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January 2017
New Year, New Career + Privately practising Nurse Practitioners an untapped resource + Remote area nurse certification + Surviving your first year as a nurse + What is depression?
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HealthTimes - January 2017 | Page 21
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I was just getting ready to eat my lunch when I got the call. The good news was that my manager had safely arrived for the pharmacy expo. The bad news was, the promotional flyers hadn’t. But I was all over it. I called my Officeworks Business Specialist and gave him the lowdown. Luckily, I had the flyer artwork on file, so he helped me arrange a reprint at an interstate Officeworks store using the Print & Copy service. All my boss had to do was pick them up on his way to the expo. He had plenty of time to set up our company stand and text me a photo of how good it looked. I’ve never seen a bigger grin on his face.
Get all over it. Visit officeworks.com.au/business-solutions
Printed for 30/01/2016.
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HealthTimes - January 2017 | Page 03
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January 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 DISTRIBUTION 46,300
Advertiser list Austra Health Australian College of Applied Psychology Barwon Health CCM Recruitment International Continence Foundation of Australia CQ University
The HealthTimes magazine is the most widely distributed national nursing and allied health publication in Australia. For all advertising and production enquiries please contact us by telephone on 1300 306 582, email contact@healthtimes.com.au or visit www.healthtimes.com.au Published by Seabreeze Communications Pty Ltd trading as HealthTimes. ABN 29 071 328 053. Š 2017 Seabreeze Communications Pty Ltd. All right 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: Midwifery Publication Date:
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Colour Artwork Deadline: Monday 20th of February 2017
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HealthTimes - January 2017 | Page 07
Privately practising Nurse Practitioners an untapped resource By Karen Keast
P
rivately practising Nurse Practitioners remain an untapped resource for meeting Australia’s escalating health care demand, research shows. University of Sydney lecturer Jane Currie, a nurse practitioner who has worked in the field of emergency nursing in both Australia and the UK, says her PhD research shows privately practising nurse practitioner (PPNP) services are increasing patient access to community and primary health care but more needs to be done to enable private practice NPs to fulfil their potential. “PPNPs are an untapped resource in addressing burgeoning health care demand, particularly in community and primary health care settings,” she says. “These are very early data as the legal changes enabling eligibility for nurse practitioners to provide services subsidised through the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS) occurred only six years ago and, like any service, it takes time to become established and to develop. “Prior to the 2010 legislation, NPs were able to work privately, however patients were unable to obtain MBS subsidy for NP services and therefore paid the full cost of the consultation.
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“If these results show anything, they show that nurse practitioners’ eligibility to provide services through the MBS and the PBS has enabled them to provide care to areas of the community that have previously been challenging to reach.” While numerous studies have showcased the flourishing role of nurse practitioners in the public setting, this pioneering evaluation study is one of the first to examine the nation’s PPNP workforce. The study, a survey of nurse practitioners followed up by interviews with participants, reveals almost three quarters of PPNPs are working in community-based roles, where they provide chronic and complex care services, and in primary health care services. The study, published in the Journal of the American Association of Nurse Practitioners, shows more than a third, or 38 per cent, are working in rural and remote settings, a quarter practice in both private and public health care, while the largest age group of PPNPs is 50 years and over. It shows PPNP services are provided both within and outside of business hours and at weekends, enabling patients to access care when fewer health services are traditionally available.
