Ncah issue 09 2014

Nursing Careers Allied Health ncah.com.au

New Year New Career Breathing new life into Education Feature cardiorespiratory physiotherapy

Nurse Leaders Feature

Guide shows Physios how to harness socialdevastated media Paramedics at helicopter rescue death Pharmacists, nurses and midwives attack Audit Commission report ACT nurses reach pay deal Pharmaceutical researches Unregulated workers a poor solution to health budget crisis develop life-saving device Australian physiotherapists want prescribing rights Private hospital surgeries on the rise Tasmanian graduate nursing positions disappointing: ANMF Waikato initiative supports nurses to support students

Issue Issue18 1 Issue 9 09/09/13 20/01/14 12/05/14 fortnightly fortnightly

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www.ncah.com.au www.ncah.com.au )SSUE p !UGUST Issue 9 2014 2014 1 ––12 20May January )SSUE p !UGUST

We hope you enjoy perusing the range of opportunities We hope you enjoy perusing included in Issue 17, 2013. the range of opportunities 9, 2014.

1, included in Issue 17, 2013.

If you are interested in pursuing any of these opportunities, Ifplease you are interested in pursuing any ofvia these contact the advertiser directly the opportunities, contact details please contact the advertiser directly via the details provided.

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The NCAH Magazine is the most widely distributed national The NCAH is the most widely distributed national nursing andMagazine allied health publication in Australia nursing and allied health publication in Australia For all advertising and production enquiries please contact For all advertising and8700, production us on +61 (0) 3 9271 email enquiries please contact us on +61 (0) 3 9271 8700, email careers@ncah.com.au or visit www.ncah.com.au careers@ncah.com.au or visit www.ncah.com.au If you would like to change your mailing address, Iforyou likeon toour change your mailing address, be would included distribution, please email or be included on our distribution, please email careers@ncah.com.au careers@ncah.com.au Published by Seabreeze Communications Pty Ltd Trading as NCAH. Published by 328 Seabreeze ABN 29 071 053. Communications Pty Ltd Trading as NCAH. ABN 29 071 328 053. © 2013 Seabreeze Communications Pty Ltd. 2014 Seabreeze Communications Pty Ltd. © 2013 All rights reserved. No part of this publication may be copied or All rights reserved. part of this publication may bepermission copied or of reproduced by anyNo means without the prior written reproduced byCompliance any means without prior written permission the publisher. with thethe Trade Practices Act 1974 ofof the publisher. Compliance thepublication Trade Practices Act 1974 of of advertisements containedwith in this is the responsibility advertisements contained in this publication is the responsibility of those who submit the advertisement for publication. those who submit the advertisement for publication.

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Education feature feature Next Publication: Regional & Remote Next Publication: Education feature Next Publication: feature 26thFebruary May 2014 Publication Date: MondayEducation 3rd 2013 Publication Date: Monday 9th September 2013 Monday 19th 20142013 Colour Artwork Tuesday 28th May January Publication Date:Deadline: Monday 9th September 2013 Colour Artwork Deadline: Monday 2nd September 2013 21st May 2014 Mono Artwork January 2013 Colour Artwork Deadline: Deadline: Wednesday Monday 2nd29th September 2013 Mono Artwork Deadline: Wednesday 4th September 2013 Mono Artwork Deadline: Wednesday 4th September 2013

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Nursing Careers Allied Health - Issue 09 | Page 5

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Allied health practitioner numbers increase

by Karen Keast Australia is now home to more than 25,900 registered physiotherapy practitioners and more than 28,100 registered pharmacy practitioners, new figures show.

The quarterly statistics released from the National Boards reveal the number of allied health professionals registered to practise continues to rise in Australia.

Physiotherapy Board of Australia data shows there are 25,915 physiotherapists - with most of those, at 7,515, living in New South Wales, 6,381 in Victoria, 4,792 in Queensland, 3,166 in Western Australia, 2,160 in South Australia, 491 in the ACT and 424 in Tasmania, while just 168 reside in the Northern Territory.

More than 69 per cent of physiotherapists are female while most, 5,395 or 20 per cent, are aged between 25 and 29 and, at the other end of the spectrum, 24 or 0.9 per cent, are aged over 80.

Pharmacy Board of Australia statistics show there are now 28,188 pharmacy practitioners with most, at 8,735 living in New South Wales, 6,955 in Victoria, 5,514 in Queensland, 3,046 in Western Australia, 2,025 in South Australia, 683 in Tasmania, 473 in the ACT, while just 210 live in the Northern Territory.

More than 60 per cent of pharmacists are female, most, 6,210 or 22 per cent, are aged 25-29, 18 per cent or 5,318 pharmacists are aged 30-34 and 12 per cent or 3,508 pharmacists are aged 35-39.

Occupational Therapy Board of Australia data reveals there are now 16,084 occupational therapy practitioners registered to practise, with most or 4,551 residing in New South Wales, 3,940 living in Victoria and 3,158 living in Queensland.

More than 91 per cent of occupational therapists are female, 22 per cent are aged 25Page 6 | www.ncah.com.au

29 and 20 per cent are aged 30-34 while just four or 0.02 per cent are aged 75-79.

Psychology Board of Australia figures show there are 31,176 psychologists in Australia, with most at 6,605 working in clinical psychology, 932 working in counselling psychology, 596 in educational and developmental psychology, 558 working in clinical neuropsychology, 522 in forensic psychology, 458 in organisational psychology, 311 in health psychology, 92 in sport and exercise psychology and 55 in community psychology.

The figures show 78 per cent of psychologists are female with 15 per cent or 4,684 aged 3034, 13 per cent aged 35-39 and 13 per cent also aged 40-44 while 63 psychologists, or 0.2 per cent, are aged 80 plus.

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Nursing Careers Allied Health - Issue 09 | Page 7

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Pharmacists, nurses and midwives attack Audit Commission report

by Karen Keast Community pharmacists, nurses and midwives have condemned some of the key controversial recommendations outlined in the National Commission of Audit report to the Federal Government.

The report recommends a $15 fee to visit the GP, which would fall to $7.50 after 15 visits per year, while concession card holders will be forced to pay $5 per visit, for 15 visits, and then $2.50 per visit.

It also calls for the states to introduce copayments for less urgent treatment in public hospital emergency departments that could be appropriately treated in a general practice setting.

