Issue 21 18 Issue 09/09/13 21/10/13 fortnightly fortnightly
Education & Feature Midwifery Maternal Feature Paramedics devastated at helicopter rescue deathcourse Griffith to launch first primary maternity services ACT nurses reach pregnancy pay deal weight plan Dietitian launches Australian physiotherapists want prescribing Tasmanian nurses threaten industrial action rights Tasmanianbehaviour graduate problems nursing positions disappointing: ANMF Childhood can predict mental health disorders
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Geneva Healthcare is the market leader in health recruitment. From your first call to us, you’ll notice the Geneva difference. That means that we go the extra mile, giving you the warm and knowledgeable service you deserve, and offering career opportunities that meet your ambitions. Just a snapshot of the opportunities we currently have available: New Zealand Midwives – Hamilton PICU Nurses - Auckland Mental Health Nurses - Auckland Physiotherapists - various locations Anaesthetic Technicians - Auckland Australia Midwives - Alice Springs Dual Registered Nurse/Midwives - Regional SA, QLD, NSW and WA Dual Registered Nurse/Midwives - Melbourne Midwives for Obstetric Led Units - Sydney Oncology RNs (chemo competent) - Melbourne Cardiothoracic Scrub and Cardiac/Thoracic Ward RNs - Newcastle Middle East Adult and Paediatric Oncology RNs - Saudi Arabia NICU Nurses - Saudi Arabia PICU Nurses - Saudi Arabia Laboratory Technologists - United Arab Emirates Executive Directors and Directors for various clinical areas in a new Women’s and Children’s Hospital - Qatar
If you’re after the best, forget the rest, put us to the test! For these jobs, or to see what else is available, contact us today. www.genevahealth.com AU 1800 123 900 | NZ 0800 900 801
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www.ncah.com.au www.ncah.com.au Issue 21 17 – 21 26 August Issue October2013 2013 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 21, 2013. included in Issue 17, 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. © 2013 Seabreeze Communications Pty Ltd. All rights reserved. No part of this publication may be copied or All rights reserved. part of this publication may bepermission copied or of reproduced by anyNo means without the prior written reproduced byCompliance any means without prior written permission the publisher. with thethe Trade Practices Act 1974 ofof the publisher. Compliance thepublication Trade Practices Act 1974 of of advertisements containedwith in this is the responsibility advertisements contained in this publication is the responsibility of those who submit the advertisement for publication. those who submit the advertisement for publication.
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Nursing Careers Allied Health - Issue 21 | Page 5
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Tasmanian nurses threaten industrial action
24/09/13 10:35 AM
by Karen Keast Tasmanian nurses and midwives have warned they will resort to industrial action within weeks unless the State Government fails to deliver better work conditions. The move comes after more than 100 nurses and midwives at the Royal Hobart Hospital unanimously rejected the government’s offer amid negotiations for a new enterprise agreement for public sector nurses and midwives. At the time of publication, the Australian Nursing and Midwifery Federation (ANMF) Tasmanian Branch vowed industrial action would begin on October 21 unless an acceptable offer from the government had not been received before October 18. The branch and the government had agreed to a two per cent pay rise over three years but the branch argues the government’s proposal reduces current conditions equivalent to Page 10 | www.ncah.com.au
cutting leave by a week or slashing salaries by two per cent. The branch says the government’s proposal includes reducing eight hour shifts to six hour shifts without mutual agreement, which would force part-time nurses to work an extra day a week and impact on patient care, along with mandatory leave rostering without mutual agreement. It also includes the removal of both the late payment of wage penalty and the right to receive 11.5 public holidays. “Nurses and midwives are propping up the public health system at the moment with incredible pressures in ED, acute wards and the primary health sector resulting from the budget cuts and increasing demand for health services,” ANMF Tasmania Branch secretary Neroli Ellis said in a statement. For the full article visit NCAH.com.au
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University link to enhance hospital’s midwifery offer the opening of the Sunshine Coast Public University Hospital. Projects that currently involve the Visiting Fellows include: Staying Connected – a study to help new mothers bond with their babies and breastfeed for as long as possible; the SAVE Trial – trialling different devices for securing drips in hospital patients; the RSVP Trial – comparing the impact of intravascular device administration set replacement at four days versus seven days on infective, clinical and cost outcomes;
The effectiveness of nursing and midwifery activities undertaken at the Sunshine Coast Hospital and Health Service (SCHHS) in Queensland looks set to benefit from a reinforced relationship with the University of the Sunshine Coast (USC). Four USC academics have been appointed Visiting Fellows in Nursing and Midwifery at the hospital. They are Professors Marianne Wallis and Jeanine Young, Associate Professor Margaret Barnes and Dr Amanda Henderson, who received the honorary positions in a ceremony last month. They will undertake research and collaborate on educational and clinical leadership projects involving nurses, midwives and other health professionals. It is understood each fellow will bring a different expertise to the Sunshine Coast Hospital and Health Service, ranging from maternal and child health to acute hospital care for adults and sub-acute areas such as palliative care. SCHHS Nursing and Midwifery Services executive director, Adjunct Professor Graham Wilkinson, confirmed the four would work with SCHHS staff to foster new research programs. USC’s Professor Wallis reportedly described the initiative as “a first step in developing international best practice in nursing and midwifery research, education and clinical practice” on the Sunshine Coast, ahead of Page 12 | www.ncah.com.au
the Pepi-Pod Safe Sleep Space project – exploring a strategy that supports cultural infant care practices while reducing the risk of sudden infant death in Aboriginal and Torres Strait Islander communities; and the National Standards Assessment Program, Collaborative Improvement Program Support for Carers (Palliative Care Australia) – which evaluates the national standards project.
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Midwives, Midwives, Midwives Looking for a rewarding rural experience in the horse capital of Australia?
