December 2019
Regional & Remote Special Feature + Telehealth - reach patients in regional and remote areas + Drug free strategies to reduce the pain of labour + Parents instrumental in child mental health treatment + Remote and regional nurses must prioritise their own mental health
OPTIMISING MATERNAL WELLBEING ACM VICTORIA 1-DAY CONFERENCE FOR MORE INFO & TO BOOK TICKETS VISIT: bit.do/OMWB2020
Keep your career moving Ready to enhance your skill set? Charles Sturt University is the perfect place to achieve your career goals. Expand your professional practice. Want to become an expert in your existing field or study something completely new? Wherever you want to take your career next, we’ve got an exciting range of undergraduate and postgraduate courses ready for you. Choose your career area.
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Find out more csu.edu.au/allied-health CRICOS Provider Number for Charles Sturt University is 00005F. © Charles Sturt University, 2019. F6339.
Page 02 | HealthTimes.com.au
Get organised for the year with our 2020 CPD calendar! Become a Champion of Change. Make 2020 the year you invest in your learning and development. CPD COURSES 2020 FEB 3&4 Wound Management Update Parramatta NSW 12 Genomics in Nursing Practice - Nursing Leaders of the Future Parramatta NSW 17&18 Wound Management Update Geelong VIC 24 Dementia and the Deteriorating Patient Canberra ACT 24&25 Wound Management Update Adelaide SA
MAR 2 Immunisation Update Launceston TAS 2 Practice Nurse Update Canberra ACT 2&3 Wound Management Update Goulburn NSW 4 Immunisation Update Brisbane QLD 5&6 Oncology Nursing Update Parramatta NSW 9&10 Wound Management Update Albury NSW 10 Elder Abuse Melbourne VIC 13 Diabetes Update Gold Coast QLD 13 Emotional Intelligence Study Day Melbourne VIC 16 Audiometry Workshop Newcastle NSW
18 Practical Management Skills for Nurse Managers Hobart TAS 19 NSQHS (2nd Ed) Changes and Challenges Bendigo VIC 23 Immunisation Update Canberra ACT 23&24 Wound Management Update Dubbo NSW 25 Urology Study Day Parramatta NSW 25 Palliative Care Parramatta NSW 26 Immunisation Update Townsville QLD
APR 2 NSQHS (2nd Ed) - Changes and Challenges Coffs Harbour NSW 3 Immunisation Update Parramatta NSW 6&7 Wound Management Update Launceston TAS 8 Breathing Life Into Infection Prevention and Control Wangaratta VIC
17 Child and Family Health Nurse Clinical Skills Workshop Parramatta NSW 17 Advanced Pain Study Day Perth WA 20 Immunisation Update Tweed Heads NSW 20 Practical Management Skills for Nurse Managers Parramatta NSW 22 Practical Management Skills for Nurse Managers Canberra ACT
1 Immunisation Update Warragul VIC
18 Advanced Pain Study Day Bunbury WA 18 Immunisation Update Coffs Harbour NSW
6&7 Introduction to Alcohol and Other Drugs Hobart TAS 7 NSQHS (2nd Ed) Changes and Challenges Darwin NT
28 Genomics in Nursing Practice - Nursing Leaders of the Future Brisbane QLD
7&8 Perioperative Safety, Changing Culture and Standards Canberra ACT
30 Ensuring Quality in Health & Aged Care Adelaide SA
8 Understanding and Application of Mindful Touch in Aged Care Parramatta NSW
24 Ensuring Quality in Health & Aged Care Canberra ACT 27 Immunisation Update Nowra NSW 27 Immunisation Update Parramatta NSW 28 Practical Management Skills for Nurse Managers Shepparton VIC
12 Aged Care Workshop Session 2 Adelaide SA
6 Binocular Vision Workshop Parramatta NSW
27 Diabetes Update Lismore NSW
30 Immunisation Update Tenterfield NSW
11 Aged Care Workshop Session 1 Adelaide SA
4 Practice Nurse Update Bega NSW
7 Practical Management Skills for Nurse Managers Brisbane QLD
16 Practical Management Skills for Nurse Managers Melbourne VIC
8&9 Mental Health Update Perth WA
MAY
18&19 Mental Health Update Orange NSW 19 Practical Management Skills for Nurse Managers Perth WA 25 Immunisation Update Parramatta NSW
1&2 Wound Management Update Melbourne VIC 8 Clinical Workshop for Care Workers – Client Assessment Course Parramatta NSW
28 Wound Round Parramatta NSW
8&9 Perioperative Safety, Changing Culture and Standards Brisbane QLD
29 Falls Risk Newcastle NSW
15 Palliative Care Canberra ACT
These CPD courses, dates and locations
03.12.19
JUL
20&21 Wound Management Update Whyalla SA 21 Diabetes Update Perth WA
6 Dementia and the Deteriorating Patient Parramatta NSW
24 Palliative Care Melbourne VIC
6 Aged Care Workshop Session 1 Hobart TAS
27 Ageing Changes and Vital Observations Sunshine Coast QLD
7 Aged Care Workshop Session 2 Hobart TAS
27&28 Wound Management Update Ballina NSW
13&14 Wound Management Update Brisbane QLD
29 Child and Family Mental Health Update Workshop Parramatta NSW
15 AOD and Mental Health Workshop Parramatta NSW