The report suggests fees for prescription drugs should rise by $5 to $41.90 but remain at $6 for concession card holders while also calling for the pharmacy sector to be opened to competition through the deregulation of ownership and location rules.

The Guild states the recommendations will decimate community pharmacy, deprive patients of access to medicines, and cause medicine shortages and rationing.

“The Guild urges to the government to be mindful of the possible negative impact on health outcomes which can occur if higher costs prevent patients from taking medicines as prescribed by their doctors,” it states.

“There is a danger that budget savings achieved through such a measure could be outweighed by higher health and hospital costs in dealing with the consequences of people choosing not to take medicines as prescribed.”

The Australian Nursing and Midwifery Federation (ANMF) states the recommendations jeopardise the health care of all Australians.

Page 10 | www.ncah.com.au

ANMF federal secretary Lee Thomas said people will postpone visiting a doctor and may not be able to afford to fill their prescriptions.

“Struggling families, low income earners on a fixed income and the most vulnerable in the community won’t possibly be able to afford to pay such outrageous fees for what should be free health care,” she said.

“As Australia’s largest health union, the ANMF is now calling on Mr Abbott to reject these recommendations and assure Australians that our universal health care system is maintained and indeed strengthened.”

The report also recommends individuals earning more than $88,000 and families earning above $176,000 should pay two per cent more in tax if they fail to take out private health insurance, while private insurers should also charge higher premiums to smokers and people with unhealthy lifestyles.

It also moots extending the scope of health professional practices, such as pharmacists and nurse practitioners, to address the future needs of Australia’s health care system.

“

Struggling families, low income earners on a fixed income and the most vulnerable in the community won’t possibly be able to afford to pay such outrageous fees for what should be free health care

– Lee Thomas ANMF federal secretary

”

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Nursing Careers Allied Health - Issue 09 | Page 11

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Get networking toa useful advance career Self-leadership toolyour for nursing nurse leaders Nurses are tapping into acould unique Building ‘self-leadership’ be networking a vital tool opportunity to discuss local professional for nurse leaders often working in high pressure issues and according advanceto their professional environments, an expert in the field. development. Karen Keast meets a young nurse Scott, leaderdirector striving to connect nurses Adam of leadership consultancy through the initiative.

Inspyr, told NCAH ‘leading from the inside out’ or fostering ‘self-leadership’ can play a critical role in building resilience.

At 23, Renee Callender is at the very beginning of her nursing career.

He described self-leadership as “being fully aware and graduate, responsiblewho for recently our emotional But thisof new began states our meaning-making powersCare and the work and in aged care at Warrigal in impact have New on ourSouth emotional responses Albion these Park Rail, Wales, already and behaviours. short,ofbeing aware ofwith ‘self’.” understands theInvalue networking her nursing peers.

“Nurse leaders are under particular pressure A 2013 Emerging Leader Ms as they’re usually Nurse required to (ENL), meet the Callender is heading up the Sydney South/ expectations of multiple stakeholders,” he Illawarra area asneed part to of have an Australian College said.

“They also quick responses of Nursingoften (ACN) initiative. because they’re operating in emergency situations.”

The ACN Regions initiative maps out 29 regions Australia-wide and is designed to provide an Scott said he had worked with many nurse avenue for ACN members to meet and network leaders, assisting them in achieving a “fully with other members in their local area. present state of mind” that allows them to Through effectively the Regions, nurses“You aredon’t ablewant to respond to situations. connect withwith their peers while outside work to be dealing a situation still of worrying to advance theirthat careers - from facilitating about something happened 10 minutes or andhour influencing discussion on regional or an ago.” state issues related to health and nursing, “Another key thing we often for focus on is and to provide opportunities continuing assisting nurse leaders to achieve what we call professional development. a ‘resourceful state’, which allows them to make Ms Callender the initiative enables decisions andsays respond effectively in anurses given to discuss any frustrations they have with situation.” workforce issues that affect safe patient care, such current as staffclimate shortages health budgets.

“The in theand health sector is one of systems constant pressure, with- funding “I think itunder kind of provides that unity nurses cuts meaning common of themselves canaactually feel theme involvedisin one having constant change.

Dealing with ‘change fatigue’ a say in some of these issues,” she says. is one of the key areas in which we help nurse “It’s getting our members actually involved and leaders in terms of building self-leadership and making them feel as though they’re a part of resilience.” a bigger community as well, and I think that’s kind of hard with the us ability all spread out -compelling some are Resilience means to “create in private, that somesupport are in public, under the meanings them insome dealing flexibly policies of NSW with change andHealth. overcoming hurts, setbacks Page 12 | www.ncah.com.au

“Whereas, I think ACN encompasses all nurses across all sorts of faculties - private, public, etc to actually bring them together to have one united voice. That’s how I see it anyway.”

Ms Callender is a participant in the ACN’s threeyear ENL program, which annually identifies and supports five pre-registration nursing students with a commitment to leadership in nursing.

It was this program, and its focus on personal and professional development to advance the nursing profession, that prompted the and grace, volition,” newchallenges Registeredwith Nurse topurpose put her and hand up to Scott says, adding that a key asset of become a key contact for her region,resilient which people as self-leaders is amembers. healthy relationship encompasses about 200 with failure.

Ms Callender, who is new to the area, is now workingleaders to develop networking in a ask bid Nurse under pressureevents should to connect nurses across South/ themselves a number of the key Sydney questions, he Illawarra Region. suggested.

“I have upam here to go to university from t Whatmoved situation I dealing with? the New South Wales’ south coast, so I am interested actually getting a bit of feedback t How aminI responding to this? around what issues face this region, and to be t What am I making this able to communicate thissituation onto themean?

ACN as well - to see if there’s anything that they might be t What do I believe about this? able to take further,” she says. t What would be morefaced usefulso to far, believe?

“The challenge I have and I have got a bit of feedback from some other key t What is within my control/not within my contacts for regions across the country, is it’s control? just been a bit of a slow start to get interest and getting ballI rolling. t Howthe can create a more robust and compelling this with situation?

“I think that’s meaning generally about because nurses, with shift work and everything, it’s so hard Adam Scott’s article on ‘Leading from the inside to actually organise a day that we can all get out’ was featured in the Autumn 2014 newsletter together.” of the Association of Queensland Nurse Leaders Undeterred, is forging (AQNL).

He Ms wasCallender also a speaker atahead. the 2013 AQNL Conference.

One of her priorities is to provide professional development opportunities for nurses.

