Nursing Careers Allied Health ncah.com.au
New Year New Career Breathing new life into Education Feature cardiorespiratory physiotherapy
Mental Health Feature
Guide shows Physios how to harness socialdevastated media Paramedics at helicopter rescue death Standards for mental health postgraduate studies ACT nurses reach pay deal Pharmaceutical researches COAGlife-saving delivers final health diagnosis develop device Australian physiotherapists want prescribing rights Overtime taking toll on Tasmania’s nurses and midwives Tasmanian graduate nursing positions disappointing: ANMF Physiotherapists urge move to prehab
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www.ncah.com.au www.ncah.com.au Issue 12– 26January August 2013 Issue 23 June 2014 117– –20 2014 Issue 17 – 26 August 2013
We hope you enjoy perusing the range of opportunities We hope you enjoy perusing included in Issue 17, 2013. the range of opportunities 12,2014. 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. If you have any queries about ourcontact publication or provided. If you any queries about ourplease publication if you would likehave to receive our publication, emailor us ifatyou would like to receive our publication, please email us careers@ncah.com.au at careers@ncah.com.au
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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 priorPractices written permission the publisher. with thethe Trade 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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Nursing Careers Allied Health - Issue 12 | Page 7
COAG delivers final health diagnosis Australians are living slightly longer and smoking less while deaths from circulatory disease and cancer are falling. On the downside, almost 63 per cent of adults are now overweight and obese while a quarter of Australians have type 2 diabetes, potentially preventable hospitalisation rates for acute and vaccine-preventable conditions have increased, and there are longer waits for elective surgery. The COAG Reform Council’s five-year report card, and final diagnosis on the nation’s health as a result of federal government funding cuts, highlighted a range of health improvements and challenges. It found Australians have among the longest life expectancies in the world - men can now expect to live to 79.9 years and women to 84.3 years while child and infant death rates have dropped 20 per cent between 2007 and 2012. The annual rate of deaths for our two biggest broad causes of death - circulatory disease (heart attacks and strokes) and cancer have fallen. While rates of new cases of female breast cancer, melanoma of the skin, bowel and cervical cancers remained stable, the actual number of people diagnosed with new cases increased between 2006 and 2010. Rates of new lung cancer cases in women significantly increased by 88 per cent between 1982 and 2012 while rates for men fell 34 per cent during the same period. “This is consistent with a peak in female smoking rates in the 1970s and 1980s,” the report states. “As the rate of lung cancer among women is likely to have not yet peaked, there is a need for on-going emphasis on early identification and treatment of this disease, despite the declining
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rates of lung cancer overall.” The national smoking rate fell from 19.1 per cent to 16.3 per cent in 2011-12. The report found 72 per cent of people presenting at emergency departments are now seen within benchmark times, up from 67 per cent, while rates of hospital acquired infections have fallen. It’s taking longer for older Australians to access aged care services, with the report finding the proportion of people who took nine months or longer to enter high residential care, after being approved, increased from 3.3 per cent in 2008-09 to 14.1 per cent in 2012-13. Australians are waiting longer for elective surgery with wait times increasing for 14 out of 15 selected surgical procedures. The report shows the cost of health care remains a concern with more than two in five, or 43.9 per cent of, Indigenous people aged 15 and over delayed or did not see a dentist in 2012-13 due to costs, while a third delayed or did not fill a prescription, and one in eight, or 12 per cent, delayed or did not see a GP. One in five, or 18.8 per cent of, Australians delayed or did not see a dentist due to cost, 5.8 per cent delayed or did not see a GP, and 8.8 per cent delayed or did not fill a prescription. The report found while the proportion of people receiving Medicare Benefits Scheme and Department of Veteran Affairs funded clinical mental health services grew an average of 12.7 per cent a year between 2007-08 and 2010-11 it slowed to just 3.9 per cent between 2010-11 and 2011-12 due to a slowing in the service rate of GPs. It also found mental health treatment rates by clinical psychologists and other allied health professionals increased steadily.
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utas.edu.au Nursing Careers Allied Health - Issue 12 | Page 9
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Program to boost rural allied health Rural and remote health facilities in Queensland are benefitting from a program designed to increase the number of allied health graduates working in regional areas. Queensland Health Minister Lawrence Springborg said 11 new graduates in allied health professions had been allocated to rural and remote facilities under the Allied Health Rural Generalist Training program, established by the Department of Health. “Nine of these graduates already have taken up their places so far, with the remaining two in the process of recruitment to the positions at Longreach and Cooktown.’’ The positions were designed to provide new graduates with on-the-job training and mentoring during the first year of their career, while also
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helping boost allied health services to rural and remote areas. “We would hope that a period of time working in regional areas will open the new graduates’ eyes to the merits of a professional career in rural Queensland,’’ he said. The positions also are being used to develop and trial a new training program that would fit allied health professionals with skills and experience more suited to working in regional and remote areas. The successful graduates have been placed into each of the 11 new positions for a period of 12 months, after which they will be replaced by a new cohort of graduates for a further year.
