Ncah issue 08 2015

Issue 8

04/05/2015

Midwifery & Maternal Health + Stepping up to nurse leadership + Rapid growth in osteopathy + Nurses return from the war on Ebola

Formerly

Nursing C areers Allied Health ncah.com.au

+ Does the way women give birth have ramiďŹ cations?

healthtimes.com.au

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HealthTimes - Issue 8 | Page 3

Issue 8 – 4 May 2015 We hope you enjoy perusing the range of opportunities included in Issue 8, 2015.

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HealthTimes - Issue 8 | Page 7

Psychological in disasters Stepping up torecovery nurse leadership

T A

By Karen KeastCollege he Australian

of Nursing (ACN) is working to forge nurse leaders who can ustralia was left reelingtheir when the worst provide leadership through contribution to bushfires in and the in nation’s history razed Vicpolicy, practice the delivery of health care. toria As on part February 7, 2009. of its new strategic direction as Saturday claimed 173 lives andnurse intheBlack national organisation advancing jured 5000 people, destroyed than 2000 leadership, ACN has launchedmore its Leadership@ homes, displaced moreof than 7500 people and ACN program - a range programs held in each killed animals designed while more than of thethousands states andof territories, to shape one million acres burnt. nurse leaders at allwere stages of their careers.

The prompted officer the establishment of ACNdisaster chief executive Debra Thoms an expert referencenurses group, with featuring says equipping the psychologists from the skills and expertise to Australbecome ian Psychological Societyis effective nurse leaders (APS) as well occupaparamount forasthe delivery tional therapists, of health services.social workers, psychiatrists, “It’s not just that general practitioners nurses are a large part and health of theseveral workforce but organisations nurses engage such with as Phoenix Austhethe community right tralia for across– Centre the health Posttraumatic Mental system,” she says.

Health.

“You need good The group leadership in orderdeto veloped a best practice provide those nurses with framework to environment guide the the appropriate provision of support and menwithin which to work so that they tal communities coming canhealth delivercare the to best care they can, and to to grips with natural such as floods, effectively recruit anddisasters, retain nurses. bushfires, and “Goingearthquakes forward there arecyclones, concerns along about with other emergencies. workforce shortages so we need to have nurse APS who seniorcan psychologist Susie Burke leaders build reallyDrsupportive and says the framework has three of support appropriate environments forlevels nurses to work aimed at providing assistance in, in order to retainpsychological them and provide them targeting the environments, affected individuals with goodboth working so thatand we communities also of thethe health professionmaximise the and potential workforce for the als working to improve people’s psychological future.” recovery.

The leadership initiative includes a Dr Burke Master says level one features adviceseries, and Leadership one-day workshop support peoplenurses, and communities in the imtargetingto senior nurse executives and mediate aftermath of a disaster. nurses aspiring to executive level roles.

Page 8 | www.HealthTimes.com.au

The seminar highlights the adaptive challenges of leadership, assists nurses to lead in “These are the things that wouldand be influence useful in a politically charged environment the andoutcomes, early weeksand afteralso a disaster keyhours, publicdays policy covers when weleverage expect that people’s needs are mainly how to technology. for physical clothing, finding Former recovery, Tasmanianshelter, Premier David Bartlett, documents and getting themselves a safe who studied leadership at Harvardinto University, place,” she says.and is facilitating the program. has developed “Their psychosocialFirst needs are not workshop met with The Leadership two-day health professionals asto much as they are by famis designed for early mid-career nurses and ily and friends andskills informal also provides practical whilesupports, inspiring and nurses to the support of organisations like Red think critically about leadership and Cross or other disaster NGOs.” their own career development.

Level two focuses on The program focuses health professionals on harnessing tapthe ping into of simple psysciences leadership chological strategies and management to teach practical theory, neuroscience, psychological skills emotional and to people intelligence, affected by social disasters. spiral dynamics, Dr Burke says the epigenetics and strategies, n e u r o l e aSkills d e r s hfor ip Psychological Recovery concepts.

(SPR),Ilze were developed in Jaunberzins, of the wake of Hurricane KatPowerMind Leadership, has rina, renowned of the developed andasisone facilitating five hurricanes histhedeadliest workshops that aim in tothe provide tory of the United States. own leadership insights into participants’ “Hurricane Katrina was the a most recent style and the realities of being leader in a enormous that impacted so many thouhealth careevent environment. sandsACN of people,” Dr Burke says. also offers a Graduate Certificate in “They wanted equip healthfor professionals Leadership and to Management registered with something that could used to for develop a large nurses and midwives thatbe aims number of people might not be atrelevant risk of knowledge, skillswho and attitudes going on to get post traumatic disorder to clinical leadership and stress management, (PTSD) or depression who nonetheless are incorporating humanbut resource management, really disrupted and impacted the event.” financial management and by quality processes.

APS intakes offers are SPR resources Course in February andand July.training which has since prepared health professionals across Victoria, Queensland and South Australia to full provide affected individuals with five For the article visit HealthTimes.com.au

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The most important factor in people’s psykey skills - problem solving, promoting positive chological recovery, regardless of the type of activities, managing reactions, helpful thinking disaster or event, is accessing social support, Dr and rebuilding social connections.

Reporting to the Chief Executive Officer of Beaufort and Skipton Health Service, the Director Burke Dr Burke says these essential skills, such as of Nursing at the Beaufort Campus undertakes thesays. overall management and administration nursing practices at thecope Beaufort problemofsolving, can help people withCampus con- and works effectively with the Director of Nursing the Skiptonincluding Campus the to ensure continuity of care andreally practicewant acrossto both sites.people The rolea fronting atchallenges, rebuilding of “You give also seeks to ensure safe and high quality patient centred care is delivered by supervising their lives in the aftermath of a disaster. chancealltostaff draw on their own resources, and directing activities of nursing staff and ensuring participate in the organisation’s “If you thinkimprovement about it - when your home has draw on their own families and friends quality processes. been destroyed you needwill to find a new placenursing for registration support and ownformal copEligible and candidates hold current withactivate AHPRA their and hold tertiary in management (or working towards the same).health As wellprofessionals as being able to live and you qualifications can’t find a new place to go to, ing resources before demonstrate clinical experience in a variety of settings, you will she havesays. relevant and yourtokids are at school and nursing the school was sweep in and offer services,” administrative experience at a senior level, with a demonstrated understanding of policy destroyed as well and you have to find a new formulation, financial and human resource management, strategic planning and appropriate school. liaison with other senior health professionals and“The other reality too is that in our current management staff.