IF YES, THEN DON’T MISS THIS OPPORTUNITY! Are you looking to escape the daily grind, need a new outlook on life, thinking about a tree change or just a few weeks away from the family to breathe? Well have we got an opportunity for you! RN Midwives / Direct Entry Midwive (BMid), with minimum 6 months experience A range of positions are available: full time, part time, casual and contract. Scone is a charming country town with a host of different attractions from magnificent national parks including the World Heritage listed Barrington Tops to the beautiful Lake Glenbawn.
WORKING FOR HUNTER NEW ENGLAND HEALTH - WHAT WE OFFER YOU! • Hunter New England Health is a ‘values’ based organisation and an Employer of Choice that values and promotes cultural diversity. • A Culture of Excellence with emphasis on lifelong learning and professional development. • An award winning Culture of Innovation. We have strong links with the internationally renowned University of Newcastle, University of New England and the Hunter Medical Research Institute – recognized for its world leading research. • Assistance with relocation and integration into the community, great salary packaging opportunities and meal and entertainment allowance. • Career succession and professional development opportunity and support You may like to consider this as an opportunity to trial a rural lifestyle with a view to relocating more permanently or simply wish to gain exposure to a rural setting.
Enquiries: Judy Bernasconie, Phone: 02 6540 2100, Email: judy.bernasconi@hnehealth.nsw.gov.au Chrissy Haddril, Phone: 02 6540 2152, Email: Christina.Haddril@hnehealth.nsw.gov.au For further information on Scone: http://www.visitnsw.com/town/Scone.aspx FOR MORE MIDWIFERY OPPORTUNITIES IN HUNTER NEW ENGLAND, VISIT nswhealth.erecruit.com.au OR Call Susan Brazil 0414452094 Susan.Brazil@hnehealth.nsw.gov.au Nursing Careers Allied Health - Issue 21 | Page 13
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Griffith to launch first primary maternity services course The childbirth journey by by Karen Karen Keast Keast Queensland’s Griffith University is preparing Childbirth has been defined as the to launch Australia’s first course focusing on culmination the pregnancy period with the provision of of maternity services in primary the expulsion of one or more newborn health care. infants from a woman’s uterus. Childbirth Griffith University School of Nursing and is also one of life’s essential journeys, Midwifery Professor Jenny Gamble said the writes Karen Keast. Master of Primary Maternity Care will be offered Any2015 midwife willwith tell the you National there isMaternity nothing in in line Services Plan’s commitment continuity of more incredible in this world to than witnessing care, demedicalising birthaand providing women childbirth and assisting mother as her baby with more for maternity services. is born intooptions our world. “We are working on demedicalising birth and University of Western Sydney Professor bringing back into the community,” said. Hannah itDahlen, a privately practisingshe midwife “Rather than a hospital-centric system,College it’s got and spokesperson for the Australian to about community-based needed.” of be Midwives, once shared hercare earlyasmemories of watching her mother, a midwife, support Professor Gamble said the course will suit women in as childbirth at a health missionary clinic in midwives, well as allied professionals, Yemen,makers in the Middle East.managers who work policy and middle in maternity services. “When I was 12, my next door neighbour gave “It’s policycatch makers birth for and managers I helped theand midwife her,” and she midwives who have worked in the hospital sector says. for all of their lives and have never experienced “I held this baby as dawn was breaking providing continuity of the care,” she said. over the Middle East and I thought - there can “People need education to enable them how to be no other job on this earth, as being at the do it differently and what it looks like. beginning of a new life.” “That component is only one of the barriers. latest statistics on childbirth in Australia IThe think there are other political barriers and show the number of childbirths has been cultural barriers.” increasing since 2001, with a total of 294,814 Professor Gamble said the course will cover women giving birth to 299,563 babies in 2010. the ‘how to’ of remodelling service delivery. The figures fromof the Australian Institutesay of “Lots and lots Directors of Nursing Health and Welfare’s Mothers and midwives don’t want toAustralia’s change their shift work Babies 2010 report, provides a snapshot of to an annualised salary,” she said. childbirth Australia.for people not to want to “It’s quite incommon change their way of working. It’s about putting Most women - 201,613 women or 68.4 per strategies cent - hadina place.” vaginal birth and 82.4 per cent of those did not involvesaid the use instruments. Professor Gamble the of program will be based on evidence in practice, with international It also shows 93,157 women or 31.6 per cent and Australian research showing continuity of gave birth by caesarean section, while 18.6 per care is cost-effective, safe and provides better cent outcomes. had a caesarean section without labour birth Page 14 | www.ncah.com.au
“It’s better for midwives, it’s better for women and it’s 13better per cent a caesarean section and for thehad babies.” with labour. The course will also cover midwifery prescribing and business skills forofmidwives wanting to Overall, 56.4 per cent women had a nonmove into private instrumental birthpractice. while about one in nine mothersUniversity had an instrumental delivery where Griffith was recently recognised either vacuumfor extraction wasand used. for itsforceps clinicalortraining midwives its commitment to driving Australia’s national A normal vaginal childbirth involves three maternity reform agenda. stages of labour, beginning with the early and Its Bachelor program, introduced active phasesofinMidwifery stage one. in 2010, was a finalist in the Workforce Council’s The early, Innovation or latent, Awards. phase is when regular Workforce uterine contractions begin and the cervix The university this year also became the begins to open and widen. second university in Australia to offer a course enabling midwives to prescribe. The labour then moves into the active phase where the accelerated cervical dilation occurs, Its Screening, Diagnostics, Pharmacology opening the cervix 3 or 4cm to 10cm. and Prescribing forfrom Midwives course is a one semester online course. Once the cervix is fully dilated, the labour moves into the second stage - childbirth.