For the full article visit NCAH.com.au
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Nursing Careers Allied Health - Issue 12 | Page 11
Former nurse fights to Physiotherapists to design their decriminalise medical cannabis own conference program By Karen Keast By Karen Keast
T
hroughout her 20-plus year nursing career, Physiotherapists will bewith ableissues to tailor this Lucy Haslam was familiar around year’s Physiotherapy Zealand (PNZ) conferpain management and New cancer treatment. ence to their individual of founded practice. and ran A community nurse,area Lucy The September 19-21 ‘Linking the Chain’ her own home nursing service in Tamworth, New conference will feature a PNZ conference smartSouth Wales, often assisting palliative care paphone app, more than 20 local and international tients. physiotherapy experts, four exterior workshops But it wasn’t until her son Daniel and the addition of eight embedded workshops. began battling bowel cancer four Physiotherapy New Zealand president Ian years ago that she realised d’Young said this year’s conference, in line with the medical benefits of the theme, aimed to link together a range of clinicannabis. cal streams into one comprehensive three-day Cannabis has event. helped Daniel, now Mr d’Young said more than 300 delegates 24, largely overcome from across New Zealand, Australia and further nausea, vomiting and afield will be able to forge their own program with poor appetite around a conference smartphone app. his chemotherapy “We want attendees to be able to design their treatments while Danown program, picking from a range of sessions iel is also using cannaon the latest clinical research, mixed with more bis oil in a final to with halt the option of adding in a specialty areasbid and the terminal disease. practical workshop or two,” he said. Now, Lucy worked and her hus“We have hard to give our special inband, a former drug squad police terest groups a big role in developing a program officer, are fighting to decriminalise the the latthat is useful both in terms of presenting medical use of cannabis Daniel and others est research and practicalfor sessions. like him. “We want them to come away from the con“Cannabis has ideas really for become our last hope,” ference with new innovation and evolvshe ingsaid. our practice to address future health chal“I think people need to see it as another medlenges.” icine instead of thissaid big taboo. Mr d’Young the conference will cover “It should just be treated like any other prekey areas of interest for physiotherapists working scribed, restricted substance. It can remain ilin New Zealand, ranging from the prevention and legal for general useinjuries but betolegal for prescribed treatment of ACL the need for robust restricted situations.” rehabilitation programs for older adults - regardSince going public with her story, Lucy, who less of the cause of their disability. now works in hospitality, said she hasincluding been inunThe event will feature speakers Cadated with messages from people usein nadian physiotherapist Diane Lee,who an also expert
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cannabis for medicinal purposes. the“We areaare of pelvic disability and pain, and Profesabsolutely amazed by how many sor Peter director- of Auckland’s Health people haveMcNair, come forward saying that they are and Rehabilitation Research Institute, who doing the same thing or they want to be able will to speak on enhancing muscle strength and endurdo the same thing,” she said. ance during rehabilitation. “We didn’t set out to start this massive camCanadian sports physician Professor Karim paign but it’s kind of clear really that the need is Khan will also cover the lack of awareness about there.” the effectiveness of physiotherapy among the The Haslam family has general public and doctors. launched an online petition, Mr d’Young said it’s an important topic for the which has received more profession and is also a focus of the PNZ’s threethan 125,000 signatures, year strategy. calling for the NSW “We are committed to promoting the value government to adopt of physiotherapy more effectively to the public, the five recommendaother health professions and national funders,” tions of a state parliahe said. mentary committee, For the full article visit NCAH.com.au outlined in 2013. If adopted, the recommendations would enable people with terminal illnesses or those who are suffering from chronic pain to choose cannabis as a treatment, while protecting them against arrest and prosecution. The NSW Nurses and Midwives’ Association (NSWNMA) Council has thrown its weight behind the fight, supporting the recommendations and the Haslam family’s petition. “Our members recognise the importance of exploring improved options for effective pain management, particularly for those patients who suffer from constant chronic pain,” NSWNMA general secretary Brett Holmes said in a statement. “We are aware of a proposed Private Member’s Bill being drafted by the Member for Tam-
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412-033 1PG FULL COLOUR CMYK PDF “If he can have some hope through taking worth and will await the NSW government’s conthe oil and if he can feel like he’s actually being sideration of this bill.” a bit empowered to fight his disease, then that’s The union stated medical cannabis is legal enough for me - that makes it worth it.” and regulated in the United States, Canada and several European countries to alleviate symptoms for Parkinson’s Disease, Multiple Sclerosis, Crohn’s Disease, and other chronic pain and post traumatic stress disorders. Lucy labelled the union’s support “fantastic”. Umoona Tjutagku Health Service Aboriginal Corporation ICN 7460 on this What are your thoughts She said the family has received a lot of controversial treatment? support in their campaign to decriminalise the medical use of cannabis, particularly from local Leave a comment on this and other nurses. articles by visiting the ‘news’ “I meet nurses every day who come and with say opportunity of (06-12 month contract an extension) section of our website ‘well done Lucy - you’re going really well’,” she http://www.ncah.com.au The position is a fulltime, your salary will be based on qualifications & work experience. revealed. “There’s a groundswell of support and if To go to the article “Former nurse The get successful applicant willand be responsible for: fights to decriminalise medical nurses behind that groundswell can help cannabis” directly, visit it along, I think hopefully we’ll get over the line. • The strategic, operational planning and governance requirements to enable delivery http://goo.gl/IjxV3E “The politicians just have it in their heads that of