“Disasters throw up a whole lot of problems change the number of disrupFull position details can be climate obtained fromscenarios our website at: and people can become overwhelmed with the tive extreme weather events that we are going sheer scale of problemsshould that they’ve got. in the first to be impacted

by McGregor will escalate it’s139 just not Enquiries be made instance to Peter onand 0407 “So teaching people solving can skillsbe forwarded possible forto: ushrsa@hrsa.com.au to be able to treat, meet people’s 257 problem or applications and being able to prioritise which is the most urmental health needs or needs for psychosocial PO Box 83 Ocean Grove 3226 Closing date: gent problem that is kind of blocking close them being recovery through health professionals.”

Applications 22 May 2015 hrsa@hrsa.com.au 24 March 2014 able to think about any of the other problems.

The APS has a range of resources on its webwww.hrsa.com.au “It’s breaking down that problem and being site for psychological preparedness for disasters able to brainstorm a whole lot of different opsuch as bushfires and heatwaves, cyclones and tions and being able to meet that problem.” floods, enabling people to prepare for the emoLevel three of the framework covers the fortional challenges of living through emergencies.

Senior Midwifery Grade 3It also features resources for disaster remal evidence-based psychologicalManager interventions Services for people with severe Maternity distress, at risk of developcovery, for the public and health professionals, Lismore Base and Grafton Base Hospitals ing mental health problems such as depression, alongside links to a range of additional resourcPTSD and complicated grief. es, including the Disaster Response Network of In conjunction with the Directors of Nursing and Midwifery you will be responsible for the provision of “This level of intervention is what psycholopsychologists the Psychological Supstrategic and operational direction of maternity servicesAPS at the Lismore Base and and Grafton Base Hospitals.

Themight position is responsible for maintaining quality professional for portal. ensuring that appropriate gists see as being their area in recovery port in practice Disastersand web clinical, educational managerial are established and maintained. You will work with after disasters, whichand is helping themidwifery 10 to 15systems per the Directors of Nursing / Midwifery Unit Managers to facilitate evidenced based, appropriate , efficient cent an affected that both might be at andofeffective servicepopulation delivery across campuses, as well as assess, plan, co-ordinate and monitor risktheofoutcomes going onof to develop best practice.significant This will bemental achieved through a number of modalities: support person, advisor, advocate, person, mentor and internal coach. Lismore Base Hospital is a major referral health problems,” Drresource Burke says. hospital located on the beautiful North Coast of NSW. Dr Burke says the three levels of support are offered at different - based on the level ofand provides the best of a country lifestyle near a major Lismore is close tostages beaches and rivers, rainforest centre.

With pleasant year-round it has aarelaxed lifestyle is close to the comment onand this and other distress and theatiming in the wake of sub-tropical the disaster.climate,Leave beaches on the Eastern Seaboard and to the rainforest hinterland.

It isby well-served by air‘news’ and other subjects visiting the “A lot of the work we’ve been doing over the transport links and is in easy driving distance of the major metropolitan centre of Brisbane. In addition to section of our website lastallsix years or so is actually trying to educate the the professional, social and cultural benefits that this proximity offers, Brisbane is also home to an http://healthtimes.com.au international airport assuring convenient to international travellers. public and health professionals that it’saccess not just

Beaufort Campus

www.hrsa.com.au

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Tell us what you think

psychological therapy in the level three type inTo apply: Contact Narelle Gleeson - Director of Nursing and Lismore Basedirectly, Hospital. visit Phone ToMidwifery, go to this article tervention needed after a disaster but there 02 6620 that’s 7577 or email Narelle.Gleeson@ncahs.health.nsw.gov.au http://tinyurl.com/mmll5ro applyofonline: https://nswhealth.erecruit.com.au/ViewPosition.aspx?Id=250443 Closing Date: 25th May areTolevels support that are appropriate at different stages,” she says.

HealthTimes - Issue 8 | Page 9

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324-026 1/2PG FULL COLOUR CMYK PDF 507-030 DIRECTOR CLINICAL SERVICES Cohuna District Hospital The Director Clinical Services is responsible to the Chief Executive Officer for the provision of optimum levels of care to patients and residents, through effective leadership, management of staff and other resources, and the development of cooperative professional relationships.

The Director Clinical Services must have a background of clinical expertise, act as a mentor and role model and facilitate the development of clinical and administrative skills in all staff placed under their responsibility. The role includes both clinical oversight and a clinical workload.

Eligible candidates will hold current nursing registration with AHPRA, have extensive experience and knowledge of contemporary management practice and the ability to lead and manage staff in an environment of change. You will also be able to demonstrate abilities in budget planning, monitoring and control, including knowledge of the relevant funding streams.

Full position details can be obtained from our website at:

www.hrsa.com.au

Enquiries should be made in the first instance to Peter McGregor on 0407 139 257 or applications can be forwarded to: hrsa@hrsa.com.au

Closing date: Applications 24 March 2014

PO Box 83 Ocean Grove 3226

close 11 hrsa@hrsa.com.au May 2015 www.hrsa.com.au

508-028 1/2PG FULL COLOUR CMYK PDF 507-029 Registered Nurse Division 1 & 2 Wyndham Clinic Private Hospital Wyndham Clinic is a purpose built private inpatient and day patient adult mental health service and day procedure centre located in Werribee, 30 km west of Melbourne, easily accessible by train and only 2 minutes from the freeway. Our mental health and drug and alcohol services offer a range of evidence based interventions to clients both inpatient and day program. Due to an expansion of our service, we have exciting opportunities for experienced Registered Nurses Division 1 and 2, both full and part time, to join our inpatient mental health team.