29 Introduction to Alcohol and Other Drugs Canberra ACT
20 Audiometry Workshop Parramatta NSW
25&26 Wound Management Update Broome WA 28 Practical Management Skills for Nurse Managers Darwin NT
AUG
14 Immunisation Update Parramatta NSW
6 Change Management for Nurse Managers Parramatta NSW 7 Palliative Care Perth WA
16 Genomics in Nursing Practice - Nursing Leaders of the Future Melbourne VIC 17&18 Motivational Interviewing Parramatta NSW 18 Wound Round Bowral NSW 22&23 Wound Management Update Muswellbrook NSW 24&25 Motivational Interviewing Perth WA 26 Self Management in Chronic Disease Parramatta NSW
are subject to change. Please refer
SEP
OCT
1 Wound Round Adelaide SA
6 Wound Round Melbourne VIC
2 Urology Study Day Parramatta NSW
8 Become a More Resilient You Parramatta NSW
3 Leadership in a Regional Area Shepparton VIC
8 Immunisation Update Parramatta NSW
3 NSQHS (2nd Ed) Changes and Challenges Wollongong NSW 3&4 Oncology Nursing Update Parramatta NSW 7&8 Wound Management Update Hobart TAS 18 Change Management for Nurse Managers Brisbane QLD
25 Palliative Care Wagga Wagga NSW
11&12 Wound Management Update Cairns QLD
JUN
webinars and online Australia during 2020. ACN also has short face-to-face CPD courses across to practice. ACN is proud to offer this range of NMBA for annual renewal and authority in achieving the hours required by the CPD courses available to assist you
10 Immunisation Update Mt Isa QLD
17&18 Wound Management Update Wagga Wagga NSW
21 Management of Palliative Care Need in Aged Care Parramatta NSW
19 Change Management for Nurse Managers Canberra ACT
24 Change Management for Nurse Managers Perth WA
24 Palliative Care Dubbo NSW
24 NSQHS (2nd Ed) Changes and Challenges Parramatta NSW
28 Ensuring Quality in Health & Aged Care Parramatta NSW
10 Change Management for Nurse Managers Melbourne VIC 10&11 Wound Management Update Darwin NT 12 Change Management for Nurse Managers Hobart TAS
18&19 Mental Health Update Wagga Wagga NSW
31 Nutrition & Hydration Coffs Harbour NSW 31 Clinical Workshop for Care Workers – Client Assessment Course Parramatta NSW
28 Breathing Life Into Infection Prevention and Control Adelaide SA 28 Assessment of the Older Person Bathurst NSW
CPD To book your place at one of these courses head to acn.edu.au/2020-cpd
12 Oral Hygiene Brisbane QLD 12&13 Wound Management Perth WA 13 Become a More Resilient You Melbourne VIC 15 Become a More Resilient You Hobart TAS
NOV 4 Binocular Vision Workshop Parramatta NSW 5 NSQHS (2nd Ed) Changes and Challenges Perth WA 9&10 Wound Management Update Mildura VIC 10 Become a More Resilient You Canberra ACT 10 Immunisation Update Parramatta NSW 12 Transforming Towards Sustainable Healthcare Melbourne VIC
16 Understanding and Application of Mindful Touch in Cancer Care Nursing Parramatta NSW
17 Become a More Resilient You Perth WA 19 NSQHS (2nd Ed) Changes and Challenges Gold Coast QLD
16 Child and Family Health Nurse Clinical Skills Workshop Parramatta NSW
23&24 Wound Management Update Port Macquarie NSW
21 Become a More Resilient You Parramatta NSW
26 Understanding and Application of Mindful Touch in Aged Care Parramatta NSW
22 NSQHS (2nd Ed) Changes and Challenges Adelaide SA 26 Breathing Life Into Infection Prevention and Control Hobart TAS 26&27 Wound Management Update Wollongong NSW 27 Aged Care Workshop Session 1 Darwin NT 28 Aged Care Workshop Session 2 Darwin NT
DEC 1 Practice Nurse Update Parramatta NSW 7&8 Wound Management Update Bathurst NSW 15 Wound Round Port Stephens NSW
Members Discounts available for ACN Fellows, and employees of ACN Affiliate organisations.
to the regional flyers at acn.edu.au/2020-cpd
for current information.
offer in your area? Contact us at See a course that’s currently not on
acn.edu.au/2020-cpd
cpd@acn.edu.au to discuss how we
can help you today.
1800 061 660
To book your place at one of our CPD courses head to acn.edu.au/cpd2020. 06.12.19
acn.edu.au/cpd2020 06.12.19
HealthTimes - November 2019 | Page 03
December 2019 We hope you enjoy perusing the range of opportunities included in this issue. If you are interested in pursuing any of these opportuities, 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 DISTRIBUTION 46,300
Advertiser list Aesthetic Education Australian College of Nursing Australian Medicines Handbook Australian Volunteers International Barwon Health Charles Sturt University
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All rights reserved. No part of this publication may be copied or reproduced by any means without the prior written permission of the publisher. Compliance with the Trade Practices Act 1974 of advertisements contained in this publication is the responsibility of those who submit the advertisement for publication.