culturally sensitive specialist Alcohol and other Drug Services to the clients there’s adequate medication out there that’s ap• The clinical competency in the management of people with addictions, current best proved and listed the TGA but they are justand not alcohol use and misuse in the local practice andon awareness around drug listening,” Lucy said. Aboriginal community • “People’s The development clinical service models individual of stories are telling me that for the Drug and Alcohol service • Dealing with staff as well as liaise effectively with treating clinicians and that’s not the effectively case; people have all sorts of needs services involved in the care and other cannabis seems to be the oneclient’s thing that people are always saying - ‘I’m getting a great Benefits of being employed by Umoona Tjutagku Health Service response, the side effects are really minimal or I can• manage them’. working in an Aboriginal Community controlled Primary Health care Service Gain experience local members startas hearing people • “If Opportunity to work part offrom a multi-disciplinary team like• nurses are well regarded trusted and Salarywho sacrifice benefits areand available Opportunities for further training/personal it’s•their area of expertise, maybe they will start development to listen.” For enquires and J &has PS: also given Daniel Lucy said cannabis Mr Dilshan Perera - Business Services Manager / Executive Assistant hope. Ph: 08 8672 5255. Fax: 08 8672 3349. Email: dperera@uths.com.au “He’s four years into this fight now and he shouldn’t be herewith with3us and he’sto: still here and Applications referees theMrs most important thing for him, even if it doesn’t Priscilla Larkins - Chief Executive Officer Mail: POa Box 166, Coober Pedy, SA, 5723. work from tumour-fighting point of view, is it’s Email: plarkins@uths.com.au giving him some hope. Aboriginal and can’t Torres Islanders are- encouraged to apply. “I think hope beStrait underrated really if you’re terminally ill and the doctors take away Applications close Friday the 4th of July 2014 at 5.00pm. your hope you’re basically ready for the coffin,” she said.
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Nursing Careers Allied Health - Issue 12 | Page 13
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Mental health stretched at Dubbo Hospital Nurses at Dubbo Hospital in New South Wales are under strain due to lack of resources to treat patients with mental health problems, according to unions. As reported by the online Daily Liberal, the Health Services Union and NSW Nurses and Midwives Union say understaffing in the hospital’s mental health unit, attributed to underfunding by the state government, could put nurses and patients at risk. “The Local Health District want staffing levels for a general mental health unit but they are running as a high dependency unit,” NSW Nurses and Midwives Union co-ordinator Darius Altman reportedly said. Acutely unwell patients required a level of care that current staffing levels were unable to deliver, he said. “Some high dependency patients might require the care of one nurse for every two patients or even one to one in some cases.” In a statement Western NSW Local Health District director of operations Lindsey Gough said there had been significant investment in upgrades to Dubbo Hospital. “There are absolutely no cuts, downgrades or reductions occurring or planned for Dubbo Health Service. “The suggestion of otherwise is incorrect and misleading.” “In fact, the $91 million investment into the redevelopment of Dubbo Health Service will result in more and improved health services to meet the changing health demands for the Dubbo region’s growing population.”
For the full article visit NCAH.com.au
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Nursing Careers Allied Health - Issue 12 | Page 15
Mental Mental health health care care for for older older Australians Australians
Depression and mental illness are not a normal part of ageing. A national Depression and mental illness are not a normal parttraining of ageing. A national charity is recommending mandatory mental health for nurses and charity is recommending health training for nurses and allied health professionalsmandatory in the agedmental care and community support sectors allied healthcare professionals in the with agedmental care and community support sectors to improve for older people illness, to improve care for older people with mental illness, By Karen Keast. By Karen Keast.
A A
lmost half of the Australian population will lmost half of the Australian population will experience mental illness at some stage in experience mental illness at some stage in their lives. their lives. SANE Australia says while the naSANE Australia says while the nation’s increasingly ageing popution’s increasingly ageing population will result in more older lation will result in more older adults living with mental illadults living with mental illness, it’s research shows ness, it’s research shows there is still a lack of there is still a lack of attention to mental illattention to mental illness in the elderly. ness in the elderly. The national The national mental health charmental health charity says people with ity says people with mental illness are more mental illness are more likely to experience the likely to experience the effects of ageing sooner effects of ageing sooner than the than the general general populapopulation while they tion while they are are also also likely likely to have multiple physical to have multiple physical health health conditions, conditions, cognitive cognitive impairments impairments and and few few supports supports -- and and experience experience financial financial difficulty. difficulty. These These factors factors also also lead lead to to older older people people with with mental mental illness illness living living on on average average 25 25 years years less less than than the the general general population. population. Late Late last last year, year, SANE SANE Australia Australia released released aa study, Growing Older, Staying Well, which study, Growing Older, Staying Well, which found found aged aged care care workers workers often often have have little little understandunderstanding ing of of mental mental health health issues issues while while there there are are few few support support and and rehabilitation rehabilitation services services aimed aimed at at older older adults adults living living with with mental mental illness. illness. ItIt also also revealed revealed people people with with mental mental illness illness face face the the ‘double ‘double stigma’ stigma’ of of age age and and mental mental illillness. ness.