We offer: Full Time and Part Time Positions are Available • An experienced, friendly and welcoming team who work together to achieve quality care delivery • A supportive management team who encourage and support staff initiative and suggestions for service improvement • Monthly Clinical Supervision • Excellent salary

Successful Candidates will have: • Demonstrated knowledge, skills and experience delivering quality, person- centred care in mental health and/ or drug and alcohol inpatient setting.

• At least 2 years postgraduate experience • A current Working with Children’s Certificate and Police Check

For more information, please contact MCooper@wyndhamclinic.com.au, call 03 9731 6646.

HealthTimes - Issue 8 | Page 11

Sleuths ofway Infection: Does the womenContact give birth Tracing have long-term ramifications?

A F

By Ellen Rosenfeld ustralian midwifery researchers

are part of an international collaboration investigating or many now we have watched West whether themonths way women give birth has a longAfrican nations struggling with the agony of term impact on babies and their future offspring. ebolaWith haemorrhagic termed ebola the nation’sfever, highnow intervention rates virus The of capacity these duringdisease labour, (EVD).

University Westernof Sydney nations to respond to an epidemic is greatly midwifery professors Hannah Dahlen and reduced by ongoing war,professors poverty and Maralyn Foureur have civil joined Soo particular beliefsofsurrounding death.

Downe, ofcultural the University Central Lancashire, They lack the numbers of of trained and Holly Powell Kennedy, Yale clinical professionals required University, to put childbirth to manage thisunder public health practices the crisis, and rely on teams microscope. of overseas clinicians to The researchers work foundedcollaboratively the with their own. international EPIIC Australian nurses (EPIgenetic Impact of have bravelyresearch joined Childbirth) the battle-front, group and developed working in astronauta hypothesis which like protective focuses on suits, the gum boots effects and epigenetic goggles, 45 of labouroften and in birth, degree heat withperiod, 95% or intrapartum humidity.

Nurses only able on health andareepigenetic to stay in these suits one arduous remodelling. hourThe at a researchers time. The ritual of their donning propose the use of and removal is critically important infection synthetic oxytocin, antibiotics andtocaesarean control; front-line have formative been air-lifted section could affectstaff a critical phase out as ahuman precaution when part of the process for the genome. is compromised. appalling death rateonofa In a paper, Is The society being reshaped ebola and the consequent sociallevel and by economic microbiological and epigenetic the way devastation is birth?, almost published incomprehensible.

Despite women give in the December the effortsofof Midwifery, the governments of Sierra 2014best edition the researchers Leone, and Guinea, between 10,000 and say it’sLiberia a “profoundly disturbing question that 12,000 people died from this truly terrible warrants urgenthave research”. disease.

Draconian measures arefor employed to “Those who might argue increased staunch the flow of labour new cases.

In Sierra intervention during and birth in theLeone, name for example, the also entire population of sixthat million of safety might pause to consider the people was recently ordered tobirth stay as at home preservation of physiological far as

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possible might be the passport for the lifelong health and well-being of not only an infant, but for period of three days in the an effort reduce alsoa for its future offspring,” paperto states. infection “The rates. day of birth may turn out to be one of Spanish Influenza life’sThe most defining events.”of 1919 was thought to have been brought soldiers Professor Dahlen, toa Australia privately bypractising returning fromspokesperson Europe after for the the Great War of midwife and Australian 1914-1918. pandemic caused deaths College of The Midwives (ACM), saysthethe way of a similar number of Australians, up toan 12,000 babies are born is vital in setting down ideal people, a hefty proportion of the microbiome that becomes a defence then of five to six shieldpopulation for life. million, already of a “When the stripped baby is born substantial their through theswathe vaginaof it goes young male population. past and through 300An estimatedtypes500 odd different of million died bacteria people that are really world-wide, important for making feeding the Influenza thatSpanish microbiome, one the most when of that baby lethal comes uppandemics onto the in history.

This mother’s chest it then virulent again, asdisease it finds was the terrifying afflicting breast, it’s in getting more young healthy people, and the important bacteria cohort perceived as having when it breastfeeds it’s getting most pandemic resistance. inIt has a particular component the been that only the immune of breastargued milk that the goodsystem bacteria young people was the very thing that caused can digest. their“The vulnerability. researchers a birth and Some that first few weeksthink of life, physiological process called hypercytokinemia particularly if the breastfeeding is exclusive and or (Osterholm, 2005; theyaare“cytokine not havingstorm” anything else, and they are Harrison, 2010) in these adults: having that skinoccurred to skin and closeyoung contact with the the shield healthy immune mumprocess is settingbyupwhich a defence for life. system over-reacts an extreme manner, “More and more in evidence is showing that attacking host babies born bycells. caesarean section have different As with microbial the scourgemake-up of ebola, rigorous bacterial in theirpublic gut health measures were used Australia in 1919 compared to babies born by in vaginal birth. to minimise infection rates: were placed “This may explain whypeople we see a 25 per in quarantine; places public assembly cent increase in type 1ofdiabetes in babies such born as cinemas, racetotracks andbirth, libraries by schools, caesarean compared vaginal and

were closed; wearingsoface masks was made asthma and allergies, that’s one hypothesis compulsory in some cities; the border between that we talk about in this paper.

New South Wales was which shut. is the “The other is and the Victoria epigentics, We areresearch extremelyshowing fortunatethat in Australia be emerging labour to and free ofare pandemic, like every nation, for we birth actuallybut priming us other genetically need constant vigilance have comprehensive optimal responses and and by missing out on that planning in case should occur. with I worked in a labour and birth,it for example elective national pandemic influenza some caesarean section, that there exercise is a silencing yearscan ago, , designed to the test that goExercise on withCumpston some of our genes so Australian government to a possible expression of our genesresponses becomes silenced.

H5N1 influenza pandemic. emergency “That has implications laterThe on for defence exercise was named for John Cumpston, the first and autoimmune disorders.”

Director-General of the said Department Health, Professor Dahlen womenof should a man had anabout extensive career injustified dealing not be who concerned a medically with infection control at a population level. caesarean section.

During “real about time” saying exercise, hypothetical “Thisthe is not if you have a “infected patients” flewis into Australia plane caesarean your baby doomed to abylife of from overseas.

