InScope No1 Autumn 2017 by Queensland Nurses and Midwives' Union

The official journal of the Queensland Nurses and Midwivesâ&#x20AC;&#x2122; Union

Autumn 2017

NEW LOOK, NEW ERA QNU now QNMU

The time is now: AGED CARE SAFE STAFFING

A helping hand SUPPORTING DOMESTIC VIOLENCE SURVIVORS

PLUS! LOTS OF CPD ARTICLES WITH REFLECTIVE EXERCISES

QNMU Scholarships now open

After a review and revamp, we’re pleased to announce our 2017 scholarship program.

QNMU members have an opportunity to receive financial support packages to assist them with their studies or professional development.

SCHOLARSHIPS AVAILABLE NOW: ■ Aboriginal and Torres Strait Islander scholarship – $3000 awarded whole or in part to an Aboriginal and/or Torres Strait Islander QNMU member to enhance their professional skills through appropriate study. ■ Undergraduate book bursary – 8 x $500 book bursaries to undergraduate nursing and midwifery students, with the aim of relieving some of the financial pressure for these students. ■ Postgraduate book bursary – 1 x $500 book bursaries to Enrolled Nurses and Registered Nurses and Midwives engaged in postgraduate studies relevant to their professions. ■ Pat Nichols Bursary – $500 to advance diabetes education and promotion by supporting a member in this field. We’ll have more scholarships on offer later in the year, so keep an eye out in future journals and qnews. All financial QNMU members are welcome to apply.

For more information on current scholarships and to download applications forms, visit www.qnmu.org.au/scholarships.

APPLICATIONS CLOSE FRIDAY 16 JUNE 2017.

INDEPTH

A helping hand: Nurses and midwives supporting domestic violence survivors

THE OFFICIAL JOURNAL OF THE QUEENSLAND NURSES AND MIDWIVES’ UNION ISSN 2207-6018 ABN 84 382 908 052

INDEPTH

IN FOCUS – CPD

38 41 42 43

Elder abuse: Recognise and report it

44 45

Wellbeing at work

106 Victoria Street West End Q 4101 (GPO Box 1289 Brisbane Q 4001) 07 3840 1444 1800 177 273 (toll free) F 07 3844 9387 E inscope@qnmu.org.au W www.qnmu.org.au T

EDITOR Beth Mohle, Secretary, QNMU PRODUCTION QNMU Communications team: Linda Brady, Melissa Campbell, Stephanie Lim, Luke Rutledge PUBLISHED BY The Queensland Nurses and Midwives’ Union PRINTED BY Fergies Print and Mail

16 22 25 26 28 30 32 34

Autumn 2017

FEATURE

Rain, hail or cyclone, nothing stops a Queensland nurse or midwife FEATURE

A helping hand: Nurses and midwives supporting domestic violence survivors PROFILE

Looking after our own: Speaking up on Aboriginal and Torres Strait Islander issues

Active patient participation in beside handover Shift handover: Don’t disregard your duty of care Nurses leading global research in partnership with clinicians and health consumers

REGULARS

INSIGHT

TEA ROOM

WINS

JUST IN

INCOMING

IN VIEW

Next on the penalty chopping block... nurses and midwives?

CALENDAR

FEATURE

ADVERTISING

PROFILE

Calling the midwife CAMPAIGN

Aged care safe staffing: The time is now OPINION

America 2017: Land of the not-so free

Good food means better health for shift workers

CAMPAIGN

Ratios rolling along FEATURE

Gender in nursing and midwifery: Should we care and why? CAMPAIGN

At the heart of nursing

DISCLAIMER: Statements expressed in articles in InScope are those of the contributor and do not necessarily reflect the policy of the Queensland Nurses and Midwives’ Union unless this is so stated. Copyright of articles remains with the contributor and may not be reproduced without permission. Statements of facts are believed to be true but no responsibility for inaccuracy can be accepted. Other material may be reproduced only by written arrangement with the Union. Although all accepted advertising material is expected to conform to the QNMU’s ethical standards, such acceptance does not imply endorsement. Visit www.qnmu.org.au/privacy to read our privacy statement.

insight

Your voice at a federal level Sally-Anne Jones QNMU President

JUST A few weeks ago, nominations were called for the elections of the Federal President and Federal VicePresident of the ANMF and I am proud to share that I have been reelected unopposed as your Federal President.

I fear the potential ‘uberisation’ of home health care — where the cheapest offer gets the job and there is no safety net of regulation, carer education, higher order skills, no standards, and no safety and quality checks.

In that capacity, and as an example of how QNMU members are represented at the federal level, I recently participated in a Fair Work Commission panel at a forum titled ‘Future of Work’.

Furthermore, while there is an increase in the number of people needing more health care support, the skilled workforce required to provide this care is either stagnant or shrinking.

It was an opportunity to speak to some of the challenges we face as nurses and midwives, focusing on the issue of our aging population.

Data abounds about the deficits to be expected in the nursing and midwifery workforce of the future. Not only is the workforce aging, the emerging workforce is not staying.

I spoke about the tsunami of baby boomers headed our way, if not already hitting our hospitals and health services. I noted that we’re all expected to live longer and survive what were once catastrophic accidents and diagnoses, and that more people over 85 will likely need care and be admitted to hospital. As our population gets older, we will also need nurses who know how to nurse the older person, and this goes beyond assisting with a shower or dressing someone.

For the ageing nursing workforce, we need solutions that harness their wisdom and experience and keep them in the workforce longer to inspire and mentor the emerging workforce. Nursing is hard physical and emotional work. It takes its toll on people. Flexibility in work arrangements may be the key. For the emerging workforce, our problem is not one of supply but what we do with them in the immediate post graduate period.

...I am proud to share that I have been re-elected unopposed as your Federal President. professions face, both now and into the future. Fortunately, nurses and midwives have a voice and can influence change — that’s why your union exists, whether it be through the QNMU or, at the federal level, the ANMF. I look forward to representing you for the next four years and advocating for positive change.

QNMU COUNCIL

The increasing prevalence of mental illness within the older population is a separate and equally distressing conundrum.

Many graduate nurses, ready for work, cannot find a permanent nursing position to go to straight out of university.

SECRETARY :

On a positive note, the rise of the Consumer Directed Care movement is empowering people to determine what care they get, where, by whom, and how much they pay for it.

And finally, not all nurses need to have a Bachelor degree or more.

COUNCILLORS :

It is a genuine customer service approach based on the choices of the consumer.

We need more density in skill than that. We have an untapped resource in the third year undergraduate students — with appropriate scope and supervision, they can participate in the care we need to give.

However, there are risks in taking this too far.

These are just some of the big ticket issues the nursing and midwifery

Beth Mohle

ASSISTANT SECRETARY : PRESIDENT :

Sandra Eales

Sally-Anne Jones

VICE PRESIDENT :

Lucynda Maskell

Julie Burgess Christine Cocks Karen Cooke Dianne Corbett Gillian Gibbs Jean Crabb Shelley Howe Phillip Jackson Leanne Jiggins Damien Lawson Lucynda Maskell David Lewis Simon Mitchell Fiona Monk Sue Pitman Dan Prentice Katy Taggart Karen Shepherd Kym Volp Deborah Watt Charmaine Wicking

insight

A new era for our union Beth Mohle QNMU Secretary

WELCOME to the Queensland Nurses and Midwives’ Union and our new look journal InScope! As you would be aware, delegates to our annual conference in July last year determined to change the name of our union to formally recognise midwives. Although midwives have been included in our tag line — the union for nurses and midwives — for many years, the determination to change our name is historical and brings us into line with other branches of the Australian Nursing and Midwifery Federation.

about their jobs and communications preferences – what topics they were interested in, how this is best presented, the frequency of communications and the various communication channels available. A very important element of these discussions was their emotional attachment to our union and how this is reinforced through our communications. So much is communicated through colour, font, type and shape. These insights have all been incorporated into the redesign of our logo.

Changing a name may seem like an easy task, but it involves a lot of planning and hard work by many.

Although our much loved logo has served us well since the early 1980s, it was time for a change.

I would like to take this opportunity to acknowledge and thank all those involved.

Some elements of our previous logo have been kept as an acknowledgment our past and where we have come.

On 1 March 2017 I witnessed a historic hearing at the Queensland Industrial Relations Commission when Deputy President Swan approved our union’s name change. This also provided us with a rare opportunity to review the “branding” of our union — the way we present ourselves to members, potential members and the wider world. Last year we undertook significant work on our communications with members, which included enhancing our digital presence. So after the annual conference determination this work was expanded to include our name change and an accompanying new “look and feel”. This involved listening to our members and potential members

But our new look is one that is in keeping with a 21st century professional, creative and responsive union. For more information about our name change see page 7. This rebranding and renaming work made us realise the importance of communicating to our members how we are making a difference everyday — to you, our professions and the broader community. Just like our members, we are so busy doing what we do that we easily forget to tell the story of what we are doing and why our work is important.

by engaging you through shorter, sharper and regular digital communications. This first edition of our new look quarterly journal InScope is the next element of our communications revamp. It’s content is driven by member feedback for more professional and CPD content and an increased focus on nursing and midwifery work. We all have an opportunity to celebrate this new era for our union, and how we are making a difference through our participation in Labour Day marches across the state this year. For the first time ever our union will be leading this march. This provides us with the opportunity not only to showcase our new brand and logo but also to celebrate being the largest union in Queensland and highlight the critical issues of concern to nurses and midwives. Labour Day is a wonderful celebration of the collective achievements of our movement in a family environment. Details of this annual celebration across the state can be found on page 7. Please join us in celebration of how, through our work, we are all making a difference.

We have already begun to incorporate feedback from nurses and midwives, and advice from communications experts, into our communications with members

tea room m Q A

We sometimes take it for granted that everyone knows their entitlements. However, for new entrants to the nursing and midwifery workforce it is often difficult to understand the plethora of entitlements and payslips across our profession. In fact, many nurses and midwives are uncertain about which allowances, loadings and penalties they are entitled to given the diversity of their work and working hours. The following questions are frequently asked of our Member Connect call centre.