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With the head fully engaged in the pelvis, pressure on the cervix increases and the woman begins to push. The baby’s head continues the descent into the pelvis, below the pubic arch and out through the vaginal opening. Direct Entry Midwives / Dual Registered Midwives
Immediate startsofavailable! The third and final stage labour is when the • Above award rates • Free accommodation placenta is expelled. • Free travel • Flexible choice of location
and Experience InRoles Australia, midwives assist in childbirth in a At Koala Nursing Agency we require you to have the variety of settings from hospitals to birthing following; • Current Australian Nursing Registration centres, community centres and(APHRA). in women’s • Current Australian National Criminal History Check. as homes, and are either self-employed • New Zealand Citizenship or Australian Citizenship/ privately practising midwives or employed Residency. through organisations. • Currenthealth workingservices holiday visaor(417) - (We are unable to provide 457 sponsorship).
• A minimum of two yearsmodel, post gradalso recentknown birthing as The continuity of (2) care suite, antemidwifery, natal and postwhere natal carewomen essential. have the caseload Koala also employsfrom Registered with experience same midwife earlyNurses in their pregnancy in the following disciplines: through labour and childbirth until around six • Rural, ICU, ED/Acute and Mental Health. weeks aftervisitbirth is increasingly becoming To apply please our website at www.koalanurses.com.au or alternatively us on nursing@koalanurses.com.au recognised inemail Australia for providing improved
1302-017 321-0261PG 1PGFULL FULLCOLOUR COLOURCMYK CMYK(typeset) PDF midwife, the partner, a friend or family member, Professor Gamble says.
Maari Ma Health
Maari Ma Health AAboriginal leading researcherCorporation whose work has focused Aboriginal Corporation
Regio
428 Arg
on issues such as the rising rates of medical Improving Aboriginal Health and closing the gap intervention inHealth childbirth, as well the as workforce Improving Aboriginal and closing gap Further i and practice development, Professor Gamble Select ‘P says the midwifery profession is gradually other do advancing in Australia.
Community Midwife Full time or part time
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Midwives now have access to Medicare and can prescribe PBS We are medicines, however many hospitals continue to keep their doors closed to privately Health practising midwives seeking clinical privileging Commu arrangements.
funding, Broken Hill, NSWinsurance
Child &
Professor Gamble says midwifery still remains collaboratively with Aboriginal Primary Health Workers to implement the Aboriginal andWork ongoing health care benefits for women, a the “nursing industrial model” Providing in much of the Maternal Infant Health Strategy integrated within Healthy Start Program. their babies and their families. where sensehealthy of normality community based ante-natal care for Aboriginalhospital women system, of the region tothe achieve in childbirth has largely been lost. pregnancies, goodmidwives birth outcomes and healthy babies. Throughout labour, will continually Nurse Manager Grade 1 monitor woman’s progress while making Travel the within the region with overnight stays is a“To requirement of the position. some extent, hospital staff have just sure the environment, including the woman’s become institutionalised and many Salary range $58k to $81k per annum dependent on qualifications and experience. A great opportunity for a Child & Family Health Nurse or Midwife to of those partner or family at the birth, supports the people have lost a really good understanding To talk about the work, please contact Helen Freeman, telephone 08 8082 from 9736 or lead an innovative and comprehensive child health program, woman’s needs. and sense of what normal birth looks like,” she
Manager Health Start Program
email Helen.Freeman@maarima.com.au
Keepin
Registe CNS or Primary Qualifie
to 0-5 child development, says. a whole of life Chronic TO APP Griffith antenatal University Professor Jenny Gamble, a within Packages: We offer five weeks annual leave, employer’s contribution to superannuation, practising midwife of 30 years, says midwives Disease development Strategy. opportunities, generous professional salary packaging provisions relocation Professor Gamble says one example is where renae.r willsupport often dismiss their actions as being “just and temporary accommodation is also offered. to of uslabour about can our become flexible emthe thirdTalk stage managed there or just present” during theleadership labour workplaces. andskills, ployment packages family friendly You will need and effective advanced expertise in hospitals, with the use ofin a serotonin injection To talk childbirth. into the leg to ensure the placenta separates To apply, pleaseor request package bycommitment contacting Renae email Renae. midwifery childan & application family nursing and to Roach developing
Roach@maarima.com.au “They are not ‘just present’,” she says.
from the wall of the uterus.
Aboriginal Health Workers and partnerships with other service
“Many don’t have an2013 idea of what that third Applications close 5:00pm Thursday 7th November “I think what a good midwife does, whatService a providers. Regional Primary Health stage of labour looks like if you don’t have that competent midwife does, what an expert drug,” she says. Regional Primary Health midwife doesinformation is extremely subtle. Further about Maari MaService is available on our website www.maarima.com.au Select ‘Publications’ to view or download our Strategic Plan, Chronic Disease Strategy and
Further information about Maari Ma is available on our website Professor Gamblewww.maarima.com.au describes midwifery as a “It’s an assessment, an ongoing otherintense documents. Select ‘Publications’ to view or download our Strategic Plan, Chronic Disease and “wonderful job” and likens the Strategy role of midwives assessing process carried out in a way that other more information on Broken Hill visit www.brokenhill.nsw.gov.au in childbirth to that of palliative care nurses makes thedocuments. woman feelFor both safe and secure working in end of life care. and not watched and observed. “When a woman is in labour she needs a degree of privacy within a cocoon of safety.
“It might seem strange but it’s about essential life journeys,” she says.
“The midwife’s job is to watch and assess and guide where needed and facilitate the birth.”
“One is going out of the world and one is coming into the world.