Some had influenza symptoms, autoimmune disorders - absolutely not,” she but others were asymptomatic or merely mildly says. unwell resumed normal They “All and statistics aretheir about an lives. increased went to shopping centres, relatives and likelihood, they don’t meanvisited that you’re going returned to workplaces.

Over a few weeks these to have this disorder. people developed influenza symptoms: fever, “What we do know is if you have to have a cough, headaches, chills, andthat myalgia.

Once caesarean section then giving baby skin to diagnosed and confirmed as influenza cases, skin and exclusively breastfeeding them can do nurses in infection control began the an awfulworking lot to make up for what they’ve missed assiduous of contact tracing; in the first in the birthprocess process.” instance, the tracing of fellow passengers seated Professor Dahlen said the investigation in closealso proximity onmidwives flights. to re-focus their should prompt Contact tracing during the to containment attention on supporting women give birth phase of a pandemic seems to require the without unnecessary intervention. character of a great in thethat first “I thinktraits midwives havedetective; got to realise instance, finely interpersonal “I’m so midwifery carehoned is the best way skills: to reduce sorry, Mrs. sections X, but we so understand sat next to caesarean that’s theyou preventative a man on the in plane hasofsince developed action that’s the who hands midwives,” shea serious influenza. You may be at risk of infection.” says.

Clearly the rationale delivering such “The number two thingfor is when a caesarean disturbing news needs careful consideration. section is needed, midwives are the ones that Close of infected passengers, index are in contacts that operating theatre that needorto be cases, may for be defined as those sittingskin in the advocating the women to have to sameand row or insupporting the two orthem threewith rows in front skin them exclusive or behind them, though thereatis the ongoing debate breastfeeding - so actually, end of the about that number should be extended day, sowhether much of the solution to this problem four or more (Shankar et al, 2014). “I know it’s istomidwifery.

a terrible inconvenience notfeel to very be able to return “And so midwives should empowered to work, Mr. Y, proud but, hard it is, we need you to and strong and thatas the answer to this and stay home the next few weeks.”

How tell many of thefor potential world’s problems thattomay citizens who at their this abrogation of their civil come from thisrail is in hands. liberties that theremidwives are penalties for breaching “Unfortunately obviously feel very quarantine? and helpless and I think we’ve got disempowered Thoughthat contemporary cultureand seems awash to change mentality around midwives with personal identifiers - the a plethora have got to stand up and sayinternet, - actually we are of plastic cards, the ubiquitous closed-circuit important, and they’ve got to start advocating TV at - possible case contacts a(CCTV) much louder, stronger level. may not be easy to find. helps to smidgeon of obsessive“WeIt have allhave of athis scientific evidence compulsivewe disorder a liberal dollop of mounting, need (OCD) to be and taken seriously and “in-it-for-the-long-haul” dogged determination, the government needs to put resources and to keep tracking Once identified, all promotion behindexhaustively. the profession of midwifery.” contacts require clinical followThe researchers have evaluation applied for and funding for up, and each and step hope in the hastesting to be their first study to process soon begin carefully recorded. their hypothesis.

TheEPIIC United States Centrewith fortheDisease The research coincides recent Control (CDC) that Prevention training short filmand Microbirth, features isProfessor personnel in Africa to go door door toresearch identify Dahlen, and investigates thetolatest possible ebola cases.events Therethatare significant about the microscopic occur during cultural barriers. The dead in some countries are childbirth. traditionally washed with bare hands. People feel that if they identify their family members, they will be taken away for isolation and treatment in centers where they inevitably die, preventing their dignified burial. The proactive approach of community contact tracing, however, is prevention in practice; families are taught that if their loved ones are identified, isolated and treated before they have vomiting and diarrhea, not only are they more likely to survive, but the infection risk for the rest of the family is greatly reduced.

The lethality of ebola is a salutary lesson to Australia about the importance of emergency planning for a pandemic in an era of global travel. Though incredibly fortunate to live in a peaceful country with greater capacity of clinical and emergency personnel for dealing with public health emergencies, we cannot afford to be complacent. If the calamitous should happen, you can be certain the sleuths of infection will be on the case.

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HealthTimes - Issue 8 | Page 13

Subsidised nannies for nurses, midwives and paramedics

By Karen Keast Shift-working nurses, midwives and paramedics can apply to access subsidised nannies for childcare at home, under a new Federal Government trial.

The $246 million two-year project, set to be funded in the upcoming Federal Budget, will extend subsidy support to families earning less than $250,000 a year who are shift workers, those living in rural and regional areas, and those who have children with special needs.

The Home Based Carer Subsidy Program will also apply to parents studying or searching for employment, and will provide care for about 10,000 children as part of the first stage of the government’s childcare reforms.

The initiative, which will begin on January 1 next year and run until December 31, 2017, will subsidise nannies attached to approved services.

Nannies must be 18 years of age and have a current Working with Children Check coupled with first aid qualifications but will not be required to hold a minimum early childhood qualification.

Social Services Minister Scott Morrison said the initiative will support families struggling to access affordable childcare services when working, studying or looking for employment.

“Key workers such as nurses, police officers, ambulance officers and firefighters, as well as other shift workers, are too often unable to access childcare and take advantage of government support because of the nature and hours of their work,” he said in a statement.

“The two-year pilot program will determine whether a more sustainable program can be affordably put in place for in-home care nanny services, including necessary integrity measures and quality standards.

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“Trialling a range of family circumstances will help determine the best settings for delivering childcare in a child’s home under the childcare subsidy.”

Australian Nursing and Midwifery Federation (ANMF) federal secretary Lee Thomas said the union had long been calling for subsidised childcare payments for nannies for shift-working nurses and midwives.

“According to a poll conducted by the ANMF, 92 per cent of Australia’s nursing and midwifery workforce currently work shifts outside regular Monday-Friday day-shift hours each month, with 78 per cent of them reporting that they work outside of Monday-Friday day shift on a weekly basis,” she said.

“For our members who predominately work these types of shifts at any hour of the day or night, on weekends and on public holidays, accessing childcare outside regular hours, is often a difficult task.