Inspyr specialises in ‘leading from the inside “I reallystrengthening want to see ifthe we can get onto some out’, people leadership education sessions withinwith the region skills of professionals strongdepending technical on feedback from actualwith members as to private where competencies.

It works the public, they not think mayincluding be lacking the and for education profit sectors high in stress region.”such as health and aged care. sectors

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Ms Callender also hopes the initiative will harness the power of nurses connecting.

“I’m finding in my own practice now, starting out, that there are a few things I will come home and be frustrated at,” she says.

“We’re not the only ones with these frustrations and grievances within our workplaces and if we talk about it together we can find a solution together…instead of just getting frustrated by trying to think of ideas by ourselves.

“That’s one of the main reasons why I think the regions are such a great idea.”

There’s one local issue Ms Callender has firsthand experience with that she hopes to tackle through her Region - the lack of employment opportunities for new graduate nurses.

The University of Wollongong Bachelor of Nursing graduate, who is now studying a Master of Philosophy (Nursing), struggled to find employment after missing out on a NSW Health new graduate position.

“I had everyone telling me - don’t worry, you’ll be fine, you’ll be fine, you’ll get one…and like pretty much everybody else last year I was actually unfortunate not to get a position,” she says.

“I didn’t apply to a private new graduate program thinking that I was going to be getting in with this new graduate program.

“Almost all of us were under the impression… that the NSW Health new graduate program was the only way to go if we were ever eligible to actually work as an RN. “I felt shut out afterwards and felt a bit down but I decided to immediately bounce back, and instead of getting myself in a bit of a rut, I started thinking of other ideas I could use instead of just a NSW Health grad job.

Ms Callender says she was rejected after several job interviews due to a lack of experience.

“Also, I was told I couldn’t apply for a public health position within the local area health as a first year, even though I had been previously employed there as an undergraduate AIN.” Ms Callender decided to send out CVs to every aged care facility with cover letters promoting a supported RN position for first year registered nurses.

“I ended up getting an interview at my current workplace and throughout my hour and a half interview I tried to convince them of the benefits to running either a new graduate program or a supported new registered nurse program,” she says.

“I tried to convince them that the benefits of that would not only be to me, or to somebody else that would be coming through looking for a job, but also to them in the future - for new registered nurses coming through to build up their workforce for later on, as a lot of the older nurses are starting to retire as well and there’s going to be a massive workforce shortage.

“They called me back a couple of days later and said they were going to offer me a fulltime position and they also offered another RN that graduated with me a part-time supported position as well.”

Ms Callender fears graduate nurses could be lost from the profession due to a lack of transition programs to support them.

“It’s sad - especially as we do all come out as registered nurses with the same Bachelor of Nursing,” she says.

For the full article visit NCAH.com.au Nursing Careers Allied Health - Issue 09 | Page 13

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“I think it’s a great way for us to meet up, out of the workplace, and to debrief - for one, about things that are going on within our workplaces with other like-minded nurses.

“I kind of started thinking outside of the box – where else will they possibly be hiring first year RNs and how can I make myself available and interesting to those people that might not have necessarily hired first year RNs in the first place?”

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Private hospital surgeries on the rise

by Karen Keast Almost 70 per cent of elective admissions occurred in Australia’s private hospitals in 2012-13.

An Australian Institute of Health and Welfare report has revealed of the two million elective admissions for surgery, 67 per cent took place in private hospitals.

Between 2008-09 and 2012-13, the number of surgical separations increased an average of two per cent for public hospitals and 3.3 per cent for private hospitals each year.

In its snapshot of the nation’s public and private hospitals, the Australian hospital statistics 2012-2013 report also highlighted the increasing cost of health care provision.

Public hospitals spent more than $42 billion in 2012-13 - an average of 4.7 per cent per year after adjusting for inflation - while revenue increased an average of 15 per cent per year.

The report shows there were 746 public hospitals across the nation employing 275,000 full-time equivalent staff in 2012-13 - and 45 per cent of those were nurses, while the number of nurses also increased 2.7 per cent each year from 2008-09.

Thirteen per cent were salaried medical officers while 14 per cent were diagnostic and allied health professionals.

Australia’s 592 private hospitals employed more than 53,800 full-time equivalent staff in 2011-12 and 56 per cent were nurses.

Public hospitals accounted for about 68 per cent of beds, with 58,300 beds, while private hospitals had 32 per cent of beds, with 28,000 beds.

The report shows there were almost 9.4 million hospital admissions in 2012-13, with 5.5 million in public hospitals and 3.8 million in private hospitals.

Page 14 | www.ncah.com.au

Throughout the period, same-day admissions increased 3.6 per cent each year and overnight admissions rose 2.7 per cent each year, while same day admissions rose 5 per cent each year in private hospitals and 3 per cent for public hospitals.

Injuries and cancer were the main reasons for hospital admissions, both at six per cent, with pregnancy and childbirth next on 5 per cent, and respiratory problems and mental health issues both at 4 per cent.

Presentations to public hospital emergency departments also increased an average of 4.2 per cent per year throughout the timeframe to 6.7 million presentations while, in comparison, private hospitals provided 531,000 ED services in 2011-12.

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For the full article visit NCAH.com.au

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The School of Nursing, Midwifery and Paramedicine (Qld) consists of a team of highly motivated academics who have built a strong teaching and learning environment. The School relies on experienced and committed casual teaching staff and is currently calling for expressions of interest from suitably qualified applicants to join the casual teaching pool for undergraduate and postgraduate tutors. Applicants who are experienced in either nursing, midwifery or paramedicine will be considered.