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Next Publication: New Year, New Career Publication Date:
Tuesday 28th of January 2020
Artwork Deadline:
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Page 04 | HealthTimes.com.au
Volunteer overseas The Australian Government supports hundreds of Australians to volunteer overseas every year 26 developing countries
Return airfares and visas covered
1-24 month assignments
Living and accommodation allowances
Diverse skills and experience needed
Training, support and disability access
Nursing, midwifery and allied health professionals can apply for a fully-supported volunteer experience
Find out more: australianvolunteers.com 1800 331 292
HealthTimes - November 2019 | Page 05
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1300 221 971 | smartnurses.com.au To receive the free window tint, customers must order and finance a new vehicle (including demonstrator models) through Smartleasing between 4 Nov 2019 – 31 Dec 2019. The new vehicle must be procured through Smartgroup’s procurement team. Customers who are eligible and opt for the free window tint must have the tint for their new vehicle arranged for by Smartleasing and completed by a Smartleasing appointed provider, after the lease has settled. Customers acknowledge that the free window tint is non-transferrable and cannot be exchanged or substituted for cash or any other product. Vehicle orders placed by Smartgroup’s procurement team prior to 4 Nov 2019 are not eligible for this offer. Customers who choose to refinance their existing novated lease vehicle or salary package a used vehicle, irrespective of finance type, are not eligible for this offer. The directors, management and employees of Smartleasing, and their immediate families, as well as Smartleasing’s related companies, agencies, suppliers and all employees of the Queensland Government are not eligible for this offer. † Negotiated Smartleasing buying power discount on chosen vehicle may vary. *Based on the following assumptions: living in NSW 2560, salary: $70,000 gross p.a., travelling 15,000 kms p.a., lease term: 60 months, using the Employee Contribution Method for FBT purposes. Images shown may not be the exact car that the calculations have been based on. All figures quoted include budgets for finance, fuel, servicing, tyres, maintenance, Vero by Suncorp comprehensive motor insurance, Hydro Platinum Pack and re-registration over the period of the lease. Also includes, for Suzuki, Audi and BMW models only, 2 year Platinum Warranty insurance. Vehicle residual, as set by Australian Taxation Office, payable at the end of lease term. The exact residual amount will be specified in your vehicle quote. Vehicle pricing is correct at the time of distribution but may be subject to change based on availability.
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Page 06 | HealthTimes.com.au
BETTY JOSEPHINE FYFFE RURAL HEALTH SCHOLARSHIPS
At the University of Newcastle we are committed to delivering quality health and medical education to those in rural and remote communities. Through the generous bequest of Betty Fyffe, a range of scholarships are available for health students from rural and remote areas. Betty was a local Tamworth girl who grew up in the surrounds of her father’s chemist shops. Betty had an absolute passion for nursing and leaves this legacy as her way of trying to improve the education of doctors and nurses in training with hope that some will return to country areas to practice their profession.
VISIT OUR WEBSITE TO LEARN MORE NEWCASTLE.EDU.AU/FYFFE 2019 1044 I CRICOS Provider 00109J
HealthTimes - November 2019 | Page 07
If you don’t have the latest book, you simply won’t have the latest information!
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Time is running out for you to win one of our great rewards. Order Now. AMH continues to support professional education and offer responsible business rewards in our quest to enhance your knowledge and the quality use of medicines in Australia. Pre-Purchase the 2020 AMH book or any current resource before December 31, 2019 to be in the running to win great rewards to help you enhance and maintain current up to date knowledge and business excellence. Prizes include conference attendance related to your profession for up to 2 people including airfares and accommodation valued at $6,600*. There are also over 40 regional prizes valued at over $20,000*. Total prize pool of $27,540*. Conditions do apply so for full information go to www.amh.net.au. *Terms & Conditions Apply. For full details and conditions of entry and/or to order your AMH resource, please go to www.amh.net.au. NSW Permit No. LTPS/19/38280. ACT Lic. No: TP 19/04222. SA Lic. No: T19/1584. 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 11am on 22/1/20. Winners will be notified by email by 28/1/20 and draw results published on AMH website on 31/1/20. All values include GST.
Page 08 | HealthTimes.com.au
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HealthTimes - November 2019 | Page 09
Telehealth an opportunity for allied health professionals
T
he ability to deliver allied health services and information to patients in rural and remote communities is made possible by telehealth. Telehealth has many important functions, including long-distance patient care, advice, education, and monitoring. It has far-reaching benefits for isolated communities and offers allied health professionals the chance to reach them where they are.
Telehealth isn’t impersonal with the assistance of modern technology, which bridges the gap for those who use it. “Some clients feel uncomfortable speaking to a faceless therapist; however, given Facetime, Skype and a variety of video apps, telehealth can be conducted face-to-face without being directly in person.”
What health?
Though clinicians may baulk at providing telehealth, they can expand their business by gaining these skills, said Dr Phillip. “Allied health providers should consider providing and expanding their service to include telehealth. “Many people are time poor or are unable to attend regular sessions due to location, health restrictions, disability, transport issues, so telehealth is a growing service industry to satisfy the changing needs of our community.”
is
tele-
Telehealth is the use of telecommunication and virtual technologies to deliver health care services outside of traditional health care facilities. Psychologist Dr Karen Phillip says telehealth is beneficial for those in rural and remote communities and also is an opportunity for clinicians. “Telehealth is about using electronic tools to provide care remotely as it brings access to care and convenience to those needing support. “Clinicians have the opportunity to expand their services to those living outside their practice area. “Client reach can expand to all over Australia and the world as they have the opportunity to receive treatment or sessions from a specialised professional clinician,” said Dr Phillip.
Page 10 | HealthTimes.com.au
Why set-up telehealth?
