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Guide shows Physios how to harness socialdevastated media Paramedics at helicopter rescue death Outstanding nurses recognised ACT nurses reach pay deal Pharmaceutical researches Nursing and allied health stakeholders react to budget develop life-saving device Australian physiotherapists want prescribing rights Speech therapy app to gain new features Tasmanian graduate nursing positions disappointing: ANMF Nurses can change the picture of the profession

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Providing mental health care for people with an intellectual disability by Karen Keast

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People with an intellectual disability experience mental health problems at a rate up to three higher than the general Issue 26times’ August 2013 Issue 10 26 May 2014 117–––20 January 2014 Issue 17 – 26 August 2013 population yet the system is failing them. We hope you enjoy perusing the range of opportunities AWeunique guide now provides a national hope you enjoy perusing included in Issue 17, 2013. the range of opportunities 10,2014. 2014. framework for action for frontline mental 1, included in Issue 17, 2013. If you are interested in pursuing any of these opportunities, health service professionals and providers, Ifplease you are interested in pursuing any ofvia these contact the advertiser directly the opportunities, contact details writes Karen Keast. please contact the advertiser directly via the contact details provided. If you have any queries about our publication or

intellectual disability and they are up to three times’ more likely than the general population to experience mental health problems, such as depression and schizophrenia.

if you would like to receive our publication, please email us “One of ourlike worst times whenplease my daughter ifatyou would to receive ourwas publication, email us careers@ncah.com.au was admitted to hospital with prolonged at careers@ncah.com.au delirium,” Michele states. DISTRIBUTION

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For all advertising and production enquiries please contact HealNET Employment Offi us on +61always (0) 3 9271 8700, email “They struggle tocebe able to adapt their Lifescreen us on +61 (0) 3 9271 8700, email eNurse careers@ncah.com.au or visit www.ncah.com.au Northern Sydney Local Health District approach or the approach of their service to eNurse Australia “We were told to put herwww.ncah.com.au in a nursing home. careers@ncah.com.au or visit Medacs Kate Cowhig International If you would like to change your mailing address, cater to the complex needs of the group. Oceania University of Medicine Kate Cowhig International Iforyou likeon toour change your mailing address, “After discharge from hospital we be would included distribution, please email accessed Medibank Health Solutions Medacs Australia Oxford Aunts Care be included on our distribution, please email aorcareers@ncah.com.au specialist, and further treatment led to a “There’s a vulnerability, there’s District a lack of Medacs Australia Northern Sydney Local careers@ncah.com.au Quick and and Easy FinanceHealth No Roads to Health complete recovery for our much-loved family workforce capacity and then there’s No Roads toAllied HealthHealth Rural Locum Nursing and member.” Smart the lackSalary of appreciation specific issues for NSW Health - IllawarraofShoalhaven Published by Seabreeze Communications Pty Ltd Trading as NCAH. Scheme NSW Health - Illawarra Shoalhaven people with intellectual disability.” Published by 328 Seabreeze Communications Pty Ltd Trading as NCAH. TR7 Health ABN 29 071 053. These words from a mum and carer of a child OceaniaUniversity Universityof of Medicine Oceania ABN 29 071 328 053. Oceania University Group of Medicine Medicine © 2013 Communications Pty Ltd. Unified Healthcare with anSeabreeze intellectual disability (ID), who also has Assoc. Professor Trollor, one of the document’s Oxford Aunts Care 2014 Seabreeze Communications Pty Ltd. © 2013 Oxford Aunts Care rights reserved. No problem, part of this publication may be copied a All mental health are featured in aor new Oxford who Aunts Care University of also New England authors heads the Department of All rights reserved. part of this publication may bepermission copied or of PulseStaffing Staffing reproduced by anyNo means without the prior written resource for frontline mental health service Pulse Developmental Disability Neuropsychiatry University ofng Tasmania Pulse Staffi reproduced byCompliance any means without priorPractices written permission the publisher. with thethe Trade Act 1974 ofof professionals, including mental health nurses, Queensland Health (3DN) at UNSW Medicine, says the guide was the publisher. Compliance with the Trade Practices Act 1974 of Quick and Easy Finance advertisements contained in this publication is the responsibility of Western District Health Service Queensland Health psychiatrists and psychologists. advertisements contained in this publication is the responsibility of developed after 15 months’ comprehensive those who submit the advertisement for publication. Quick and Easy Finance TR7 Health those who submit the advertisement for publication. Quick and Easy Finance consultation, research and collaboration with University of New South Wales (UNSW) Royal Flying Doctor Service UK Pensions funding from the Department Royal Flying Doctor Serviceof Health. researchers recently launched a quick TR7 Health Unified Healthcare Group reference document - the first of its kind in TR7guide Health provides cover image provided by theThe University of Transfers Newpractical Englandsteps to improve Australia - in Front a bid to improve access to mental UK Wimmera Groupof UKPensions Pension accessibility within four Healthcare different groups UK Pension Transfers health services for people with an ID. service providers - from primary care to generic Unified Healthcare Group Unified Healthcare Grouphealth through to public health and private The Accessible Mental Health Services for specialist ID health providers. People with an Intellectual Disability: A Guide Theatre && Critical feature Next Publication: Regional RemoteCare feature for Next Providers, also known as The Guide, is Publication: Education feature “The guide is basically saying…the way to Next Publication: Education feature Tuesday 3rd 10thFebruary June 2014 Publication Date: Monday 2013 available online. Publication Date: Monday 9th September 2013 address this issue is by understanding what Monday 2nd 20142013 Colour Artwork Tuesday 28thJune January Publication Date:Deadline: Monday 9th September 2013 Colour Artwork Deadline: Monday 2nd September 2013 should be the underlying principles of service Associate Professor Julian Trollor, UNSW 4th June 2014 Mono Artwork January 2013 Colour Artwork Deadline: Deadline: Wednesday Monday 2nd29th September 2013 Mono Artwork Deadline:Mental Wednesday 4th September Intellectual Disability Health chair, 2013 delivery, what should be the key components Mono Artwork Deadline: Wednesday 4th September 2013 says about 400,000 Australians live with an and how do you do that in real time,” he says. Page 4 | www.ncah.com.au