And it’s up to the woman giving birth as to who “catches” the baby in childbirth – be it the
“If we don’t get those both right, we are not going to get anything else right.” Nursing Careers Allied Health - Issue 21 | Page 15
or ema
Applic
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Dietitian launches pregnancy weight plan by Karen Keast Most Australian women are eating the kilojoules for two while pregnant, not the nutrition for two, according to leading dietitian Melanie McGrice. The renowned Melbourne dietitian has taken her passion for weight management to print with the recent launch of her book, The Pregnancy Weight Plan. An Advanced Accredited Practising Dietitian (AdvAPD) and director of one of the nation’s largest dietetic companies, Nutrition Plus, Ms McGrice said many pregnant women are confused when it comes to what and how much they should eat during pregnancy. “They often don’t know how many additional kilojoules they can have and in what form they should have them,” she said. Ms McGrice said she realised many of her clients began struggling with their weight during pregnancy, which was impacting on both the mums and their babies in the short term and also long term. “It’s a really big issue,” she said. “The recent figures are that 74 per cent of Australian women are gaining too much weight during pregnancy. “I would really encourage every woman who is pregnant to have at least one consultation with an APD while they are pregnant.” Ms McGrice said extra weight gain during pregnancy increased the risk of complications with obese mums having double the chance of miscarriage and stillbirth, double the risk of their baby having a birth defect, triple the risk of pre-eclampsia and a higher risk of caesarean birth. She said mums gaining too much weight are also putting their babies at risk – significantly increasing their risk of childhood obesity. “By making sure you are gaining the right amount of weight during pregnancy, mums can have a huge impact on...two generations.” Page 16 | www.ncah.com.au
Ms McGrice said overweight women also have less chance of falling pregnant while those undergoing IVF have almost double the risk of miscarriage as women of a healthy weight. She said her book was not just for mums and those wanting to boost their fertility but was also a resource for other APDs and health professionals. “I really see in the industry at the moment there’s a lot of physicians, GPs, midwives and obstetricians, who aren’t weighing their clients, the mums, during pregnancy,” she said. “They aren’t talking to them about nutrition at all. I would really like to see other health professionals either refer pregnant mums to see a dietitian or to suggest to mums to have a copy of the book.” The Pregnancy Weight Plan includes customised weight management plans for before, during and after pregnancy and includes nutritional information, food diaries, safe and sensible exercise programs, meal plans and 33 healthy 30-minute recipes.
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Nursing Careers Allied Health - Issue 21 | Page 17
The childbirth journey by Karen Keast Childbirth has been defined as the culmination of the pregnancy period with the expulsion of one or more newborn infants from a woman’s uterus. Childbirth is also one of life’s essential journeys, writes Karen Keast. Any midwife will tell you there is nothing more incredible in this world than witnessing childbirth and assisting a mother as her baby is born into our world. University of Western Sydney Professor Hannah Dahlen, a privately practising midwife and spokesperson for the Australian College of Midwives, once shared her early memories of watching her mother, a midwife, support women in childbirth at a missionary clinic in Yemen, in the Middle East. “When I was 12, my next door neighbour gave birth and I helped the midwife catch her,” she says. “I held this baby as the dawn was breaking over the Middle East and I thought - there can be no other job on this earth, as being at the beginning of a new life.” The latest statistics on childbirth in Australia show the number of childbirths has been increasing since 2001, with a total of 294,814 women giving birth to 299,563 babies in 2010. The figures from the Australian Institute of Health and Welfare’s Australia’s Mothers and Babies 2010 report, provides a snapshot of childbirth in Australia. Most women - 201,613 women or 68.4 per cent - had a vaginal birth and 82.4 per cent of those did not involve the use of instruments. It also shows 93,157 women or 31.6 per cent gave birth by caesarean section, while 18.6 per cent had a caesarean section without labour Page 18 | www.ncah.com.au
and 13 per cent had a caesarean section with labour. Overall, 56.4 per cent of women had a noninstrumental birth while about one in nine mothers had an instrumental delivery where either forceps or vacuum extraction was used. A normal vaginal childbirth involves three stages of labour, beginning with the early and active phases in stage one. The early, or latent, phase is when regular uterine contractions begin and the cervix begins to open and widen. The labour then moves into the active phase where the accelerated cervical dilation occurs, opening the cervix from 3 or 4cm to 10cm. Once the cervix is fully dilated, the labour moves into the second stage - childbirth. With the head fully engaged in the pelvis, pressure on the cervix increases and the woman begins to push. The baby’s head continues the descent into the pelvis, below the pubic arch and out through the vaginal opening. The third and final stage of labour is when the placenta is expelled. In Australia, midwives assist in childbirth in a variety of settings from hospitals to birthing centres, community centres and in women’s homes, and are either self-employed as privately practising midwives or employed through health services or organisations. The continuity of care model, also known as caseload midwifery, where women have the same midwife from early in their pregnancy through labour and childbirth until around six weeks after birth is increasingly becoming recognised in Australia for providing improved
midwife, the partner, a friend or family member, Professor Gamble says. A leading researcher whose work has focused on issues such as the rising rates of medical intervention in childbirth, as well as workforce and practice development, Professor Gamble says the midwifery profession is gradually advancing in Australia.
and ongoing health care benefits for women, their babies and their families. Throughout labour, midwives will continually monitor the woman’s progress while making sure the environment, including the woman’s partner or family at the birth, supports the woman’s needs.
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Griffith University Professor Jenny Gamble, a practising midwife of 30 years, says midwives will often dismiss their actions as being “just there or just present” during the labour and childbirth.
Professor Gamble says midwifery still remains a “nursing industrial model” in much of the hospital system, where the sense of normality in childbirth has largely been lost. “To some extent, hospital staff have just become institutionalised and many of those people have lost a really good understanding and sense of what normal birth looks like,” she says.
“They are not ‘just present’,” she says.
Professor Gamble says one example is where the third stage of labour can become managed in hospitals, with the use of a serotonin injection into the leg to ensure the placenta separates from the wall of the uterus.