Have you received a letter from AHPRA or the Health Ombudsman? The QNMU assists financial members with notifications from AHPRA or the Health Ombudsman (OHO). As soon as you receive a letter or email from AHPRA or the OHO you should complete a Request for Representation (RfR) form, available on our website, and forward copies of all correspondence and attachments you receive to the QNMU. You should not respond directly to a notification from AHPRA or the OHO without QNMU assistance. The QNMU retains the services of a law firm to help you directly with your AHPRA or OHO matters. But please remember, your matter cannot progress through us until your documentation is received. Deadlines set by AHPRA and the OHO need to be met on time as extensions are not normally granted. We understand how stressful these matters can be for members and their families. Remember, the QNMU is here to help you. Complete your RfR form, send in your documentation, and someone from our legal team will contact you.

If you have questions for our Tea room column email memberconnect@ qnmu.org.au

To complete your RfR form visit www.qnmu.org.au/rfr

Random drug testing: Your rights and responsibilities While the QNMU does not support workplace drug testing, whether regular or random for nurses or midwives, various courts and tribunals have supported drug and alcohol testing on workplace health and safety grounds. Indeed, some industries, particularly mining, have a legislative framework that allows for drug testing. Ordinarily, if an employer wishes a worker to undergo a random drug test they would be required to have a drug and alcohol policy in place prior to the introduction of any testing.

Asking a nurse or midwife to submit to a random drug test is a very invasive request. If this happens to you, contact the QNMU immediately. We also encourage members to contact the QNMU if their employer seeks to introduce a drug and alcohol policy so we can participate in discussions around its necessity or scope.

Are you covered by Professional Indemnity Insurance (PII)? We’ve recently heard from a number of members who have been audited by AHPRA regarding their PII cover. According to the PII requirement, a practitioner must not practise the profession in which they are registered unless they have appropriate PII arrangements in place. Nurses and midwives need to demonstrate they are covered by PII for the entire period they have been practicing. That’s why it’s important to make sure your union fees are up-to-date – if you let your membership fees lapse, you may not be covered for PII by the QNMU. QNMU membership provides you with comprehensive PII. As a member, you’re covered for up to $10 million for each and every claim, and $70 million in the aggregate. This is the most cost effective way for nurses and midwives to ensure coverage at work. Please note: midwives in private (independent) practice, self-employed or not working under a contract of employment are not eligible for PII cover. For more information, or if you’ve got any questions about your membership fees or need to check you’re a financial member, call 3099 3210 or 1800 177 273 (toll free outside Brisbane).

wins

TriCare’s appalling Long service agreement terminated leave FOLLOWING the QNMU’s application to recovered for the Commission, TriCare’s poor workplace (EA5) has finally been terminated Opal members agreement after six months of litigation! THE QNMU has also successfully recovered more than $38,000 in unpaid long service leave for Opal aged care workers.

Not content with paying some of the lowest wages in aged care, TriCare also employed some staff on many conditions that were below the Award.

The QNMU investigated the issue after some of our members raised concerns about inaccurate long service leave accruals on their payslips.

The QNMU spent about 18 months opposing EA5 in the Commission. Since 2012, base wages in the Award have increased each year, leaving many EA5 rates well and truly behind.

We were able to recover 1680 hours of long service leave amounting to more than $38,000 — all of which will go back to our members.

The termination of this disgraceful agreement means our aged care workers are now better off with improved entitlements under the Nurses Award 2010, including: ■ Guaranteed minimum hours for part time employees by agreement ■ Rostering arrangements for part-timers must be agreed with the employee ■ Pay increases every July that will continue to lift wages beyond EA5 rates.

QNMU recovers public holiday leave for Ramsay members QNMU HAS recovered a whopping 4300 hours of unpaid leave plus money amounting to $185,000 — all of which will go back into the pockets of 170 Ramsay nurses and midwives. QNMU fought for our members after Ramsay unlawfully deducted their leave in respect of public holidays not worked.

QNMU HAS RECOVERED 4300 HOURS OF UNPAID LEAVE PLUS MONEY AMOUNTING TO

$185,000!

Part of the solution QNMU PRIVATE Hospital Organisers have been invited to hold joint forums on workload management and professional practice obligations at a number of private hospitals around the State. The forums are conducted with QNMU Organisers and facility managers following discussions at consultative committee meetings where workload management is a standing agenda item. These committee meetings are also known as a Local Consultative

Committee, Hospital Consultative Team or Staff Consultative Committee meeting. Members benefit from a forum where workload strategies are discussed and resolved between members, QNMU Organisers and managers. If you would like to work with your local Organiser to address workload management issues please contact the QNMU.

Training allowance recovered for CQHHS members A CONVERSATION with a QNMU member recently uncovered a $30,000 hole in allowances paid to AINS at the Central Queensland Hospital and Health Service. The QNMU discovered some AINs had not been paid the targeted training allowance (Cert III) and was able to help members recover nearly $30,000 in back paid allowances. This is a big win for our members and a reminder of why it’s always important to check your payslips!

wins

Member wins against employer retaliation PROUD QNMU member Janet Baillie celebrated a legal win against her former employer recently after exposing their attempts to silence her workplace activism. The Red Cross Blood Service was fined $20,000 and ordered to pay Janet $5000 in compensation, after the court found the service had engaged in adverse action and contravened the Fair Work Act. Adverse action is activity that unfairly targets a worker for exercising their lawful workplace rights. In Janetâ&#x20AC;&#x2122;s case, she was targeted for engaging in protected industrial action which included wearing and displaying stickers and badges, distributing campaign material in support of an enterprise bargaining campaign, and encouraging other Red Cross employees to participate in protected industrial activities. Representing Janet in the Federal Circuit Court, the QNMU said Janet had stood up for better wages and skills retention during enterprise negotiations and her employer had retaliated by making false accusations of unsatisfactory performance against her.

Janet Baillie presents QNMU Secretary Beth Mohle with a framed print as a thank you gift.

Protected industrial activity is a workplace right, and great outcomes like this are a warning to employers to play by the rules. Members who have had adverse action taken against them should contact the QNMU.

Left to right: Sandi Emblem, Kevin Crank, Janet Baillie and Sue Condon

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QNMU to lead Labour Day marches IT’S BEEN a long time coming but the QNMU has finally been given the honour of leading the Labour Day marches across the state this year.

NEW LOOK, NEW ERA QNU now QNMU TIMES they are a-changin’ at your favourite union, and it’s all rather exciting! By now you will have noticed we have a new name, a new logo and a flash new looking journal — you may have even noticed our website looking fresh and different and a rather spiffy set of new social media handles. Yes the QNU is now the QNMU, a fantastic milestone that recognises the separate but associated profession of Midwifery and brings it formally into our name. The QNU officially became the Queensland Nurses and Midwives’ Union (QNMU) on 2 March. Of course midwifery has been part of our full title for a while – QNU: The union for nurses and midwives — but it wasn’t quite the same. Adopting a new name also gave us the perfect excuse to refresh our branding which is why over the next few months you’ll see a whole new suite of QNMU material roll out. We had to change everything to QNMU anyway, so why not go the whole hog!

Of course you may still get some material bearing our old logo and name, but that will change as the old stock is exhausted. If you look closely you’ll see we’ve stayed in the blue and pink colour range — not straying too far from the old colours, and reflecting marketing science that says people associate blue hues with trust and integrity, and pinks with care, respect and sensitivity. And you’ll note we’ve added some purples in there too to recognise the strength of women given our predominantly female workforce. Our lovely healthcare cross motif is a nod to our old logo and you’ll see we have a great new motto “Making a difference” which lends itself wonderfully to the work we do as nurses, midwives and unionists. Oh and our journal has a new name too — InScope referring to our scope of practice, the scope of our activities and work, and putting things under scrutiny. There’s a lot to take in but we hope you like it. So here’s to the next chapter in our fantastic organisation.

Despite being Queensland’s biggest union, the QNMU has never led the march — but this year, the same year we celebrate a name and branding change, it’s all ours! The new branding means we’ll be marching with bold new t-shirts, flags and banners which are sure to make us one of the most colourful groups in the parade. But we need as many people as possible to really make the most of this great opportunity, so please come along and bring a friend or three. You’ll receive a free t-shirt!

Event details In Brisbane, the Labour Day march will begin as usual from the corner of Wharf and Turbot streets at 10am on Monday 1 May, and end with a family fun day at the RNA Showgrounds. Elsewhere around Queensland, marches and celebrations will take place as follows: SATURDAY 29 APRIL: Bundaberg, Ipswich, Cairns, Toowoomba SUNDAY 30 APRIL: Sunshine Coast, Gold Coast, Maryborough MONDAY 1 MAY: Rockhampton, Gladstone, Mackay, Townsville, Moranbah For more details about events in your area visit the QCU website at: www.queenslandunions.org/event/ The annual marches are an opportunity to celebrate union achievements, including the eighthour day and minimum wages, and strengthen our resolve to defend hard won wins like penalty rates.

2016 Labour Day march, Brisbane

COME ALONG AND GET A FREE T-SHIRT! 7

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NEW GROUP SHINES A LIGHT ON REFUGEE ISSUES THE QNMU has started a new special interest group to support the fair and compassionate treatment of refugees. Nurses and Midwives for Refugees and Asylum Seekers (NAMRAS), was established late last year after members involved in the Baby Asha vigil at Lady Cilento Children’s Hospital raised the idea of the QNMU forming a refugee activist group. The new group, which was given the green light by QNMU’s council in December, is now part of our social justice agenda and taps into our nursing and midwifery, and union values. “As nurses and midwives, our values of caring and advocacy dovetail neatly with the need to ensure refugees and asylum seekers are treated humanely and with dignity,” QNMU councillor and NAMRAS founding member Janet Baillie said. “And of course as unionists who believe in equality and a fair go for all, we can’t just turn a blind eye to the appalling policies that harm and disadvantage vulnerable people seeking safety.” The group is still in its infancy and based in Brisbane for the moment, but we do have a Facebook page open to all interested QNMU members and are hoping to reach out to the rest of the state via teleconferences and other means over the next 12 months. So far our small founding committee have represented NAMRAS at the Multicultural Development Association’s (MDA) Welcomefest

and the Baby Asha vigil one-year anniversary. The QNMU is also one of the foundation members of the Unions for Refugees Committee run by the Queensland Council of Unions.