Considerations for implementing telehealth It is crucial to explain to clients how telehealth works as it can be unclear, said Dr Phillip. “It remains confusing for some consumers to understand how a non-personal appointment can work, how payment is made, and
what confidentiality issues may present. “It is imperative the health clinician ensures their telehealth service is conducted in a private room just the same as if a client is in the room with the clinician. “Setting up a telehealth service means access to good internet service, confidentiality issues considered, and accessibly of telehealth preference of client met.” If telehealth is phone-based without the aid of visual, it’s vital to have excellent phone rapport, explains Dr Phillip. Tips for developing a rapport over the phone • Listen to what your client is saying; this includes tonality change, speed of voice adjustment, specific words expressed and pauses used. • Empathise with their situation or issue. • Adjust your vocal tone to match and connect with your client. • Paraphrase to ensure you understand your client correctly, and they know you are listening accurately. • Ask relevant questions and allow the client to expand in whatever area they need. • Collaborate with your client about their treatment. Dr Clinton Moore, a psychologist providing telehealth services, says it’s interesting that telehealth is sometimes preferred even when access to a tradition service is available. “This may be due to client concerns about visiting a physical psychologist’s practice, or out of convenience if they work from home and are unable to leave due to other commitments such as children.” While convenience and accessibility are apparent gains, one of the most significant benefits of telehealth for clients in rural areas is anonymity, explains Dr Moore.
“For those living in small towns, it can be difficult to maintain confidentiality when there may only be one psychology practice and other members of the community will be able to see you entering their office. “Although it would be wonderful to have no stigma around accessing mental health treatment, the reality is that it is still very much present and can prevent people from seeking help. “Telehealth means that clients in remote areas can still share their story with a professional without having to worry about their neighbours knowing.” There are several barriers to telehealth, though, according to Dr Moore, which include: Inability to gauge body language across a digital medium “By having to interact across either a web conferencing program such as Skype or a telephone, many subtle nuances are lost that might otherwise have informed the process of therapy.” Access to high quality and high-speed telecommunication networks “Australia is a vast country, and large sections are still not well covered in terms of internet connections. “This is particularly a problem given that mobile devices are increasingly replacing landlines. “It’s not uncommon for Skype sessions to freeze or drop out even when directly connected to a wired connection. But mobile data networks can be even more temperamental.” Clients at increased risk of suicide Telehealth poses a significant challenge for psychologists treating those in remote areas, as
HealthTimes - November 2019 | Page 11
the risk of suicide is high. “As you can imagine, a dropout is annoying at any time but can mean life or death if dealing with a crisis such as a suicidal client. “Clients in extremely remote areas are often unable to receive the emergency responses that we are used to in the city, but the psychologist still has a duty of care to ensure client safety. “This can mean calling an ambulance that may be over an hour away after a client leaves a telehealth session with no notice - a nerveracking experience for everyone involved.” Strick requirements to access telehealth Australians living in highly remote areas (classified as MMM regions 4-7) face the additional challenge of meeting access requirements for telehealth services under Medicare. “Young adult males living in highly isolated areas are up to six times more likely to suicide than their urban counterparts. “These same people are required to attend a GP in person before receiving rebated telehealth sessions. “For many, this requirement may be a deterrent to attending therapy if they are required to take off the better part of a day to travel to the nearest town with a GP to obtain a Mental Health Treatment Plan. “It’s wonderful that people in rural and remote areas can access subsidised mental health assistance, but there’s still a way to go before some of the most vulnerable in our country can truly call it accessible,” said Dr Moore.
Page 12 | HealthTimes.com.au
Telehealth just as effective as face-toface A study, ‘Telehealth delivery of memory rehabilitation following stroke,’ by Monash University researcher Dr Dana Wong showed that telehealth was as effective as face-to-face, group-based rehabilitation programs. “Not only did we find that people improved just as much on our key measures of memory function, but in some areas, our participants using telehealth improved even more than those being treated face-to-face. “We believe a key reason for this is in the integration of clinicians and the rehabilitation sessions into the patient’s everyday environment. “This provides the clinician with extra information and context about the patient’s everyday life. “It helps the clinician focus treatment, and it also maximises the relevance for the patient and aids in the generalisation of strategies and skills. “Telehealth is unlikely ever completely to replace face-to-face rehabilitation treatment but provides a feasible way to expand services into regional and rural areas to reach people in need of stroke rehabilitation support,” said Dr Wong. Simone Dudley, an occupational therapist with Therapy Connect, believes telehealth is key to increasing choice for those in rural and remote areas. “There can be difficulties recruiting allied health professionals with specific skills in thin market regions which subsequently affects participant choice and outcomes and reduces
WORKHOP PROGRAMME 2020
Weekend Workshops available for 2020 For more information visit: www.aesthetictraining.com.au Contact us at: 1300 817 524 or hello@aestheticeducation.com.au
Introduction to Cosmetic Injectables: Online + 2 day in-clinic workshop $1990 Our two day Introduction to Cosmetic Injectables workshop is Aesthetic Education’s flagship course and ideal for healthcare professionals who are passionate about facial aesthetics and anti-ageing. Our comprehensive online component will prepare you for the two day workshop where you will be given the opportunity to practice and enhance your skills on live models. Call today and let us help you get started in your exciting new career!
Platelet Rich Plasma: 1 Day in-clinic workshop $1190 Over the one day workshop we discuss the theory and practice of Platelet Rich Plasma (PRP) treatments for aesthetic purposes of skin rejuvenation. As with all AE workshops you will be given ample opportunity to practice your skills on live models.