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“We are trying to say to everybody really, there’s a strong policy and human rights basis to make sure services are accessible and this is how you can do it.”

It also details the principles underpinning the provision of mental health care to people with an ID, a range of reasonable steps mental health services can implement and the implications for each major component of the mental health system. Assoc. Professor Trollor says it also features quotes from health care professionals, parents and carers of people with an ID, and colourful illustrations that work to enrich the document. “You will see the art work, which is all art work from people with an ID, that vary in severity some of them quite severe - but the art work has been collected to complement each chapter and we’re excited we have been able to illustrate the inclusive approach by including that art work.” The Guide provides a selection of tools and diagnostic resources, examples of models of best practice, and tools and resources for consumers, family and carers. It also outlines lists of advocacy services and guardianship, professional associations and interest groups, research and academic organisations, training and education, and other resources. Assoc. Professor Trollor says for those wanting to up-skill, there are also free e-learning modules that the university launched last year focused on ID mental health at IDMH eLearning - www.idhealtheducation.edu.au.

“We are about to complete an emergency presentations module for people who work in the emergency department.” With eight free modules available, Assoc. Professor Trollor says the website will continue to expand to offer more free modules and resources. “We are really pleased with the feedback from that site,” he says. “We have got a couple of thousand users and they are very active and have been very complimentary about the material.” As Australia embraces the National Disability Insurance Scheme (NDIS), Assoc. Professor Trollor says the time is right to improve capacities within the nation’s health service. “The idea is that we try and build capacity and awareness more generally so that everybody is doing a better job, right from the generalist in primary care right through to more highly specialised services,” he says. “The benefit in doing that is that you then have a vision for this vulnerable group who need early intervention.

For the full article visit NCAH.com.au Nursing Careers Allied Health - Issue 10 | Page 5

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The Guide outlines an overview of mental health needs and highlights barriers to accessing the appropriate mental health services for people with an ID.

“What’s on there currently are a range of modules that introduce ID, its impact on people’s lives, the intersection of mental health and ID, that outline of taking people through the skills and assessment of a person with ID and possible mental health problems, taking the person through management - what are the principles of things they should consider in managing that person, and it takes you through how you communicate with a person with an ID,” he explains.

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Outstanding nurses recognised by Karen Keast A nurse who championed an innovative system that enables mental health nurses to attend police and ambulance call-outs to people with mental illness is the Nurse of the Year. NorthWestern Mental Health’s Steve Brown received the top accolade in the 2014 HESTA Australian Nursing Awards. A mental health nurse, Mr Brown was recognised for his work to develop the Police Ambulance Clinical Emergency Response (PACER) system to improve the crisis management of people living with mental health. The system has been credited with a decrease in mental health presentations to one of Melbourne’s busiest emergency departments Northern Hospital.

“Our work involves more than just nursing – we have to consider and incorporate the clients’ and their families’ wishes, whilst advocating for the client and ensuring they receive the best possible care.” The award for Team Innovation went to the Apunipima Pe˜ pi-pod Program, based at Cape York Health Council, for its work to reduce the rates of Sudden Unexpected Death in Infancy (SUDI) among Aboriginal and Torres Strait Islander communities. Mr Brown and Ms Sabri were each presented with a $5000 ME Bank account and a $5000 education grant while the Apunipima Pe˜ pi-pod Program received a $10,000 grant.

“People living with mental illness, who are in a crisis, can now be attended by trained police and clinicians, in their home,” Mr Brown said.

HESTA Chair Angela Emslie said the winners showcased the difference high quality nursing can make to improving people’s lives.

“This eases the impact on hospital emergency departments and significantly reduces the individual’s distress and anxiety.”