NAMRAS Nurses and Midwives for Refugees and Asylum Seekers

ACTION ON ICE

If you are interested in joining NAMRAS please email Linda Brady at lbrady@qnmu.org.au Useful resources: QNMU Social Policy on refugees and asylum seekers www.qnmu.org.au/policysheets NAMRAS Facebook page www.facebook.com/ namrasofficial

QNMU NURSES and midwives will participate in upcoming summits to help the government fine-tune a plan to tackle the drug, ice. Premier Annastacia Palaszczuk has released a draft plan to tackle the growing problem of ice (crystal methamphetamine) in our community. The draft plan, Action on Ice, informs Queenslanders about the drug and its effect on individuals, families, front line service providers and the community. As part of consultation on the draft plan, a number of summits will be held around the state — the first in Rockhampton on 27 April. The QNMU will ensure nurses and midwives are in attendance. For more information or to view the draft plan, visit www.getinvolved.qld.gov.au/gi/ consultation/3602/view.html

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Midwives looking out for each other IT WAS all about Y-O-U! Midwives from across Queensland came together at the Midwifery Wellness Event last month to pick up some practical tips and advice about taking care of themselves and each other. Having grown increasingly worried about the wellbeing of her fellow colleagues, QNMU member and RBWH Registered Midwife Jenny Hopman approached the QNMU with the idea for the event. “One of the biggest challenges facing our profession is burnout,” Jenny said. “Midwives are nurturers and we all care very deeply about the women and families in our care… but it can be a challenge to care for ourselves.

“I hope midwives got some useful information to take home and start using in their practice.” Midwives heard from qualified wellness experts such as clinical psychologist Carrie Thomson-Casey, clinical nutritionist Audra Starkey and clinical hypnotherapist Bree Taylor Molyneaux. It was a great opportunity to meet midwives from across the state — including as far as Kingaroy — and share each other’s experiences and stories. Members interested in organising similar events are encouraged to speak with their local Organiser. See page 49 for more pictures from the event.

QNMU member and Midwifery Wellness Event organiser Jenny Hopman (left) pictured with QNMU Assistant Secretary Sandra Eales.

“As we know self-care has flowon effects for everyone in our lives including our colleagues.

Carrie Thomson-Casey speaking about the the physiological and psychological aspects of burnout and stress.

QUEENSLAND HEALTH PAYROLL – don’t repay unless you’re certain

Left to right: Carrie Thomson-Casey, Bree Taylor Molyneaux, Jenny Hopman and Audra Starkey.

WE’RE AWARE Queensland Health has recommenced seeking repayments from nurses and midwives who it claims have been overpaid as part of its ongoing payroll debacle. A reminder of the QNMU’s long standing position that members should be absolutely sure they incurred an overpayment under the payroll debacle before repaying any money to Queensland Health. Members are understandably angry at the thought of having their

pay docked based on the calculations of a faulty system. Our view is that any money asked for should be proven to be owed by Queensland Health. Queensland Health needs to provide objective evidence to show that you have been paid and owe the money they are requesting you to repay. If you’ve been approached by QH about making repayments, contact us immediately for assistance on 3099 3210 (or toll free outside Brisbane on 1800 177 273).

No excuse for abuse! 10 May Cairns Occupational violence is on the increase in both frequency and severity and is the subject of a taskforce report recently published. This important course will unpack the taskforce recommendations and provide some strategies to implement now in your workplace to assist in providing you and your co-workers with a safer workplace.

Union Training Program APRIL – JUNE 2017 Aged Care - Rosters, workloads and consultation 26 April Brisbane Often nurses are so busy at work that it can be difficult to stop and think about what needs to be happening to make resident care safer. When there are workload and rostering issues at work, it becomes hard for everyone. Come along and find out what we can practically do to improve these issues in your workplace.

Aged Care and Private Hospitals - Getting prepared for our next agreement 27 April Brisbane The course covers the enterprise bargaining process step by step with a focus on how we can achieve the best bargaining and campaigning outcomes for members quickly. Come along and find out how to make your next agreement your best agreement.

QH - Consultative Committees - How to make them work 4 May Brisbane The course will cover how we can make consultative committees’ work, how to get more involved and what we can do when the committee isn’t working properly. Knowing how to get issues addressed and responded to is the key to seeing real improvement for nurses and midwives locally.

Assertiveness Skills 9 May Cairns The assertiveness skills course is designed for anyone who wishes to communicate their ideas more clearly and confidently in a team environment. In this program, participants will focus on skills to generate mutual understanding and cooperative outcomes in both personal and workbased relationships.

Creating a safe workplace (WH&S) 11 May Cairns 15 June Gold Coast Nursing unions throughout Australia have made significant inroads into improving the health and safety of our members. This course aims to provide nurses and midwives with practical advice and tools to create a safe workplace culture.

Workplace Representatives 1 (3 day course) 16-18 May Brisbane This course assists activists and potential activists to develop the skills required to organise their workplace. Members should have completed the Being a QNMU Contact in the Workplace course before they enrol on Workplace Representatives 1.

QH – BPF for NUMs and MUMs 24 May Brisbane As a NUM or MUM preparing your service profile, calculating Nursing/Midwifery hours per patient day and getting your Service Profile and resource allocation signed off in accordance with EB9 can be a challenge. BPF notional ratios are mandatory for all settings including those that have legislated prescribed ratios. This course takes us through working up a Service Profile, calculating Nursing/Midwifery Hours per patient day and resource allocation, and finally getting the BPF signed off and operational in your unit. All members are welcome at this course.

Knowing your entitlements and understanding the Award! (2 day course) 30-31 May Townsville What are my entitlements right now in 2017? Am I in the State or Federal Industrial Relations system? How do I find my entitlements and find answers to my questions? This course is a must for all nurses. It’s about knowing how to determine your entitlements and how to find that information quickly.

QH Rostering – Equity & Work Life Balance 1 June Townsville Poor rostering practices are often the result of running a service that is too large with staffing numbers that are too small, resulting in poor patterns of rostering, difficulty with accessing all forms of leave and even non-compliance with your basic entitlements. Come along to find out how to improve the roster in your work unit.

Aged Care and Private Hospitals Everything you wanted to know about your agreement but were afraid to ask! 14 June Brisbane Understanding your new agreement and what you are entitled to is that final step in bringing your enterprise agreement to life. This course will allow you to get really familiar with your own agreement through practical activities. We will answer the tricky questions and look at ways to address issues in this agreement and how we raise issues for the next agreement too.

QH - How to make the BPF work for nurses and midwives 14 June Gold Coast QH is required to implement the Business Planning Framework (BPF) fully in every unit however there are lots of compliance issues. The BPF ratios sit on top of the legislated ratios. So if the BPF is not working properly in our unit it is time we got that sorted out. This course takes us through working up a Service Profile, calculating Nursing/Midwifery Hours per patient day and converting HPPD into notional nurse/midwife: patient ratios. We’ll then explore the barriers to implementing the BPF and how to address those barriers. This course is open to all levels of nurses/ midwives in the public sector and vital for every nurse and midwife.

Aged Care and Private Hospitals – How to raise issues and feel safe 15 June Brisbane Fear can often be the thing that stops us raising important issues in the workplace. Many times issues can be worked through easily but if a problem does arise it’s important that we know our rights.

Health & Safety Representative training for nurses and midwives (5 day course) 19-23 June Brisbane (Approved Training for H&S Reps Facilitated by Safe Work College) This is employer paid training and leave for elected Health and Safety Representatives (HSRs) and Deputies. Please contact us for an information kit. This course supplies the knowledge and skills needed by elected HSRs and Deputies to exercise their powers and entitlements as specified in the Work Health and Safety Act 2011. HSRs will gain an understanding of the objectives of the legislation, knowledge of their role under the legislation, skills in representing workers, skills in identifying workplace health hazards and the processes by which they can be controlled and practical skills in undertaking workplace inspections.

Courses are extremely popular and book out quickly. Avoid being disappointed. Get your enrolment in early.

To enrol visit www.qnmu.org.au/education or phone 3840 1431

just in 5 MAY INTERNATIONAL DAY OF THE MIDWIFE

12 MAY INTERNATIONAL NURSES DAY

Nurses and midwives rock! GET READY to take a well-earned bow ladies and gents because your international days of celebrations are just around the corner. International Day of the Midwife on 5 May and International Nurses Day on 12 May are an opportunity for us to pause, breathe, reflect and celebrate our role as the heart of our health system. Sometimes we are so busy with the day-to-day rigours of our working life that we forget how fabulous we really are! The truth is, we make a difference to thousands of people every day. We make a difference to our patients and residents, to their families and loved ones, and to our communities. We save lives and keep patients and residents safe, we educate and innovate, we guide new life into the world, we protect the vulnerable, and we give hope and comfort to those who are frightened and in pain.

This year the QNMU is encouraging members to be kind to themselves and their colleagues, and these two commemorative days are a perfect opportunity to do just that. Positive workplaces are better for everyone’s health and wellbeing. They are also more productive. For nurses and midwives, workplaces where colleagues have each other’s back and staff feel valued and respected are generally less stressful and less prone to error — which of course means better outcomes for our patients and residents. So this May, share the love! Celebrate the important role you and your colleagues have, and take a moment or two to acknowledge one another for a job well done. SNAP HAPPY: If you or your colleagues are holding events to celebrate please send us your pics — we have a Facebook page we’d love to share them on!

Get your pink on for the Mother’s Day Classic RIGHTO folk, dust off your sneakers and slap on some sunscreen — it’s time to hit the streets for the annual Mother’s Day Classic fun run (or walk!). The annual fundraiser will be held around the country on Sunday, 14 May to raise money for research into breast cancer programs and the National Breast Cancer Foundation. The run is celebrating its 20th year this year and over the past two decades has raised more than 30 million dollars for breast cancer research. In addition to events in Brisbane at Southbank and the Gold Coast at Broadbeach, regional events have been confirmed for Bowen, Cairns, Hamilton Island, Hervey Bay, Innisfail, Mackay, Magnetic Island, Sunshine Coast, Tannum Sands, Tin Can Bay and Toowoomba. There is likely to be a few more locked in so be sure to keep an eye out. For more information or to register, visit www.mothersdayclassic.com.au

New CPD ‘toolkit talks’ NEED CPD points but would rather remain in the comfort of your own home? Our new webinar ‘toolkit talks’ might be just the thing for you!