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Nursing Careers Allied Health - Issue 09 | Page 15

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This is a fabulous clinical development and leadership opportunity … Ɛ ůŽŶŐ ĂƐ LJŽƵ ĂƌĞ Ă ƐŵĂƌƚ ƉŚŽŶĞ͕ ĞŵĂŝů ĂŶĚ ďĂƐŝĐ ƐŽĐŝĂů ŵĞĚŝĂ ƵƐĞƌ LJŽƵ͛ůů Įƚ ƌŝŐŚƚ ŝŶ͘ EŽ ĨŽƌŵĂů /d ͬ typing experience required as virtually everything is accessible and entered via a touch screen… dŚĞ ďƌĂŶĚ ŶĞǁ ^ƚ ^ƚĞƉŚĞŶƐ WƌŝǀĂƚĞ ,ŽƐƉŝƚĂů ŝƐ ƵƐƚƌĂůŝĂ͛Ɛ ĮƌƐƚ ĨƵůůLJ ŝŶƚĞŐƌĂƚĞĚ ĚŝŐŝƚĂů ŚŽƐƉŝƚĂů͕ ĂŶĚ ŝƚ ǁŝůů ďĞ ŽƉĞŶŝŶŐ ŝƚƐ ĚŽŽƌƐ ůĂƚĞƌ ƚŚŝƐ LJĞĂƌ͊ dŚĞ Ψϴϳ͘ϱ ŵŝůůŝŽŶ ϵϲ ďĞĚ ŝŶͲƉĂƟĞŶƚ ĂŶĚ ďƵƐLJ ĂLJ ^ƵƌŐĞƌLJ ĨĂĐŝůŝƚLJ ŝƐ Ă ͞ƐƚĂƚĞ ŽĨ ƚŚĞ Ăƌƚ ŚŽƐƉŝƚĂů ŽĨ ƚŚĞ ĨƵƚƵƌĞ͘͟ dŚŝƐ ŝƐ LJŽƵƌ ŽƉƉŽƌƚƵŶŝƚLJ ƚŽ ďĞ ŝŶǀŽůǀĞĚ ǁŝƚŚ ĚĞůŝǀĞƌŝŶŐ ĞdžĐĞƉƟŽŶĂů ŶƵƌƐŝŶŐ ĐĂƌĞ ǁŝƚŚ ƚŚĞ ůĂƚĞƐƚ ĐƵƫŶŐ ĞĚŐĞ ƚĞĐŚŶŽůŽŐLJ ǁŝƚŚ ĨƵůůLJ ŝŶƚĞŐƌĂƚĞĚ ƉĂƟĞŶƚ ƌĞĐŽƌĚƐ͕ ŝŶĐůƵĚŝŶŐ ŵŽŶŝƚŽƌŝŶŐ ĂŶĚ ƚŽƵĐŚ ƐĐƌĞĞŶ ƉŚLJƐŝͲ ĐŝĂŶͬƉƌŽǀŝĚĞƌ ŽƌĚĞƌ ĞŶƚƌLJ ĂŶĚ ƚŽ ďĞ Ăƚ ƚŚĞ ĨŽƌĞĨƌŽŶƚ ŽĨ ĞŵĞƌŐŝŶŐ ƚĞĐŚŶŽůŽŐŝĞƐ͘ ͻ &ƵůůLJ ŝŶƚĞŐƌĂƚĞĚ ƚŽƵĐŚ ƐĐƌĞĞŶ ƉĂƟĞŶƚ ĞŶƚĞƌƚĂŝŶŵĞŶƚ ĂŶĚ ĐŽŵŵƵŶŝĐĂƟŽŶ ƐLJƐƚĞŵƐ ͻ dŽƵĐŚ ƐĐƌĞĞŶ ĐŽŵƉƵƚĞƌƐ ŝŶ ĞǀĞƌLJ ƌŽŽŵ ƚŽ ƌĞĐŽƌĚ ĐůŝŶŝĐĂů ĮŶĚŝŶŐƐ͕ ŵŽŶŝƚŽƌ ĐĂƌĞ ĂŶĚ ƚƌĞĂƚŵĞŶƚ plans ͻ DŽďŝůĞ ĐĂůů ƐLJƐƚĞŵƐ ƚŽ ĐŽŵŵƵŶŝĐĂƚĞ ǁŝƚŚ ƉĂƟĞŶƚƐ ĂŶĚ ĂŶƟĐŝƉĂƚĞ ĐůŝĞŶƚ ŶĞĞĚƐ ƌĞĚƵĐŝŶŐ ĐĂƌĞ ĚĞůŝǀĞƌLJ ƟŵĞƐ ͻ Barcoded pharmacy dispensing system ͻ ůĞĐƚƌŽŶŝĐ ƚƌĂĐŬŝŶŐ ŽĨ ĐůŝŶŝĐĂů ĞƋƵŝƉŵĞŶƚ Ͳ LJĞƐ LJŽƵ ǁŝůů ŬŶŽǁ ǁŚĞƌĞ ƚŚĂƚ ǁŚĞĞůĐŚĂŝƌ ŝƐ ǁŝƚŚŽƵƚ ŚĂǀŝŶŐ ƚŽ ǁĂůŬ ƚŚĞ ůĞŶŐƚŚ ĂŶĚ ďƌĞĂĚƚŚ ŽĨ ƚŚĞ ŚŽƐƉŝƚĂů͊ ƵƌƌĞŶƚůLJ ǁĞ ĂƌĞ ƌĞĐƌƵŝƟŶŐ EƵƌƐĞ DĂŶĂŐĞƌƐ ĂŶĚ ĞdžƉĞƌŝĞŶĐĞĚ ůŝŶŝĐĂů ƐƚĂī ƚŽ ǁŽƌŬ ŝŶŝƟĂůůLJ Ăƚ ƚŚĞ ĞdžŝƐƟŶŐ ^ƚ ^ƚĞƉŚĞŶƐ ,ŽƐƉŝƚĂů ŝŶ DĂƌLJďŽƌŽƵŐŚ ǁŚŝĐŚ ŝƐ ϯϱ ŬŵƐ ĨƌŽŵ ƚŚĞ ŶĞǁ ĨĂĐŝůŝƚLJ ŝŶ ,ĞƌǀĞLJ ĂLJ͘ Maryborough is a quaint historical rural community (pop 40,000) next to the thriving beachside ůŽĐĂƟŽŶ ŽĨ ,ĞƌǀĞLJ ĂLJ ;ƉŽƉ ϴϬ͕ϬϬϬͿ ĂŶĚ ĂƉƉƌŽdžŝŵĂƚĞůLJ ϯ ŚŽƵƌƐ͛ ĚƌŝǀĞ ĨƌŽŵ ƌŝƐďĂŶĞ ŽŶ ƚŚĞ ďĞĂƵƟĨƵů Fraser Coast͘ dŚĞƐĞ ŶĞǁ ůĞĂĚĞƌƐŚŝƉ ƉŽƐŝƟŽŶƐ ĂƌĞ ĐƌŝƟĐĂů ĂŶĚ ƉŝǀŽƚĂů ŝŶ ƚŚĞ ĨƵƚƵƌĞ ƐƵĐĐĞƐƐ ŽĨ ^ƚ ^ƚĞƉŚĞŶƐ ,ŽƐƉŝƚĂů ŝŶ ,ĞƌǀĞLJ ĂLJ͘ /ƚ͛Ɛ ĐƌŝƟĐĂů ƚŚĂƚ ǁĞ ƌĞĐƌƵŝƚ ƐƵĐĐĞƐƐĨƵůůLJ ƚŽ ƚŚĞƐĞ ůĞĂĚĞƌƐŚŝƉ ƉŽƐŝƟŽŶƐ ŶŽǁ ƐŽ ƚŚĂƚ ƐƚĂī ŚĂǀĞ ͞ƟŵĞ ƚŽ ƐĞƩůĞ ŝŶ͟ ĂŶĚ ĐŽŶƚƌŝďƵƚĞ ƚŽ ƚŚĞ ƐĞƫŶŐ ƵƉ ŽĨ ƚŚĞ ŶĞǁ ĨĂĐŝůŝƚLJ͕ ĂŶĚ ƐƵƉƉŽƌƚ ƚŚĞ ĐůŝŶŝĐĂů ƚĞĂŵƐ ŝŶ ƚŚĞ ƚƌĂŶƐŝƟŽŶ ƚŽ ƚŚĞ ŶĞǁ ĨĂĐŝůŝƚLJ ĂŶĚ ƚŚĞ ŶĞǁ ƚĞĐŚŶŽůŽŐŝĞƐ͘ dŚĞƐĞ ĂĚǀĂŶĐĞĚ ĐůŝŶŝĐĂů ŶƵƌƐŝŶŐ ĂŶĚ ůĞĂĚĞƌƐŚŝƉ ŽƉƉŽƌƚƵŶŝƟĞƐ ĂƌĞ Ă ŐƌĞĂƚ ĐĂƌĞĞƌ ŵŽǀĞ ĂŶĚ LJŽƵ͛ůů ďĞ ůŝǀŝŶŐ ĂŶĚ ƉůĂLJŝŶŐ ŝŶ Ă ǀŝďƌĂŶƚ ƌƵƌĂů ďĞĂĐŚƐŝĚĞ ĐŽŵŵƵŶŝƚLJ ǁŚĞƌĞ ŝƚ ŝƐ Ă ŐƌĞĂƚ ƉůĂĐĞ ƚŽ ƌĂŝƐĞ Ă ĨĂŵŝůLJ ĂŶĚ ĐŽŶŶĞĐƚ ǁŝƚŚ Ă ĐŽŵŵƵŶŝƚLJ ƚŚĂƚ ǀĂůƵĞƐ LJŽƵƌ ĐůŝŶŝĐĂů ĞdžƉĞƌŝĞŶĐĞ ĂŶĚ ƐŬŝůůƐ͘

