Healthtimes June 2015

June 2015

Mental Health & Nurse Leaders Features + Safewards shines spotlight on good nursing care + Wanted - nurses to lead the way in health reforms + Psychological impact of rebuilding lives after floods + Transforming dementia care in hospitals

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SPECIALISE IN MENTAL HEALTH Australian Catholic University aims to produce professional graduates who will make a difference, who are: • up-to-date; • committed to person-centred care; • well versed in recovery-orientated practice; • equipped with the skills and knowledge to influence public policy; • imbued with a lifelong commitment to social justice and equity; • responsive to the needs of consumers, carers, families via a multi-disciplinary collaborative approach.

Our postgraduate programs offer: • a shift in focus from acute inpatient treatment to that of recovery-oriented practice; • professional development opportunities to keep pace with such change; • opportunities to build the required knowledge, skills and competencies for the workforce; • appropriate preparation to respond to the needs of consumers and carers.

“ACU has partnered with stakeholders to develop our postgraduate courses in Mental Health. It is exciting to be part of genuine collaboration to support people in their mental health recovery.”

PROFESSOR BRIAN MCKENNA, PROFESSOR OF MENTAL HEALTH NURSING Applications open now for mid-year. Visit

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HealthTimes - June 2015 | Page 03

June, 2015 We hope you enjoy perusing the range of opportunities included in this Issue.

If you are interested in pursuing any of these opportunities, please contact the advertiser directly via the contact details provided. If you have any queries about our publication or would like to receive our publication, please email us at contact@healthtimes.com.au DISTRIBUTION 43,219 The HealthTimes magazine is the most widely distributed national nursing and allied health publication in Australia.

For all advertising and production enquiries please contact us by telephone on 1300 306 582, email contact@healthtimes.com.au or visit www.healthtimes.com.au Published by Seabreeze Communications Pty Ltd trading as HealthTimes.

ABN 29 071 328 053. Š 2015 Seabreeze Communications Pty Ltd. All right reserved. No part of this publication may be copied or reproduced by any means without the prior written permission of the publisher. Compliance with the Trade Practices Act 1974 of advertisements contained in this publication is the responsibility of those who submit the advertisement for publication.

Advertiser list Austra Health Australian Catholic University Australian College of Mental Health Nurses Careers Australia Castle Hill Day Surgery CCM Recruitment International CQ Nurse First State Super Geneva Health Hays Healthcare Hepburn Health Jane Lewis Lifescreen Medacs Australia Nurse at Call Oceania University of Medicine Pulse Staffing Quick and Easy Finance Royal Flying Doctor Service Smart Salary Swinburne University of Technology The Simpson Centre for Health Services Unified Healthcare Group

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HealthTimes - June 2015 | Page 13

Safewards shines spotlight on good nursing care

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dynamic evidence-based practice model that aims to reduce seclusion and restraints in mental health wards is putting the emphasis back on the care at the centre of mental health nursing.

UK mental health nurse Professor Len Bowers, a Professor of Psychiatric Nursing at London’s Institute of Psychiatry, developed the Safewards model and 10 point intervention to improve safety for patients and staff in acute mental health wards through the establishment of calmer and more positive environments.

Safewards is now being trialled at 18 inpatient wards at Monash Health and NorthWestern Mental Health, Alfred Hospital and Werribee Mercy in Melbourne, and in regional Victoria at Wangaratta, Bendigo and in the Latrobe Valley. The Centre for Psychiatric Nursing (CPN), based at the University of Melbourne, is overseeing the trial, which has been funded by the state’s Department of Health.

Trial lead Dr Bridget Hamilton, a mental health nurse and senior lecturer at the School of Health Sciences at the University of Melbourne, says Safewards is a change in practice that champions good mental health nursing.

“Everyone knows there is such a thing as deescalation - using words to assist people who are charged up to calm down but it takes time and we don’t always notice but some nurses are better at it than others - they’ve got a much better repertoire of skills,” she says.

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“In an inpatient unit, all of a sudden, instead of being an associate charge nurse or someone who is highly regarded because you’re efficient and you make sure everything runs efficiently on the day you’re in charge, you’re being recognised for being the go-to person if a patient’s upset - you’re going to be the most skilful person for talking them down.

“It’s really nice the way that Safewards shifts the emphasis from maybe being a good organisational citizen to being a good interpersonal practitioner.