Ms Currie says it’s encouraging to see that legislative changes in 2010, which enabled nurse practitioners to access reimbursement for care delivered through the MBS and the PBS, have led to increased patient access to community-based health care services, particularly for under-serviced populations, such as the homeless, mental health and women’s health. “That really is exciting to think that the legislation has facilitated nurse practitioners to provide services to underserved areas of the community, which was the initial intent of the nurse practitioner role,” she says. But Ms Currie says her survey of 73 nurse practitioners, working in every state and territory across Australia except for the Northern Territory, outlined several restraints to the PPNP role, including limitations to the MBS items able to be initiated by nurse practitioners. PPNPs can now provide services and be reimbursed through four MBS item numbers - all characterised by their length of patient consultation. “One of the challenges for the NPs providing care subsidised through the MBS is that they are only able to access a limited number of items for pathology and diagnostic imaging and this has limited their true potential,” Ms Currie says. “For example, in caring for a patient that requires a referral for an investigation that’s not available to nurse practitioners through the MBS, the NP would need to consider an alternative approach to ensure the patient still receives the care they require. “This might be to refer the patient back to their GP and then request that the GP then refer the patient for that investigation through the MBS. So, we’re learning that there are limitations to the MBS. “It might be the case in the near future that the NP MBS items are reviewed in order to further facilitate what we know is a role with great
potential to improve access to health care for people, across our communities.” Since the first nurse practitioner was authorised in Australia in 2001, there are now more than 1400 registered nurses endorsed as nurse practitioners. While it is unclear how many NPs are employed in public or private health care services, nurse practitioners are working in settings ranging from community health centres to GP clinics, residential aged care facilities, hospitals, prisons, schools and universities, pharmacies and in private homes. As highly educated, skilled and experienced registered nurses, nurse practitioners can prescribe medications, request and interpret Xrays and blood tests, diagnose health conditions, as well as refer to medical specialists. Ms Currie, who has also published a paper on the collaborative arrangements of PPNPs, says other study data presented at the Australian College of Nursing conference recently shows 96 per cent of survey participants report undertaking direct patient care as part of their role, more than 50 per cent see up to 15 patients a day, while 80 per cent treat their patients on a regular basis. “We know that 81 per cent interact with the public health care system and the majority of that interaction is patient referrals to health specialists - so there’s lots of potential there to improve access to care which is excellent,” she says. Ms Currie is now working on a paper examining PPNP access to the MBS and PBS and another on PPNP practice activities. “Already it’s very easy to see that this is only one piece of the puzzle - that there is more work that will need to be done in terms of understanding the broader impact of the role and to capitalise on the untapped potential of PPNP services in meeting the ever increasing demand for health care in Australia.”
For more articles visit HealthTimes.com.au HealthTimes - January 2017 | Page 09
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Physiotherapist sets sight on world leading amputee care A WA amputee physiotherapist will learn from the world leaders in amputee rehabilitation this year, after receiving a Churchill Fellowship. Sir Charles Gairdner Hospital senior physiotherapist Beck Hefferon will travel to the USA, Sweden, Germany and the UK for seven weeks, from May, to investigate leading research, evidence-based practice and innovation in areas ranging from advanced prosthetic rehab, gait deviation analysis and osseointegration to emerging neuroprosthetic treatments for phantom limb pain. Ms Hefferon, who has spent the past five years specialising in amputee physiotherapy, says WA is lagging behind international best practice, with no consistent guidelines, protocols or clinical pathways to ensure continuity of care, compounded by a lack of experienced amputee clinicians. “There hasn’t really been an injection of new life into this system for some time, in my opinion, and also the major prosthetic companies are either US or European based, so we are isolated from the development steps that come through,” she said. “Whilst we have an adequate system and we’re able to do the best we can, I think we could be doing better. “There are things that we need to get ourselves up to date with to be able to offer amputees the same level of service that they might get internationally.” More than 4,400 diabetes-related amputations are performed at Australian hospitals each year.
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For the full article visit HealthTimes.com.au HealthTimes - January 2017 | Page 11
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Where will 2017 take you? DEVELOP YOUR CAREER. EXPERIENCE A NEW CULTURE. The Australian Volunteers for International Development (AVID) program enables Australians to share their skills overseas through fully-supported volunteer opportunities in 22 countries.
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Major cuts to allied health scholarships Allied health has been dealt a $72.5 million blow, with the Federal Government slashing its funding for health workforce scholarships over four years. Services for Australian Rural and Remote Allied Health (SARRAH), the peak body for rural and remote allied health professionals, has called on the government to reverse the funding cuts which it fears poses a major risk to undergraduate and postgraduate students wanting to pursue education from 2018 onwards. In a letter to parliamentarians, SARRAH CEO Rod Wellington said while the organisation received a funding agreement to provide $1.72 million for 190 allied health scholarships this year, the move represents a 65 per cent cut based on the allocation of 548 allied health scholarships in 2016.