,ĞĂůƚŚ tŽƌŬĨŽƌĐĞ YƵĞĞŶƐůĂŶĚ &Žƌ Ă ĐŽŶĮĚĞŶƟĂů ĐŽŶǀĞƌƐĂƟŽŶ ƌĞŐĂƌĚŝŶŐ ƚŚĞƐĞ ƉŽƐŝƟŽŶƐ ŽŶƚĂĐƚ͗ >ŽƵŝƐĞ ĂŵďƵƌLJ ŽŶ ;ϬϳͿ ϯϭϬϱ ϳϴϳϱ

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What more do you need?

,ĞĂůƚŚ tŽƌŬĨŽƌĐĞ YƵĞĞŶƐůĂŶĚ ĂƌĞ ƌĞĐƌƵŝƟŶŐ ĨŽƌ ƚŚĞ ƚƌĂŶƐŝƟŽŶ ƉƌŽũĞĐƚ Ăƚ ƚŚĞ ^ƚ ^ƚĞƉŚĞŶ͛Ɛ WƌŝǀĂƚĞ ,ŽƐƉŝƚĂů ĨƌŽŵ DĂƌLJďŽƌŽƵŐŚ ƚŽ ,ĞƌǀĞLJ ĂLJ͘ ƌĂŶŐĞ ŽĨ ƉĞƌŵĂŶĞŶƚ ƌŽůĞƐ ĨŽƌ DĂŶĂŐĞƌƐ͕ EƵƌƐĞƐ ĂŶĚ ůůŝĞĚ ,ĞĂůƚŚ ŽƉƉŽƌƚƵŶŝƟĞƐ ĂƌĞ ŶŽǁ ĂǀĂŝůĂďůĞ ĨŽƌ ,WZ ƌĞŐŝƐƚĞƌĞĚ͕ ĐůŝŶŝĐĂůůLJ ĞdžƉĞƌŝĞŶĐĞĚ ƉƌŽĨĞƐƐŝŽŶĂůƐ͘ dŚĞ ĨŽůůŽǁŝŶŐ ƉŽƐŝƟŽŶƐ ŽīĞƌ Ă ƉĞƌĨĞĐƚ ďůĞŶĚ ŽĨ ůŝĨĞƐƚLJůĞ͕ ĐĂƌĞĞƌ ĂŶĚ ƐƚĂďŝůŝƚLJ ƌŝŐŚƚ ŽŶ ƚŚĞ ĚŽŽƌƐƚĞƉ ŽĨ ƚŚĞ ďĞĂƵƟĨƵů &ƌĂƐĞƌ ĐŽĂƐƚ͘

Managerial ͻ ůŝŶŝĐĂů YƵĂůŝƚLJͬ/ŶĨŽƌŵĂƟĐƐ EƵƌƐĞ DĂŶĂŐĞƌ ͻ ůŝŶŝĐĂů EƵƌƐĞ DĂŶĂŐĞƌ Ͳ dŚĞĂƚƌĞ ͻ ůŝŶŝĐĂů EƵƌƐĞ DĂŶĂŐĞƌ Ͳ ^ƵƌŐŝĐĂů tĂƌĚ

Nursing ͻ ͻ ͻ ͻ

ůŝŶŝĐĂů EƵƌƐĞ ;>ĞǀĞů ϮͿ Ͳ Kd ůŝŶŝĐĂů EƵƌƐĞ ;>ĞǀĞů ϮͿ Ͳ ^ƵƌŐŝĐĂů tĂƌĚ ZĞŐŝƐƚĞƌĞĚ EƵƌƐĞƐ Ͳ dŚĞĂƚƌĞ ŶƌŽůůĞĚ EƵƌƐĞƐ Ͳ dŚĞĂƚƌĞ