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SANE Australia has now called for a stigma SANE Australia has now called for a stigma reduction campaign targeting the aged care secreduction campaign targeting the aged care sector and community support services around the tor and community support services around the issue of mental illness in older adults. issue of mental illness in older adults. The charity has recommendThe charity has recommended mandatory mental health ed mandatory mental health training for nurses and altraining for nurses and allied health professionals lied health professionals working in aged care working in aged care and community supand community support sectors. port sectors. It’s also encourIt’s also encouraging GPs and other aging GPs and other primary health care primary health care professionals to seek professionals to seek additional training and additional training and education in the treateducation in the treatment of coexisting ment of coexisting physical physical and and mental mental health health problems. problems. SANE SANE Australia Australia communicacommunications director Paul tions director Paul Morgan Morgan says says with with the the wave wave of of ageing ageing Baby Baby Boomers Boomers approaching, approaching, it’s it’s vital vital to to address address the the needs needs of of older older people people living living with with mental mental illness, illness, which which is is distinct distinct from from demendementia. tia. “There “There is is quite quite aa significant significant proportion proportion of of people who are living with a mental people who are living with a mental illness illness long long term,” term,” he he says. says. “There’s “There’s this this proportion proportion of of the the population, population, maybe maybe three three per per cent, cent, who who are are psychiatrically psychiatrically disabled. disabled. “When “When you you have have got got aa large large part part of of the the popupopulation lation entering entering those those 60s 60s and and 70s 70s years, years, there there are are going to to be be aa lot lot more more people people in in the the aged aged care care going
demographic who have illnesses like schizophredemographic have and illnesses like schizophrenia and bipolarwho disorder so forth. nia and bipolar disorder and so forth.
“They are already disadvantaged and “They are already and often stigmatised and disadvantaged isolated by having often stigmatised and isolated by having those conditions and have poor physical those conditions andonly havebepoor physical health, and that will made more health, and willwhen only they be made more complex andthat worse have older complex and worse when they have older age problems as well.” age problems as well.” SANE Australia investigated the experience SANE Australia investigated the experience of ageing with a mental illness, surveying 111 of ageing with a mental illness, surveying 111 people in early 2013. people in early 2013. Most respondents were female, at 73 per Most respondents were female, at 73 per cent, and aged predominantly between 50 and cent, and aged predominantly between 50 and 64, at 74 per cent. 64, at 74 per cent. The majority of participants had been diagThe majority of participants had been diagnosed with depression, at 45 per cent, followed nosed with depression, at 45 per cent, followed by schizophrenia, at 28 per cent, bipolar disorby schizophrenia, at 28 per cent, bipolar disorder, at 23 per cent, anxiety disorders, at three per der, at 23 per cent, anxiety disorders, at three per cent, and personality disorders, at one per cent. cent, and personality disorders, at one per cent. The charity also conducted 26 interviews with The charity also conducted 26 interviews with consumers and service providers with results consumers and service providers with results used to identify barriers to effective care and to used to identify barriers to effective care and to inform recommendations for improvements. inform recommendations for improvements. Mr Morgan says separate SANE Australia reMr Morgan says separate SANE Australia research of people with conditions such as schizosearch of people with conditions such as schizophrenia phrenia and and other other psychotic psychotic conditions conditions shows shows 70 70 per cent regularly smoke, 47 per cent are per cent regularly smoke, 47 per cent are obese, obese, and and 49 49 per per cent cent have have aa lifetime lifetime history history of of an an alcoalcohol or drug dependence. hol or drug dependence. “People “People with with serious serious mental mental health health problems problems have have much much worse worse physical physical health health than than the the rest rest of of the the population,” population,” he he says. says. “So “So when when you you combine combine that that with with people people getgetting ting older older you you are are looking looking at at rates rates of of diabetes diabetes and and heart heart disease disease and and other other problems problems that that are are going to be way above the national average going to be way above the national average -- in in the the population population of of people people who who are are already already getting getting poorer poorer services. services. “They “They are are likely likely to to be be getting getting even even poorer poorer in in their their older older age age -- so so looking looking after after these these people people and and looking looking out out for for them them is is terribly, terribly, terribly terribly important.” important.” Older people people with with mental mental illness illness are are also also ofofOlder
ten not embedded within services and may have ten not embedded within services may have become separated from family and and friends resultbecome separated from family and friends resulting in isolation from the community, Mr Morgan ing in isolation from the community, Mr Morgan adds. adds. “A very strong message is that amongst a “A veryofstrong thatworkers amongst population peoplemessage that agediscare willa population of people that aged care of workers will be looking after, a significant number those are be looking a significant number of those are going to beafter, people with existing ongoing mental going problems to be people ongoing mental health andwith theyexisting are going to be easy to health problems ignore,” he says. and they are going to be easy to ignore,” says. be late for appointments, they “Theyhemight “They might be late for appointments, they may have a reluctance to come out, they won’t may have a reluctance to come out, they won’t be knotted into services as well. be knotted into services as well. “Because they are going to be easy to miss, “Because they are going to be easy to miss, they are going to be neglected and we want to they are going to be neglected and we want to see proactive systems to identify and look after see proactive systems to identify and look after those people whether it’s in aged care settings, those people whether it’s in aged care settings, whether it’s in people who are nurses and alwhether it’s in people who are nurses and allied health professionals who are seeing people lied health professionals who are seeing people through community health centres or visiting through community health centres or visiting them in their homes. them in their homes. “We really need to be looking at these people “We really need to be looking at these people and encouraging them to become involved with and encouraging them to become involved with health systems. health systems. “We also need to be educating and training “We also need to be educating and training staff in what sorts of behaviour and things will staff in what sorts of behaviour and things will help those people with a mental illness because help those people with a mental illness because they they might might just just be be seen seen as as awkward awkward people people or or people who don’t turn up for appointments people who don’t turn up for appointments -- well, well, it’s it’s because because they’ve they’ve got got an an illness. illness. “Allied health professionals “Allied health professionals who who work work with with GPs GPs as as well well -- that’s that’s one one touch touch point point that that can can help help spark spark off off aa lot lot more more integrated integrated care care for for this this older older population.” population.” SANE SANE Australia Australia is is now now working working on on guidelines guidelines to to assist assist health health professionals professionals to to better better care care for for older people with mental illness, which will older people with mental illness, which will be be rereleased leased in in late late 2014. 2014. “We don’t “We don’t need need to to give give up up on on people people just just because because they they are are old old and and affected affected by by mental mental illillness,” ness,” Mr Mr Morgan Morgan says. says. “They “They have have every every right right to to care care as as much much as as everybody everybody else.” else.”