“Our award recipients have not only demonstrated extraordinary care and compassion in the course of their work - they have gone above and beyond what is expected of them,” she said.

The annual awards, now in their eighth year, shine the spotlight on the exceptional contribution of nurses, midwives, personal care attendants and assistants in nursing to improve patient care, in service provision and also advocacy. The awards honoured Royal District Nursing Service’s Zoe Sabri with the Outstanding Graduate accolade for her work in assisting elderly clients to live safely in their own homes. Ms Sabri, 24, is based at RDNS Springvale, and was recognised for providing high levels of patient engagement and outstanding primary care to one of Melbourne’s most culturally diverse communities. “It’s challenging to get some families working together with us because of their culture and traditions,” Ms Sabri, speaking at the awards, said. Page 6 | www.ncah.com.au

“

Our work involves more than just nursing – we have to consider and incorporate the clients’ and their families’ wishes, whilst advocating for the client and ensuring they receive the best possible care.

– Ms Sabri at RDNS Springvale

”

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Nursing Careers Allied Health - Issue 10 | Page 7

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Psychologist studies chronic fatigue impact by Karen Keast Eighty-five per cent of people with the debilitating illness Chronic Fatigue Syndrome (CFS) have difficulties reading and following directions even when it comes to a new medication, according to a New Zealand study. Dr Don Baken, a clinical psychologist at Massey University’s School of Psychology, surveyed 221 people with CFS, also known as Myalgic Encephalopathy (ME), in a bid to gain new insights into the impact of the condition which affects about 20,000 New Zealanders and around 250,000 Australians. Dr Baken said survey respondents reported a very low quality of life with more than three quarters struggling with basic everyday tasks and meeting family responsibilities while two thirds had difficulties counting money for purchases. “They also rated their executive functioning to be extremely low for abilities such as planning, organising, strategising, paying attention to and remembering details, and managing time and space,” he said. Classified as a neurological disorder by the World Health Organisation, people with CFS experience extreme fatigue, muscle and joint pain, cerebral symptoms of impaired memory and concentration alongside impaired cardiovascular function, gut disorder and sensory dysfunction. Dr Baken said most respondents misunderstood and stigmatised by condition.

felt the

“Because of the nature of the condition and the stigma that many feel because of it, it’s difficult for this group to advocate for themselves,” he said. “More needs to be done to understand the impact of this condition and how society can support the people who suffer from it.” The survey, which was conducted for Associated New Zealand ME Society (ANZMES), comes as Page 8 | www.ncah.com.au

researchers at Queensland’s Griffith University hope to develop a quick diagnostic test, for earlier and better treatment. Griffith Health Centre is home to the National Centre for Neuroimmunology and Emerging Diseases (NCNED) which is dedicated to research on the interaction between the nervous system and the immune system. Facilities at the centre will be extended in June 2014 with the opening of a specialised CFS clinic. The new integrated facility will provide treatment to patients and build on the research being conducted with participants, which has shown a strong association between the condition and a dysfunctional immune system. Leading CFS researcher Professor Sonya Marshall-Gradisnik said Griffith’s research was pioneering the way internationally. Professor Marshall-Gradisnik said she hopes the centre will not only discover the cause of the illness but also effective treatments. “We now have the capacity, not only for advanced research but also the potential to provide a clinical service to people who have been unable to find appropriate care in the past,” she said.

“

They also rated their executive functioning to be extremely low for abilities such as planning, organising, strategising, paying attention to and remembering details, and managing time and space

– Dr. Baken

”

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Nursing Careers Allied Health - Issue 10 | Page 9

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Dietitian’s malnutrition research highlights nursing factors by Karen Keast Malnourished renal and geriatric hospital patients are missing out on vital nutrition due to environmental factors such as nurses being interrupted, according to a dietitian’s awardwinning research. Kelly Lambert, a renal clinical lead dietitian at Wollongong Hospital’s Department of Clinical Nutrition, studied 18 patients admitted to acute renal or geriatric wards assessed as malnourished or at risk of malnourishment in July and August 2009. In the study, recently published in the Dietitians Association of Australia’s (DAA) journal Nutrition and Dietetics, an audit found patients received the Nutrition as Medication (NAM) 66.4 per cent of the time while the refusal rate was low at 8.9 per cent. Under 48 incident observations, the study found patients received NAM 58.3 per cent of the time, with a refusal rate of just 3.6 per cent. Ms Lambert said one of the main reasons that contributed to patients failing to receive NAM was due to nurses being interrupted on the ward. “It was things like visitors coming to the ward and asking ‘where’s my mum?’, by other nurses asking them to check stuff and by other patients asking stuff, so those factors are really important ones that we have to try and eliminate,” she said. “Some of the other reasons were just systemic ones like the supplement not even being delivered to the ward, so it actually can’t start the process.” In recognition of the research, the DAA recently presented Ms Lambert with its 2014 Emerging Researcher Award at its national conference in Brisbane.