Lipolysis & Fat Reduction: 1 Day in-clinic workshop $1590 (Price includes 1 Lipolysis solution kit) Lipolysis is a popular treatment for fat reduction. Our one day workshop teaches students to perform injectable lipolysis therapy to many body areas including the very popular under chin area. Price includes one lipolysis solution kit to get you started.
Advanced Skin Treatment: 1 Day in-clinic workshop $950 AE's one day Advanced Skin Treatment workshop will help practitioners to make sense of the multiple brands and ingredients on the market. You will then be able to provide your clients with the ideal products & routines for their skincare needs at home and at the same time advise on how energy-based devices such as Laser, IPL and Plasma pen can be used concurrently for best results.
consistency and continuity of supports. “Telepractice is an evidence-based, innovative solution to providing access to personcentred high-quality allied health therapy supports in thin market regions,” said Ms Dudley. Advice on setting up telehealth as an allied health professional • Research the various platforms and get to know the technology and capabilities (screen sharing, use of digital features, etc.). Practice with friends and colleagues. • Start with one client in an area that you are confident and work on problemsolving around how to adapt delivery to an online method. • Allocate resources to planning for session delivery and adapting methods to suit an online service delivery. • Be willing to offer the client a “proof
of concept” trial to test equipment, platform and environment and you as a clinician. • Be prepared for a lot of behind the scenes work to facilitate the delivery of services via telehealth. • Support the client with the “set up” phase to ensure adequate connection, space for sessions, positioning for sessions, resources are available, others in the team are connected, confidentiality and consent issues addressed. • Work hard on communications with the client and relevant others before sessions to ensure all required resources are available. • Work with family members, support workers or allied health assistants to facilitate interventions into a client’s routine. • Be prepared for fails.
HealthTimes - November 2019 | Page 13
Non-medical strategies to reduce the pain of labour
A
drenalin, the fear hormone, and interventions drive the birthing experience for many women, according to Australian midwives, but with the right support, it doesn’t have to be this way. Belinda Joyce, midwife and author of Survive and Enjoy Your Baby, said there are many strategies to reduce the pain of childbirth, but simply educating woman about labour can be powerful. “Just knowing how labour works and understanding what’s normal can have a positive impact.” A woman’s endorphins, which act as natural opioids, can be triggered with massage, meditation, guided imagery, deep breathing, music, dim lights, and more, throughout labour, explained Ms Joyce. “Being active and changing positions for comfort, and to open the internal diameter of the pelvis, are also important. “Women … who can get themselves into the ‘zone’ and birth drug-free feel such accomplishment. I truly believe it helps to set them up for those early weeks of mothering.” Some women need pain relief but delaying the use of medication helps establish labour and allows the baby to get into an ideal birthing position, said Ms Joyce. The power of endorphins Fear and the associated
Page 14 | HealthTimes.com.au
adrenaline
release can slow or even stop labour. The antidote? Endorphins. Endorphin hormones are released by the brain during labour to relieve pain. They have a similar effect to opioid drugs and are the same hormones that give people the ‘runners high’ after exercising, explained Ms Joyce. “During labour, endorphins will rise as the pain increases, and we can optimise this natural endorphin release by keeping the labouring mother comfortable, calm and feeling safe. “Endorphins are at their highest levels in women who feel relaxed, safe and calm. “So, those women will feel less pain and report feeling ‘high’ during labour and even in the early days after birth.” “We see the adrenaline release most obviously when women arrive at the hospital, and their labour ‘stops’ and then restarts once they settle in and feel comfortable.” Non-medical interventions during labour Massage Massage stimulates the release of endorphins. The lower back is most often massaged, but any form of massage will be helpful. A scalp massage can also be useful in relaxing the mother.
Massage oil enhances the sensations, as your hands will glide more freely. You can also use labour blends of essential oils. Midwives are generally well skilled at massage and can help guide the support person. Guided Imagery This technique involves all five senses. You can use a recorded script or download an app. Research shows that guided imagery can reduce fear and anxiety. This is great to practice in pregnancy to use it effectively in labour. Some women even memorise their script so they can use it in labour without the recording. Meditation Meditation is grounding and relaxing and is best practised during pregnancy. A guided meditation differs from guided imagery in that whole-body senses are not involved, just the mental state. Many recordings are available online or can be downloaded via an app. Deep breathing Contrary to what we see in movies, we don’t generally teach Lamaze style breathing in Australia. However, breathing deeply and breathing away the discomfort, rather than quick panicked breaths that don’t help with relaxation, are helpful. Most women know how to breathe, and depending on their stage of labour, midwives can demonstrate different patterns to try. Music Music sets the mood and can be very relaxing. Classical music works best.
Dim lights Keeping the room dark, quiet and calm helps the labouring mother feel safe and in control. The music and dim lights in combination helps people, including midwives and doctors, to slow down. So, when they walk into the delivery room, they can feel the mood has been set and they will be quiet and calm as well. Other ideas · Heat packs · Position changes, swaying and rocking · Emotional support from known support person, eye contact, listening etc · Baths, showers, spas. Baths really reduce the pain felt during labour. Hypnobirthing to promote a calmer birth Eugenie Pepper, a certified hypnobirthing practitioner, said hypnobirthing can harness hormonal physiology to promote a less painful birth. “During labour, the body produces a chemical called oxytocin, which helps progress labour. “Stress hormones affect the production of oxytocin. “Hypnobirthing takes breathing exercises and adds relaxation, visualisation and mindfulness and meditation techniques to help women relax and concentrate on the body and the birth. “Hypnobirthing can help manage stress hormones and reduce anxiety, which leads to a calmer birth.” When it comes to pain management during labour, there are many ways to encourage a gentle, less painful birth. Midwives can be guided by the client’s needs and preferences, as each woman and birth are unique.