Webinars will be advertised through our monthly qnews email, including details on how and when to register.

These monthly webinars focus on various topics and issues relevant to NUMs and MUMs, but are open to all QNMU members. Each session lasts an hour and includes a guest speaker talking about issues that assist you in delivering your roles.

■ Thursday 20 April – Collegial Generosity – Mary Chiarella

All you need to participate is an internet connection.

Upcoming ‘toolkit talks’:

■ Tuesday 16 May – The Barrett Inquiry – Sally Rob and Judy Simpson ■ Tuesday 20 June – Building a learning circle – Sam Woodhouse To enrol visit www.qnmu.org.au/education

just in

Driving solutions for car parking woes

just in

THE QNMU is aware of members’ concerns around car parking in a number of hospital and health service facilities around the state, and we have been working with management and the government to tackle them.

ROCKHAMPTON HOSPITAL

Here’s a quick update for members working in these locations…

The QNMU has been representing members at weekly meetings with the Central Queensland Hospital and Health Service to keep abreast of construction and raise any potential issues.

SUNSHINE COAST UNIVERSITY HOSPITAL Staff at SCUH now have access to reduced parking rates through an annual pass, which is also available at a pro-rata rate for part time employees.

Car parking capacity at Rockhampton Hospital will double from 400 to 800 following construction of a new car parking facility later this year.

While acknowledging there are challenges around building a new car park, an important part of our role in

these meetings is to raise, and seek resolution to, staff safety concerns about interim parking arrangements. While we are still in the early stages, the QNMU is working to ensure that security measures will be in place to ensure the safety of staff across all shifts as well as those who may be on call. We will continue to keep open channels of communication with CQHHS and members until the car park is complete.

TOWNSVILLE HOSPITAL

IPSWICH HOSPITAL

While this is not an ideal solution, a full time car parking pass will provide unlimited access for staff 24/7, 365 days a year.

Public car parking at Townsville Hospital has reached a crisis point and we are aware some members are arriving an hour before their shift just to secure a spot.

To further improve affordability of car parking for staff, SCHHS has agreed to salary sacrificing arrangements for car parking fees above the normal cap amount.

Many members are also parking a long distance away from the hospital, which is not only inconvenient but also risky with QNMU receiving a number of reports of vehicle vandalism.

Parking time limits in the streets around Ipswich Hospital will increase from three to nine hours following a meeting between the West Moreton Hospital and Health Service and Ipswich City Council recently.

Plans are also in place to deliver a range of transport options to access the SCUH hospital campus, including a public transport hub and cycle links.

While ground level parking has created an additional 300 spaces, this is not a solution as Townsville Hospital is a growing facility, and with a large number of students arriving for placement these spot are quickly filled.

Staff will be provided access to showers, lockers and toilets should they choose to cycle. The QNMU recently handed over a car parking petition of 1300 signatures to Sunshine Coast Hospital and Health Service Chief Executive Kevin Hegarty as part of our ongoing campaign to improve parking options at SCUH. We understand many members are frustrated at the current car parking situation and we will continue to monitor the situation closely for any improvement opportunities.

Following a meeting with Townsville Hospital and Health Service recently to discuss the ongoing problems, THHS has agreed to move 34 fleet cars to an alternate location, freeing up these parking spaces as a temporary solution. We recently met with state MPs to suggest the construction of a multistorey car park in partnership with the nearby university as a long term solution and we’re surveying members to find out exactly what they think is an appropriate long term solution. Please keep an eye out for dates of branch meetings for members to keep updated with the situation.

Council also agreed to prioritise the installation of solar lights at Limestone Park to improve security until permanent lighting can be installed. The QNMU has received a number of reports from Ipswich Hospital members about damage and vandalism to their cars when parked at Limestone Park. This is unacceptable. Staff are encouraged to report any damage to police so it can be logged and support our call for police and council patrols in the area. We also encourage members to use the free shuttle bus service between the carpark and hospital where possible. We are currently seeking to have the bus service hours extended to 11pm.

STAY TUNED FOR FURTHER UPDATES AS WE ARE LOBBYING GOVERNMENT FOR PERMANENT SOLUTIONS. PLEASE CONTACT YOUR LOCAL ORGANISER FOR MORE INFORMATION ABOUT CAR PARKING IN YOUR AREA.

indepth PROFILE

Rain, hail or cyclone,

NOTHING STOPS

a Queensland nurse or midwife F CYCLONE Debbie thought she could sweep Queensland nurses and midwives away from their duties, she was sorely mistaken.

Described as a one in a 100 year event, Cyclone Debbie smashed the coastal towns of Bowen and Airlie Beach, stripped the Whitsunday islands, tore up homes and businesses, and left tens of thousands of residents without power and supplies when she made landfall on Tuesday, 28 March. But nurses, midwives and health workers in North Queensland are no stranger to unwelcome visitors like Debbie and pulled out all the stops in preparation for her arrival, bunkering down and sleeping on hospital floors to ensure they would be ready to start their shift in the morning. AIN and QNMU member Gaye Kazakoff-Corr was forced to turn around when she tried to get into town in for her shift at Proserpine Nursing Home on Wednesday morning. “There was water across the roads, trees and powerlines down everywhere and it was pitch black,” Gaye said. “I turned around and came home, but once it was light and I could see the roads I went into work.”

An army Chinook from Townsville arrives with supplies and relief staff for Mackay, Bowen and Proserpine Hospitals. Source: Mackay Hospital and Health Service

The morning after Debbie moved inland to Collinsville overnight and by 3am had been downgraded to any active tropical low. By daylight she was hammering the region with gale force winds and heavy rain. There was a heart stopping moment for Proserpine Nursing Home when residents in the Whitsunday wing had to be evacuated. “Water was inundating the place and we really didn’t have a choice. Fortunately all the residents were evacuated to our Crystal Brook building safely but it was quite nervewracking,” Gaye said. “The glass door in one of our dining rooms had blown open and shattered. Rain was leaking in through the ceiling and even though the Crystal Brook building was a Category 5 cyclone-ready building, there was an inch of water on the ground floor and water was rushing into the corridors. “Staff were frantically mopping floors and I could see people walking down the street outside who were up to their knees in water!” In the days following the cyclone, many health professionals across the Whitsunday and Mackay districts pulled double shifts, working throughout the day and night caring for patients and residents. Despite being short staffed and running on generator power, Gaye said staff at the nursing home worked tirelessly to ensure residents were safe and well looked after. “Our residents were well settled but some of them were very worried and kept coming out wanting to know what was going on,” she said.

...from kitchen, laundry and cleaning staff to nurses, everyone who could get into work was there doing the best they could. “We were already short staffed and trying to clean up as much damage as we could but it was amazing how everyone just pitched in and helped out… from kitchen, laundry and cleaning staff to nurses, everyone who could get into work was there doing the best they could. “There were two RNs and an AIN who worked more than 36 hours straight as other staff were unable to leave their homes to relieve them.”

Then the floods came… As NQ started the long and heartbreaking process of post-cyclone clean-up, many other parts of the state were just starting to feel the full extent of Debbie’s reach. Heavy rain and high tides combined to cause havoc for coastal communities like Sarina and Mackay’s Northern Beaches, and rivers spilled into towns and cities all across the state from Gladstone and Rockhampton in Central Queensland all the way down to Logan, the Gold Coast and across the NSW border. Beaudesert Clinical Midwife, Registered Nurse and QNMU member Anne Patterson left her home on Thursday morning for a four hour lecture at the Hospital, but with

PROFILE indepth

Battening down the hatches in Rockhampton AT THE TIME of going to print, ex-Tropical Cyclone Debbie’s wet weather system was still causing trouble with Rockhampton bracing for heavy flooding. Fortunately, record-high flood predictions were revised down, sparing the city from what would have been its worst flooding since 1918.

Gaye (middle) with residents Mary (left) and Faye (right) from Proserpine Nursing Home read all about Debbie in the paper. Source: Whitsunday Guardian

floodwaters rising stayed on to help until Sunday night. “I quickly ducked downtown before the shops all shut at midday as per the Premier’s announcement, and I bought undies for our staff at the hospital, toothpaste, deodorant and a jacket — I knew we were going to be there a while!” Anne said. Along with a fellow colleague who had just pulled a double shift, Anne did an afternoon shift on Thursday and slept in a room at Beaudesert Hospital that night. “That night was crazy! There was wind and rain and it was a really anxious night because we couldn’t get choppers in and we couldn’t get the ambulance out,” she said. “Fortunately we didn’t need them. We were also flooded in with the full theatre team so we had anaesthetists and doctors on hand so we were thankfully okay.”

All hands on deck Anne said the severe weather event brought real community spirit. “Everyone pitched in and was happy to do so. Not only did we have our staff but we had people from Logan and QEII Hospitals coming here, working their butts off and having fun while doing it!” Anne said. “One of our staff members Mike had the foresight to bring along his camper and stayed outside the hospital on Thursday night because he couldn’t get home.

“The next morning he cooked everyone a hot breakfast of beans and scrambled eggs, it was wonderful.”

Heroes of our community QNMU Secretary Beth Mohle extended her personal thanks to members working in the affected areas. “The incredible resolve and care showed by our health professionals is amazing to see, with many working double shifts to ensure the community received the help and support they needed,” Beth said. “I would like to personally thank you for your hard work and tremendous efforts during the cyclone and subsequent flooding and clean-up, and hope everyone came through safe and sound. “You are truly the unsung heroes of our community.”

What are your leave entitlements?

But the QNMU Rockhampton office on the banks of the Fitzroy River was taking no chances. QNMU Rockhampton Organiser Grant Burton said in situations like these, it was always better to be overly cautious than sorry. “We’ve sand bagged the area around the office and placed black plastic over all the doors and around our air conditioning unit,” Grant said. “Everything has been lifted to desk height and we’ve put all of our important paperwork safely away!” Grant said staff would still be on hand if members need union assistance. “We may lose power for about a week and our Rockhampton office may have to be closed for that time, but QNMU staff and I in Rocky are ready and available to assist members who have urgent questions or require aid.” He said Queensland Health and other private facilities had already sent memos to members about policies around emergent flood leave.