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“This cut in funding for the 2017 cohort of students will have a longer term adverse impact on the rural and remote health workforce,” he said in the letter. “At a minimum, successful scholars should be afforded a mechanism through which they can maintain their financial support beyond 2017. “This will ensure that a cohort of allied health professionals is not lost in the transition to the new Health Workforce Scholarship Program to be rolled out during 2017.” Late last year, Rural Health Assistant Minister Dr David Gillespie said the overhauled scholarship program was being finalised and would be launched in early 2017, after it was first expected to begin on July 1, 2016.
For the full article visit HealthTimes.com.au
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Remote Area Nurse - Andamooka, SA Full Time Opportunity • Salary Packaging Benefits Join a great Australian icon. Working with the Royal Flying Doctor Service (RFDS) you will be joining a team of dedicated professionals providing health care to people living and working in regional, rural and remote Australia. RFDS Central Operations operates primary health care clinics in Andamooka, Marla and Marree. We are seeking an experienced and enthusiastic Remote Area Nurse (RAN) to join our primary health care team in Andamooka. The RAN will be a part of a multidisciplinary team providing primary health care and emergency services to the community and visitors. RFDS Central Operations operates a two nurse staffing model. This is a unique and exciting career opportunity and workplace offering attractive remuneration and benefits including salary packaging and relocation allowance. If you are keen to move your career into an organisation that makes a real difference to all Australians, apply now. For further details and the position description, please visit our website at www.flyingdoctor.org.au The Royal Flying Doctor Service is an Equal Opportunity Employer
HealthTimes - January 2017 | Page 13
Surviving your first year as a nurse By Karen Keast
A
n Australian College of Nursing (ACN) 2015 Emerging Nurse Leader (ENL) has urged graduate nurses wanting to survive and thrive in their first year in the workforce to continue learning, avoid office politics, connect with nurse leaders, prioritise self-care and embrace opportunity. Jenyfer Joy, who began work as a registered nurse at Sydney’s Westmead Hospital in 2016 after completing her Bachelor of Nursing (Advanced) at the University of Western Sydney, is a mentor to student nurses. Here are Jenyfer’s five essential tips for nursing graduates wanting to excel in their first year in the health workforce: 1. Keep learning. In many ways, your education is just beginning. Seek to learn about your organisation, your area of practice, your new role and embrace all learning opportunities. “I first started in radiology and I had no idea what it was all about,” she says. “I’d had no exposure to that kind of nursing, so it was really about going back to the basics again and starting from scratch.” 2. Steer clear of office politics. “There’s a lot of distractions in the workforce but just really focus on what you went into nursing for - which is to provide best patient care and high quality care to the patient and their family as well,” she says. When new nurses receive negative comments or treatment, they should strive to rise above it. “People have that perception of the new graduate as not knowing anything, having no experience but just forget about that and don’t focus on that - focus on your strengths.”
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3. Connect with nurses. Connect with your new graduate coordinator, nurse educators, your manager, senior nurses and nurse leaders. Seek a mentor, inside as well as outside, the nursing profession, Jenyfer advises. 4. Look after yourself. The demands of nursing and shift work can take an emotional and physical toll on new nurses. Jenyfer says it’s important to seek a balanced life. “We’re exposed to a lot of trauma and a lot of emotional distress, so take time out of work to look after yourself, to exercise, healthy eating and getting good sleep - just the basics.” 5. Embrace opportunity. Making the most of the opportunities that come your way, and taking your career to the next level is completely up to you, Jenyfer says. “You’re an adult now, you need to take responsibility for everything you do - it’s your career. Grab all the opportunities you can in your first year because that’s when you’ll get the most support.” Jenyfer says the ENL program has elevated her nursing career. Now working in a permanent position in ICU, Jenyfer is pursing a career in critical care and she also wants to help develop and nurture the next generation of nurse leaders. “I’ve learnt that leadership isn’t about a position, it’s all about being the best leader you can be. The program has changed my way of thinking…it’s changed my career completely, to be honest.”