Allied Health ͻ WŚLJƐŝŽƚŚĞƌĂƉŝƐƚƐ ;>ĞǀĞů ,WϯͲ,WϰͿ /Ĩ LJŽƵ ĂƌĞ ƚŚŝŶŬŝŶŐ ĂďŽƵƚ Ă ŶĞǁ ůŽĐĂƟŽŶ ƚŽ ƐĞƩůĞ ǁŝƚŚ LJŽƵƌ ĨĂŵŝůLJ ĂŶĚ ŚĂǀĞ Ă ĚĞƐŝƌĞ ƚŽ ŬĞĞƉ LJŽƵƌ ĐĂƌĞĞƌ ŽŶ ƚƌĂĐŬ ƚŚĞŶ ŽŶĞ ŽĨ ƚŚĞƐĞ ƉŽƐŝƟŽŶƐ ĐŽƵůĚ ďĞ ƉĞƌĨĞĐƚ ĨŽƌ LJŽƵ͊ W͗ ;ϬϳͿ ϯϭϬϱ ϳϴϳϱ E: recruitment@healthworkforce.com.au t͗ ǁǁǁ͘ ŚĞĂůƚŚǁŽƌŬĨŽƌĐĞ͘ĐŽŵ͘ĂƵ

Nursing Careers Allied Health - Issue 09 | Page 17

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Unregulated workers a poor solution to health budget crisis Amid the shortage of qualified nursing staff and rising health costs, expert opinion has questioned the value of replacing registered or enrolled nurses with unregulated nursing workers.

Writing in The Conversation, Christine Duffield, Professor, Nursing and Health Services Management at Sydney’s University of Technology, has questioned the validity of replacing RNs and ENs with assistants in nursing.

While the salary of an assistant in nursing ranges between 55% and 77% of that of a registered nurse, resulting in cost savings, Professor Duffield contends replacing fully qualified nurses is not a workable solution.

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“Assistants in nursing may be cheaper, but replacing large numbers of registered nurses with low-skilled staff is not the answer to the nation’s health budget crisis. On the contrary, it poses a risk to patient safety and is likely to result in poorer outcomes.�

There are two methods of introducing assistants in nursing to the ward: substitution, whereby assistants in nursing replace RNs and ENs; or a complementary model whereby assistants in nursing are added to ward staffing.

Professor Duffield cited international research, including findings from Australia, which found that decreasing the hours of care provided

by RNs and ENs through substitution with assistants results in compromised patient outcomes and increased risk of complications and even death.

For the full article visit NCAH.com.au

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e:Cowhig info@kcr.ie Kate International Healthcare Recruitment t: +353 49 St. Stephen’s Green,1671 Dublin 2,5557 Ireland 31 Southampton London, WC1B 5HJ, UK Kate Cowhig InternationalRow, Healthcare Recruitment

49 St. Stephen’s Green, Dublin 2, Ireland t: +353 1671 5557 31 Southampton Row, London, WC1B 5HJ, UK

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Nursing Careers Allied Health - Issue 09 | Page 19

Get networking to advance your nursing career Nurses are tapping into a unique networking opportunity to discuss local professional issues and advance their professional development. Karen Keast meets a young nurse leader striving to connect nurses through the initiative.

At 23, Renee Callender is at the very beginning of her nursing career.

“Whereas, I think ACN encompasses all nurses across all sorts of faculties - private, public, etc to actually bring them together to have one united voice. That’s how I see it anyway.”

Ms Callender is a participant in the ACN’s threeyear ENL program, which annually identifies and supports five pre-registration nursing students with a commitment to leadership in nursing.

But this new graduate, who recently began work in aged care at Warrigal Care in Albion Park Rail, New South Wales, already understands the value of networking with her nursing peers.

It was this program, and its focus on personal and professional development to advance the nursing profession, that prompted the new Registered Nurse to put her hand up to become a key contact for her region, which encompasses about 200 members.

A 2013 Emerging Nurse Leader (ENL), Ms Callender is heading up the Sydney South/ Illawarra area as part of an Australian College of Nursing (ACN) initiative.

Ms Callender, who is new to the area, is now working to develop networking events in a bid to connect nurses across the Sydney South/ Illawarra Region.

The ACN Regions initiative maps out 29 regions Australia-wide and is designed to provide an avenue for ACN members to meet and network with other members in their local area.

“I have moved up here to go to university from the New South Wales’ south coast, so I am interested in actually getting a bit of feedback around what issues face this region, and to be able to communicate this onto the ACN as well - to see if there’s anything that they might be able to take further,” she says.

Through the Regions, nurses are able to connect with their peers outside of work to advance their careers - from facilitating and influencing discussion on regional or state issues related to health and nursing, and to provide opportunities for continuing professional development.

Ms Callender says the initiative enables nurses to discuss any frustrations they have with workforce issues that affect safe patient care, such as staff shortages and health budgets.

“I think it kind of provides that unity - nurses themselves can actually feel involved in having a say in some of these issues,” she says.

“It’s getting our members actually involved and making them feel as though they’re a part of a bigger community as well, and I think that’s kind of hard with us all spread out - some are in private, some are in public, some under the policies of NSW Health.

Page 20 | www.ncah.com.au

“The challenge I have faced so far, and I have got a bit of feedback from some other key contacts for regions across the country, is it’s just been a bit of a slow start to get interest and getting the ball rolling.

“I think that’s generally because with nurses, with shift work and everything, it’s so hard to actually organise a day that we can all get together.”

Undeterred, Ms Callender is forging ahead.

One of her priorities is to provide professional development opportunities for nurses.

“I really want to see if we can get onto some education sessions within the region depending on feedback from actual members as to where they think education may be lacking in the region.”

Ms Callender also hopes the initiative will harness the power of nurses connecting.

“I’m finding in my own practice now, starting out, that there are a few things I will come home and be frustrated at,” she says.

“We’re not the only ones with these frustrations and grievances within our workplaces and if we talk about it together we can find a solution together…instead of just getting frustrated by trying to think of ideas by ourselves.

“That’s one of the main reasons why I think the regions are such a great idea.”

There’s one local issue Ms Callender has firsthand experience with that she hopes to tackle through her Region - the lack of employment opportunities for new graduate nurses.

The University of Wollongong Bachelor of Nursing graduate, who is now studying a Master of Philosophy (Nursing), struggled to find employment after missing out on a NSW Health new graduate position.