“I think what a good midwife does, what a competent midwife does, what an expert midwife does is extremely subtle.
“Many don’t have an idea of what that third stage of labour looks like if you don’t have that drug,” she says.
“It’s an intense assessment, an ongoing assessing process carried out in a way that makes the woman feel both safe and secure and not watched and observed.
Professor Gamble describes midwifery as a “wonderful job” and likens the role of midwives in childbirth to that of palliative care nurses working in end of life care.
“When a woman is in labour she needs a degree of privacy within a cocoon of safety.
“It might seem strange but it’s about essential life journeys,” she says.
“The midwife’s job is to watch and assess and guide where needed and facilitate the birth.”
“One is going out of the world and one is coming into the world.
And it’s up to the woman giving birth as to who “catches” the baby in childbirth – be it the
“If we don’t get those both right, we are not going to get anything else right.” Nursing Careers Allied Health - Issue 21 | Page 19
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Midwives now have access to Medicare funding, insurance and can prescribe PBS medicines, however many hospitals continue to keep their doors closed to privately practising midwives seeking clinical privileging arrangements.
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QLD allied health workers reject pay offer Hervey Bay allied health workers have passed a motion to formally reject the Queensland State Government’s latest pay offer and are in the process of deciding whether to take industrial action. With allied health workers having held mass meetings outside the Fraser Coast’s two major public hospitals over the latest pay negotiations with the Queensland State Government in recent weeks, a motion to reject the latest pay offer was passed at a mass meeting outside Hervey Bay Hospital on Thursday 10 October. The offer made by the Queensland State Government was for 5.9 per cent over three years, with a 1.5 per cent increase in the first year and a 2.2 per cent increase in each of the next two years. The Together union, one of the largest unions in Queensland, which unites and represents employees across a broad range of industries including allied health workers, said the motion Page 20 | www.ncah.com.au
included an agreement to fight the offer from the State Government. According to Together Union organiser Donna Webster the offer, which affects a broad range of allied health workers including occupational therapists, dentists, mental health workers and pharmacists, came with significant cuts to entitlements, including reductions to rural and student allowances and reduced leave for some roles. For the full article visit NCAH.com.au
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NURSE UNIT MANAGER (Medical Unit) Hamilton, Victoria The Medical Unit offers a diverse range of services including Medical, Subacute Rehab, Day Oncology and Critical Care & Emergency Services. The Nurse Unit Manager position is well supported by a number of specialist nurses who assist in the coordination of clinical practice in the specialty areas. • 5 ED Cubicles • 4 ICU beds • 23 Acute Beds (Includes 8 Funded sub-acute rehab/GEM beds • 3 Chemotherapy Cubicles This role offers the successful applicant the opportunity to work in a progressive and stimulating environment at Western District Health Service. This position requires strong leadership skills and a focus on clinical outcomes. The successful candidate for this role will need to have advanced clinical skills, demonstrate effective and professional nursing practices in planning, implementing and monitoring effective nursing practice. To be successful in this role, you will need to demonstrate and possess: 1. Current registration with the Nursing Board of Australia. 2. Previous management experience in a similar environment. 3. The ability to co-ordinate and promote the organisations quality improvement program.
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Nursing Careers Allied Health - Issue 21 | Page 21
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Childhood behaviour problems can predict mental health disorders by Karen Keast Childhood behaviour problems are a robust predictor of future physical and mental health problems, according to a preeminent Australian psychologist. University of New South Wales Professor of Psychology, and director of the university’s Child Behaviour Research Clinic, Mark Dadds said early intervention and putting in place partnerships with parents could steer many children with early onset conduct problems away from a life of physical and mental health issues. “It’s time to stop ignoring these kids as being hyperactive and the problem of schools and juvenile justice and saying we need to think of these kids as an opportunity to intervene early and make a difference to the health of Australia,” he said. Professor Dadds discussed the issue as one of the key note speakers at the 48th Australian Psychological Society Conference, titled Psychology for a Healthy Nation, recently held in Cairns. Professor Dadds, whose current research involves mapping early developmental and intervention pathways with aggressive and antisocial children, said the early signs of future mental health problems could often be found in common childhood non-compliance behaviours ranging from aggression to tantrums, fighting, swearing, stealing and lying. But Professor Dadds stressed while every child could go through a phase of behaviour problems, it was a major concern in the estimated five per cent of children, especially Page 22 | www.ncah.com.au
boys, who have behaviour problems that are interfering with their lives. “Those problems every child does. What we are looking for here is a child who is stuck… and the parents and teachers can’t cope.” Professor Dadds said children with concerning behaviour problems are at high risk of entering the juvenile justice system and are also at greater risk of substance abuse and depression. He urged psychologists to consider children with behaviour problems as an important group within the psychological mental health zone. “It’s a sign of the potential mental health problems through the lifespan. Some kids grow out of it, not all,” he said. Professor Dadds hopes his message will also get across to other health professionals, including psychiatrists, GPs and paediatricians. “A lot of those kids are getting diagnosed with ADHD when they are not - they have got conduct problems,” he said. “Importantly, if we get it early and you put in place these partnerships with the parents to give them some of the best evidence-based programs for managing these kids - that has a really good success rate.” Professor Dadds, who also practices as a child and family therapist, urged health professionals to learn to differentiate between conduct problems and ADHD, to investigate what the best evidence-based treatments are and to discover what local resources are available. “At the moment, only one in four children that need this kind of help receive it in Australia,” he said. “We all need to make a big effort. We need to be sensitive to children with behaviour problems – they can be identified and they can be helped early.”