HealthTimes - November 2019 | Page 15
Reproductive and sexual health for everyone, everywhere. Family Planning NSW delivers reproductive and sexual health education for nurses and midwives. Our highly popular education program will enable you to step up to the next stage of your career or to advance your skills.
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HealthTimes - November 2019 | Page 17
Parents instrumental in child mental health treatment
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wareness of mental health issues among children is growing, with increasing numbers of children seeking treatment for a variety of conditions. But when it comes to treating children, it’s important for mental health professionals to foster relationships with their patients’ parents, in order to facilitate long term healing. “When children seek and require psychosocial treatment, it’s beneficial to bear in mind it’s a family system and not a child alone that’s being treated,” says Psychotherapist, Julie Sweet. “Parents having identified an area of concern, whereby their children are involved, can begin open and transparent communication with their child. “Dependant on the child’s age, once identified, parents can start the process of seeking support through mental health services and family therapy, as well as therapeutic intervention for the child.” According to Ms Sweet, parents play an instrumental role in the success of their children’s mental health treatment. “If defensiveness, guilt and fear can possibly be suspended by parents, and instead replaced with openness, emotional agility, empathy and compassion, outcomes can greatly vary.” Ms Sweet says we do better when we know better, so parents educating themselves and utilising resources not only enables improved skill
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sets to develop, it provides children with the best care and treatment. “Parents are encouraged to ask for help, lean in to their supports and broadened their network in gaining mental health assistance. “If parents choose therapy for their children, depending on how the clinician operates and whether they are as I am, a psychotherapist, or perhaps they may be a clinical psychologist, or a family therapist, it will be the mental health service that will advise parents as to their best practice. “Often clinicians meet with parents, separately to the child and gather information, then with a clear care plan established between clinician and parents, the therapeutic process may commence with the child directly. “Again services function differently and other child focused services may meet with the child solely when the process commences and once rapport, trust and a therapeutic alliance is formed between the therapist and child, parents may later be included in the process.” “It’s in the best interest of the family that they engage with a service they feel comfortable with the treatment plan.” Ms Sweet says while each therapist will need to make their own decision, it’s in everyone’s best interest to make an effort to establish rapport with all parties. “My therapeutic practice is for the individual
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so in this case I’d work directly with the parents, separately. “Referrals and additional services may need to also be used collaboratively which I’d incorporate in my work with the parent, such as couples therapy, mental health services specifically for children, specialised trauma informed clinicians, drug and alcohol support services and other crisis centres and mental health support.” When it comes to confidentiality, rules depend on the child’s age, and whether or not there is risk of harm to self or others, however overall confidentially laws do apply to minors. Regardless, parents need to have an inane understanding of the process, and be willing to be transparent with treating therapists. But Ms Sweet says while parent response does have an impact, it’s natural for parents to present with feelings of angst, angry, uncertainty, fear, confusion, overwhelm and anxiety. “Parents often do the very best they can with the tools they use, so if parents can be guided,
supported, seek treatment without stigma and do so safely with a road map, they are in a better position to make an informed decision to their child’s treatment. “If parents are provided with a treatment plan they feel they can adapt to or implement, it’s going to be more viable, not only for them yet their child as well. Ms Sweet says therapists need to be mindful of their patients’ parents and consider offering therapeutic services to them too, should they identify any worrying signs. “Sometimes people forget to ask, who is caring for the carer? “Therapists can offer parents wrap around holistic support, and refer further support services to the family system so their needs are met. “They can help parents learn more about the brain, trauma, emotional intelligence, behavioural change and a new way to function. “So much can be achieved if the family is willing to support the child, seek help and accept support.”
HealthTimes - November 2019 | Page 19
Saving little lives - new funding for a national stillbirth awareness public health campaign
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ed Nose Australia welcomes the Federal Government’s announcement today that it has awarded significant new funding to Red Nose and its partners to launch a national stillbirth awareness campaign. Red Nose Australia CEO Keren Ludski said Red Nose and its partners are thrilled to receive this funding to launch a national health promotion campaign focused on building awareness of stillbirth and appropriate risk prevention strategies. “Six babies are stillborn every day in Australia – or 2,107 each year – and little progress has been made in reducing stillbirth rates over the last 20 years,” Ms Ludski said. “This funding will enable Red Nose and its partners to reduce the stigma surrounding stillbirth and help reduce the unacceptably high rates in Australia,” she said. “Our goal is reduce stillbirth by 20% over the next three years – which would represent around 600 little lives saved and their families spared the heartache of losing their child before they have even had the chance to take their first breath,” Ms Ludski said. “Red Nose has long been known for its work to reduce infant deaths, having successfully reduced SIDS in Australian by 85% through its ‘Back to Sleep’ campaign.” “With this new campaign, we aim to replicate the success of the ‘Back to Sleep’ program and empower families and the community with the tools to help keep more babies safe during pregnancy.” The campaign will be led by Red Nose in partnership with SANDS Australia, Stillbirth Foundation, Stillbirth CRE, University of Newcastle, and Community Hubs Australia.