“That doesn’t always happen for nurses. If a nurse is caring and takes a bit longer…they can be quite criticised for that.

“There’s something about Safewards that helps to redress that and pay attention to the fact that people who have good skills in managing other people who are upset, those are things that should be highly valued in their own right.”

The Safewards trial is the first of its kind in Australia and the largest one in the world outside the original cluster randomised controlled trial that was used to prove the value of Safewards in the UK. Safewards enables mental health nurses to address ‘flashpoints’ - moments of opportunity to prevent conflict - with specific interventions, while some of the interventions directly target patients.

For the full article visit HealthTimes.com.au

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Transforming dementia care in hospitals

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ustralian hospitals are failing to provide appropriate acute services for people living with dementia.

While one in four people living with dementia require hospital services each year, an Alzheimer’s Australia report shows the hospital environment is often an unsafe place for patients with dementia.

People living with dementia experience worse clinical outcomes compared to patients without dementia in hospitals - they are twice as likely to experience an adverse event such as falls, sepsis or pressure ulcers and three times more likely to experience fractures and delirium.

As a result, people with dementia stay in hospital almost twice as long as those without dementia, they face a fivefold increase in mortality rates and a higher likelihood of readmission.

Alzheimer’s Australia CEO Carol Bennett says while some of those issues are due to the nature of dementia, a lot of the evidence suggests that many of those differences are also largely attributable to the hospital environment.

“Hospitals are a very inhospitable environment in most cases for people with dementia,” she says.

Ms Bennett says improving the quality of acute care for people living with dementia will boost their health outcomes and deliver a more efficient use of our nation’s health care spending.

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“The way that we support people with their dementia really does impact on the quality of life that they can have and the extent to which they manage the condition,” she says. “It really is that simple.

“If we can make the hospital environment more conducive to them having a better quality of life, that will make a huge difference to them, to their families, to their community, to the cost of care of dementia.

“There is a very strong argument that this is a key part of prevention, certainly as far as delaying the onset or the progression of the condition goes.”

The Dementia Care in the Acute Hospital Setting report highlights a range of issues and practical strategies to improve hospital care for people with dementia.

It says dementia often goes unrecognised or undocumented which contributes to the patient’s needs not being met, and calls for the identification of cognitive impairment.

“We know that 50 per cent of people with dementia don’t have their diagnosis documented during their hospital stay so it’s being missed and that’s really alarming,” Ms Bennett says.

Questions about cognitive impairment can be included on a pre-admission form or hospitals could require people at risk of cognitive impairment to be screened within 24 hours of admission, the report suggests.

For the full article visit HealthTimes.com.au

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Wanted - nurses to lead the way in health reforms

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n Australian nursing leader fears the voice of nurses is being left out of the crucial conversation around the nation’s health care reforms.

Australian College of Mental Health Nurses (ACMHN) chief executive officer Kim Ryan said while governments are looking at nursing models to drive change, the nursing profession often remains unheard.

“I look at some of the expert reference groups or commissions and who sits on those groups and wonder where the nurses are,” she said.

“Nurses need to be an equal partner in all of those discussions but I’m not seeing anything from government at all that’s putting nurses in peak positions to be able to be equal players in all of these conversations.

“Nursing is still a highly feminised profession and whether that reduces our relevance and whether we’re just seen to be the caring profession, I don’t know.”

Ms Ryan has called for more nurses and mental health nurses to take up the gauntlet and embrace prominent positions on health agendas at every level, in a bid to achieve a better health system with improved patient outcomes.

Ms Ryan said nurses have a right to stand up and be counted.

“We are the people that are there 24 hours a day, seven days a week and we’re the largest part of the health profession so we’ve got to

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step up and say to these other professions and organisations and governments - you need to hear our voice as nurses,” she said.

“We all have a right to have a vision and have a plan and a purpose about what it is we want to achieve and we can do that with all of our colleagues, we just need to have people standing up and saying - we are important and you need to listen to us.

“Everyone needs to understand more about what nurses can do if they are put into positions to actually provide leadership to people and to the health care system.”

Ms Ryan said it’s important for nurses to understand that leadership is not just for those working in nurse management positions.

Leadership is nurses having a passion and striving to achieve their goal, she said.

“My goal is for people to better understand about the importance of mental health nursing and providing better mental health to our community,” she said.