If you have been affected by recent weather, please look at your enterprise agreement to check for storm, flood and cyclone leave. QH employees can refer to Section C7 of their policy here: http://bit.ly/2ocHwB8 For further assistance or advice contact Member Connect on (07) 3099 3210.

QNMU Rockhampton office

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A helping hand NURSES AND MIDWIVES SUPPORTING DOMESTIC VIOLENCE SURVIVORS

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OU CAN find them holding the hand of women in their darkest and most desperate hours. For the survivors of domestic violence, they’re more than just a shoulder to cry on and a listening ear — they’re a source of solace and knowledge during a time of greatest need. Today, there are a number of organisations dedicated to supporting domestic violence survivors that benefit from the expertise and skillset of a nurse or midwife. Micah Projects is one such not-forprofit organisation, providing support and advocacy services to individuals and families in need. As a Community Health Nurse working with Micah Projects, QNMU member Ros Butler visits domestic violence survivors who have fled their homes and are in temporary accommodation.

“It’s important to be open and not to be judgemental. A lot of these women have been assaulted yet believe they deserve what has happened to them– many won’t go to a hospital even if they have injuries,” she said. “Nine times out of 10 the women I see only have the clothes on their back. They are embarrassed and humiliated.”

When two lives are on the line QNMU member Rebecca Denny is a midwife and Director at My Midwives, a midwifery practice providing several models of care for women seeking continuity of care and a known caregiver. For Rebecca, an already bad situation becomes all the more desperate when there’s another life to look after.

Ros conducts health assessments on survivors and works closely with a team of nurses, clinicians, nutritionists and counsellors to achieve the best outcome for the woman.

“Many of the women who come to us either through referrals from the police or from social workers are pregnant while fleeing a domestic violence situation,” Rebecca said.

“Having a nurse working directly with the teams is paramount,” Ros said.

“When you’re pregnant life is already turned upside down, but these women have the added stress of being in a dangerous life situation.

“Many of the women we see have experienced horrific domestic violence and may present with head injuries or fractures. A number of women also have chronic illness such as heart disease and asthma as well as extreme anxiety.

“It’s more pertinent that they have a known midwife they can trust and know really well so they have someone to turn to at any time of the day or night during their pregnancy.”

“An extensive health assessment is imperative to identify pre-existing illness and ensure the women are referred to the appropriate health services for follow up treatment.”

A continuity of care model becomes all the more beneficial in these situations, as women get to know their midwife in a comfortable and safe environment.

Ros said it was also important to simply sit down with the women and give them an opportunity to talk about what’s happened.

“It’s all about gaining the woman’s trust. There’s never a set guideline on what to do but the most vital thing is to respect the woman and her choices,

and also be aware of our legal and ethical obligations,” Rebecca said. “We work with a number of people at different times throughout the process, such as child protection services, hospital social workers, both private and public social workers, counsellors and the police. “We’re constantly thinking about the woman’s and the baby’s safety.”

Feeling what they feel Caring is at the heart of what nurses and midwives do, so it comes as no surprise that working with domestic violence survivors can take an emotional toll. “It goes without question really. In our role as a midwife we become so much more,” Rebecca said. “We are their friend, their advocate, their support person, their nutritionist, their confidant — it can be really emotional because I become a part of this woman’s life during a very volatile and scary time for her. “One particular case comes to mind… When I first met this woman she had just fled her home and was so timid and frightened. We cried together that first day and that just opened up the channels for communication and trust.

Rebecca Denny, midwife, Director at My Midwives and QNMU member.

“For me, seeing women empowered in taking those first steps to seeking the help they need and carving out a different life for themselves, that is the unmistakable reward of this job.”

indepth FEATURE “Ultimately, she was able to give birth the way she wanted to and found a safe environment for herself and her children. Life has taken a wonderful turn for her and it’s just beautiful to see. “For me, seeing women empowered in taking those first steps to seeking the help they need and carving out a different life for themselves, that is the unmistakable reward of this job.” Having previously worked as a Child Health Nurse in paediatrics, it was a natural progression for Ros to move into working with domestic violence survivors. “When you’re a nurse you see it all and you can’t help but care and want to help,” Ros said. “I think as a nurse and as a health professional, the women feel more inclined to talk to me about their situation than they would to others. “Some of the stories are horrific and it’s very confronting for me to think that someone these women loved has done this to them.” According to Ros, the job gives new meaning to not taking your work home with you. “It can be very all-consuming but I always try to leave my work at the door and pick it back up when I come in again. “You absolutely have to do that for your own sanity and I think that’s one of the reasons I don’t burn out. I wouldn’t be able to work in this area otherwise.”

It takes a special someone Suffice to say this kind of work isn’t for the faint of heart. But proper training and a strong support network are essential for managing and even thriving in such an emotionally taxing job. “It’s important to remember that in everyday life, not everyone’s been exposed to something like this,” Rebecca said. “I sought information and education around domestic violence to ensure I was fully capable of providing advice to women. I spoke to social workers at hospitals so I could add to the care I provide and I also took some online courses.” Likewise, Ros has participated in a number of training courses which cover mental health, first aid, deescalating situations, assessing and identifying what’s triggering aggression in a person, and more. “Even though we come in after that aggression has already occurred, those skills really come into play when talking to a woman and helping her understand and accept that what happened wasn’t her fault,” she said. “My advice to other nurses who are interested in working with domestic violence survivors is to have really good self-care. You have to know how to take care of yourself if you’re going to help others.”

The first steps to curbing DV The tragic cases of domestic violence victims Tara Brown and Theresa Bradford, among many others, have called into question the need for tougher bail laws and heavier prosecution for domestic violence offenders. Tara Brown’s partner Lionel Patea had breached numerous protection orders and attacked her multiple times before murdering her on the Gold Coast in 2015.

Community Health Nurse and QNMU member Ros Butler (left) with QNMU Secretary Beth Mohle.

Similarly, Gold Coast nursing student Theresa Bradford was killed by her estranged husband two weeks after he was granted

bail following an assault on his wife late last year. This has prompted the Queensland government to consider tightening the state’s bail laws for perpetrators of domestic violence. On 23 March, state parliament passed new bail laws requiring domestic violence offenders to prove why they should be released on bail. Ros believes these cases are a reminder there is still a long way to go to curbing domestic violence. “We are advocating for more stringent rules governing the release of people who have a known history of violence,” she said. “The laws we have aren’t adequate — men on domestic violence court orders continue to be repeat offenders because they know even if they go to jail they’ll be out in a month.” Ros said it was also critical that women who reach out for help are taken seriously. “In all honesty I think many women feel they aren’t being heard when they make complaints or try to reach out. “But with an increasing number of services available to women in need, more are coming forward to seek help. Things are changing but much too slowly and more needs to be done.” In 2015, 140 recommendations were laid out in the Not Now, Not Ever report to tackle domestic and family violence. Of those recommendations, 46 have now been implemented and 77 more have been started on with $200 million allocated to tackling the issue. The Not Now, Not Ever report was prepared by the Special Taskforce on Domestic and Family Violence in Queensland based on insights gathered from engagement with communities and individuals, and has set the vision and direction for our state’s strategy to end domestic and family violence and ensure those affected have access to safety and support. View the report on the Queensland Government’s website: http://bit.ly/2m1mumF

FEATURE indepth

Reaching out – a survivor’s story I’ve been married for 30 years and my husband has been violent toward me for half that time.

In the past eight years, this violence started to escalate dangerously. It wasn’t until my daughter called the police on one occasion after he had attacked me that I actually began to reach out for help. Up until then I had kept this side of my life very much in the dark – I had not dealt with it nor told anybody about it — in fact I didn’t feel I could speak out about it until my daughter called the police. It weighed heavily on me that this was obviously becoming distressing for her and her siblings. No child should ever have to witness something like that. The thought of the impact this had on my children was what made me contact the domestic violence support centre and take the first steps toward seeking help. For me, it was very much about trying to understand why domestic violence occurs. What I came to realise is there’s not really any explanation — domestic violence is a senseless thing. To this day, my husband is completely in denial of the fact that he was a perpetrator of domestic violence. Unfortunately, there is absolutely no acknowledgement or understanding from him about what he has done and he blames me for the situation.

Support from the QNMU During this time, I was working at a hospital while studying. I was struggling to complete a certain number of hours at work while things at home were escalating with ongoing violence from my husband. It was hard to be honest with work about my absenteeism but I felt the need to explain what I was going through at home, as it was really the only explanation I could provide. Unfortunately there was very little understanding and support from management at work, and I was even faced with aggression at times. At a time when I was stressed out and anxious, I felt harassed at work too. I wasn’t getting the support I needed from work and I immediately called the QNMU after an incident where a higher manager was extremely aggressive toward me. My QNMU representative came to every single meeting thereafter and made sure I was treated fairly. She was familiar with all the processes and assisted me in lodging grievances, helped me with disciplinary responses, came with me to performance meetings I was called to attend, and was my industrial advocate. She made my employer aware of the domestic and family violence leave I was entitled to, and helped to

To this day, he is completely in denial of the fact that he was a perpetrator of domestic violence. negotiate suitable shifts that would suit my family circumstances. It was a relief to have someone on my side. Her guidance and support at work and in my studies has taken a lot of the stress out of the situation. I also experienced a big change in management’s attitude toward me after the state government introduced new legislation and policies around domestic violence. It was almost like management now had something to work off and began to become more understanding of my situation.

indepth FEATURE I am gradually progressing back to my usual work hours, and my backto-work coordinator is present and supportive, and it is a relief to know I can call on my QNMU representative to advocate on my behalf at any time.

Speaking out Even though my husband and I are now separated, he has moved back into the family home. This isn’t ideal and we have probably gone backwards but he seemed to change and it was the best thing to do in terms of finances. While he isn’t as bad as he used to be, he is definitely still abusive.