leave it at the bedside and say - you can drink it in your own time,” she said. “That doesn’t guarantee that a patient has actually consumed it. “The way it’s supposed to be delivered is that you watch the patient drink it. Signing off means that you’ve observed that they’ve swallowed it - like any other medication.” She said waiting for doctors to write the NAM directly on to medication charts also caused delays. “The first thing that’s happened locally is we have now eliminated one of those steps in the process,” she said. “We can write directly onto the medication chart so we have eliminated that problem of having the delay in the doctors needing to chart it for us.” Ms Lambert advised dietitians to regularly visit wards to ensure patients are actually drinking NAM. “Don’t assume that it will work as you think it should - it’s always good to check at the local level that things are working correctly,” she said. She said nurses also have an integral role to play when it comes to screening and managing malnutrition. “Their role is really valuable because they’re the frontline people that deal with people who are malnourished,” she said. “We need them to have their radar on at all times about patients who are not eating well, who report some rapid weight loss; even if they are overweight initially. “That process of screening for malnutrition is really critical - that’s one of the critical roles of nurses.

Ms Lambert said her study showed nurses would sign off NAM as being given to patients without guaranteeing that patients had consumed the drink.

“Nurses are a really valuable link in the chain in administering this Nutrition as Medication and dietitians need to work with them to help the process work well.”

“What we observed was that nurses would often sign off that it was given but they would

Ms Lambert’s next piece of research will focus on memory loss in renal patients.

Page 10 | www.ncah.com.au

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Nursing Careers Allied Health - Issue 10 | Page 11

Nursing and allied health stakeholders react to budget by Karen Keast The Federal Government’s 2014-15 budget has delivered mostly painful cuts to health and missed opportunities, according to some of the peak bodies representing nurses, midwives and allied health professionals.

The much-maligned $7 Medicare co-payment for GP visits, out-of-hospital pathology and diagnostic imaging services and the rise in the price of prescriptions have come under attack, while the budget also revealed plans to dismantle Health Workforce Australia, the Australian National Preventive Health Agency and the Australian Institute of Health and Welfare (AIHW).

Ms McLaughlin welcomed the three-year funding for rural nursing and allied health scholarships.

On the flip side, the budget’s blueprint to provide $200 million over five years for research to improve treatment for dementia and an extra $13.4 million in funding for 500 rural nursing and allied health scholarships has been applauded. The Australian Nursing and Midwifery Federation (ANMF) said the savage cuts to the nation’s health care system will dangerously compromise safe patient care. ANMF acting federal secretary Annie Butler said the co-payment will increase costs and worsen health outcomes. “Co-payments will shift the cost burden onto individual consumers and the Australian public hospital system overall by driving more and more people into busy emergency departments,” she said. “But as frontline health care professionals, nurses know that people must seek treatment sooner rather than later, otherwise those socalled minor ailments develop into serious, often chronic illnesses which go on to require expensive chronic care in hospitals.” The Australian College of Nursing (ACN) fears people with chronic conditions will be among those hardest hit under the changes. Page 12 | www.ncah.com.au

“The scholarships announced by the government will have a positive impact in attracting nurses to work in rural health services, and will support the professional development of those nurses already practising in rural settings.” The Australian Physiotherapy Association (APA) applauded the medical research fund and infrastructure, the commitment to fully roll out the National Disability Insurance Scheme (NDIS) by July 2019, and $140.6 million in funding to continue the operation of the Primary Care Electronic Health Records (PCEHR). The APA expressed disappointment at the $160 million cut to Indigenous health programs and also a missed opportunity - with the government failing to take on board its proposal

“

Co-payments will shift the cost burden onto individual consumers and the Australian public hospital system overall by driving more and more people into busy emergency departments

– Annie Butler ANMF acting federal secretary

”

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of granting physiotherapists the power to refer their patients to relevant medical specialists. The APA believes this initiative could save the Medicare Benefits Scheme (MBS) $13.6 million annually.

“Given that existing Medicare Locals run a number of different health care programs, including mental health services, speech pathology and physiotherapy programs, the APA maintains it is vital that allied health community connections be retained,” it said in a statement. The Pharmaceutical Society of Australia (PSA) and The Guild expressed concerns at the impact the budget will have on pharmacists and pharmacies.

“The increase in the co-payment may mean that some patients feel they need to make a decision about the medicines they are taking and this raises some very serious issues regarding patients’ safe and effective use of medicines,” he said. Mr Kardachi said despite the nation’s large and highly-trained pharmacist workforce, the budget had failed to better utilise the skills and expertise of pharmacists to tackle areas of unmet need. “This significant increase in co-payments means that the role of the community pharmacy network, and pharmacists as medication managers, will be even more critically important and needs to be properly remunerated in the next pharmacy agreement,” The Guild stated. Nursing Careers Allied Health - Issue 10 | Page 13

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The peak physiotherapy body also called for the new Primary Health Networks (PHNs), which are set to replace the 61 Medicare Locals, to maintain connections with communities and work with local hospital networks.