“I’d like to see a mental health nurse working in every general practice in Australia.

“Now, that’s a goal that I won’t be giving up on. I may not achieve it in my lifetime but certainly I’ll be looking for all the opportunities I can find to continue to advocate for it.

For the full article visit HealthTimes.com.au

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HealthTimes - June 2015 | Page 21

Nursing job interviews

By Karen Keast You’re getting closer. You’ve made it past the nursing job application stage with an exceptional cover letter and resume, and you’ve also addressed the selection criteria. Now it’s time to prepare for the job interview. Here, some of Australia’s nurse recruitment experts share their most common nursing job interview questions.

General questions Nursing interview questions will be specifically targeted to each advertised position. Ensure you know the key selection criteria inside and out, advises Anette Smith, Recruitment and Retention Nurse Manager at the Royal Perth Hospital in Western Australia.

“From the key selection criteria, you really need to think about the questions that are possible. It helps to talk to people about what questions could come from that.”

The job interview will usually include questions on the National Safety and Quality Health Service Standards. It will also include scenariobased clinical and problem solving questions, teamwork and leadership questions, and customer or patient service questions.

Some of these questions will be behavioural questions which are designed to test the applicant for the specific characteristics required for the position, and clinical questions which aim to assess the applicant’s critical thinking skills. These questions enable the

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interviewer to evaluate how well the applicant thinks on their feet and how they would prioritise tasks in a given situation.

Questions can vary slightly depending on the health organisation that’s recruiting.

As a not-for-profit private healthcare provider, nursing recruiters at Victoria’s Epworth HealthCare ask questions about customer service and the values of the organisation. “I think it’s a really good thing for people to ponder how they’re going to work in a values-based organisation,” Liz Powne, HR Manager of Workforce Development says. “I might say to somebody - these are the values of Epworth HealthCare, can you tell me what this value means to you in your practice as a nurse or nurse manager? Can you speak to a time when you were perhaps challenged on this value and how you dealt with it?”

Nurses are also often quizzed on working within their scope of practice. “We might ask them to talk about a task they aren’t familiar with,” says Robyn Fox, Acting Executive Director of Nursing and Midwifery Services at Metro North Hospital and Health Service in Queensland. “What would they do to prepare themselves for that, who they would refer to? It’s very important they don’t undertake a skill or an activity that’s outside their scope of practice, that they haven’t had the education and support for.”

Questions for nurse graduates Nurse graduates may be straight out of university but recruiters will treat finding the right nurse graduate for their organisation just as seriously as filling an executive nursing position. Recruiters are looking for graduates who showcase good interpersonal skills, such as excellent communication and team work, as well as enthusiasm and a caring personality, problem solving skills, those with an inquiring approach to their practice, and graduates who are already considering the future direction of their career. Grade point averages at university are important to the interview panel but emotional intelligence and resilience are just as crucial as academic intelligence, Ms Fox says. “It comes down to how they apply themselves to answering the questions.”

Nurse graduates will often receive a basic level of questioning in their job interview, such as:

* Tell us about yourself? * What qualities do you possess that will make you a successful registered nurse? * What nursing areas pique your interest and why? * What is an effective team you’ve been a part of and what was your contribution to that team? * Why do you want to work here? * What are your strengths and weaknesses? * What do you know about the National Safety and Quality Health Service Standards? * How do you maintain your national registration with the Australian Health Practitioner Regulation Agency?

For the full article visit HealthTimes.com.au

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ZO511242 For further details and to apply visit Job Vacancies on www.hhs.vic.gov.au HealthTimes - June 2015 | Page 23

Psychological impact of rebuilding lives after floods

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new study shows Queensland flood victims experienced more psychological distress in the wake of the state’s devastating floods than as the actual disasters unfolded.

Psychologist Kelly Dixon’s study found lengthy rebuilding processes and difficult experiences with insurance companies in the recovery phase contributed to poor mental health outcomes, including increased symptoms of posttraumatic stress disorder (PTSD), depression and anxiety.

Ms Dixon, a PhD student from Queensland University of Technology’s School of Psychology and Counselling, was working at Lifeline when Mackay was flooded in 2008.

She says talking to flood victims prompted her to investigate their experiences.

“When people go through a really stressful life event, most people find it’s difficult but once it’s over they are okay and some people will continue to struggle for a long time,” she says.

“I’ve always been interested in why - what makes the difference?