QNMU playing a part The QNMU has been heavily involved in helping to ensure survivors of domestic violence receive the support and access to services they need.

Lobbying for paid domestic and family violence leave We stood with other unions in support of a nationwide campaign to include paid domestic and family violence leave in national employment standards. Late last year, Queensland became the first state to implement a minimum 10 days paid domestic and family violence leave as a core condition in the public sector. We are now pushing for workers in all sectors and across all states and territories to also be given the same rights.

I know it’s not sustainable to keep going in this situation and I’m attending counselling where I am speaking to psychologists to get the help I need. Domestic violence is never easy to deal with. You can be in denial and you can disconnect from the real world but it doesn’t ever go away. At a time when I was at my lowest, the support I received from the QNMU was invaluable and it was a relief to know there was help when I needed it. This has had a big impact on me and on my children and I hope that others who are in the same situation speak out and access the resources available to get through this. Anonymous, QNMU member and Registered Nurse

Where to get help If you are in immediate danger, phone the police on 000. For help and advice, call: ■ DV Connect Womensline 1800 811 811 ■ DV Connect Mensline 1800 600 636 ■ Sexual Assault Helpline 1800 010 120 ■ Elder Abuse Helpline 1300 651 192

Care packs for survivors fleeing domestic violence We partnered with Queensland Country Women’s Association and DVConnect to collect care pack items to be delivered to women fleeing domestic violence. Thank you to all our members who donated to this cause — we have received thousands of donations from as far as Mareeba, Toowoomba and Cape York! QNMU Secretary Beth Mohle (right) with Queensland Country Women’s Association’s Mary Martyn (left)

FEATURE indepth

In Australiaâ&#x20AC;Ś FREE information and training sessions In partnership with the Queensland Council of Unions, we hosted free information and training sessions for our members to help raise awareness about domestic violence. Thanks to everyone who attended! The sessions were a big success and provided practical advice and tips on addressing issues relating to domestic and family violence, particularly in the workplace. Due to popular demand and the positive feedback we received, the QNMU is currently organising further sessions across the state. Keep an eye on your emails and Facebook for more info!

On average at least ONE woman A WEEK is killed by a PARTNER OR FORMER PARTNER.

ONE in THREE women has experienced physical violence since the age of 15.

Left to right: QNMU Secretary Beth Mohle, Minister Shannon Fentiman, Kerriann Dear from DV Work Aware, Jennifer Thomas from The Services Union and Tanie Sansey from DV Work Aware.

Of these women who experience violence, more than half have children in their care.

EVERY YEAR, over

300,000

women experience violence from someone OTHER THAN A PARTNER. Kerriann Dear from DV Work Aware providing practical advice and tips on addressing issues relating to domestic and family violence.

Donation to the Teresa Bradford appeal Following the tragic death of nursing student and domestic violence victim Teresa Bradford, the QNMU donated $1000 to help provide assistance to Theresaâ&#x20AC;&#x2122;s four children in the coming days, months and years.

Domestic or family violence against women is the single largest driver of homelessness for women.

Source: Domestic Violence Prevention Centre, Gold Coast Inc.

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LOOKING AFTER OUR OWN SPEAKING UP ON ABORIGINAL AND TORRES STRAIT ISLANDER ISSUES As a Registered Nurse working directly with Aboriginal and Torres Strait Islander patients — and as an active member of the QNMU — Laurie West is advancing the issues that are personal to him and Aboriginal and Torres Strait Islander people.

N INDIGENOUS man born into the Kalkadoon tribe in the Mt Isa area, Laurie works as a Clinical Nurse at the Aboriginal and Torres Strait Islander Community Health Services Browns Plains Medical Clinic.

The clinic delivers comprehensive chronic disease care and primary health care for Aboriginal and Torres Strait Islander people. “From my perspective, nobody listens to a whinger,” Laurie said. “It’s about getting out there and doing something, standing up and going about it the right way.” After graduating high school, Laurie practiced as an AIN before pursuing nursing studies at Deakin University. His passion for improving health outcomes for Aboriginal and Torres Strait Islander people was passed on to him by his mother, who was a health worker for 40 years. “She’s a real hands-on people person … that’s what I got from Mum. “I pursued nursing studies because I thought I could achieve more and have more influence at an RN level. “I’ve not only been able to get my hands dirty, but I’ve also had the opportunity to deliver education to new staff, teach clinical skills and issues around cultural safety and awareness.”

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Taking action through the QNMU reference group Just 1.1% of Australian nurses and midwives identify as Aboriginal or Torres Strait Islander, a figure that represents a serious underrepresentation of Indigenous people in our health sector. Ensuring the voices of Indigenous people are heard at every level — particularly in the decision-making process — is essential if we want to make meaningful change. And that’s exactly why the QNMU’s Aboriginal and Torres Strait Islander Members Reference Group was formed. Laurie, who has been involved with the reference group since its inception last year, said it was an opportunity to guide the union on policies and actions and bring Indigenous issues to the table. “We need to be looking after our own mob, and we need to empower the Aboriginal and Torres Strait Islander workforce,” Laurie said.

Cultural safety is key One issue the reference group is focusing on is cultural safety.

Naturally, ensuring patients have access to quality health care is vital, but so too is the environment in which it is delivered. “There’s a difference between cultural awareness and cultural safety,” said Laurie. “Cultural safety is about being able to work in a safe space, a safe environment. It’s a matter of not just being aware of Indigenous culture, it’s about being able to practice safely in that environment.” Cultural safety is not just for health workers, of course. It extends to everybody, including patients. “Non-compliant patients become compliant just because they’ve seen a black face in the clinic. “It’s about how you communicate with them … you can sit down with them and have a yarn. “We come into the nursing workforce with the clinical knowledge, but we also come in with the cultural knowledge.” It’s this cultural knowledge that is currently informing discussions within the reference group about how the QNMU can better advocate for cultural safety in all health workplaces, whether that be through developing policies or providing training.

It’s about getting out there and doing something, standing up and going about it the right way.

indepth PROFILE Rising above bureaucracy Unfortunately, addressing Indigenous health issues is often hindered by roadblocks

What is CATSINaM?

One of the challenges community controlled health services often face is the bureaucratic structures of our political system, including the processes that determine how funding is allocated.

The Congress of Aboriginal and Torres Strait Islander Nurses and Midwives is Australia’s peak body representing Indigenous nurses and midwives. CATSINaM’s vision is for Aboriginal and Torres Strait Islander nurses and midwives to play a pivotal role in achieving health equality across Australia’s health system for Aboriginal and Torres Strait Islander Peoples and communities.

“It makes me very angry and frustrated,” Laurie said.

QNMU works closley with CATSIM. For more information or to become a member, visit http://catsinam.org.au/

“At the moment there is money going into the wrong places. Much of the funding isn’t going back into community control. “I think funding really needs to go towards strategies that are directly aimed at closing the gap, and that’s in our community controlled centres.” The focus on short-term funding is particularly problematic, with emphasis placed on government submissions and reports. These are things that require time and resources. “Unfortunately, Aboriginalcontrolled health care services don’t have the ability to employ someone to write reports,” Laurie said. Chronic disease programs offering services such as healthy eating, exercise programs and stress management rely on shortterm funding, and the task of writing and submitting applications often falls to the health care workers themselves.

Advocating where it counts But if these challenges highlight one thing, it’s the necessity for Indigenous people to have a more powerful voice where it counts. “To get better outcomes for Indigenous health we need to empower our own workforce and we need our own mob in there doing that. “And that’s what the union is for. It’s a platform for us where, if we choose to get more involved, we can influence decisions and look out for each other.”

QNMU Aboriginal and Torres Strait Islander Members Reference Group The QNMU’s Aboriginal and Torres Strait Islander Members Reference Group was formed in 2016 by and for QNMU members who identify as Aboriginal or Torres Strait Islander. The group meets every two months (either in person or via teleconference), and aims to inform the union’s direction on issues relating to Aboriginal and Torres Strait Islander members, including cultural safety. NEXT MEETING: The next reference group meeting will take place on Tuesday 2 May 2017 (5 – 6pm). Reference group members can either join the meeting at our QNMU Brisbane office or by teleconference. RSVP by 27 April to Annie Cowling at the QNMU on 3840 1484 or email acowling@qnmu.org.au.

PROFILE indepth

Calling the midwife Right: Bee with baby Gus at a six week discharge home visit.

“LIKE MOST midwives, I found midwifery to be a calling. I view it similar to a call to becoming a mother. It’s an innate desire to live that lifelong experience.” That’s how Registered Midwife Bee Schaeche views her career of 10 years, which spans both the public and private midwifery systems, as well as her current role in Midwifery Group Practice. Bee always had a desire to become a midwife, but her post-high school life started out very differently, as she fulfilled other life pursuits including travel, having four children of her own, and even spending 10 years as a casino floor manager. “Then the calling became very strong,” Bee said. “I first became a Registered Nurse and practiced for one year because that was the prerequisite back then, and then went on to do a Master of Midwifery.”

I found midwifery to be a calling.

Much has changed for the midwifery profession, even in the short 10 years that Bee has been working as a midwife. “I think midwives are becoming more recognised in their own right, and that’s evident even just in the context of how clients view us and speak to us,” Bee said. “In days gone by we were often referred to as ‘nurse’ or ‘sister’, whereas now I’m referred to as ‘my midwife’. “I think having the Bachelor of Midwifery coming through has helped midwives be viewed as specifically trained to provide maternity care.”

Always woman centred For Bee the most rewarding aspect of her role is the joy and fulfilment she experiences knowing she has helped make a woman’s childbearing journey the best it could be. “A good midwife recognises when care is in danger of becoming organisational-centred or midwifecentred, instead of woman-centred. I think that would resonate with most midwives,” she said. “While you’re looking after that woman, you are responsible for the decisions you make with the woman to be in her best interests.

Bee pictured at the christening of baby George. Bee was the midwife at George’s birth and also that of his two older siblings.