PSA national president Grant Kardachi fears pharmacists could be put in a position where they may need to advise patients on managing their medicines based on financial pressures.

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Nursing Careers Allied Health - Issue 10 | Page 15

Lessons learnt in Flinders University telehealth pilot by Karen Keast An innovative Flinders University project trialling telehealth in palliative care, aged care and rehabilitation is delivering positive results for patients, health care professionals and providers. The Telehealth in the Home pilot, which was launched in February 2013, investigates the use of iPads and Fitbit activity monitors in the provision of online, at-home support for 145 patients and their carers in the region south of Adelaide. The Flinders University-led project, run in partnership with SA Health through the Repatriation General Hospital and several specialist clinical networks, uses a team approach that integrates GPs, aged care and clinical services, and includes nurses and allied health professionals. Flinders University School of Medicine Professor Colin Carati, who is also an executive member of the Australasian Telehealth Society, said it’s time for lessons learnt in the Flinders project and other telehealth pilots to be rolled out into mainstream practice. “The time for pilots is over. There’s a saying around - we are all sick of ‘pilotitis’,” he said. “As one of my colleagues, Tori Wade, quipped telehealth has more pilots than Qantas. “I think it will come to pass and it will be a very powerful and useful form of health care.” Under the trial, which is set to conclude in late June, patients and their carers use telehealth applications on iPads to self-report health data while rehabilitation patients access online tools for exercises. Page 16 | www.ncah.com.au

Fitbit devices report patient activity, videoconferencing connects patients and their carers with their health professionals, while palliative care patients and their carers complete questionnaires on their progress, including pain levels. “If a combination of signals reach a certain critical point that will flag indication of intervention where somebody will make contact with that person and just see how they are going, a little more personally,” Professor Carati added. Professor Carati said the pilot’s focus on using telehealth in palliative care and rehabilitation is unique and the early results are positive. “The palliative care group we have is thinking very hard about this being now the new model of care and I’m confident that in both of those respects, the rehab and the palliative care, some way will be found to continue providing care in this way,” he said.

“

If a combination of signals reach a certain critical point that will flag indication of intervention where somebody will make contact with that person and just see how they are going, a little more personally.

– Professor Carati

”

continued on overleaf

410-016 1PG FULL COLOUR CMYK PDF continued from previous page “I think the aged care sector is one that’s going through very rapid change and I have absolutely no doubt that over the next little while the aged care service providers will be all over this.”

“We get a sense that there’s a very positive response to this - people feel as though they are being better looked after, and they are more able to make contact with health care providers.” One of the key findings of the pilot is the need for “good interaction” between a technical team and health care teams, Professor Carati said.

“In most respects, we have been pleasantly surprised about how readily people have picked up on the technology and how positively they have embraced having their health care delivered in this way. “The other side of it is the clinicians themselves see the positive benefits in this. “We now have a bunch of new champions within the health care system who have seen how it works, see what it can do and are very positively engaged with integrating the use of these technologies into new models of health care.”

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Professor Carati said initial results of the pilot support previous findings in telehealth research which show patients are able to interact with health care professionals more easily and frequently.

“The other findings are that, by and large, the populations that we thought would not embrace technology have done so,” he said.

continued from previous page “I think the aged care sector is one that’s going through very rapid change and I have absolutely no doubt that over the next little while the aged care service providers will be all over this.”

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Professor Carati said initial results of the pilot support previous findings in telehealth research which show patients are able to interact with health care professionals more easily and frequently.

“The other findings are that, by and large, the populations that we thought would not embrace technology have done so,” he said.

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• To balance competing priorities and work demands and to identify and respond appropriately to critical and urgent clinical needs; • To support the management team in appropriately prioritising patient need and to operate efficiently and effectively with a view to meeting community needs and providing a financially sustainable service; • To understand and operate in a work environment driven by the need to meet clinical quality and safety guidelines; and • To work closely and in collaboration with internal and external stakeholders. To be considered for the position you will: • Be a Registered Nurse and Midwife holding current registration with the Nursing and Midwifery Board of Australia; • Hold relevant postgraduate qualification/s and or technical qualifications or working towards and • Have membership of relevant professional college/organization.

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Speech therapy app to gain new features An app designed to help speech therapists working with autistic children develop kids’ capabilities in speech and widen their grammar and vocabulary is set to develop new features, following a fresh funding injection.

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Nursing and allied health stakeholders react to budget

As reported by technology title TechCrunch, the app, called Avaz AAC, has already achieved widespread by Karen uptake Keast in Australia as well as the US, Denmark, India and Italy. The Federal Government’s 2014-15 budget has delivered painfulcommunication cuts to health and Avaz AAC is anmostly image-based tool missed opportunities, according some of that enables autistic children to use to their picture the peak bodies nurses, midwives identification skillsrepresenting to create “picture messages”, and allied professionals. which are health then spoken by a speech engine.