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Looking for a tree change? We are seeking expressions of interest from qualified, registered midwives looking for permanent and/or temporary work in a rural Maternity Unit, situated in the town of Cooma, Southern NSW. Cooma Maternity Unit is part of the Cooma District Hospital and is a Level 3 Maternity Unit caring for low risk women. The hospital has the capacity to support normal birth for women when birthing occurs from 36 weeks gestation onwards and offers antenatal, intra partum and post-natal care. Cooma is surrounded by national parks and is an hour from the south coast beaches, Canberra, NSW Ski Fields and the Snowy Mountains. The position(s) offer great lifestyle opportunities for you and your family, with good schools and many sporting activities in the Cooma area. The model of care is GP Obstetrician led with fulltime midwifery input. The unit is staffed by a single midwife per shift, requiring the applicant to work autonomously whilst liasing with the GP Obstetrician. Approximately 150 babies are delivered per year. Our nursery is classified as a Level 2, with higher acuity neonatal care offered by the tertiary referral centre one hour away. We offer genuine woman centred care with a focus on family support. Our unit’s postnatal beds can accomodate partner overnight stay, which is in line with our family friendly model of care. We are currently working towards baby friendly accreditation. All staff employed within Cooma District Hospital qualify for addtional salary packaging benefits. If you are a registered midwife and are interested in working in a rural setting, with a great team, please contact Cooma Hospital. Email: SNSWLHD-CoomaHospital@health.nsw.gov.au Ph: (02) 6455 3230 Mob: 0417 674 046
HealthTimes - January 2017 | Page 15
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Mental Health Service - The Latrobe Regional Hospital (LRH) Mental
Health Service is the regional provider of mental health services in Gippsland. Gippsland provides a fantastic regional lifestyle with easy access to Melbourne. LRH Mental Health Service is a recovery oriented and trauma informed service and we are seeking dynamic and passionate staff to join our team. Acute Complex Care Co-ordinator - Psychiatric Enrolled Nurse Acute Community Intervention Service - Mental Health Clinicians Acute Community Intervention Service - Mental Health and Police Response RN and EN - Inpatient Units - Aged, Adult and Parent and Infant Unit – Full-time/Part-time/Casual Community Mental Health Clinicians - Adult and Child and Youth Teams Neuropsychologist – Part-time Acute and Bed Based Services We offer a supportive environment with clinical educators, preceptors, clinical supervision, a nurse practitioner mentoring program and professional development opportunities. Please visit www.lrh.com.au and go to our employment sections to view current vacancies and register your interest. For enquiries please contact Cayte Hoppner, Director of Mental Health on (03) 5173 8549 or email choppner@lrh.com.au.
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HealthTimes - January 2017 | Page 17
Remote area nurse certification Want to work remote this year? A new certification process will support newto-remote nurses and midwives heading off the beaten track. By Karen Keast
A
pioneering initiative aims to set a new benchmark for nurses and midwives aspiring to remote and isolated practice in Australia. CRANAplus, the peak professional body for the remote health workforce, is developing a certification process designed to set a minimum standard for nurses and midwives interested in pursuing a career working remote. CRANAplus CEO Christopher Cliffe says the RAN Certification Project will provide a framework for practitioners t o demonstrate their practice against the nine professional s t a n d a r d s , which serve as the foundation of remote practice. Mr Cliffe says the standards and the certification process are designed to produce more reliable, consistent, high quality and accessible health care, delivered by suitably skilled, experienced and recognised remote area nurses (RANs). “Where we carry our biggest risk and where we struggle the most is with new people coming through - it’s a very hard industry. Because it’s quite isolated, there’s not a great deal of supervision and support out there,” he says.
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“It’s very hard to know whether you’re doing a good job, a great job or a bad job when there’s no-one else around to work with you. “No-one else is responsible for the standard of care that you provide except yourself, and we would like to see that this is an easy way, and a standardised way, for people to be able to benchmark themselves against the professional standards and the broader industry. “We are working in an extended, an expanded scope, out in remote areas so I think this is a good, safe professional way of assessing to make sure that you are a safe practitioner, and that is the responsibility of each health care professional.”