“Particularly when you’ve known the woman for months, you’re not only professionally and ethically invested, you’re emotionally invested.” Midwives who can build a trusting relationship with the woman can be the difference between the woman

being overwhelmed by their deep fears of childbirth and alleviating that stress, she said. “I had a woman who was referred to the birth centre who had three previous births, and on paper they seemed perfectly normal, but in her mind she was traumatised because she felt she hadn’t been listened to or respected. “So I met with her and talked her through what I was able to offer her over the coming months to build a relationship with me and talk about all the ways this birth would be made different to her other births. “While I couldn’t guarantee any sort of birthing outcome, I could guarantee she would be respected, listened to, and supported in her decisions. “By the time she came to have birth she decided she would try for a normal birth, and she had a beautiful water birth in the pool with her husband, and she said it was the most empowered birth for her.”

More than a name change With our union now incorporating midwifery into the name, Bee regarded the change as “hugely important”. “Language is so important in the way midwives are viewed,” Bee said. “Nurses and midwives are siblings as far as I’m concerned, and I think it’s a wonderful recognition of two separate professions banding together to support each other in matters that affect us all as health care professionals.”

indepth CAMPAIGN

AGED CARE SAFE STAFFING –

the time is now HE ANMF has released a groundbreaking report into the appalling state of our aged care sector, providing strong evidence to support legislated aged care ratios.

Commissioned by The Australian Nursing and Midwifery Federation, the first-of-its-kind National Aged Care Staffing and Skills Mix Project Report presented evidence of serious deficiencies in staff numbers and skill mix in the sector, and called for a new staffing methodology to ensure residential aged care facilities have the right number of staff with the right qualifications. The key findings were: ■ Residents should receive an average 4 hours and 18 minutes of care per day — compared to the current average of 2.84 hours which is currently being provided ■ A skills mix of Registered Nurses 30%, Enrolled Nurses 20%, and Assistants in Nursing (however titled) 50% is the minimum skills mix to ensure safe residential care.

A little background… Note: The following information has been taken from the ANMF report. Visit http://anmf.org.au/mediareleases/entry/media_161202 to read the full report. Over the past two decades, the number of residential aged care facilities nearly doubled from 134,810 in 1995 to 263,788 in 2014. Over the same two decades, there have been numerous productivity reports and senate inquiries which have consistently recommended the need to establish a method of determining safe staffing levels and skills mix in the aged care sector. Despite these recommendations, successive governments have failed to establish and legislate for evidence-based staffing levels and skills mix that provide vulnerable older

Australians with a minimum safe standard of care. While the Aged Care Act 1997 stipulates that the numbers of care staff should be “adequate” to meet the assessed care needs of residents, it provides no clear parameters on what the staff levels and skill mix must be based on to be considered “adequate”. A growing body of national and international research clearly demonstrates that inadequate levels of qualified nursing staff leads to an increase in poor patient/resident outcomes, which generally results in increased costs. In the acute setting, the implementation of safe mandated minimum staffing has been shown to prevent adverse incidents and outcomes, reduce mortality and prevent readmissions thereby cutting health care costs. It is widely agreed the same improvements could be made in the aged care sector.

The evidence backs the anecdotes The Staffing and Skills Mix report delivers the scientific evidence we need to backup our case for better staffing levels in aged care.

National Aged Ca re Stafﬁng and Skills Mix Pro ject Report 2016 Meeting residen ts’ care needs: A study of the req uirement for nursing and person al care staff

“So they go without meal breaks, half the time they don’t go to the toilet, and they do overtime or double shifts.” Pat said the system often “falls down” when staff are not replaced during their lunch breaks, placing other staff in difficult situations. An example of this occurred when a client in a dementia wing soiled herself and her husband was coming to visit. To preserve her dignity the nurse decided to change her pad before her husband arrived. The other nurse was on her lunch break, so the resident was hoisted by the only nurse available, even though the policy said it took two people. But as a result of the resident being hoisted by one nurse, she slipped out of the hoist. Fortunately she wasn’t injured. “But that’s what staff often do,” said Pat. “They make decisions thinking they’re doing what’s right for the resident, but sometimes it’s to their own detriment.”

But of equal importance are the personal stories from nursing staff, residents and relatives who have witnessed first-hand what is really going on. Pat McLean worked as an AIN for nearly 38 years before becoming an Enrolled Nurse. She said poor staffing in aged care has always been an issue. “When I worked in residential care, on the night duty there was one RN responsible for 250 people,” Pat said. “The thing is, most staff who work in aged care are very caring people. “They tend to put themselves second to ensure their residents get the care they need.

When I worked in residential care, on the night duty there was one RN responsible for 250 people. Pat Maclean, EEN

CAMPAIGN indepth

A case study in why we need ratios A RECENT incident at a Queensland TriCare facility has brought the issue of unsafe staffing in aged care into the public spotlight including in a recent new report on Channel Ten’s The Project. Woodgate resident Heather Brown, whose husband is a resident at a TriCare facility, discovered blood stains on her husband’s sheets. She said her husband had been wearing a urine-soaked pad for 12 hours, causing the skin on his scrotum to tear and bleed. Furthermore, in May 2015 Heather said she was asked by the facility to assist in cleaning her husband due to a lack of staff. Upon her arrival, Heather was shocked to see her husband sitting on the veranda covered in his own faeces.

Heather’s story drew media reports and prompted a flood of stories from other family members, all with their own experiences involving relatives not receiving proper care.

Not the fault of nurses QNMU Secretary Beth Mohle said the TriCare incident reinforced the urgent need for minimum staffing ratios. “No one is suggesting the nursing staff are to blame for these incidents,” Beth said. “We know aged care workers everywhere want to provide the very best care possible for their residents. “The sad reality, however, is that in many cases there simply aren’t enough staff employed to share the high workloads.”

TriCare refuses ratios In 2013/14, the O’Shea family, which owns TriCare, was reported by the Courier Mail as being worth $342 million, up $7 million from the previous year. Despite these huge profits, TriCare has been unwilling to increase staffing levels. The QNMU recently tried to negotiate minimum ratios through TriCare’s latest enterprise agreement, but the employer refused. This will be an ongoing priority for us, and we won’t give up.

For providers, as much as residents, these are standards that need to be set. If we do it in other areas, why wouldn’t we do it [in aged care]. Waleed Aly, The Project into the Future of Australia’s aged care sector workforce to recommend legislating safe staffing levels in aged care. You can support the petition here: http://bit.ly/2mkWx2C The challenge now is to keep up the momentum. We encourage you to tell us your stories about your experiences in aged care, whether as a nurse or a relative of a resident.

Change.org petition receives national attention

We will be ramping up our campaign — both in Queensland and at a federal level — to get aged care front and centre on the political agenda.

Following the TriCare incident, Heather Brown created a Change.org petition calling on the Senate Inquiry

Your stories will be our most powerful tool to get real change where it’s needed.

indepth OPINION EN YEARS ago, I was returning from a trip to Cuba with Academy Award winning filmmaker Michael Moore.

My husband and I had been featured in Moore’s 2007 documentary film, Sicko, which investigated health care in the United States. We were two people among millions of Americans who faced health care insecurity and financial ruin, before Barack Obama was elected president in 2008 and before the 2010 passage of the Affordable Care Act (also known as Obamacare). After 30 years of marriage — during which we always carried employer-sponsored health insurance coverage — our out-of-pocket health expenses over and above our private insurance deductible, monthly premiums and required co-payments drove us to sell our home and eventually file for bankruptcy. Though fighting serious health issues, we were forced to move in with one of our six grown children and put our remaining household possessions in storage. What my husband’s heart and artery disease and my own cancer had not taken from us in terms of our struggle and our will to survive, the US health care system seemed designed to finish off.

HEALTH CARE UNCERTAINTY AND INSECURITY Fast forward to early 2017 in America, and I cannot overstate the health care uncertainty and insecurity that once again looms for many more people than the estimated 50 million Americans who were uninsured before Obamacare became law.

AMERICA

2017 LAND OF THE NOT-SO FREE BY DONNA SMITH, EXECUTIVE DIRECTOR, PROGRESSIVE DEMOCRATS OF AMERICA

The election of an ultra-conservative Republican regime meant that an ideology of devotion to the free market would prevail. Ripping apart the protections of Obamacare was a promise the conservative Republicans had made to their loyal voter base. What the Republicans failed to accurately predict was the public backlash against their rapid moves to dismantle the only access to health care millions of Americans have under Obamacare. Protests grew around town hall meetings in congressional districts, and millions of Americans wrote letters and made phone calls. In some Democratic districts, constituents lined up in long queues to tell their health care stories and share their fears and anger about losing their coverage. Then in late March, and in a stunning victory for supporters of fairer health care, the Republican’s flawed bill to repeal and replace Obamacare was pulled by Trump minutes before the House vote was to occur. Despite Republicans campaigning against Obamacare since 2010 and the party now in control of both Houses, the bill still did not have enough votes to pass — many Republican lawmakers sent a clear message that they answer to their voters, not the President.

OPINION indepth For now, it appears Obamacare will remain the law of the land, with Republicans admitting they have no future health care plans now that their bill is defeated. For many of us, myself included, this is a terrifying time. While I was a strong supporter, contributor and volunteer for Bernie Sanders’ primary campaign for the presidency, I had expected Hillary Clinton to win on November 8, 2016.

to protect the core social safety net programs for the sick, the elderly or the disabled in America. Those programs include Medicare and social security for the elderly and disabled, and Medicaid for the poor, and those are the targets for slashed and privatized benefits under the new order.

No matter how unfavourable Clinton’s image was with many Americans, I had believed most people wouldn’t vote for the Republican candidate who had spewed racist, sexist, and disturbingly vile vitriol.

For Americans like myself — who are over 50 but not yet 65 and eligible for Medicare health coverage — the Republicans in Congress and Trump in the White House are in favour of allowing private insurance companies to charge five times as much in monthly premiums as they would charge younger policyholders.

It was at first laughable and then unthinkable that Donald Trump would ever presume to fill the role of the highest elected office in America.

That means my coverage could soar and likely would soar to more than $2,000 a month for weaker coverage.

WHAT NEXT FOR AMERICAN HEALTH CARE?

As many who know me have already learned, I do not intend to burden my family with that expense.