The app’s picture vocabulary is described as The much-maligned $7 Medicare co-payment “exhaustive” andout-of-hospital is colour-codedpathology linguistically, to for GP visits, and assist language development. Used under the diagnostic imaging services and the rise in supervision of a speech therapist, the app can the price of prescriptions have come under help children develop communication skills and attack, while the budget also revealed plans learn new words and grammar. to dismantle Health Workforce Australia, the Australian National Preventive Health Agency Now, India based company Invention Labs, and the Australian Institute of Health and which developed Avaz AAC, has raised Welfare (AIHW). $550,000 in seed funding with a view to adding new features to the the app.budget’s blueprint to On the flip side, provide $200 million over five years for research to improve treatment for dementia and an extra thein full article visitrural NCAH.com.au $13.4 For million funding for 500 nursing and allied health scholarships has been applauded.

Page 20 | www.ncah.com.au

The Australian Nursing and Midwifery Federation (ANMF) said the savage cuts to the

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“The introduction of co-payments will undoubtably undermine the very real principles of universal access and equity in health care that the introduction of Medicare enshrined,” executive manager Kathleen McLaughlin said. Ms McLaughlin welcomed the three-year funding for rural nursing and allied health scholarships. “The scholarships announced by the government will have a positive impact in attracting nurses to work in rural health services, and www.oxfordaunts.co.uk will support the professional Website: development of those practising Phone: +44nurses 1865already 791017 in rural settings.”

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The Australian Physiotherapy Association (APA) applauded the medical research fund and infrastructure, the commitment to fully roll out the National Disability Insurance Scheme (NDIS) by July 2019, and $140.6 million in funding to continue the operation of the Primary Care Electronic Health Records (PCEHR).

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409-032 410-032 1PG FULL COLOUR CMYK PDF of granting physiotherapists the power to refer their patients to relevant medical specialists. The APA believes this initiative could save the Medicare Benefits Scheme (MBS) $13.6 million annually.

PSA national president Grant Kardachi fears pharmacists could be put in a position where they may need to advise patients on managing their medicines based on financial pressures.

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Palliative Care team. The preferred candidate will be able to strategically lead and develop Palliative Care at WDHS. A strong ability to provide clinical advisory and direction and to effectively develop our Advanced Care Planning strategy are essential requirements in this role. To be considered for this role you must be a registered nurse with post graduate palliative care qualifications and/or considerable experience in this field. To view the position description or to apply for this role, please visit our career’s page http://www.wdhs.net/careers/careers to submit your application.

Excellence in Health Care – Putting People First Nursing Careers Allied Health - Issue 10 | Page 21

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“The increase in the co-payment may mean that some patients feel they need to make a The peak physiotherapy body also called for the decision about the medicines they are taking new Primary Health Networks (PHNs), which and this raises some very serious issues are set to replace the 61 Medicare Locals, to regarding patients’dedicated safe and effective use of If you enjoy the rewards of working in a strong, maintain connections with communities and medicines,” he said. workteam with local hospital networks. providing health support and services to the expanding Mr Kardachi said despite the nation’s large communities of the Western consider a career at “Given that existing Medicare Locals runDistrict, a and then highly-trained pharmacist workforce, the number of different healththe care programs,position budget currently had failed to available: better utilise the skills and WDHS. We have following including mental health services, speech expertise of pharmacists to tackle areas of pathology and physiotherapy programs, the unmet need. APA maintains it is vital that allied health “This significant increase in co-payments community connections be retained,” it said in means that the role of the community a statement. pharmacy network, and pharmacists as The Pharmaceutical Society of Australia (PSA) medication managers, will be even more and The Guild expressed concerns at the critically important and needs to be properly impact the budget will have on pharmacists remunerated in the next pharmacy agreement,” and pharmacies. An opportunity exists for a ClinicalThe Nurse Consultant to lead our Guild stated.

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Nurses can change the picture of the profession by Karen Keast Nurses have the power to be a force for change in tackling the major health care challenges facing the nation, according to the Australian College of Nurses (ACN). To mark International Nurses’ Day, an initiative of the International Council of Nurses (ICN), ACN is highlighting the vital role of nurses in Australia’s health care system, their impact on health outcomes and how nurses can be a part of the solution to the rising tide of health care issues. As part of this year’s IND theme, ‘Nurses - A Force for Change’, ICN has released a raft of measures in a bid to ‘change the picture’ of the nursing profession internationally and in Australia. The blueprint shines the spotlight on workforce planning, the measurement of care outcomes, nursing workloads and the importance of positive practice environments. ACN Fellow Cheyne Chalmers said the nursing profession faces a wide range of challenges such as the “silver tsunami”. “With the ageing population that we have now as well as our ageing workforce, making sure that we have got enough nurses to actually care for the people who are going to need care in the next 20 to 30 years is, I believe, going to be a significant challenge for us,” she said. “To make sure that our workforce is able to be contemporary, with the way that technology is moving so quickly, and the changing nature of health care, it’s really important that nursing steps up to that challenge as well. “The key issues for us are making sure that we continue to build our workforce, retain really good nurses and that we are responsive and flexible to the needs of our population.” Page 22 | www.ncah.com.au