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SANDS Australia CEO Jackie Mead said she is delighted to partner with Red Nose and others on this important campaign. “The new campaign recognises the profound impact that stillbirth has on families and we are pleased that the experiences of bereaved parents will be used to help develop health promotion messages,” Ms Mead said. “We hope the campaign will help dispel the myths that are shared during pregnancy and provide evidence-based advice to parents in ways to reduce their risk,” she said. Ms Ludski said Red Nose is also very pleased to be partnering with Community Hubs Australia, developing a program to deliver information to migrant women aimed at reducing the risk of stillbirth during pregnancy. Community Hubs Australia have an incredible network across Australia, empowering migrant women within our community. Red Nose will also partner with the University of Newcastle through SMS for Dads, recognising the important role fathers play during pregnancy and their capacity to provide real support and advice for their partners. Ms Ludski thanked the Health Minister for his support and the announcement today. “We commend the Health Minister for recognising that stillbirth is a national issue and for committing significant new funding to help reduce stillbirth rates,” she said. The health promotion campaign will be rolled out from early next year and will target women and men across Australia with the goal to reduce stillbirth by 20 per cent over three years.
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HealthTimes - November 2019 | Page 21
Remote and regional nurses must prioritise their own mental health
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hile extremely rewarding, the nature of the work involved with nursing can have an impact on mental health if proper self-care isn’t undertaken. For nurses working in remote or regional communities, managing mental health can be even more challenging, and they’re faced with the additional strain of isolation. “Working in a remote region can be extremely isolating,” says psychotherapist Dr Karen Phillip. “Nurses in remote locations may experience social factors, geographical isolation, professional isolation and cultural issues. “While it is dependent on the type of work nurses undertake, unless they have a network of friends or family, professional and personal support, it can be very challenging.” Working in a remote community presents its own set of challenges. “Loneliness can create feelings of isolation, depression and anxiety. We are social beings and need connections with others. “Working remotely may affect this opportunity to integrate, share and exchange feelings, thoughts and ideas. Diverse rur¬al con¬text and prac¬tice set¬tings can also result in isolation. “Working as a nurse is demanding and challenging. Nurses see the best and worst of people’s experiences and lives.
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“Sharing or debriefing is essential, however, many remote positioned nurses may struggle finding a suitable debrief service or person. “Ongoing professional development and connection with supervisors is essential to provide a balance for all nurses. “Nurses need time away from the rigors of their work demands and this can prove difficult in rural communities.” Rural communities may suffer a range of mental health issues, not only due to isolation, but the added intensity of adverse weather events, such as droughts and floods that affect the community economically and mentally. “Nurses are at the forefront of these issues when seeing patients,” says Dr Phillip. “They take on a role of medical support, advisor, midwife, therapist, and confidante.” Living in rural communities means socially you’re likely to be integrating with your patients. “You know their issues, demons and conditions which all needs to remain confidential.” Nurses in remote locations have to cope with their own experiences of isolation while needing to treat and counsel others experiencing chronic illness, medical complications, separation from family, isolation and other issues our rural communities experience. In addition to the issues presented by distance and emotional isolation, nurses are also
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isolated from professional networks and peers. “When we are isolated, we can have too much time to reflect within. “Often our mind races and conjures up things of concern or as an escape from reality. In other words, we may future project negativity which can become dangerous to our mental health.” Dr Phillip says inclusion within a professional network and educational framework would help to mitigate these factors and provide opportunities for collaboration between other rural health staff. “Nurses can often suffer workplace stress from patients, work and personal demands and workplace pressures placed by colleagues. “This, combined with isolation, can compound into a feeling of despondency. “Rur¬al nurs¬es need to utilise a wide range of skills to man¬age patients across their lifes¬pan and to meet com¬mu¬ni¬ty needs, as many communities rely heavily on
nurses for a wide range of issues, guidance and collaboration.” By their very nature, many nurses take on the emotional stressors of their workday. Dr Phillip says it’s crucial for nurses to have sufficient rest, appropriate supervision and debriefing. “Find a person to speak with about the daily or weekly experiences and emotional burden experienced. While people in rural and remote Australia experience mental health issues at the same rate as those in the cities, it can be more difficult to access health care and support services. It’s important for nurses to access the wide range of online and telephone support services which can provide instant access to support. “Regional nurses are incredible, dedicated and professional individuals. Support is needed to enable them to maintain their strength and dedication.”