“I had everyone telling me - don’t worry, you’ll be fine, you’ll be fine, you’ll get one…and like pretty much everybody else last year I was actually unfortunate not to get a position,” she says.

“I didn’t apply to a private new graduate program thinking that I was going to be getting in with this new graduate program.

“Almost all of us were under the impression… that the NSW Health new graduate program was the only way to go if we were ever eligible to actually work as an RN. “I felt shut out afterwards and felt a bit down but I decided to immediately bounce back, and instead of getting myself in a bit of a rut, I started thinking of other ideas I could use instead of just a NSW Health grad job.

Ms Callender says she was rejected after several job interviews due to a lack of experience.

“Also, I was told I couldn’t apply for a public health position within the local area health as a first year, even though I had been previously employed there as an undergraduate AIN.” Ms Callender decided to send out CVs to every aged care facility with cover letters promoting a supported RN position for first year registered nurses.

“I ended up getting an interview at my current workplace and throughout my hour and a half interview I tried to convince them of the benefits to running either a new graduate program or a supported new registered nurse program,” she says.

“I tried to convince them that the benefits of that would not only be to me, or to somebody else that would be coming through looking for a job, but also to them in the future - for new registered nurses coming through to build up their workforce for later on, as a lot of the older nurses are starting to retire as well and there’s going to be a massive workforce shortage.

“They called me back a couple of days later and said they were going to offer me a fulltime position and they also offered another RN that graduated with me a part-time supported position as well.”

Ms Callender fears graduate nurses could be lost from the profession due to a lack of transition programs to support them.

“It’s sad - especially as we do all come out as registered nurses with the same Bachelor of Nursing,” she says.

For the full article visit NCAH.com.au Nursing Careers Allied Health - Issue 09 | Page 21

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“I think it’s a great way for us to meet up, out of the workplace, and to debrief - for one, about things that are going on within our workplaces with other like-minded nurses.

“I kind of started thinking outside of the box – where else will they possibly be hiring first year RNs and how can I make myself available and interesting to those people that might not have necessarily hired first year RNs in the first place?”

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Caregivers START YOUR OE EXPERIENCE

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OXFORD AUNTS CAN HELP YOU WORK AND TRAVEL IN THE UK AND BEYOND! t Up to 12 week assignments (or longer). t Living & caring for people in their homes. t Board & lodgings on assignment. t Dormitory accommodation provided whilst undertaking your initial UK training t Professional and friendly support.

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Celebrating midwives

by Karen Keast There’s one day on the calendar to celebrate one of the world’s most ancient professions but time rarely stands still for midwives.

Midwives across the globe paused to mark International Day of the Midwife on May 5 and its sub-theme of ‘midwives changing the world one family at a time’.

But with one baby born every minute and 42 seconds across Australia, there’s little rest for the nation’s 33,436 midwives.

The latest Nursing and Midwifery Board of Australia quarterly data reveals there are 30,278 health practitioners registered as both nurses and midwives and 3,158 registered midwives across the nation.

The data shows there are 85 eligible midwives able to prescribe medicines and another 233 eligible midwives with a notation on their registration, who will be able to prescribe scheduled medicines when they complete a Board-approved program of study for prescribing.

Queensland is leading the way with 26 eligible midwives, while there are 18 in New South Wales, 16 in Western Australia, 14 in Victoria, eight in South Australia, two in Tasmania and one in the ACT. When it comes to eligible midwives with notations, there are 94 in Queensland, 47 in Victoria, 41 in New South Wales, 28 in Western Australia, 17 in South Australia, four in Tasmania, and one each in the ACT and Northern Territory.

Website: www.oxfordaunts.co.uk Phone: +44 1865 791017

Oxford Aunts Care

Page 22 | www.ncah.com.au

Australia’s midwifery profession has taken major leaps in the past decade with midwifery now recognised as a profession in its own right, distinct from nursing.

For the full article visit NCAH.com.au

409-001 1PG FULL COLOUR CMYK PDF NAHRLS LOCUM SERVICE

Locum Requests Now Open for First Quarter Next Financial Year 212 placements available from 1 July to 30 September 2014

1300 NAHRLS (1300 624 757) Following the success of the NAHRLS program and the importance of reaching the greatest area of need, we are doing things a little differently next financial year.

Prioritisation of applications will take place from Monday, 2 June 2014 and successful applicants will be notified shortly thereafter.

The NAHRLS Team have reopened our locum request applications for the first quarter of next financial year.

There are 187 nursing & midwifery and 25 allied health Australian Government funded placements available this quarter so it is important that you get your locum requests in as soon as possible!

This means that if your staff leave requirements fall between 1 July and 30 September 2014, you are now required to complete our online Client Job Order Form and submit your application on or before 30 May 2014.

Applications will close at midnight on Friday, 30 May 2014.

Scan QR Code for full article and submit your application at www.nahrls.com.au.

Nursing Careers Allied Health - Issue 09 | Page 23

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Nurse and midwife sisters battle BRCA at Waikato

by Karen Keast Two New Zealand sisters - a midwife and a duty nurse manager - have received treatment for the rare gene mutation BRCA at Waikato Hospital, where they both work.

Hamilton sisters Amber Argaet, 34, a midwife, and Tara Ellingham, 32, a duty nurse manager, are now working to raise awareness - not only for the general public but also to women working in health care.

“All women ought to make sure they are selfchecking for any breast abnormalities and those who are eligible need to have regular mammograms,” Ms Ellingham said.

“If family history suggests the possible presence of a harmful BRCA mutation, talk to a doctor.

“For women working in health, it’s important to heed the advice we give to patients,” she added.

“None of us are exempt from illness, no matter our age or occupation - keep setting a good example by seeking medical advice when you believe your health is in jeopardy.”

The sisters, who have worked at Waikato DHB for 14 years and both have young families, tested positive for the mutated BRCA gene after Ms Ellingham was diagnosed with breast cancer two years ago.

The BRCA1 and BRCA2 genes produce tumour suppressor protein, resulting in cells that are more likely to develop extra genetic alterations that can lead to cancer.

women with BRCA2 will develop breast cancer before the age of 70.

Meanwhile, 39 per cent of women with BRCA1 and up to 17 per cent of women with the BRCA2 will develop ovarian cancer.

Ms Ellingham had a partial mastectomy, received chemotherapy for 18 months, had five weeks’ radiotherapy and recently completed her treatment for breast cancer.