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Nurse survives terrifying snake bite ordeal A Brisbane mental health nurse is on the path to recovery after receiving a potentially fatal pit viper snake bite while on holiday in Nepal. Delmae Ryan, 49, flew home following visits to two hospitals in Pokhara, the second largest city in the country, after being told there was no anti-venom in Nepal. The endorsed enrolled nurse, who works at Logan House, endured three plane flights in pain to eventually arrive home and was admitted to Princess Alexandra Hospital, where emergency physician and clinical toxicologist Dr Colin Page embarked on a major search for the right type of anti-venom. The search was hampered because Delmae was bitten in the dark and couldn’t identify the snake, forcing Dr Page to match her bite, from her bloods, to the suspected snake. The drama unfolded on September 29, the final day of Delmae and her husband’s 10-day trip to Nepal to visit her mother, an aid worker. Delmae and her husband were getting into a car at night, after having dinner with her mother, when her husband felt something “roll under his foot” in the dark. “He said it felt just like a pencil or something and then I came to get in behind him…I felt like something smacked my foot and there was this pain,” she recalled. “I knew something had bitten me and when I got into the light I could see these two blood spots on my foot. “I thought I was going to get some sort of respiratory reaction but I didn’t get any nausea or any respiratory issues whatsoever.
Kingaroy Health Service Darling Downs Hospital and Health Service Are you an experienced nurse looking for a challenging role in a rural area? Kingaroy Health Service are seeking qualified nurses in the following positions: Job Ad Reference: H13DD10269 - Clinical Nurse (Medical Surgical Unit) (Nurse Grade 6) The Clinical Nurse is responsible for providing advanced clinical direct patient care in an efficient manner within an integrated framework, providing nursing leadership whilst supporting whole of service development. Job Ad Reference: H13DD10270 - Registered Nurse (Midwife) (Nurse Grade 5) The Registered Nurse (Midwife) is responsible for providing safe and reliable direct patient care in an efficient manner within an integrated framework in a rural setting with particular skills relevant to women, maternity and paediatric care. Job Ad Reference: H13DD10271 - Registered Nurse (Nurse Grade 5) The Registered Nurse is responsible for providing direct patient care across the Kingaroy facility in an efficient manner within an integrated framework. Remuneration value up to $96 147 p.a., comprising salary between $3015.20 - $3230.00 p.f. (f/t) or salary rates: $39.67 - $42.50 p.h. (p/t), employer contribution to superannuation (up to 12.75%) and annual leave loading (17.5%), (Nurse Grade 6) or Salary between: $2306.80 - $2964.20 p.f. (f/t) or salary rates: $30.35 - $39.00 p.h. (p/t), (Nurse Grade 5) (Temporary full time and/or part time positions to cover various periods of leave, hours negotiable. Applications will remain current for 12 months). To apply for the positions above: Enquiries: Mark White (07) 4162 9205. Application Kit: (07) 4616 6258 or www.health.qld.gov.au/workforus Closing Date: Monday, 18 November 2013.
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For the full article visit NCAH.com.au Nursing Careers Allied Health - Issue 21 | Page 23
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Nurses and midwives bear the brunt of sharps injuries by Karen Keast Nurses and midwives suffer the highest rate of needlestick and sharps injuries among Australian healthcare workers each year.
The ANMF also wants conventional needles to be replaced where possible with lock syringes or retractable syringes.
Needlestick and other sharps injuries remain the most common and potentially most dangerous injuries that face nurses and midwives in Australia.
Ms Thomas said while it was important to educate and train nurses about the everyday dangers of needles and other sharps, employers also need to take vital preventative action.
Australian Nursing and Midwifery Federation (ANMF) federal secretary Lee Thomas said while there are an estimated 180,000 reports of needlestick and sharps injuries to nurses, midwives and other healthcare workers occurring each year across the nation – the figure could actually be much higher. “With approximately half of all injuries not reported, this means the actual number of injuries to nurses and other healthcare workers could be as high 36,000 cases a year,” she said. “We’re obviously very concerned about the potential harm to nurses, exposing them to the risk of contracting HIV/AIDS and Hepatitis B or C.” As part of National Safe Work Australia month, the ANMF and the Alliance for Sharps Safety and Needlestick Prevention in Healthcare have renewed calls for state and federal jurisdictions to mandate the use of safety engineered devices (SEMDs). The ANMF estimates it would cost $50 million to equip Australia’s public hospitals with safe needle use education and safety equipment but only a small number of hospitals have introduced the safety devices. “We are pleased that some individual hospitals are making an effort to improve safety for nurses through their own practices but overall, there continues to be slow progress in rollingout safety devices through workplaces for nurses,” Ms Thomas said. “Employers have an obligation to ensure safety in the workplace.” Page 24 | www.ncah.com.au
“Employers also need to be reminded of their obligations to health and safety legislation in developing and implementing safety control plans for nurses and healthcare workers,” she said. “Needle disposal containers should be placed close to where nurses and midwives are carrying out procedures and the containers should never be overfilled. “Needles should never be recapped. Nurses must always report any needle or sharps injury.” Ms Thomas said unlike other western countries, including the United States and Canada, Australia has no nationally mandated approach to the utilisation of safety devices to prevent needlestick injuries to nurses and other healthcare workers. “We continue to call on Federal and State Governments to work together with key stakeholders to ensure that protocols are aligned with the mandatory use of safety engineered devices and education of healthcare workers – so that Australia is brought into line with other countries.” Alliance chair Professor Cathryn Murphy said every needlestick or sharps injury at work was a foreseeable hazard to healthcare workers. “International experience has proven that the risk of occupational exposure to bloodborne pathogens from a needlestick or sharps injury can be eliminated through the mandatory use of safety engineered devices, education of healthcare workers and mandatory reporting of injuries.”
