added Minister Wyatt. RAHC has recruited 1042 health professionals to more than 5,000 placements since its first placement in December 2008. This represents over 455 man-years of healthcare to the Territory. RAHC has experienced continued growth in demand for its services. Each year the actual number of placements has exceeded the contracted maximum under the funding agreement. The RAHC program is currently funded until 30 June 2018.


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UNDERSTANDING VICTIMS’ EXPERIENCE

THE KEY TO DRIVING CHANGE FOR A CQUNI RESEARCHER It was her confronting experience on the frontline of domestic and family violence that prompted Dr Silke Meyer to take on research into the complex victim support system. Now a researcher and lecturer with CQUniversity, Dr Meyer’s work is empowering other frontline responders to grow their impact for vulnerable women and children, too. Originally from Germany, Dr Meyer began her career as a social worker in intensive support services for families. After completing a Master of Criminology in Europe, then a PhD in Australia, Dr Meyer applied to join CQUniversity, to develop postgraduate programs in domestic and family violence practice – the first of their kind in Australia. “I’ve had the opportunity to turn my practice background and passion into my research, and then to turn my research expertise into a teaching program,” Dr Meyer said. “I now teach as part of a fabulous team at CQUni, in an innovative area of postgraduate studies, and my research projects complement that teaching.” Last year, Dr Meyer also led CQUniversity research commissioned by the Queensland Family and Child Commission, which highlighted the role of social support and community connectedness to empower parent victims of domestic and family violence. Analysing data from the ‘Talking Families’ survey of 2,501 parents across Queensland, her work found connectedness was a key protective factor. Dr Meyer’s current research projects include two program evaluations for the Department of Communities, Child Safety and Disability Services and an independent project examining procedural justice experiences of victims, perpetrators and court-related staff members. This project is supported by CQUniversity and Queensland’s Department of Justice and Attorney General. “Understanding how court experiences can shape the behaviour and decisions of those affected by domestic and family violence is crucial in better CRICOS Code: 00219C | RTO Code: 40939 | P_MISC_170044_RSH_HT2

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protecting victims and children, and supporting perpetrators towards becoming safer partners and parents,” Dr Meyer said. CQUniversity’s commitment to engaged research, through partnerships with a wide range of stakeholders, is especially rewarding for Dr Meyer. “I’ve been fortunate to work closely with government departments, NGOs and communities in my research – so I’ve been able to see the impact of my research on policy and practice in Queensland, and that is pretty rewarding for a researcher. It confirms that we’re doing meaningful work,” she said. CQUniversity’s suite of DFV courses includes a unit in Child Safety and Domestic Violence, and Dr Meyer currently has 32 students taking on the confronting topic. “The fact their learning is based solidly in real-life, local research findings is so important to them, and it really transforms the way they do their jobs,” Dr Meyer explained. Regardless of your professional background, CQUniversity offers comprehensive support for aspiring Research Higher Degree (RHD) students, to develop and consolidate research skills, and apply them in practical, real-world settings. The Uni offers part-time or full-time study options, online or at one of many regional and metropolitan locations across Australia. Visit cqu.edu.au/rhd for more information.


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Hurry!

Time is running out! Glad I booked “The Book” early last year! *Greg Mapp Major Prize Winner 2017

Book “The Book” early and share in rewards valued at over $26,000¥ and you could be a winner like Greg. AMH continues to offer professional business rewards to support you the the nurse, the midwife, the allied health professional. Purchase the 2018 AMH book or any current resource before December 31 and you will be in the draw to win one of these great rewards¥ to help you further in your quest for knowledge and excellence. Prizes include attending a conference related to your profession, new laptop computers and future editions of AMH resources. National Winner A major prize comprising flights, accommodation, conference registration, transfers & meal vouchers for up to 2 people to attend an Australian conference in their field, to the maximum value of $6,600¥.

Regional Winners

(NSW/ACT, VIC/TAS, QLD/NT, SA/WA)

4 x first prizes of either an Apple MacBook, a Microsoft Surface Pro or Lenovo Yoga to the maximum value of $3,300. Each region will also have 6 secondary runners-up who will receive a free copy of the next edition of Australian Medicines Handbook (Book or Online) valued at $220 each. Each region will also have 3 supplementary runners-up who will receive a free copy of the next edition of the AMH Children’s Dosing Companion (Book or Online) valued at up to $115 each. Maximum total prize pool of $26,460¥.

*Here’s what Greg had to say: “The conference was a success and the location was fantastic. We probably would never had experienced that without AMH.” Adj Assoc Prof Greg Mapp.

Terms & Conditions Apply. For full details and conditions of entry and to order your AMH resource, just go to www.amh.net.au. NSW Permit No. LTPS/17/18011. ACT Lic. No: TP 17/01940. SA Lic. No: T17/1833. The promoter is Australian Medicines Handbook, Level 13, 33 King William St, Adelaide SA 5000. The random prize draw will take place at Level 13, 33 King William St, Adelaide at 2pm on 23/1/18. Winners will be notified by email by 29/1/18 and draw results published on AMH website on 31/1/18. All values include GST.

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HealthTimes - December 2017 | Page 23


COSMETIC INJECTABLES 3 DAY WORKSHOP Aesthetic Training Australia provides Health professionals with a programme that leads to real opportunities and excellent understanding of Aesthetic procedures. Our trainers and staff provide students with a knowledge and ongoing support vital to success. Each delegate will be competent in the delivery of basic techniques of Botulinum Toxin and Dermal Fillers. Aesthetic Training Australia also provides Health Professionals with a strong understanding of business practice, marketing and legalities required to manage a successful cosmetic injectable business. Expand your clinical skills as a healthcare professional. Enjoy additional income by offering rewarding treatments that can improve clients self-esteem. Upcoming workshops: 19th, 20th & 21st February 2018 16th, 17th & 18th April 2018 (Melbourne) 4th, 5th & 6th June 2018

‘Ongoing monthly support & training’ Page 24 | HealthTimes.com.au


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HealthTimes - December 2017 | Page 25


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HealthTimes.com.au Page 26 | HealthTimes.com.au


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