Nursing Careers Allied Health - Issue 12 | Page 17
Standards for mental health postgraduate studies
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he Australian College of Mental Health Nurses (ACMHN) is working to forge accreditation standards for postgraduate studies in mental health nursing. In a project with Queensland Health, ACMHN is developing a national framework that will outline agreed criteria, supporting values and principles for postgraduate studies along with a course accreditation process. ACMHN CEO Kim Ryan said the move will provide national consistency for graduate diplomas and masters qualifications in mental health nursing. “What we are going to do with Queensland Health is develop a framework that looks at what constitutes, in mental health nursing, a graduate certificate, a graduate diploma and a masters in line with the Australian Quality Framework (AQF)”. “So then universities can go okay, this is what the college says should fit into a graduate certificate, a graduate diploma, a masters - we don’t have a framework like that for any other nursing specialty. “This is going to help us guide what postgraduate mental health nursing should look like, so we’ve got consistency across the sector.” Ms Ryan said it’s been largely left up to universities to decide the learning objectives for
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their postgraduate mental health nursing studies. “Universities have pretty much directed what that looks like,” she said. “If someone who has got a graduate diploma in mental health nursing, we as a profession can say - we think it’s important that they’ve been able to undertake this level of education, they have this level of knowledge, skills and education, and be able to apply that in a clinical environment.” ACMHN is establishing an expert reference group to drive the project and plans to open the process up to consultation later this year, with the standards expected to be completed by February 27, 2015. Ms Ryan said once completed, universities meeting the standards will have the option to seek college accreditation for their mental health nursing postgraduate studies. “Universities have already got their courses and there will be no requirement on them to actually meet the criteria or to have their courses accredited by the college,” she said. “But one would guess that in a market-driven environment, if you wanted to go and do a postgraduate mental health nursing course it would probably be good to try and look for one that the college has accredited.” Ms Ryan said the project is part of the college’s objective to set and achieve national standards in high quality mental health nursing care. “We are trying to better articulate and define what mental health nursing is and provide more opportunities to support nurses who are working in mental health,” she said. “For us it’s trying to build a workforce and trying to get more people interested and supported to undertake mental health nursing.”
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Former nurse fights to decriminalise medical cannabis By Karen Keast
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hroughout her 20-plus year nursing career, Lucy Haslam was familiar with issues around pain management and cancer treatment. A community nurse, Lucy founded and ran her own home nursing service in Tamworth, New South Wales, often assisting palliative care patients. But it wasn’t until her son Daniel began battling bowel cancer four years ago that she realised the medical benefits of cannabis. Cannabis has helped Daniel, now 24, largely overcome nausea, vomiting and poor appetite around his chemotherapy treatments while Daniel is also using cannabis oil in a final bid to halt the terminal disease. Now, Lucy and her husband, a former drug squad police officer, are fighting to decriminalise the medical use of cannabis for Daniel and others like him. “Cannabis has really become our last hope,” she said. “I think people need to see it as another medicine instead of this big taboo. “It should just be treated like any other prescribed, restricted substance. It can remain illegal for general use but be legal for prescribed restricted situations.” Since going public with her story, Lucy, who now works in hospitality, said she has been inundated with messages from people who also use
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cannabis for medicinal purposes. “We are absolutely amazed by how many people have come forward - saying that they are doing the same thing or they want to be able to do the same thing,” she said. “We didn’t set out to start this massive campaign but it’s kind of clear really that the need is there.” The Haslam family has launched an online petition, which has received more than 125,000 signatures, calling for the NSW government to adopt the five recommendations of a state parliamentary committee, outlined in 2013. If adopted, the recommendations would enable people with terminal illnesses or those who are suffering from chronic pain to choose cannabis as a treatment, while protecting them against arrest and prosecution. The NSW Nurses and Midwives’ Association (NSWNMA) Council has thrown its weight behind the fight, supporting the recommendations and the Haslam family’s petition. “Our members recognise the importance of exploring improved options for effective pain management, particularly for those patients who suffer from constant chronic pain,” NSWNMA general secretary Brett Holmes said in a statement. “We are aware of a proposed Private Member’s Bill being drafted by the Member for Tam-
worth and will await the NSW government’s consideration of this bill.” The union stated medical cannabis is legal and regulated in the United States, Canada and several European countries to alleviate symptoms for Parkinson’s Disease, Multiple Sclerosis, Crohn’s Disease, and other chronic pain and post traumatic stress disorders. Lucy labelled the union’s support “fantastic”. She said the family has received a lot of support in their campaign to decriminalise the medical use of cannabis, particularly from local nurses. “I meet nurses every day who come and say ‘well done Lucy - you’re going really well’,” she revealed. “There’s a groundswell of support and if nurses get behind that groundswell and can help it along, I think hopefully we’ll get over the line. “The politicians just have it in their heads that there’s adequate medication out there that’s approved and listed on the TGA but they are just not listening,” Lucy said. “People’s individual stories are telling me that that’s not the case; people have all sorts of needs and cannabis seems to be the one thing that people are always saying - ‘I’m getting a great response, the side effects are really minimal or I can manage them’. “If local members start hearing from people like nurses who are well regarded and trusted and it’s their area of expertise, maybe they will start to listen.” Lucy said cannabis has also given Daniel hope. “He’s four years into this fight now and he shouldn’t be here with us and he’s still here and the most important thing for him, even if it doesn’t work from a tumour-fighting point of view, is it’s giving him some hope. “I think hope can’t be underrated really - if you’re terminally ill and the doctors take away your hope you’re basically ready for the coffin,” she said.