Meanwhile, Ms Argaet had to choose between high surveillance, in the hope it could catch her cancer early, and prophylactic surgery, which would remove as much tissue as possible to reduce her risk of developing cancer.

“I decided prophylactic surgery was the best option for me and after numerous tests, scans and specialist appointments, at 33-years-old I underwent a bilateral salpingo-oopherectomy (ovary removal) and bilateral mastectomies,” she said.

The sisters, who lost their father to prostate cancer, his sister to ovarian cancer, his brother to stomach cancer and his mother to breast cancer as a result of the mutated BRCA gene, have spoken highly of the care they received at Waikato DHB. Ms Ellingham said her care exceeded her expectations.

Women with BRCA1 or BRCA2 have a higher risk throughout their lifetime of developing breast and ovarian cancers.

“The doctors and surgeons at Waikato Hospital made what was a very daunting process as comfortable as they could - staff came in on their days off, they shared new research and advice, and would sit and answer thousands of questions,” she said.

Statistics reveal up to 65 per cent of women with the BRCA1 mutation and 45 per cent of

“It’s great to know that the hospital you work for gives brilliant care.”

Page 26 | www.ncah.com.au

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EARN SOME EXTRA $$$ Nursing and Midwifery Educators and Clinical Specialists NCAH is looking to hire expert nurses and midwives to write nurse practice related articles on a freelance basis.

If you are an experienced Australian nurse educator or nurse specialist, and you are interested in writing to complement your income on a very flexible basis we would love to hear from you.

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Page 28 | www.ncah.com.au

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Team leader, Australian Nurse-Family Partnership Program Support Service Abt JTA is an international health and social sector consulting firm specialising in operating in remote and challenging environments for clients in the international development sector and extractive industries. Abt JTA provides a comprehensive range of services from policy to service delivery in the public and private sectors to contribute to long term benefits for clients and communities.

The ANFPP is a nurse-led home visiting program that supports mothers expectant with an Indigenous child, based on an Internationally recognized model and adapted to the Australian Indigenous context. The ANFPP is managed by Abt JTA and we now seek an experienced technical Team Leader to play a crucial leadership role on the program.

Overview Established in Australia in 2008, The Australian Nurse-Family Partnership Program (ANFPP) is a part of the Australian Government’s commitment to improve the health of Aboriginal and Torres Strait Islander people, with particular focus on maternal health and early childhood development.

The program includes 18 critical model elements of the internationally recognized Nurse Family Partnership Program with over 30 years of research showing compelling evidence of its effectiveness in improving pregnancy outcomes, child health and development, and parental life course.

The Opportunity The Team Leader will work with the Program Manager to deliver the service on budget and in a timely manner. As well as contributing to the development of reports, oversight of data analysis and revision of technical and marketing materials, the Team Leader will ensure the accuracy of online content and printed program communications.

Critical to the role is the ability to establish and maintain a culture that both reflects the theoretical framework of the ANFPP and is appropriate to the Indigenous service delivery context. The Team Leader will have access to mentors in relation to this and is expected to undertake extensive Cultural Awareness training as appropriate to their previous experience.

The Team Leader will deliver some parts of the training and is responsible for development and maintenance of the workforce strategy for the program including recruitment, core training, professional development of staff, and provision of ad-hoc advice and support. The Team Leader may provide Reflective Practice to the Nurse Supervisors in the program.

Our requirements The Team Leader is the technical lead for the ANFPSS and is expected to gain a thorough knowledge of the program with a minimum of 5 years prior experience in a clinical or technical leadership role in a community based Maternal and child health setting.

For further information and application Please review the position description. For further enquiries please contact Stephen Kennedy on +617 3114 4631. Applications should be submitted online via our website including a covering letter and CV. Applications close 4pm, Friday 30 May 2014 (AEST). www.abtjta.com.au/careers

Nursing Careers Allied Health - Issue 09 | Page 29

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Physiotherapy students average 1000 clinical training hours

by Karen Keast Physiotherapy students completed an average of 1000 clinical training hours and nursing students averaged 899 training hours in 2012.

New Health Workforce Australia (HWA) statistics reveal more than 5600 registered physiotherapy students enrolled in accredited physiotherapy programs in 2012 completed between 594 and 1470 clinical training hours, with 58 per cent of students completing between 1000 and 1470 clinical training hours.

In the same year, 62,965 nursing students completed between 800 and 1478 training hours across 44 nursing programs leading to registration as a registered nurse, with almost 60 per cent of students completing between 801 and 920 hours of clinical training.

The average of 899 training hours was 12 per cent above the mandatory minimum.

Nursing students are required to complete a minimum of 800 clinical training hours while accreditation requirements for physiotherapy do no specify a minimum number of clinical training hours required to graduate.

The statistics are contained in newly released HWA clinical training profiles on the nursing and physiotherapy professions.

HWA is developing a series of 25 health profession profiles, which are designed to inform reform in professional clinical training requirements in the tertiary sector.

It plans to also release clinical training profiles on dietetics, optometry, pharmacy, podiatry, and on Aboriginal and Torres Strait Islander Health practitioners and health workers.

HWA acting chief executive officer Ian Crettenden said the profiles form the first snapshot of clinical training for a range of health professions in Australia.

Page 30 | www.ncah.com.au

“There is a large difference in the amount of clinical training hours completed by nursing and allied health students, depending on the course they are enrolled in,” he said.

“There is also an increasing pressure for appropriate clinical training places with the recent growth in nursing and allied health students.

“Given this, we need to know what difference this variation in the length of clinical training hours has on how well prepared students are to practice,” Mr Crettenden said.

“These profiles will provide a stronger basis for National Boards and their accreditation bodies to determine clinical training requirements in the future.”

The physiotherapy profile reveals across the 26 programs, most physiotherapy placements, at 38 per cent, occur in acute care, 18 per cent are in sub-acute, 11 per cent are in ambulatory/outpatient services and less than 10 per cent occur in educational institutions, private practice, primary care, aged care and human services.

Meanwhile, 84 per cent of places were in metropolitan locations, 15 per cent were in regional areas and only one per cent occurred in remote settings.

The nursing profile found 24 nursing programs required students to complete between 801 and 920 hours of clinical training, which is up to 15 per cent more than the national minimum requirement.

Ten of the 44 nursing programs had clinical training requirements of exactly 800 hours.

For the full article visit NCAH.com.au

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Nursing Careers Allied Health - Issue 08 Nursing Careers Allied Health - Issue 01

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