“That’s why this trial of 10,000 low-to-middle-income families will come as a relief to them and we thank the government for acknowledging the issues shift workers face in accessing mainstream childcare services.”

Ms Thomas said the ANMF would like to work with the government to ensure the trial meets the needs of interested nurses and midwives.

“The feedback from our members will be useful in assisting the government to gauge its effectiveness,” she said.

Families and service providers will be able to apply for the pilot later this year.

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Miwatj Health is an Aboriginal Community Controlled Health Organisation delivery primary health care services in the East Arnhem Region in the Northern Territory. We are currently looking for experienced, enthusiastic and reliable people to fill several positions to complement much needed services aimed at improving the health of local people in Aboriginal communities.

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In this position you will be working collaboratively with patients and clinical teams to provide appropriate multidisciplinary care and services for Aboriginal women and children. In addition to relevant qualifications, experience working with Aboriginal communities and the ability to provide culturally appropriate support are required.

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In this position you will be providing support to the Chronic Disease Outreach Program and assist in the development, implementation and evaluation of culturally appropriate Aboriginal health projects and programs.

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In this position you will be delivering direct high quality and comprehensive nursing care and individual case management within the clinic. Applicants should demonstrate a broad range nursing experience and utilizing clinical skills with confidence.

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HealthTimes - Issue 8 | Page 15

Walk with midwives to raise funds for Indigenous midwifery students

By Karen Keast

M

idwives for a better tomorrow.

That’s the theme of this year’s International Day of the Midwife (IDM), established by the International Confederation of Midwives, and held around the globe each year on May 5.

The Australian College of Midwives (ACM) has established a Walk with Midwives for IDM to raise funds for the Rhodanthe Lipsett Indigenous Midwifery Trust, which provides financial assistance to Aboriginal and Torres Strait Islander midwifery students.

ACM chief executive officer Ann Kinnear said more than 50 people have already registered to hold walks at Thursday Island, Gove, Byron Bay, Alice Springs, Sydney, Canberra and Adelaide, and she hopes the number of registrations will continue to increase.

“We are delighted with the response of our members and midwives all around the country in organising walks, all sorts of walks, to celebrate,” she said.

“This is the first year of the Walk with Midwives and we hope it will grow each year.”

Ms Kinnear said the day was not only a celebration of midwifery but also a chance to raise awareness about the critical role midwives play in reducing maternal and neonatal mortality and also in ensuring that women and babies have the best health outcomes in their pregnancy and birth.

“Midwives play such an important role in the lives of families and mothers during this important time in their pregnancy and birth,” she said.

“All women need a midwife regardless of whether they’re well or whether they have complications - midwives do create a better tomorrow.”

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Ms Kinnear said this year’s theme resonates with the mantra of the Rhodanthe Lipsett Indigenous Midwifery Trust, which works to support Indigenous students into the midwifery profession.

Midwifery advocate Pat Brodie AM, chair of the Trust and an Adjunct Professor at the University of Technology Sydney, said the Trust assists midwifery students and also works to address the nation’s severe shortage of Aboriginal and Torres Strait Islander midwives.

Professor Brodie said Australia is home to just 200 Indigenous midwives.

“We note recent reports from the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) which identify that at least 1096 Aboriginal and Torres Strait Islander midwives are needed - 5.5 times the number we currently have,” she said.

“About four per cent of the Australian population giving birth are Aboriginal or Torres Strait Islander women and the percentage of Aboriginal and Torres Strait Islander midwives is 0.7 per cent.

“Pregnancy and childbirth is a critical moment in women’s lives and all Australians need to think about the numbers of Aboriginal and Torres Strait Islander mothers and babies who need that extra support.

“That support comes from having access to a midwife that they know and trust, which is more often than not going to be an Aboriginal and Torres Strait Islander midwife.

“We currently have a shortage and we need to address that urgently.”

For the full article visit HealthTimes.com.au

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HealthTimes - Issue 8 | Page 17

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27/04/2015 11:48:33 AM 19 HealthTimes - Issue 8 | Page

Sleuths Infection: Does theofway womenContact give birth Tracing have long-term ramifications?

By Ellen Rosenfeld A F

ustralian midwifery researchers are part of an international collaboration investigating or many now we have watched West whether themonths way women give birth has a longAfrican struggling with theoffspring. agony of term impactnations on babies and their future ebola haemorrhagic termed ebola With the nation’sfever, high now intervention rates virus disease The ofcapacity these during labour, (EVD).

University WesternofSydney nations to professors respond to Hannah an epidemic is greatly midwifery Dahlen and reduced Foureur by ongoing poverty Soo and Maralyn have civil joinedwar, professors particular cultural beliefs death.

Downe, of the University of surrounding Central Lancashire, TheyHolly lack Powell the numbers of oftrained and Kennedy, Yale clinical professionals required University, to put childbirth to manage this public health practices under the crisis, and rely on teams microscope. of overseas clinicians to The researchers work collaboratively founded the with their EPIIC own. international Australian Impact nurses (EPIgenetic of have bravely joined Childbirth) research the andbattle-front, group developed in astronautaworking hypothesis which like protective focuses on suits, the gum boots effects and epigenetic goggles, 45 of labour often and inbirth, degree heat withperiod, 95% or intrapartum humidity. only able on healthNurses and are epigenetic to stay in these suits one arduous remodelling. hour at aresearchers time. The ritual of their The propose thedonning use of and removal is critically important infection synthetic oxytocin, antibiotics and tocaesarean control;could front-line haveformative been air-lifted section affect staff a critical phase outthe as human a precaution when part of the process for genome. is compromised.

The appalling death rate In a paper, Is society being reshaped on of a ebola and the consequent social andby economic microbiological and epigenetic level the way devastation almostpublished incomprehensible.

Despite women giveisbirth?, in the December the best efforts the governments of Sierra 2014 edition of ofMidwifery, the researchers Leone, and Guinea, between 10,000that and say it’s Liberia a “profoundly disturbing question 12,000 people died from this truly terrible warrants urgenthave research”. disease. measures to “ThoseDraconian who might argueareforemployed increased staunch the during flow oflabour new cases.