“A lot of people did have traumatic experiences or potentially traumatic experiences during the flood itself, especially in Mackay because that was a sudden event, while other people were saying that the stuff going on after the flood was the difficult part for them.”

Ms Dixon’s research focused on investigating the factors that predict psychological outcomes following the Mackay flood and also the

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Brisbane floods in 2011 using a mixed methods design.

In the first study, she explored which aspects of the Mackay flood and its aftermath that people found the most stressful.

The second study investigated the role of flood-related stressors in predicting posttraumatic stress symptoms and depression with 158 flood victims between seven to nine months after the Brisbane flood and 3.5 years after the Mackay flood.

The study found aftermath stress was the strongest predictor of posttraumatic stress symptoms while prior mental health, repair time and self-efficacy were the strongest predictors of depression.

Ms Dixon, a psychologist of 20 years who has a private practice in Mackay, says three quarters of people surveyed revealed the most difficult aspect was in the wake of the flood and dealing with insurance companies.

“What my research highlights is that in these two particular events at least, the rebuilding process actually for a lot of people was more significant, more difficult to deal with than the actual event,” she says.

Ms Dixon says the research also highlighted the impact of insurance companies on flood victims’ mental health.

For the full article visit HealthTimes.com.au

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Thanks in advance, UNSW Team

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HealthTimes - June 2015 | Page 25

Allied health and nursing role in aged care demand

N

ew Zealand’s allied health and nursing workforce has a role to play in finding solutions to alleviate the increasing demand on residential aged care, according to a researcher behind a new study.

University of Auckland’s Freemasons Department of Geriatric Medicine senior research fellow Joanna Broad said delaying or averting entry to residential care, for older people who would prefer to stay at home where feasible, could avert growing demand for residential aged care.

“Stepping up the work on ways to provide adequate/excellent care at home may be one avenue - a range of community-based supports and initiatives can be explored,” she said.

“Because many who enter aged care do so directly from an acute hospital stay, one aspect is evaluating and improving post-discharge care and rehabilitation following acute hospital admissions.

“Allied health workers and nurses will have other suggestions that could be tested. Their voices need to be heard.”

Ms Broad was the leader in a study, recently published in the Australian and New Zealand Journal of Public Health, which found almost half of New Zealanders, aged 65 and over, will move into residential aged care before they die.

With figures showing 38 per cent of those aged 65-plus in New Zealand die in residential aged care, researchers examined the extent of people living in residential aged care who die during stays in acute hospitals.

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They found another nine per cent die during those hospital stays, taking the total to 47 per cent.

“We know from our data that this is an under-estimate, so about half of all older New Zealanders will move into care at some stage of their lives,” Ms Broad said.

“That contrasts greatly with the estimate of five to six percent of people aged 65-plus living in care at any one time, in NZ and in other countries.

“We think this will be of interest to people and their families planning their retirement, and to health service providers, government agencies, organisations supporting older people, and to insurance companies.”

Researchers found the median overall estimates of lifetime use of residential aged care for people aged 65-plus varied among other countries.

The median report for United States was 41 per cent, Finland stood at 47 per cent, the United Kingdom at 28 per cent, and Australia ranged between 34 and 53 per cent.

With an ageing population and increasing longevity, researchers pointed to a need to monitor residential aged care use and to better understand the pressures that lead to residential aged care entry and the determinants of length of stay.

For the full article visit HealthTimes.com.au

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hays.com.au HealthTimes - June 2015 | Page 27

Dietitians keeping the body in mind

By Karen Keast

A

pioneering Sydney program is tackling the nutritional and physical health of young people with severe mental illness.

Keeping the Body in Mind is possibly the first Australian initiative that works to improve the physical health outcomes of people with early psychosis.

The program, which features an Accredited Practising Dietitian (APD) and exercise physiologist, has been shown to reduce antipsychotic-induced weight gain in clients aged between 15 and 25.

Operating out of the Bondi Junction Community Health Centre since 2012, the program has been such a success it’s now being expanded beyond the early psychosis program to all mental health services across South Eastern Sydney Local Health District.

PhD candidate and APD Scott Teasdale said the benefits of the program prove it’s time to transition more dietitians into working in the field of mental health.

“It’s a simple concept but it’s a very challenging cohort and I think it’s time that we can start moving APDs into early psychosis as core members of the mental health team,” he said.