Adjunct Professor Chalmers, an executive director of Nursing, Midwifery and Support Services at Melbourne’s Monash Health, said there are increasing opportunities for nurses to take on leadership roles in the provision of primary care. “We need to be having discussion and debate around this as nurses,” she said. “So looking at how we can have advanced nurse roles - whether they’re nurse practitioner roles or whether they’re senior nursing roles, working with different communities, and for us it’s about supporting our workforce to do that. “One of the big issues at the moment is around nurse prescribing, and so what are the challenges for nurses to prescribe in and what environments could we be prescribing in?” Adjunct Professor Chalmers said work around developing a nurse endoscopy role at a local level was a good example of how nurses can step up to the nation’s health care challenges. “Bowel cancer is a significant issue for the population,” she said. “There are certain areas in the population that don’t necessarily have timely access to bowel screening because they might live in a rural centre or be isolated. “We have trained a nurse endoscopist - I think around the country the opportunity for nurses to step up and take on these different roles, if you like, that are still nursing roles can add immense value to the population. “We have got some significant challenges ahead of us and I think this is the perfect opportunity for nursing to stand up and say, actually as a workforce - we are able to support efficient and sustainable health care models and we want to be engaged in that conversation and we actually want to be part of the solution.”

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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. Nursing and Midwifery experts are sought to write articles covering one or more clinical areas including but not limited to: • Accident & Emergency • Aged Care • Paediatric Nursing • Healthcare IT & Information • Midwifery & Neonatal nursing • Neurology • Nurse Leadership and Management

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Nursing Careers Allied Health - Issue 10 | Page 23

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Campaign hearts nurses and midwives by Karen Keast Who hearts nurses and midwives? The Queensland Nurses’ Union (QNU) is asking the public to show their love for the state’s nurses and midwives. The union has launched a social media campaign calling for the public to take a photo of themselves, showing their hands forging the shape of a heart, to let the state’s caring profession know that they are valued. QNU secretary Beth Mohle said nurses and midwives desperately need a morale boost in the wake of the largest job cuts in the state’s history. “It is about the fact that our members are feeling very undervalued right now and they are feeling quite distressed, across all sectors, that they are not able to deliver the quality of care that they would want to,” she said. “That’s because, across all sectors, there’s an increasing pressure for dollar-driven health care…and not enough focus is on the quality of care and the outcomes for patients. “When the community is at their most vulnerable, when they are sick and injured, when they are having babies…nurses and midwives are there for them. “We are calling for a bit of reciprocal support if you like.” Ms Mohle said the campaign, launched in the lead to International Nurses’ Day, has already proven a hit with people taking ‘selfies’ and posting them on social media sites, including the union’s Facebook page, through Twitter and on Instagram. QNU figures, accessed through Right to Information (RTI) requests, show more than 1350 nursing and midwifery jobs have been Page 24 | www.ncah.com.au

culled - the majority at Metro North where 496 positions have been axed. The figures also show Townsville has lost 156, 143 have gone at Metro South, 120 at Wide Bay, 66 at Darling Downs, 64 on the Sunshine Coast, 53 on the Gold Coast and 48 at Cairns and Hinterland. Another 44 have been axed at West Moreton, 40 have gone across Central Queensland, 32 at South West, 27 at Children’s Health Queensland, 22 at Cape York, 13 across Torres Strait and Northern Peninsula and 11 at Mackay. According to the union, more than 3700 fulltime equivalent hospital and health services jobs have gone since September 2012. The campaign comes as Mater Public Hospital’s 2300 nurses and midwives prepare to vote on a draft enterprise bargaining agreement. After two years of negotiations, Mater public staff have been offered a 2.5 per cent pay rise back dated to May 1, 2012, short of the three per cent pay rise the QNU had hoped to achieve. “Unfortunately we were not able to obtain improvement on other significant issues, but the QNU Mater Public Branch recognises that negotiations and conciliation in the Fair Work Commission have been exhausted,” Ms Mohle said. “Continued legal wrangling would not yield results and could jeopardise some members’ entitlements. “The QNU acknowledges that Mater will put the final draft agreement to ballot so that Mater nurses and midwives can decide if it is acceptable.’’

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Physiotherapists drive insurance change by Karen Keast Western Australia’s at-fault insurance scheme for people injured in motor vehicle accidents is leaving a trail of road casualties in its wake, according to physiotherapists.

“That’s probably why I got into physiotherapy because I want to look after people, and that idea of looking after those less fortunate is really important.”

The Australian Physiotherapy Association (APA) is calling for the state government to follow in the footsteps of New South Wales, Victoria, Tasmania and the Northern Territory which have no-fault accident insurance.