The voluntary certification process will enable nurses and midwives to log in to an online portal, expected to be launched on the CRANAplus website early this year, where they can selfassess against the nine professional standards of remote practice. The standards cover areas such as registration, endorsement or eligibility for practice; health, wellbeing and resilience; culturally respectful practice; practices within a comprehensive primary heath care model of service delivery; works within care pathways and develops networks of collaborative practice; clinical knowledge and skills to safely undertake the role; recent clinical practice in a remote and isolated location; an ongoing commitment to education relevant to remote practice; and practices within a safety and quality framework.
Under the initiative, nurses and midwives will be certified for a timeframe of three years. After that, they can continue to update their certification through the online portal. Mr Cliffe says the certification process will also assist nurses and midwives working towards gaining the experience and qualifications required to achieve their RAN certification. “It takes a lot of time and money and energy to gather the qualifications, to gather the experience that’s required and we don’t want to exclude those people, so if they start this process and they find they’re not quite there yet, what happens is they get a provisional certification,” he says. “With that provisional certification is a work plan that’s automated and our professional officers will work with these individuals to help them develop their education plan, their professional development plan about what they need to be doing over the next six to 12 months to get up to speed so that they can get their full certification.” RAN certification aims to not only set a minimum standard for remote and isolated practice but also works to identify RANs to their patients, colleagues and employers. Mr Cliffe says the initiative, developed by the workforce for the workforce, has received strong support from within the health sector. “Employers so far seem very keen on this because it’s a way of making sure there’s a minimum standard in regards to the preparation of the workforce but also the
clinical standards in regards to the care that they’re providing,” he says. “The other big thing that seems to be coming back as feedback from the industry is that it also defines - what is a remote area nurse. “You’ve got a ticket to say - yes, I’ve met the minimum standard and that gives some great flexibility to be able to work across states, across jurisdictions, and removes some of this jurisdictional duplication. “A lot of the feedback is - why didn’t we do this before?” CRANAplus is working with a group of remote and isolated area nurses to test the assessment criteria of the nine professional standards to assist with the development of the online portal ahead of its launch. Mr Cliffe says the RAN certification initiative will bolster the remote and isolated nursing and midwifery professions. “I think it’s a really exciting thing for us to be doing,” he says. “We’re not saying remote area nurses should do it but we’re giving them a platform to be able to affordably and efficiently prove to themselves and prove to others that they meet the minimum standards.”
Have your say! Leave a comment on this and other articles by visiting healthtimes.com.au
HealthTimes - January 2017 | Page 19
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HT-701-CTR-00625 1/2PG FULL COLOUR CMYK PDF Are you interested in a career in healthcare but not on the clinical frontline? A career in clinical coding may be what you are looking for. Clinical Coders are one of two occupations that make up most of the health information management profession. Clinical Coders convert clinical information from patients’ medical records into alphanumeric codes according to a health classification system. These codes form part of a data collection which is used for research, funding and healthcare planning. The 22274VIC Certificate IV in Clinical Classification will prepare you for entry into a career in clinical coding. Coursework and Assessments: Online, distance education Duration: 850 hours over a 2 year enrolment period Fee: $5,600 payable in 4 instalments of $1,400 over the 2 years Intakes: March and July
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HealthTimes - January 2017 | Page 21
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HealthTimes - January 2017 | Page 23
What is depression? By Karen Keast
D
epression is more than feeling low. It’s a serious illness that affects your mental and physical health. Depression affects how you think, feel and behave causing feelings of sadness and loss of interest in every-day activities, and lasts for two weeks or more. The signs of depression can range from lowered self-esteem to changes in appetite or weight, changes to sex drive, poor concentration and memory, lower energy levels and a lack of motivation, while you are also less likely to experience feelings of happiness. At any one time in Australia, it’s estimated three million people are living with depression or anxiety. Dr Jan Orman, GP services consultant at Australian not-for-profit organisation the Black Dog Institute, says while most people will experience depression at some stage in their lives, some people are more vulnerable to depression than others. “Some of that is because of genetic predisposition to mood disorders and some of it is because of personality predisposition to depression - people like perfectionists and anxious worriers are much more prone to getting depressed, even if they don’t have the genes for depression, than somebody who is a much more relaxed personality.” People are also more at risk of developing depression if they are have a medical illness or have experienced significant life stress or trauma.