HealthTimes - November 2019 | Page 23
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HealthTimes - November 2019 | Page 25
Nursing no place for gender stereotypes, says male nurse For Luke Yokota, a career in nursing wasn’t always on the cards. In fact, initially, Yokota wanted to become an engineer. “My original call into nursing didn’t start at an early age nor did I think I would ever want to be a nurse. “When I was a child many other professions came to mind before nursing. Some were quite the opposite, I wanted to be in construction. “My childhood aspiration was to be a civil engineer. Ever since I was young I had the greatest fun with Lego. I used to build late at night when I was little, my mum recalls I didn’t want to sleep when I received my first Lego set. “Life went on and I continued to love to draw, build and play. In high school, Yokota enrolled into classes such as advanced mathematics, physics and engineering. “Through high school I had convinced myself that I wanted to be a civil engineer and was positioning myself in the best position to achieve this goal, I had support from my teachers, friends and family.” But it was also during that time, when young adults are forced to consider their futures, that Yokota began hearing stories about nursing that resonated with him. “I started to hear nurses are incredible people. They support people, are with people
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in the both the hardest moments and most joyful moments in their life. “My interest peaked and I started to investigate.” None of Yokota’s family members were medical health professionals, nor did he spend much time in hospital as a child, so his knowledge of nursing was limited. “It took me some time to put it all together and even what I thought was a nurse in the early days has been superseded by what I know today. “During the same time, my interest further increased with nursing when my grandfather went into care. “I would often visit him in his aged care home down the road from where we lived. Instantly I decided to volunteer. From my experience of volunteering at the nursing home my admiration for the profession grew.” After taking a gap year, Yokota told his grandfather than he was about to forge a career in nursing. “At first my grandfather was in disbelief and surely assumed it was a joke and started laughing. “He couldn’t rectify a man wanting to be a nurse based on his beliefs and life experience. “This shook my confidence as up until this point I hadn’t really received any negative feedback. “However, with conviction and gentle
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support of others I continued with my choice of profession.” After completing some hospital, age care and community placements the reality that Yokota would soon be a registered nurse and have the responsibility to care for individuals began to sink in. “As a new registered nurse, I was very fortunate to be part of a graduate nursing program. “From there I found further insight into the fine intricacies of modern health care. “I have been invited to participate in working groups which address the change required for health to remain relevant and accessible. “These experiences have shown me that nursing is a profession that has an appetite for change and a profession for the future. “Nurses see change is needed within our health care system and they are willing to be the agents of change.
“There is no contesting that there is such a huge diversity in nursing, from nurse practitioners, paediatric nurses, nurse researchers, nursing mangers, equipment specialists. “This is why I continue to be a nurse and have plans to continue for many years to come as long as the profession and patients will have me.” Yokota says he would encourage anyone – man or woman - to look beyond the traditional framing of nursing and see its translation into modern health care, love for people and willingness to challenge the status quo. “I am very proud to be a part of the nursing profession. “During my career as a nurse I have never looked back. “Willing to give it my all, be with people and support them as much as possible.”
HealthTimes - November 2019 | Page 27
New Stolen Generations resources to guide GPs, dentists, aged care
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eneral practitioners, dentists and the aged care sector will be better placed to support Stolen Generations survivors following the launch of new resources at Parliament House today. The resources, launched by the Minister for Indigenous Australians The Hon Ken Wyatt AM MP, were developed by The Healing Foundation in collaboration with Stolen Generations survivors and peak bodies including the Royal Australian College of General Practitioners, the Australian Dental Association, Aged & Community Services Australia and the Aged Care Industry Association. Interacting with aged care staff, GPs, dentists and other services is often difficult for Stolen Generations survivors[1], The Healing Foundation’s Chair Professor Steve Larkin said. “Many Stolen Generations survivors experienced childhood trauma as a result of their forced removal from family, community, culture and language, and sometimes also as a result of abuse and racism experienced after their removal,” Professor Larkin said. “Every day events can trigger the original trauma, particularly if a situation brings back the lack of control Stolen Generations survivors experienced when they were taken from their families.” Stolen Generations survivor and member of
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The Healing Foundation’s Stolen Generations Reference Group Geoff Cooper said he hoped the fact sheets would create greater awareness about the best ways to provide services to the Stolen Generations without triggering trauma. “Little changes can make a big difference to how we feel when we walk in to a service. Things like not making us talk about bad stuff that’s happened to us if we don’t want to, and explaining what you’re going to do before you do it so we aren’t caught off guard.” The resources are part of The Healing Foundation’s Action Plan for Healing project, funded by the Department of Prime Minister and Cabinet in 2017 following the 20th anniversary of the 1997 Bringing them Homereport, which highlighted the contemporary needs of the Stolen Generations and their descendants. An Australian Institute of Health and Welfare analysis conducted as part of the Action Plan for Healing project found there are over 17,000 Stolen Generations survivors in Australia today, and by 2023 will all be aged over 50 and eligible for aged care. “The development of the fact sheets has been guided by Stolen Generations survivors: they identified the key issues encountered when dealing with GPs, dentists and aged care providers, what is helpful and what should be avoided,” Professor Larkin said.
“We’ve been delighted with the level of interest the resources are already receiving from the target sectors, and are excited to see the materials taken up at the practice and provider level nationally.” Australian Dental Association CEO Damian Mitsch said the organisation was proud to have supported the creation of the dental resource. “This resource will go a long way in providing education and helpful tips to guide dental practitioners in providing effective dental care to Stolen Generations survivors,” Mr Mitsch said. The Royal Australian College of General Practitioners’ Chair of Aboriginal and Torres Strait Islander Health, Associate Professor Peter O’Mara, congratulated The Healing Foundation on the launch of this vital resource for general practitioners. “This new resource provides essential context and useful tools to assist GPs to identify and understand the impacts of trauma for their patients. These are principles of good clinical
practice, which is beneficial for all patients,” Associate Professor O’Mara said. The CEO of Aged & Community Services Australia (ACSA), Patricia Sparrow, said the organisation and its members were pleased to have contributed to the aged care resource. “We believe the work of The Healing Foundation in providing information about how aged care services acknowledge the needs, and care for Stolen Generations survivors is critical. “Through these resources, providers of aged care are able to better understand some of the trauma and triggers as well as the diversity of needs for Stolen Generations survivors, which must be considered in delivering the best quality care for all people,” Ms Sparrow said. Resources will now be developed for hospitals, allied health professionals and disability services.
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HealthTimes - November 2019 | Page 29
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