In Sierra intervention and birth in theLeone, name forsafety example, thealso entire population of sixthat million of might pause to consider the people was recently ordered to stayasat far home preservation of physiological birth as

Page 20 | www.HealthTimes.com.au

possible might be the passport for the lifelong health and well-being of not only an infant, but also its future offspring,” for afor period of three days inthe an paper effort states. to reduce “The day of birth may turn out to be one of infection rates. life’s The mostSpanish defining events.” of 1919 was thought Influenza Professor a Australia privately by practising to have been Dahlen, brought to soldiers midwife spokesperson Australian returningand from Europe afterfor thethe Great War of College of The Midwives (ACM), says the thedeaths way 1914-1918. pandemic caused babies are born is vital setting down ideal of a similar number of in Australians, up toan12,000 microbiome that becomes a defence people, a hefty proportion of the shield life. then for population of five to six “When the baby is born million, already stripped of a through theswathe vagina of it goes substantial their past and through 300young male population. odd types500 of An different estimated bacteria are really million that people died important for feeding world-wide, making that microbiome, the Spanish Influenza when one of that the baby most comes onto the lethal up pandemics mother’s chest it then in history.

This again, it finds was the virulentas disease breast, it’s getting more terrifying in afflicting important bacteria young healthy people,and the when cohortit breastfeeds perceived it’s as getting having amost particular component pandemic resistance.inIt the has breast milk that goodsystem bacteria been argued thatonly the the immune of can digest. young people was the very thing that caused birth and that firstresearchers few weeks think of life,a their“The vulnerability.

Some particularly if the breastfeeding is exclusive and physiological process called hypercytokinemia they not havingstorm” anything(Osterholm, else, and they are or aare“cytokine 2005; having that skin occurred to skin and close young contactadults: with Harrison, 2010) in these mum is settingby up awhich defence for life. the process theshield healthy immune “Moreover-reacts and more evidence is showing that system in an extreme manner, babies born by cells. caesarean section have different attacking host bacterial make-up in theirpublic gut As withmicrobial the scourge of ebola, rigorous compared to babies born by vaginal birth.in 1919 health measures were used in Australia “This may explainrates: why people we seewere a 25 per to minimise infection placed cent increase inplaces type 1ofdiabetes babies born in quarantine; public in assembly such by compared to tracks vaginaland birth, and as caesarean schools, cinemas, race libraries

were closed; wearing so face masks was made asthma and allergies, that’s one hypothesis compulsory some the border between that we talk in about in cities; this paper.

New“The South Wales was shut. other is and the Victoria epigentics, which is the We are research extremelyshowing fortunate that in Australia be emerging labourtoand free pandemic, like every nation, we birthofare actuallybut priming us other genetically for need constant vigilance comprehensive optimal responses andand by have missing out on that planning in case it should occur. Iwith worked in a labour and birth, for example elective national influenza some caesareanpandemic section, that there exercise is a silencing years ago,go Exercise , designed that can on withCumpston some of our genes to so test the Australian a possible expressiongovernment of our genesresponses becomes to silenced.

H5N1 influenza pandemic. emergency “That has implications laterThe on for defence exercise was named for John Cumpston, the first and autoimmune disorders.”

Director-General of the Department of Health, Professor Dahlen said women should anot man had an about extensive career in justified dealing be who concerned a medically with infection control at a population level. caesarean section.

During time” saying exercise,if hypothetical “Thistheis “real not about you have a “infected flewisinto Australia plane caesareanpatients” your baby doomed to by a life of from overseas.disorders Some had autoimmune - influenza absolutelysymptoms, not,” she but says.others were asymptomatic or merely mildly unwell resumed normal They “All and statistics aretheir about an lives. increased went to shopping centres, relativesgoing and likelihood, they don’t meanvisited that you’re returned to workplaces. to have this disorder. Over a few weeks these people developed influenza symptoms: fever,a “What we do know is if you have to have cough, headaches, chills, andthat myalgia.

Once caesarean section then giving baby skin to diagnosed and confirmed as influenza cases, skin and exclusively breastfeeding them can do nurses working in infection control began the an awful lot to make up for what they’ve missed assiduous of contact tracing; in the first in the birthprocess process.” instance, the tracing of fellow seated Professor Dahlen said passengers the investigation in close also proximity on midwives flights. to re-focus their should prompt Contact during the to containment attention on tracing supporting women give birth phase a pandemic seems to require the withoutofunnecessary intervention. character traits of a great in the that first “I think midwives havedetective; got to realise instance, interpersonal “I’m so midwiferyfinely carehoned is the best wayskills: to reduce sorry, Mrs. X, but we understand you sat next to caesarean sections so that’s the preventative aaction man on the plane has of since developed a that’s in thewho hands midwives,” she serious says. influenza. You may be at risk of infection.”

Clearly rationale foris when delivering such “The the number two thing a caesarean disturbing news needs careful section is needed, midwives are consideration. the ones that Close of infected passengers, or to index are in contacts that operating theatre that need be cases, may be as those sittingskin in the advocating for defined the women to have to same rowthem or insupporting the two orthem threewith rowsexclusive in front skin and or behind them,- though there at is ongoing breastfeeding so actually, the end debate of the about whether number should be extended day, so much that of the solution to this problem to four or more (Shankar et al, 2014). “I know it’s is midwifery.

a terrible inconvenience notfeel to be able to return “And so midwives should very empowered to Mr.and Y, but, hard it is, we need youand to andwork, strong proud thatasthe answer to this stay the next few weeks.”

How tell manyhome of thefor potential world’s problems thattomay citizens whothis railis at of their civil come from in this theirabrogation hands. liberties that there midwives are penalties for breaching “Unfortunately obviously feel very quarantine? disempowered and helpless and I think we’ve got Thoughthat contemporary cultureand seems awash to change mentality around midwives with identifiers - the a plethora havepersonal got to stand up and sayinternet, - actually we are of plastic cards, the ubiquitous closed-circuit important, and they’ve got to start advocatingTV at (CCTV) possible case contacts a much -louder, stronger level. may not be easy to find. smidgeon of obsessive“WeIt helps have to allhave of athis scientific evidence compulsive disorder a liberal dollop of mounting, we need(OCD) to beand taken seriously and “in-it-for-the-long-haul” determination, the government needs dogged to put resources and to keep tracking exhaustively.