321-041 1PGFULL FULLCOLOUR COLOURCMYK CMYK(typeset) PDF 1320-030 1PG LOUR CMYK PDF Flight Nurses> Are you keen to utilise ALL of your nursing skills? • Attractive remuneration • Diverse career opportunity • Based in Port Augusta, South Australia The Royal Flying Doctor Service of Australia (RFDS) is one of the largest and most comprehensive aeromedical organisations in the world. We are seeking registered nurses with General and Midwifery Nursing Certificates who are currently registered with the Australian Health Practitioner Regulation Agency. You will also have comprehensive experience and/or post graduate qualifications in a critical care area, together with high level customer services skills and a professional approach to service delivery. Working in a diverse, fulfilling and rewarding environment, RFDS nurses are at the forefront in delivery of aeromedical health services. If you are keen to progress your career with an organisation that makes a real difference to all Australians, apply now. Please direct your confidential enquiries to Greg McHugh Ph: (08) 8150 1313 Applications to: HR Coordinator RFDS Central Operations PO Box 381 Marleston DC SA 5033 Email: careers@flyingdoctor.net The Royal Flying Doctor Service is an Equal Opportunity Employer
Midwifery Scholarships> Have you always dreamed of working for Australia’s famous aeromedical health service but do not meet the Flight Nurse position requirements to be endorsed as a Midwife? The Royal Flying Doctor Service, Central Operations is now providing an exciting opportunity for suitably qualified Registered Nurses to access a limited number of Midwifery Scholarships. The Scholarships will provide financial support to those Nurses so they may gain this important qualification. These scholarships are to be used for costs associated with your study towards a Midwifery Qualification in 2014/15 such as course fees, text books, etc Selection Criteria: • Registered General Nurse with AHPRA Registration; • Emergency Nursing or Critical Care Certificate / experience; • Significant relevant post graduate nursing experience; • Australian citizenship or permanent residency in Australia. The approved course, leading to endorsement as a Midwife and any other post graduate midwifery program requirements, may be completed in any state of Australia. Employment post registration as a Midwife will be with RFDS Central Operations. For further information and to request an Application Package please contact: Kate Guerin, HR Coordinator PO Box 381, Marleston BC SA 5033 Email: careers@flyingdoctor.net
Applications close: 1 November 2013 Nursing Careers Allied Health - Issue 21 | Page 25
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Physiotherapy journal moves online by Karen Keast The Australian Physiotherapy Association’s renowned Journal of Physiotherapy will move online, becoming an open-access publication in January. One of the world’s leading physiotherapy publications, the quarterly journal will make the transition in a bid to increase its readership while attracting more authors to publish their ground-breaking research in the journal. Up until now the journal’s content has been limited to paying subscribers but major research funding bodies are increasingly requiring authors to grant open access to ensure publically-funded research is available to everyone. “The Journal of Physiotherapy is always striving to be the best of its kind by publishing the highest quality physiotherapy research out there,” Journal of Physiotherapy editor Mark Elkins, an Associate Professor at the University of Sydney, said. “The open access model will help the journal continue to do this.” Assoc Professor Elkins said the open access format will also encourage more researchers to publish their findings in the journal. “By introducing free open access to its research papers, Journal of Physiotherapy offers physiotherapists a high-ranking, Englishlanguage publication in which to publish their research, with wide readership and listing on 20 major bibliographic databases.”
simple walking training on flat ground compared with training on exercise bikes (Leung 2010). Other research has shown how treadmill training increases the likelihood of achieving independent ambulation for people who cannot walk after stroke (Ada 2010), while producing significant and lasting improvements in walking speed and distance, once stroke survivors can walk (Polese 2013). APA CEO Cris Massis said the new format will enable anyone world-wide to access the journal’s cutting-edge research and information and to share it through social media. “The online model will not only open up current research to the public but archive articles will be easy to find and access,” he said. “Journal of Physiotherapy is facilitating the spread of physiotherapy related knowledge and research throughout the world, which is truly special.” The journal will become open access from January 1, 2014. Paper copies will be available to APA members on request.
VOLUME 59 • NO 3 • SEptEmbER 2013 VOLUME 59 • NO 3 • SEptEmbER 2013
Official Journal of the Australian Physiotherapy Association
VOLUME 59 • NO 3 • SEptEmbER 2013
Official Journal of the Australian Physiotherapy Association
Official Journal of the Australian Physiotherapy Association
Assoc Professor Elkins said for the past 60 years the journal has published high-quality evidence of the effectiveness of physiotherapy interventions for many conditions, ranging from sporting injuries to Parkinson’s disease, pain during labour, osteoarthritis and cystic fibrosis. He said one of its key findings have included how greater benefits in functional exercise capacity can be achieved among people with chronic obstructive pulmonary disease, with Page 26 | www.ncah.com.au
© Luurn Willie Kew, 2008. Licensed by Japingka Gallery 2013. © Luurn Willie Kew, 2008. Licensed by Japingka Gallery 2013.
© Luurn Willie Kew, 2008. Licensed by Japingka Gallery 2013.