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“If he can have some hope through taking the oil and if he can feel like he’s actually being a bit empowered to fight his disease, then that’s enough for me - that makes it worth it.”
HAVE YOUR SAY What are your thoughts on this controversial treatment? Leave a comment on this and other articles by visiting the ‘news’ section of our website http://www.ncah.com.au To go to the article “Former nurse fights to decriminalise medical cannabis” directly, visit http://goo.gl/IjxV3E
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Nursing Careers Allied Health - Issue 12 | Page 21
Overtime taking toll on Tasmania’s nurses and midwives Tasmania’s public sector nurses and midwives are increasingly working overtime and double shifts to fill roster shortages. Australian Nursing and Midwifery Federation’s (ANMF) Tasmanian Branch secretary Neroli Ellis said the impact of the state’s health cutbacks, as detailed in a recent independent health policy analyst’s report, was taking a toll on the state’s nurses and midwives. Ms Ellis said there were 26 double shifts in one general ward alone, last month. “They are sick of it - there’s no doubt nurses do not want to work this amount of overtime,” she said. “They get called on their days off on a regular basis to come in and do extra work; they are almost ethically obliged to do the overtime to ensure there is safe staffing. “Mistakes and quality of care do deteriorate when you are working unsustainable hours. “Nurses and midwives are getting tired in the public sector because there’s no real commitment to employ the correct numbers of nurses on a permanent basis.” Hobart analyst Martyn Goddard’s report into Tasmania’s public hospitals, based on Australian Institute of Health and Welfare data, found the system has lost 167 FTE nurses, or six per cent, from 2011 to 2013 while nurses’ average FTE sal-
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aries increased 12 per cent compared with seven per cent for all states and territories. “This has almost nothing to do with general wage increases and almost everything to do with the sharply declining efficiency with which Tasmanian public hospitals are being staffed and administered,” Goddard states in the report. “Rather than employing an adequate number of nurses, those who remain are required to work long and expensive periods of overtime.” Goddard’s report also found the number of FTE doctors fell 21 per cent while their salaries increased 32 per cent, and the overall costs of running Tasmanian hospitals rose “substantially faster” than the national average. Ms Ellis said system inefficiencies were resulting in nurse unit managers waiting three months to employ into vacant base grade nursing positions. “The nurse unit managers are incredibly frustrated that they can’t employ more nurses and yet are relying on overtime,” she said. “To recruit to a vacant position requires nine levels of endorsement to even commence the recruitment process, so that all takes time. “While they are trying to recruit, they have got roster shortages or holes in the roster that have to be filled by someone and they are more often than not filled by someone having to do a double shift. “It’s very poor management, both from a patient safety aspect and a nurses’ safety aspect and of course the bottom line, to now rely on so much overtime.” Ms Ellis said the branch plans to release a document outlining 40 cost-saving solutions, most around system efficiencies, to improve the state’s embattled health system and ultimately patient care.