Mr Barnwell said the government’s decision to raise car registration fees was a “golden opportunity” for change.

The lobbying comes as South Australia and the ACT also appear to be gravitating towards no-fault accident insurance in line with the implementation of the National Disability Insurance Scheme (NDIS). APA spokesperson and physiotherapist Tim Barnwell labelled the state government’s failure to introduce a no-fault insurance scheme in last week’s budget “disappointing”. The Murdoch-based physiotherapist said the current system penalises people injured in road accidents, including many of his clients - one a pedestrian. “We received a letter today saying that they (the Insurance Commission of WA) wouldn’t pay any invoices yet until they determined liability in the case,” he said. “Now, that can be fairly standard and that’s what happens in an at-fault scheme. “The thing that makes her case interesting is that she was a pedestrian in a road traffic accident, and yet they still have to investigate to prove that she’s the one not at-fault. “To me that just defines why we need the system to change.” Mr Barnwell, a physiotherapist of more than 13 years, said the at-fault system leads to litigation, poor outcomes, and increases stress and heartache for those recovering from injuries. “Society needs to look after people who are less fortunate in my view,” he said. Page 26 | www.ncah.com.au

“The government can talk all it likes about wanting to implement the National Disability Insurance Scheme and then also the no-fault insurance scheme but at the end of the day you have to make some actual legislative changes to make it occur,” he said. “It’s all very well talking but there’s no action at the moment. “In essence what they’ve done is raise registration so they can raise more money and we all know that when they want to, if and when they want to implement no-fault insurance they are going to want to raise registration again. “All that does is cause more of an issue for them trying to sell that second raise to the public for what is a very justifiable program that needs to be implemented. “The fact that it can get implemented in other major states and WA is still seen as a robust, positive economy - we’re the very state that should be able to implement it.”

“

The government can talk all it likes about wanting to implement the National Disability Insurance Scheme and then also the no-fault insurance scheme but at the end of the day you have to make some actual legislative changes to make it occur

– Mr Barnwell

”

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Nursing Careers Allied Health - Issue 10 | Page 27

Providing mental health care for people with an intellectual disability by Karen Keast People with an intellectual disability experience mental health problems at a rate up to three times’ higher than the general population yet the system is failing them. A unique guide now provides a national framework for action for frontline mental health service professionals and providers, writes Karen Keast.

intellectual disability and they are up to three times’ more likely than the general population to experience mental health problems, such as depression and schizophrenia.

“One of our worst times was when my daughter was admitted to hospital with prolonged delirium,” Michele states.

“In fact, access is very poor - there are very limited specific services and generic providers, general practitioners, mental health specialists in terms of psychiatrists, psychologists and mental health nurses.

“We explained that she was usually a bright, sociable young woman with lots of friends and an excellent quality of life. “The medical team disbelieved us and assumed she was always like she was on admission. “We were told to put her in a nursing home. “After discharge from hospital we accessed a specialist, and further treatment led to a complete recovery for our much-loved family member.” These words from a mum and carer of a child with an intellectual disability (ID), who also has a mental health problem, are featured in a new resource for frontline mental health service professionals, including mental health nurses, psychiatrists and psychologists. University of New South Wales (UNSW) researchers recently launched a quick reference document - the first of its kind in Australia - in a bid to improve access to mental health services for people with an ID. The Accessible Mental Health Services for People with an Intellectual Disability: A Guide for Providers, also known as The Guide, is available online. Associate Professor Julian Trollor, UNSW Intellectual Disability Mental Health chair, says about 400,000 Australians live with an Page 28 | www.ncah.com.au

Assoc. Professor Trollor says access to health services and the capacity of health services to meet the need is inadequate.

“They feel ill-equipped to deal with this area and they don’t have the skills and the training. “They struggle to be able to adapt their approach or the approach of their service to cater to the complex needs of the group. “There’s a vulnerability, there’s a lack of workforce and capacity and then there’s the lack of appreciation of specific issues for people with intellectual disability.” Assoc. Professor Trollor, one of the document’s authors who also heads the Department of Developmental Disability Neuropsychiatry (3DN) at UNSW Medicine, says the guide was developed after 15 months’ comprehensive consultation, research and collaboration with funding from the Department of Health. The guide provides practical steps to improve accessibility within four different groups of service providers - from primary care to generic public health and private health through to specialist ID health providers. “The guide is basically saying…the way to address this issue is by understanding what should be the underlying principles of service delivery, what should be the key components and how do you do that in real time,” he says.

“We are trying to say to everybody really, there’s a strong policy and human rights basis to make sure services are accessible and this is how you can do it.”

For the full article visit NCAH.com.au Nursing Careers Allied Health - Issue 10 | Page 29

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The Guide outlines an overview of mental health needs and highlights barriers to accessing the appropriate mental health services for people with an ID.

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Reducing Clinical Risks Strengthening clinical handover to comply with the NSQHS Standards

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