Editorial Editorial 143 Towards evidence-based physiotherapy 143 Towards evidence-based physiotherapy Research Editorial Research 145 management of hip osteoarthritis 143 Physiotherapy Towards evidence-based physiotherapy 145 Physiotherapy management of hip osteoarthritis 159 Alternative exercises and urinary incontinence Research 159 Alternative exercises and urinary incontinence 169 length for 6-min walkof test COPD 145 Course Physiotherapy management hipinosteoarthritis 169 Course length for 6-min walk test in COPD 177 walk exercises distance in systolic heart failure 159 6-min Alternative and urinary incontinence 177 6-min walk distance in systolic heart failure 189 and for prediction of recovery post-stroke 169 Incidence Course length 6-min walk test in COPD 189 Incidence and prediction of recovery post-stroke 199 coaching in neurological rehabilitation 177 Activity 6-min walk distance in systolic heart failure 199 Activity coaching in neurological rehabilitation 189 Incidence and prediction of recovery post-stroke
Appraisal Appraisal 207 Critically Appraised Papers 207 Critically Appraised Papers 211 Clinimetrics Appraisal 211 Clinimetrics 213 Critically Clinical Practice Guidelines 207 Appraised Papers 213 Clinical Practice Guidelines 214 Clinimetrics Media 211 214 Media 213 Clinical Practice Guidelines 214 Media
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Nursing Careers Allied Health - Issue 21 | Page 27
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Physiotherapists assess impact of e-games by Karen Keast Physiotherapists need to understand the positive and negative impacts of electronic games on children’s health, according to a leading Australian research physiotherapist. Curtin University School of Physiotherapy Professor Leon Straker, who is also a Senior Research Fellow with the National Health and Medical Research Council, said it was important physiotherapists understood the movement implications of e-games to help prevent and manage disorders. “Together with TV and computer non-game use, playing e-games makes up the majority of leisure screen time for most children,” he said. “Nearly all children in Australia now regularly play e-games, and do so for a sufficient amount of time each week to mean this may have an impact on their health. “Physiotherapists need to be aware of this important part of many children’s lives.” Professor Straker recently presented his research on the impact of e-games on children’s physical health at the Australian Physiotherapy Association’s Conference 2013, held in Melbourne. More than 2000 physiotherapists are expected to gather for the biennial industry event which will focus on the new moves and innovation in physiotherapy. Professor Straker’s first clinical job was as a paediatric physiotherapist at a major children’s hospital before he moved into community physiotherapy and in the past 15 years he has been researching the interaction of children and technology within an ergonomics framework. Professor Straker said his research investigated the physiological and movement demands of traditional sedentary e-games, such as gamepad input devices, keyboards, joystick and steering wheels and also active e-games, including Song PlayStation 2 Eye Toy and Dance Mat, Sony Playstation 3 Move Page 28 | www.ncah.com.au
and Microsoft Xbox Kinect and Nintendo Wii Remote. “Children playing active e-games have a higher heart rate, respiration rate, limb and trunk movement, muscle activity and energy expenditure,” he said. “We are currently comparing the movement of children playing e-games with the real world game to assess e-game fidelity.” Research shows the negative effects of e-game use can potentially include acute trauma, overuse injuries and increased sedentariness. Professor Straker said games like the Wii remote have resulted in contact injuries with players injuring themselves when accidentally making contact with another person or furniture in the real space. He said delayed onset muscle soreness has been reported for active e-games where the player is unaccustomed to the device, while overuse can result in inflammation of joints or tendons from repeated similar actions. Professor Straker said extensive use of sedentary e-games was comparable to lengthy computer use. “Sustained poor postures during sedentary e-game use are similar to prolonged computer postures and likely to result in similar issues, for example neck/shoulder pain and back pain from raised shoulders and slumped sitting.” Professor Straker said there are also potential musculoskeletal benefits of e-games, including enhanced motor coordination and physical activity. “For active games involving stepping/jumping such as games with a dance mat or whole body games, (they) require muscle movement which may help with muscle fitness and joint/ bone loading which may help with joint/bone development,” he said.
Careers with Queensland Health Intensive Care Unit, Division of Surgery, Princess Alexandra Hospital, Woolloongabba, Metro South Hospital and Health Service. Salary between $60 183 - $77 334 p.a (f/t) or $30.35 - $39.00 p.h. (p/t), (Nurse Grade 5) (Several full time and part time positions (hours negotiable) and several temporary full time and temporary part time positions (hours negotiable). (Applications will remain current for 12 months). Duties/Abilities: Provide direct and indirect client focused nursing care to patients as an independent professional nurse. Collaborate with peers and the multidisciplinary team to achieve high quality patient outcomes and maintain recognised clinical standards within timeframes. Enquiries: Jennifer Robertson/Nicky West (07) 3176 2718 Job Ad Reference: H13PA10244 Application Kit: (07) 3176 4301 or www.health.qld.gov.au/workforus Closing Date: Monday, 28 October 2013
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Position Vacant – Nurse Unit Manager (Extended Care Unit) An opportunity has become available for a suitably qualified and experienced Registered Nurse to take up the Nurse Unit Manager position within our Extended Care Unit. The Extended Care Unit is currently in the planning stage for a new building with construction expected to commence in 2014 with resident occupancy in early-mid 2015. Post graduate gerentology qualification is essential and tertiary management qualification will be highly regarded. The Nurse Unit Manager has overall responsibility for resident care, accreditation, ACFI documentation and legislative compliance with the support of relevant departments/units of the Health Service. The position includes an attractive salary, as well as salary packaging, entertainment allowance and a relocation allowance. Swan Hill District Health is also strongly committed to professional development. Further information and position description is available from www.shdh.org.au or contact Mrs. Kathy Wright, Executive Officer – Clinical Services on (03) 50339250 or by email to kwright@shdh.org.au Applications addressing the selection criteria and including the names of three referees should be forwarded to the Human Resources department, Swan Hill District Health, PO Box 483, Swan Hill 3585, Victoria or email: hrmanager@shdh.org.au. by COB Friday 1 November 2013. Nursing Careers Allied Health - Issue 21 | Page 29
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321-007 1/2PG FULL COLOUR CMYK PDF What I like about OUM is that I can continue to work part time and continue my studies in medicine. The ability to combine my studies with the cases I was seeing in the hospital really enhanced my education.
4HE EMPLOYMENT EXPERTS RN to MBBS FOR .URSES AROUND !USTRALIA
Take the next step, earn your MBBS at Oceania University of Medicine. 3PECIALISING IN A RANGE OF PERMANENT AND TEMPORARY ROLES
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OCEANIA UNIVERSITY OF MEDICINE
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