Once promotion behind the profession of identified, midwifery.”all contacts require clinical followThe researchers haveevaluation applied forand funding for up, in thetoprocess has testing to be theirand first each study step and hope soon begin carefully recorded. their hypothesis.

The EPIIC United States Centrewith fortheDisease research coincides recent Control (CDC) Prevention training short filmand Microbirth, that featuresis Professor personnel in Africa to go door door toresearch identify Dahlen, and investigates theto latest possible cases.events Therethat areoccur significant about the ebola microscopic during cultural barriers. The dead in some countries are childbirth. traditionally washed with bare hands. People feel that if they identify their family members, they will be taken away for isolation and treatment in centers where they inevitably die, preventing their dignified burial. The proactive approach of community contact tracing, however, is prevention in practice; families are taught that if their loved ones are identified, isolated and treated before they have vomiting and diarrhea, not only are they more likely to survive, but the infection risk for the rest of the family is greatly reduced.

The lethality of ebola is a salutary lesson to Australia about the importance of emergency planning for a pandemic in an era of global travel. Though incredibly fortunate to live in a peaceful country with greater capacity of clinical and emergency personnel for dealing with public health emergencies, we cannot afford to be complacent. If the calamitous should happen, you can be certain the sleuths of infection will be on the case.

HealthTimes - Issue 8 | Page 21

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HealthTimes - Issue 8 | Page 23

Psychological recovery in disasters

By Karen Keast

A

ustralia was left reeling when the worst bushfires in the nation’s history razed Victoria on February 7, 2009.

Black Saturday claimed 173 lives and injured 5000 people, destroyed more than 2000 homes, displaced more than 7500 people and killed thousands of animals while more than one million acres were burnt.

The disaster prompted the establishment of an expert reference group, featuring psychologists from the Australian Psychological Society (APS) as well as occupational therapists, social workers, psychiatrists, general practitioners and several health organisations such as the Phoenix Australia – Centre for Posttraumatic Mental Health.

The group developed a best practice framework to guide the provision of support and mental health care to communities coming to grips with natural disasters, such as floods, bushfires, earthquakes and cyclones, along with other emergencies.

APS senior psychologist Dr Susie Burke says the framework has three levels of support aimed at providing psychological assistance targeting both the affected individuals and communities and also the health professionals working to improve people’s psychological recovery.

Dr Burke says level one features advice and support to people and communities in the immediate aftermath of a disaster.

Page 24 | www.HealthTimes.com.au

“These are the things that would be useful in the hours, days and early weeks after a disaster when we expect that people’s needs are mainly for physical recovery, shelter, clothing, finding documents and getting themselves into a safe place,” she says.

“Their psychosocial needs are not met with health professionals as much as they are by family and friends and informal supports, and also the support of organisations like Red Cross or other disaster NGOs.” Level two focuses on health professionals tapping into simple psychological strategies to teach practical psychological skills to people affected by disasters.

Dr Burke says the strategies, Skills for Psychological Recovery (SPR), were developed in the wake of Hurricane Katrina, renowned as one of the five deadliest hurricanes in the history of the United States.

“Hurricane Katrina was the most recent enormous event that impacted so many thousands of people,” Dr Burke says.

“They wanted to equip health professionals with something that could be used for a large number of people who might not be at risk of going on to get post traumatic stress disorder (PTSD) or depression but who nonetheless are really disrupted and impacted by the event.”

APS offers SPR resources and training which has since prepared health professionals across Victoria, Queensland and South Australia to provide affected individuals with five

key skills - problem solving, promoting positive activities, managing reactions, helpful thinking and rebuilding social connections.

Dr Burke says these essential skills, such as problem solving, can help people cope with confronting challenges, including the rebuilding of their lives in the aftermath of a disaster.

“If you think about it - when your home has been destroyed and you need to find a new place to live and you can’t find a new place to go to, and your kids are at school and the school was destroyed as well and you have to find a new school.

“Disasters throw up a whole lot of problems and people can become overwhelmed with the sheer scale of problems that they’ve got.

“So teaching people problem solving skills and being able to prioritise which is the most urgent problem that is kind of blocking them being able to think about any of the other problems.

“It’s breaking down that problem and being able to brainstorm a whole lot of different options and being able to meet that problem.”

Level three of the framework covers the formal evidence-based psychological interventions for people with severe distress, at risk of developing mental health problems such as depression, PTSD and complicated grief.

“This level of intervention is what psychologists might see as being their area in recovery after disasters, which is helping the 10 to 15 per cent of an affected population that might be at risk of going on to develop significant mental health problems,” Dr Burke says.

Dr Burke says the three levels of support are offered at different stages - based on the level of distress and the timing in the wake of the disaster.

“A lot of the work we’ve been doing over the last six years or so is actually trying to educate the public and health professionals that it’s not just psychological therapy in the level three type intervention that’s needed after a disaster but there are levels of support that are appropriate at different stages,” she says.

The most important factor in people’s psychological recovery, regardless of the type of disaster or event, is accessing social support, Dr Burke says.

“You really want to give people a chance to draw on their own resources, draw on their own families and friends for support and activate their own coping resources before health professionals sweep in and offer services,” she says.

“The other reality too is that in our current climate change scenarios the number of disruptive extreme weather events that we are going to be impacted by will escalate and it’s just not possible for us to be able to treat, meet people’s mental health needs or needs for psychosocial recovery through health professionals.”

The APS has a range of resources on its website for psychological preparedness for disasters such as bushfires and heatwaves, cyclones and floods, enabling people to prepare for the emotional challenges of living through emergencies.

It also features resources for disaster recovery, for the public and health professionals, alongside links to a range of additional resources, including the Disaster Response Network of APS psychologists and the Psychological Support in Disasters web portal.