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Nursing Careers Allied Health - Issue 12 | Page 23
Pharmacists applaud community pharmacy inquiry The Victorian Legislative Council will investigate opportunities for community pharmacies to have an enhanced role in primary and preventative care. The inquiry, which is open to submissions until June 30, will consider the role of pharmacies in post-acute health care, aged care, personalised medication management and vaccinations. It will also examine pharmacies making referrals to other health care professionals, community pharmacies in rural and remote Victoria, and the remuneration, workforce and financial issues related to expanding the role of community pharmacies. The inquiry will also consider the enhanced role of pharmacies in providing flu vaccinations in Queensland and the Northern Territory. Queensland pharmacists have administered more than 8500 immunisations across 80 community pharmacies as part of the Queensland Pharmacist Immunisation Project (QPIP) since April 1. Pharmaceutical Society of Australia (PSA) Victorian Branch president Michelle Lynch said the inquiry had a broad scope. “We certainly have been in discussions with the Department of Health and the minister about ensuring that the resources of health professionals are maximised,” she said. “We obviously think there’s an opportunity to better utilise the pharmacists that we have in the community to achieve better health outcomes for the public of Victoria. “It’s just really reviewing the role that pharmacists can have particularly in rural and remote and regional areas where there is a shortage of access either to services or to other health professionals, and just better utilising the pharmacists
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and the access points they provide, particularly in community pharmacy, in ensuring that we are delivering the right services to our patients.” Ms Lynch, a pharmacist with independent specialist consulting company PharmConsult who also works in community pharmacy, said community pharmacists have a role to play in the provision of immunisations. “Obviously with the right framework to allow the appropriate accreditation and training, which obviously needs to go in line with provision of those services but we absolutely think that’s something pharmacists can do,” she said. “It’s all about, I suppose, public access. It’s not trying to replace anyone else’s health professional role, it’s really about collaboration.” Ms Lynch said better utilising pharmacists in community pharmacies could improve health outcomes for consumers and also work to meet the government’s agenda to contain rising health costs. “These are things that we talk about over a federal level and a state level as well and it’s obviously been about trying to ensure that the public, in this particular case in Victoria, has access to the services that we need,” she said. The Pharmacy Guild has also welcomed the inquiry. “Whilst both the Guild and the PSA are optimistic of the progress of our advocacy work to date, we will certainly not rest on our laurels and ensure our submissions and presentations to the Legislative Council of the Victorian Government will hopefully result in community pharmacy being recognised and remunerated for the great work they do and can do - for the benefit of all Victorians,” Guild Victorian Branch president Anthony Tassone said.
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Nursing Careers Allied Health - Issue 12 | Page 25
Physiotherapists urge move to prehab By Karen Keast Physiotherapists are urging more people to consider prehabilitation in a bid to safeguard themselves against sports and fitness injuries this winter. Sports physiotherapists offer prehabilitation or prehab, corrective training to amend problems before injuries occur, which can target specific sports and individual needs. The call comes as physiotherapists prepare for the annual influx of sprains, strains and other injuries as a result of winter sports. Australian Physiotherapy Association (APA) president Marcus Dripps said prevention, with a prehabilitation assessment and plan, was the best medicine. “We see the same risk factors again and again for sports and fitness injuries but usually by the time the patient sees a physio, it’s too late,” he said. Mr Dripps said an APA sports physiotherapist can assess posture, core stability, muscle strength and flexibility, joint alignment, mobility and incorrect movement patterns. “It’s not so different to going to a dentist or doctor for regular check-ups. Everyone has their own set of particular weaknesses, inflexibilities and movement incongruities.” Melbourne sports physiotherapist Aidan Rich has been offering prehabilitation for the past five years. Mr Rich, a member of the APA’s national sports committee who works at LifeCare Sports Medicine in Ashburton and Croydon, said the biggest risk factor for injury is having a previous injury - so it’s important to avoid a first-time injury. He said a sports injury can have long-lasting implications.
Page 26 | www.ncah.com.au
“Something like an anterior cruciate ligament injury, the return to play is typically around 10 to 14 months after an injury,” he said. “Only about 30 or 40 per cent of people get back to their pre-injury level of competition and the re-injury rate for that knee or the opposite knee is about 30 per cent. “It’s an injury that is career halting or career limiting and we know that if you injure your anterior cruciate ligament, for example, that the risk of early-onset osteoarthritis in your knee is dramatically increased.” Mr Rich, who has worked with a variety of sports and musculoskeletal conditions as a sports physiotherapist in the past eight years, said studies show prehabilitation programs work to prevent knee injuries in court sport players, hamstring injuries in AFL players, and serious injuries in soccer players. FIFA’s renowned 11+ prevention program, a warm-up based on a scientific study out of Norway, has been designed to reduce injuries among amateur soccer players. Mr Rich said the program has produced “good results”, showing teams that completed the 20 minute warm-up at least twice a week achieved a 30 to 50 per cent reduction in the number of players injured. He said providing prehabilitation was a simple solution aimed at helping people remain injury-free. “That’s the thing I enjoy - we get to make a difference in someone’s long-term health and long-term enjoyment of their sport,” he said.