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Types of depression The Diagnostic and Statistical Manual of Mental Disorders - the DSM-5, refers to depression as Major Depressive Disorder (MDD). While depression is traditionally viewed as a single entity, where the condition is determined by its severity level and length of presence, the Black Dog Institute has developed an alternative hierarchical model designed to identify the particular types of depression and their causes - whether the causes are biological, psychological or other. The organisation suggests treatments are then tailored to the specific type of depression and its causes. The Black Dog Institute’s model outlines four types of depression: * Melancholic depression. This is a more severe depression which is also defined by psychomotor disturbance, such as low energy, poor concentration or slow movements. This biological depression affects less than 10 per cent of people with a depression diagnosis. The organisation says it responds best to physical treatments, such as antidepressant medication, and only minimally responds to other treatments such as counselling or psychotherapy. * Psychotic depression. This is the least common type of depression. It is characterised by an even more severely depressed mood, a more severe psychomotor disturbance compounded by psychotic symptoms, such as delusions or hallucinations. It only responds to physical treatments.
* Non-melancholic depression. Estimated to account for up to 90 per cent of depression, this type of depression is characterised by a depressed mood and social impairment, such as difficulty in dealing with relationships or work. This type of depression is often linked to stressful life events or in conjunction with the person’s personality style, and responds well to different sorts of psychological treatments, while antidepressant medications can also be used. * Atypical depression. This type of depression has characteristics that contrast with some of the usual characteristics of depression. People are able to experience happiness through some events, have significant weight gain or increase in appetite, experience excessive sleeping and typically also feature a personality style where they are quick to believe others are rejecting them. Dr Orman says people will get better from depression over time, regardless of the type of depression they experience. “But sometimes that time can be many years and in the meantime they’ll have done awful things to their lives and their relationships - it will have interfered with their academic progress for example in teenagers, or in adults it will interfere with their careers.” Looking for depression Dr Orman says nurses, midwives and allied health professionals should continually be on the lookout for patients experiencing depression. While some patients will present with visible signs of depression, such as being physically slow or having difficulty answering questions, others will present with signs that are often easily missed. “Personality styles drive the way someone with depression’s non-melancholic depression will appear when they present, so the anxious worrier will present anxious and worried but more anxious and worried than usual because their depression is driving the increase in anxiety,” she says.
“The perfectionists will present with an inability to complete tasks because they can’t get anything right. Depression provides an amplification of certain aspects of personalities, particularly anxious worrying and irritability. “Don’t leave depression out of your assessment of a patient, even when you’re assessing them for physical illness because people with physical illnesses are more likely to get depressed.” Dr Orman says there a range of screening tests health practitioners can use that may indicate a risk of depression, including the self-report K10 and the Depression, Anxiety, Stress Scales (DASS) questionnaire, as well as the Edinburgh Postnatal Depression Scale (EPDS). She says nurses, midwives and allied health professionals should refer to GPs for a proper medical assessment, as some illnesses can present similar to depression, such as thyroid problems. The GP will then decide whether to refer to a psychologist. Discuss suicidality When health practitioners find depression, they should ask about both depression and suicide, Dr Orman says. “Suicidality is a separate issue and can occur in the absence of depression and when depression is really only mild on clinical assessment.” While it’s a difficult conversation to have, Dr Orman advises practitioners to discuss suicide. One way, is using the third party questioning technique. “As an example, you can say… ‘As you know, I think you are suffering from depression. A lot of people in this situation when they are feeling depressed and sometimes when they just feel low, think that life isn’t worth living and begin to have suicidal thoughts. Have you experienced that during this time when you’ve been feeling low?’