Tell us what you think Leave a comment on this and other subjects by visiting the ‘news’ section of our website http://healthtimes.com.au To go to this article directly, visit http://tinyurl.com/mmll5ro

HealthTimes - Issue 8 | Page 25

Aussie and Kiwi nurses return from war on Ebola

By Karen Keast The final contingent of Australian and New Zealand nurses and doctors are returning home from combatting the world’s deadliest disease in Sierra Leone in early May. The Australian Government announced it would close the Ebola Treatment Centre (ETC) at Hastings Airfield on April 30 due to a stabilisation of the Ebola outbreak in West Africa, with the number of new infections on the decline.

The news comes as a second New Zealand health care practitioner, who left Sierra Leone on April 15, is being tested for Ebola after developing minor symptoms while self-monitoring.

The practitioner has been airlifted to Wellington Hospital and is being cared for in one of the country’s four specialty isolation facilities while the patient’s blood samples are tested in Melbourne.

The Australian-funded ETC opened in December 2014 as part of the international response to the Ebola outbreak, which has now claimed more than 10,800 lives while there’s been more than 26,000 reported confirmed, probable and suspected cases of Ebola in Guinea, Liberia and Sierra Leone.

The centre, established by the United Kingdom and managed by Aspen Medical, has admitted 216 patients, with 36 successfully treated for Ebola, while another 120 patients presenting with Ebola-like symptoms have been monitored and discharged after being treated for lassa fever, HIV, malaria and gastroenteritis. There have been nine nonEbola deaths at the ETC. Three clinical incidents resulted in the precautionary medical evacuations of health

Page 26 | www.HealthTimes.com.au

workers at the ETC to the United Kingdom but no clinicians have contracted Ebola.

A total of 61 Australian and New Zealand nurses and doctors have worked at the ETC alongside 12 support team members.

In a statement, Foreign Affairs Minister Julie Bishop thanked the dedicated health care workers and congratulated Aspen Medical for its professionalism.

“No local or international staff employed at the ETC contracted Ebola, demonstrating the effectiveness of the ETC’s strict protocols and the quality of staff training,” she said.

The final Aspen Medical team members departed Sierra Leone on May 3 after the handover to the UK Government.

Aspen Medical CEO Bruce Armstrong said Australian and New Zealand health professionals saved lives at the Australianflagged ETC. “We are proud of what was achieved over the past five months,” he said.

“Not only the 36 Ebola survivors but also the 120 survivors of other diseases that kill in Sierra Leone, who we were able to treat at the ETC.” Mr Armstrong said the nursing team was on the frontline of the global war against Ebola in West Africa.

“They endured the most challenging conditions they have ever faced - having to wear PPE (personal protection equipment) in the heat whilst delivering care to the sick and dying,” he said.

for the full article visit HealthTimes.com.au

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HealthTimes - Issue 8 | Page 29

Rapid growth in osteopathy

By Karen Keast Osteopathy is statistically the fastest growing health profession in Australia and boasts an almost 100 per cent graduate uptake.

While it remains one of the smallest of the 14 health professions registered under the national scheme, the profession has increased from about 300 osteopaths 10 years ago to now reaching almost 2000 registered osteopaths practising across Australia.

Osteopathy Australia chief executive Antony Nicholas said the profession has grown at a significant rate in the past few years in line with an increasing number of people experiencing back problems, arthritis and other musculoskeletal conditions.

“There’s been a much bigger drive from health consumers around taking care of themselves,” he said.

“The whole manual therapy area has grown substantially, whether that’s physiotherapists, chiropractors or osteopaths, all of which have quite an overlap in their scopes of practice.”

With three universities in Australia producing up to 150 osteopathy graduates each year, and higher intakes expected in the next few years, Mr Nicholas said the profession will continue to grow in Australia.

“About 75 per cent of the profession is just in Victoria and New South Wales, and although there are about 140 osteopaths in Queensland, the rest of the states have less than 50 osteopaths, so there’s a huge area for the potential growth and expansion of the profession in all those other states,” he said.

“We’re hoping that by about 2020 we will be closer to the 3000 mark. We would like to see some new courses starting in Queensland or Western Australia or even in the Northern Territory.”

Page 30 | www.HealthTimes.com.au

Mr Nicholas said most students who choose osteopathy as a career path have come into contact with the manual treatment either directly or through a family member’s treatment experience.

“We are quite pleased that it’s about a 100 per cent graduate employment,” he said.

“Ninety-eight per cent of osteopaths will work in private practice and we are seeing an increasing trend of osteopaths also working in corporate ergonomics, a few in aged care or corporate health but the vast majority are working in private practice either in multidisciplinary allied health clinics or osteopathy-specific clinics.”

Mr Nicholas, who is also deputy chair on the Allied Health Professions Australia board, said despite the growth in the profession, there’s still a level of misunderstanding about the work of osteopaths among the public and other health practitioners.

As part of Osteopathy Awareness Week, held from April 19-25, the national professional association representing the nation’s osteopaths worked to promote the profession and the benefits of osteopathy.

Osteopaths complete a minimum of five years’ university training in anatomy, physiology, pathology, general medical diagnosis and osteopathic techniques and treat back and neck pain, sports injuries, headaches, whiplash, postural problems, sciatica, knee and heel pain, shin splints, occupational injuries and carpal tunnel syndrome.

“The core philosophy of osteopathy is about structure governs function and what they mean by that is that if the muscles are relaxed and loose and the joints aren’t constricted then the body can move more freely, so the lymphatics can move more freely, so the circulation and all that works better, so therefore the body can heal itself better,” Mr Nicholas said.

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Make the dream of becoming a doctor a reality, earn your MD at Oceania University of Medicine.

Attractive fee structure for our Graduate Entry Program.

Over 150 students currently enrolled and over 50 graduates in Australia, New Zealand, Samoa and USA. Home-based Pre-Clinical Study under top international medical school scholars, using world leading Pre-Clinical, 24/7 online delivery techniques.

Clinical Rotations can be performed locally, Interstate or Internationally.

Receive personalised attention from an Academic Advisor.

OUM Graduates are eligible to sit the AMC exam or NZREX.

Applications are now open for courses starting in January and July - No age restrictions

OCEANIA UNIVERSITY OF MEDICINE

INTERNATIONALLY ACCREDITED For information visit www.RN2MD.org or 1300 665 343

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