For the full article visit NCAH.com.au
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Nursing Careers Allied Health - Issue 12 | Page 27
Psychologists workshop emotional impact of strokes By Karen Keast The emotional toll of stroke and its impact on physical recovery was on the agenda at the recent Clinical Psychologist National Conference in Melbourne. Statistics show about 50,000 people encounter a new or recurrent stroke each year and more than 400,000 people live with the effects of stroke in Australia. Professor of Clinical Psychology Ian Kneebone, of the University of Western Sydney, said stroke survivors are in a high risk group for depression and anxiety, with around 50 per cent of post stroke patients suffering clinical depression while 20 per cent experience anxiety. “If you are depressed after a stroke, you are likely to be in hospital longer, you’re likely to have more functional problems, you’re less likely to go home and more likely to go to some sort of supported accommodation,” he said. “You’re more likely to have another stroke and you’re more likely to die sooner.” Professor Kneebone, who presented a workshop on the topic at the Australian Psychological Society’s (APS) June 20-22 conference, said depression and anxiety was often overlooked due to the focus on the patient’s physical recovery post stroke. “The other thing is a lot of the symptoms of stroke overlap with something like depression so, for instance, fatigue is a sign of depression but it’s also common after stroke, memory and concentration problems are common after stroke and they are also signs of depression - so it makes it harder to detect,” he said. “I’m involved in a project up at Hunter New England Health Local Health District in Newcastle where we are attempting to screen for depres-
sion and anxiety after stroke as routine, and their screening rate is about five per cent at the moment. “Where I worked previously in the UK we went from 55 per cent to 80 per cent so it’s early days in terms of this being developed in this country.” Professor Kneebone, who was a member of the core steering group that developed the National Stroke Strategy for England and retains a visiting post at the University of Surrey in the UK, said it’s important for clinical psychologists to consider the emotional recovery of stroke survivors, particularly around issues such as fear of falling. “Up to 60 per cent of people are affected by fear of falling,” he said. “Being a bit vigilant is important but if you are fearful of falling it’s an independent risk factor of losing functional ability. “The important thing about the fear of falling is it’s a risk factor for actually having falls and so the more fearful you are, the less you do, you de-condition and then when you do try and do something, you are more likely to fall over.” Professor Kneebone said psychologists can intervene to assist stroke survivors to manage their fear, working to improve their functional ability and their outcomes. Clinical psychologists should firstly work to educate survivors about how the fear of falling can be self-fulfilling, he said. “Getting them to think - if I can manage my fear, I can continue to do things, I’m more likely to get home from hospital, I’m less likely to be a burden to others - those sorts of things start to change their mind,” he said.
For the full article visit NCAH.com.au Page 28 | www.ncah.com.au
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is a postgraduate course developed specifically EnrolledNursing or Registered The Vocational Graduate Certificate in for Cosmetic is a Nurses wishing to enter the field specifically of cosmeticfor medicine. postgraduate course developed Enrolled or Registered Nurses wishing to enter the field of cosmetic medicine. This government-accredited qualification will provide nurses with the knowledge and hands-on skills required towill work in a cosmetic medical This government-accredited qualification provide nurses with the practice and/or accreditedskills day required hospital performing knowledge and hands-on to work in a cosmetic cosmetic nursing, medical dermal and injectable procedures. practicetherapies and/or accredited day hospital performing cosmetic nursing,
Contact us
www.aacds.edu.au enquiries@aacds.edu.au www.aacds.edu.au 08 9226 3366 enquiries@aacds.edu.au Follow us on www.facebook/aacds 089328 9226 6760 3366 08 Follow us on www.facebook/aacds
Authorised providers of RCNA (APEC) endorsed Continual Nursing Education. Authorised providers of RCNA (APEC) endorsed Continual Nursing Education.
& get your overseas adventure dermal therapies and injectable procedures. underway The course is completed online over one semester full-time or two semesters Practical in dermal therapies The coursepart-time. is completed onlinecompetencies over one semester full-time or and two injectables proceduresPractical are completed on-campus in Perth, Sydney and and semesters part-time. competencies in dermal therapies the Gold Coast. proceduresare arecompleted completedon-campus on-campus in Perth, Sydney, injectables procedures in Perth, Sydney and Melbourne and the Gold Coast. the Gold Coast. For further information, please contact the Australasian Academy of Cosmetic Dermal Scienceplease on 08 9226 3366the or visit www.aacds.edu.au For further information, contact Australasian Academy of 9328 6760 Cosmetic Dermal Science on 08 9226 3366 or visit www.aacds.edu.au
REGISTERED TRAINING ORGANISATION PROVIDER NO: 51373 REGISTERED TRAINING ORGANISATION PROVIDER NO: 51373
Nursing Careers Allied Health - Issue 12 Nursing Careers Allied Health - Issue 01
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Nursing and Midwifery Superguide What I like about The employment experts is that I can –OUM now available The essential resource for continue to work THE SUPERGUI RVISI DE: A SUPE
part time and continue e uperguid in The Sstudies my medicine. The ability to combine my studies with the cases I was seeing in the hospital really enhanced my education. for n Continuum A Supervisio Midwives Nurses and
ON CONTINU
UM FOR NURS
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Vivian Ndukwe, RN from Melbourne, OUM Class of 2012
RN to MBBS for Nurses around Australia
Take Nursing the next step, earn your MBBS at and Midwifery Oceania University of Medicine. professionals Specialising in a range of permanent & temporary roles
June 2013
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OUM is proud announce an even more attractive fee structure 2013. fortoNurses & Midwives in Australia and across from the world. Applications are now open for courses beginning in February and August. Happy new year from the team at Medacs The Superguide: � New facilities, greater capacity and over 150 students currently enrolled. Healthcare! A practical, user friendly and concise � Study from a Home Base under faculty top international medical schools. multimedia resource fromfrom HETI. If you are a Nurse or Midwife seeking a new perm � ReceiveItpersonalised attention from your own Advisor. opportunity in 2014 or you have an interest in a includes essential elements forAcademic contract position in regional or remote locations sound, evidence-based clinical � OUM Graduates are eligible to sit for the AMC exam or NZREX. across Australia then and we would love to speak to you supervision of nursing midwifery � OUM Graduates are employed in Australia, New Zealand, Samoa and USA. about your options. professionals: Point of Care Supervision, Facilitated Professional We always have a range of exciting perm or temp Development, Clinical Supervision nursing/midwifery opportunities available! and scenarios on DVD.
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