For the full article visit HealthTimes.com.au HealthTimes - January 2017 | Page 25
New Zealand midwife takes the helm at ICM
N
ew Zealand midwife Dr Sally Pairman is the new CEO of the International Confederation of Midwives (ICM). Dr Pairman, who has a distinguished midwifery career spanning 33 years, will move from Dunedin to The Hague, in the Netherlands, this month to take up the prominent position as head of the organisation known as ‘the global voice’ for midwifery. The ICM, which will celebrate its 100th anniversary in 2019, comprises 130 midwives’ associations in 113 countries - representing an estimated 400,000 midwives. “This is a very exciting opportunity because there is now strong research evidence to support what midwives have always known - that care led by well-educated, regulated and autonomous midwives, integrated within health systems - is the best solution to the challenges of ensuring quality maternity care for mothers and their babies around the world,” Dr Pairman said. “The ICM’s mission is to ensure that all women, irrespective of their economic status, have access to midwifery care and because millions of women throughout the world cannot yet take this for granted, there is a huge job to be done.” Dr Pairman has been involved in the ICM for almost 10 years, as co-chair on the regulation standing committee and as a member of the scientific professional programme committee.
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Dr Pairman, who until recently was Director of Learning and Teaching and Co-Head of the School of Midwifery at Otago Polytechnic, has been integral to advancements in New Zealand’s midwifery profession. Dr Pairman was involved in a campaign that led to midwives gaining the right to practise autonomously through the Nurses Amendment Act 1990, was a founding member and later became president of the New Zealand College of Midwives, and was the first Chair of New Zealand’s midwifery regulatory body, the Midwifery Council, when it was established in 2003. New Zealand’s internationally r e n o w n e d midwifery-led model of maternity care has had an impact on ICM’s philosophies, Dr Pairman said. “We are really the only country in the world where maternity services are integrated throughout the whole maternity journey and midwife-led continuity of care is embedded in the maternity system,” she said. “This is recognised by colleagues internationally and they look to us to see what may be transferrable to their contexts.” Dr Pairman, who holds a master’s degree and a doctorate, has also been at the frontier of major changes to midwifery education, helping to design New Zealand’s first midwifery undergraduate degree and the first master of midwifery program.
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HealthTimes - January 2017 | Page 27
What is heart failure? It’s not as common a cause of death as reports would have us believe By Frank Bowden, ACT Health
W
hen George Michael died last year news reports all over the world announced the cause as heart failure. The same condition was cited as the cause of death of 61 year old Devo band member Bob Casale, 27 year old Ecuadorian footballer Christian Benitez, actor River Phoenix, The Doors lead singer Jim Morrison, former First Lady Nancy Reagan and Lord of the Rings’ Christopher Lee, well known for playing Saruman the White. There is even a website that lists celebrities who have died of heart failure. As a general physician I know “heart failure” was unlikely to be the cause of death of most of these people. What actually is heart failure? While they are all related to each other, “heart failure”, “heart attack” and “sudden cardiac arrest” are not synonyms. A lay person could be excused for thinking a heart that has “failed” has suddenly stopped, but this is not the medical meaning. Heart failure occurs when the heart is unable to pump enough blood to the other organs to satisfy their need for oxygen and nutrients. It usually manifests as tiredness and weakness, breathlessness and swelling of the
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legs and abdomen. Sudden death may occur as a consequence of heart failure, but it is not a feature of the disease. The most important causes of heart failure are coronary artery disease (which causes a heart attack) and high blood pressure, but it can also be the result of damage to the heart muscle itself (cardiomyopathy), problems with the valves (such as “aortic stenosis”) or when the heart’s rhythm is disturbed and it beats too fast, too slow or irregularly (“atrial fibrillation”). What’s a heart attack? A “heart attack” occurs when one of the arteries in the heart suddenly blocks, depriving the heart muscle of oxygen. Typically, a heart attack produces severe, central, crushing chest pain. How much heart muscle dies depends on the extent of the blockage and how quickly the blood flow can be restored through medical intervention. An oxygen-starved heart is unstable and prone to rhythm abnormalities, so a heart attack is one of the common triggers of a “sudden cardiac arrest” which means the heart suddenly and unexpectedly stops.
For the full article visit HealthTimes.com.au
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Issue
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1
23rd Jan
30th Jan
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3
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5
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HealthTimes - January 2017 | Page 29
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HealthTimes - January 2017 | Page 31
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