“Keeping the Body in Mind has been so effective that there are now three full-time mental health dietitians targeting early psychosis and established severe mental illness in South Eastern Sydney Local Health District.”

Mental health teams are traditionally formed with psychiatrists, case managers, nursing specialists, occupational therapists and social workers - all targeting the mental health recovery of the client.

While some inroads have been made in addressing the nutritional and physical health in established mental illness, this program targets the crucial initial two years of psychosis,

Page 28| www.HealthTimes.com.au

when clients begin taking their antipsychotic medication.

The program features embedded lifestyle interventions, through an APD and an accredited exercise physiologist, as part of a multidisciplinary mental health team.

Mr Teasdale, who spoke about the program at the Dietitians Association of Australia’s recent 32nd national conference, said the program addresses the rapid weight gain that occurs as a result of antipsychotic medication.

“We’re seeing twice the rate of diabetes and two to three times the rate of obesity in these clients compared to the general population, which leads to a 15 to 20 year mortality gap,” he said.

“Their hunger significantly increases from the outset of antipsychotic use. For a lot of people it becomes insatiable and includes constant cravings for sweet foods and drinks.

“Combined with lower education levels, lower culinary skills, restricted budgets, and potentially impaired cognitive functioning, we find people experiencing psychosis consuming large amounts of cheap, convenient, processed food.

“It’s not good for their mental health and it’s obviously not good for their physical health either.”

Under the program, Mr Teasdale provides best practice intervention which ranges from one-on-one consultations to practical initiatives such as mindful eating, cooking groups and shopping tours.

“A lot of these young people do not get the opportunity to cook a meal and sit down as a family to eat, which I believe is a crucial part of therapy,” Mr Teasdale said.

For the full article visit HealthTimes.com.au

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Time to grow your career at HealthTimes.com.au HealthTimes - June 2015 | Page 29

Allied health students lend a helping hand in Malawi

By Karen Keast

E

xercise physiologist Cody Waldon has a new perspective on helping people reach their health goals after providing treatment as part of an aid mission to Malawi in Africa.

The 22-year-old former Graduate Diploma in Exercise Science student, from Elanora on the Gold Coast, last year joined a group of Griffith University physiotherapy and exercise physiology students and lecturers in the landlocked country - one of the world’s least developed nations.

The group worked with organisations 500 miles and African Vision Malawi to provide disability assessments, develop exercise plans, provide patient education and to fit orthoses and prostheses to patients.

Cory said the group assisted people with epilepsy and stroke as well as children with club foot, while they also helped people suffering with unmanaged arthritis and joint pains.

“It gets to the point where the pain becomes severe enough for them to change how they move or change what they’re doing to get around,” he said.

“That has a long term effect because they change their gait and change how they move just to suit the pain which then can lead to almost deformities and things like that.

“With a lot of the movement type issues and the arthritis or joint pains, a lot of the time it was getting them to do a range of movement exercise or small strength-based exercises - generally if you can strengthen the area around it, it gives it some more support and can reduce the pain.”

Cody said the experience also pushed him beyond the boundaries of his exercise physiology knowledge and skills.

Page 30| www.HealthTimes.com.au

“We had one girl with cerebral palsy that had some sort of strange allergic reaction - had quite severe swelling on her hands, feet and face that hadn’t been spotted by anybody,” he said.

“We immediately sent her to the hospital - it was a simple thing but it was more of a medical concern than an exercise physiology one.

“Even though some of these things weren’t your scope and you couldn’t help specifically with what was going on, you had to still problem solve to figure out how you could help or to find someone who could.

“Having those things come up that were well outside your scope of practice but you still had to deal with were the most challenging and the most rewarding.”

During the aid mission, the group came across hospital physiotherapists using simple tools such as old tin cans and balls to perform mobility exercises with young children.

Now working at a private practice in Tweed Heads, Cody said the experience had left an indelible impact on the way he approaches his practice.

“I certainly start to think a little more straightforward to the goals that the person wants to achieve now, whereas before you would pick up a referral and look at whatever their issues were and you’d devise a huge plan of where you’d want them to be from a health point of view,” he said.

“In the end, sometimes if the person says - I want to be able to get up out of my chair and walk to the fridge or be able to go for a nice walk with my kids around the river - that’s sometimes more important than anything else.”

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HealthTimes - June 2015 | Page 31

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