What the next few months will hold for health care policy is hard to say. Since Election Day, it has been nearly impossible to predict what the next shock to the American system would be, whether political, health care or other. The Republican hand-culled cabinet has already moved to allow environmental, health and safety protections to be dumped in favor of unregulated, free market abuses. There is no longer any reason to believe that the Republicans intend

In 2017, the American people are the victims of a failure to our social conditions and our access to care. Americans will be returning to massive numbers of uninsured people who will suffer without access to care. I hope the people of Australia recognise the incredible danger of embracing any measure of retreat from your universal system (Medicare). For our earth, for one another, for me, hold on to universal health care. It is freedom.

US citizen Donna Smith is a former journalist and advocate for high quality, universal public health care. In 2013 she attended the QNMU’s Annual Conference, where she spoke about her family’s struggle with America’s private health insurance system. After learning that her private health system wouldn’t cover treatment for her uterine cancer or her husband’s chronic coronary disease, she was forced to declare bankruptcy. With the election of President Donald Trump and an administration intent on repealing the beginnings of a fairer American health care system known as Obamacare, Donna’s warning against an Americanised health system is now more relevant than ever. She reflects on the uncertainty currently facing millions of Americans who face the real possibility of losing their access to health care.

For our earth, for one another, for me, hold on to universal health care.

Rally in support of the Affordable Care Act, at The White House, Washington, DC USA

It is freedom. Photo: Ted Eytan

indepth CAMPAIGN

RATIOS ROLLING ALONG Since July last year, Queensland has been one of the few jurisdictions in the world protecting patient safety with legislated nurse-to-patient ratios.

RATIOS

SAVE LIVES WE CANNOT underestimate the progress we’ve made since the ratios rollouts began.

when their workplace fails to comply with the correct ratio as set out in the legislation and the BPF.

We’ve successfully resolved compliance issues in a number of areas and we’ve heard lots of positive feedback from our members.

The Deputy Director General of Queensland Health has made it very clear to Hospital and Health Services (HHS) that nurse and midwives should be supported and even encouraged to complete workload forms.

Thank you to members who completed our ratios compliance survey. We’ve been meeting regularly with Queensland Health to communicate your concerns. Of course, there are still issues we’re working through, including the ongoing problem of some team leaders being included in the ratio. This is despite Queensland Health stating clearly that this should not happen when it was not the practice of the ward to allocate team leaders a patient load prior to 1 July 2016. Remember, your local Nursing and Midwifery Consultative Forum is the platform for raising your concerns. We encourage members to continue completing workload reporting forms

Backing it up with research Our ratios campaign has always been built on hard evidence that proves why we need ratios and, just as importantly, why the rollout needs to continue throughout the rest of the public and private sectors. Researchers from the University of Pennsylvania (UPenn) have teamed with the Queensland University of Technology and Queensland Health to undertake a series of studies on the success of ratios. In December, Dr Matthew McHugh and Professor Linda Aiken from UPenn visited Brisbane to discuss the research so far.

The aim of the research was to answer two key questions: 1. Did the ratios legislation change staffing where it was below the minimum ratio? 2. Did those improvements in staffing lead to improved outcomes over time (for both patients and nurses/ midwives)? A ‘quasi experimental’ approach is being used to conduct the research, meaning data is collected pre and post legislation implementation. This enables the research team to look at changes over time, both in prescribed and non-prescribed facilities (including private hospitals). Dr McHugh said their research was all about collecting data from the frontline — ie, nurses and midwives. “Many researchers use existing sources of data collected from HR, payroll or administrative data sources,” Dr McHugh said during his presentation. “We tend to find that you only get one chance to get that data right. If

CAMPAIGN indepth

BPF REVIEW UNDERWAY Thanks to the QNMU’s lobbying, the spotlight will be shone on the BPF and compliance.

THE BUSINESS Planning Framework (BPF) is the industrially mandated workload tool we use to ensure we have the right numbers and skill mix of nurses and midwives to deliver safe, high quality health care. It’s also the tool we use to increase the supply of nursing/midwifery resources if the legislated ratio (in prescribed locations) does not match what is required in a particular ward, unit or facility. Although the BPF has been in place for over 15 years, we know there are still many workplaces that do not apply it correctly. The QNMU therefore requested Queensland Health conduct a state-wide review of the BPF to measure how it is being implemented and complied with across all HHSs. The review, which is currently underway, will occur over an eightweek period and conclude in May.

QNMU member and Helen Kinch begining the BPF review at Ipswich Hospital.

it’s entered in a wrong way you can’t use it, so you end up losing whole hospitals based on a single data entry problem. “So we go directly to nurses and aggregate their information, what they tell us about staffing, the work environment, the patient safety climate where they work. Then we link that with patient outcomes.”

The research The research team will conduct three separate surveys to get results that most accurately reflect what’s happening in our health facilities.

Study 1 – June 2016 The first survey was completed in June 2016 — pre ratios implementation. “We couldn’t have been more pleased with the degree of responses we got,” Dr McHugh said. “In no other place have we got such an overwhelming response from nurses, and the degree of

Each HHS will have its own review team which will include, among others, a QNMU Organiser and a local QNMU representative with expert clinical and BPF knowledge.

Compliance with the BPF is a long-term issue, and this review presents nurses and midwives with a unique opportunity to ensure it is being applied correctly.

Members getting involved Many QNMU members have put up their hands to become BPF workloads champions. These activists play an essential role assisting us with mapping where we need to focus our attention throughout the review. They will also ensure all public sector nurses and midwives are properly informed by sharing knowledge and talking about BPF practices in their workplace. While the role of the BPF workloads champion has been established in response to the BPF review, we see the role as pivotal to achieving the longer-term outcomes of our ongoing workloads campaign. If you want to get involved, contact your Local Organiser on 3840 1444.

participation and enthusiasm was really excellent.

issue of how close hospitals are to compliance,” said Dr McHugh.

“We really need to make sure that keeps going as we do the two followup surveys.”

“Whereas the third and final survey is the one that really helps us observe an effect or change over a three year period.”

Study 2 – May 2017 The next survey will be the first post-implementation survey and will mirror the first in order to track progress so far. This survey will also include additional questions about nurses’ experience of the implementation. So it’s your chance to be honest and have your voice heard when and where it matters. The team at UPenn and QUT will also conduct a set of key stakeholder interviews to gather information on some of the implementation issues, including what’s worked and what hasn’t.

Study 3 – May 2018 “I think our main goal for the second survey is to actually assess the

“So that is really going to be able to give us the answer to the question: does staffing improve in a measurable and meaningful way, and do those changes in staffing translate to changes in patient outcomes above what you would expect in the absence of such a policy?”

Have your say If you’re a Registered Nurse working in either the public or private sectors, you will receive an email invitation in May to complete the second ratios evaluation survey. Given the high participation rate in the first survey, it’s important this is maintained in the second. The more people who complete the survey, the stronger the evidence will be. Plus it’s your chance to have your say.

indepth FEATURE

Gender in nursing and midwifery SHOULD WE CARE AND WHY?

URSES and midwives ike to celebrate the history of their profession and a big part of that is celebrating women.

There’s no doubt that nursing and midwifery are predominantly female professions — both historically and still today. But in the year 2017, how far have we come? Do we still feminise nursing and midwifery, and how does this impact the male nurse and midwife population. The Australian Journal of Advanced Nursing recently published a report titled ‘Male or nurse, what comes first?’. The study highlights issues regarding men in nursing, particularly around the context of Australia’s looming nursing shortage and the ongoing issue of men leaving the nursing profession at a higher rate than women.

FEATURE indepth

The study looks at:

“Societies are never static. They’re always changing.

■ ROLE MISCONCEPTION – “I am not a male nurse, I am a nurse.”

“I think it’s really important to celebrate our origins and history, recognising that things change over time.

■ THE OUTSIDER WITHIN – “…feeling of being isolated and a minority within nursing.” ■ PROVIDING NURSING CARE MARGINALISATION – “…aware of potential for accusations of inappropriate behaviour and innuendoes of sexual deviance or homosexuality.” ■ PATIENT ALLOCATION MARGINALISATION – “…predominantly allocated male patients.” To read an abstract of the study or to purchase, visit http://search. informit.org/document Summary;res=IELAPA; dn=578254074252576

An evolving profession The idea of nursing moving towards a gender-neutral profession is one that a lot of nurses perhaps don’t want to consider … or simply don’t think about. One view – as suggested by the AJAN study – is the need to “enhance a more cultural and societal normalisation of nursing as a genderneutral profession … [in order to] encourage more men into nursing”1. Whether you agree with this or not, there’s no denying our nursing identity has evolved over the years. Registered Nurse and QNMU member Dan Prentice, who has been nursing for 40 years, said things were certainly different now for men working in nursing. “When I started my training 40 years ago, males in nursing — particularly in Queensland — were quite rare,” Dan said. “Whereas nursing was once seen as just a female profession, I think it’s now seen as primarily female with a broad acceptance that anybody can be a nurse.” But when it comes to diversifying the workforce, Dan said history and change can coexist.

“But if you’re talking about moving towards a gender-neutral profession, you’d have to think seriously about what we might lose in the process. “Obviously there’s no problem with having as many males in nursing as possible, but that in itself may change the nature of nursing, and I suspect that some of the social thoughts around nursing are very much tied to its femaleness.”

Role misconception Of course, addressing gender issues in nursing is more complicated than simply recruiting and retaining more men. The AJAN study highlighted the issue of ‘role misconception’, something that speaks more to how society perceives nursing rather than an issue within the profession itself. Registered Nurse of four years Daniel Hartwig described his friends’ reactions when he decided to become a nurse. “A lot of my mates thought it was a bit weird that I would go for nursing … they thought it was a female role, not a male role,” Daniel said. “One of my mates thought I’d turned gay, to be honest. Another mate said I was doing it just to pick up chicks.” While nurse gender stereotypes may have blurred over time, many patients still struggle with the idea of a male nurse. The study quotes participants claiming they had either been mistaken for a medical student or asked why they hadn’t become a doctor.

Dan said he occasionally got patients who were uncomfortable with being looked after by a male nurse. “But on the other hand there have been many occasions where male patients have said, ‘Glad you’re here’. “Part of the care we deliver is that indirect care of how you interact with people, and I guess some males feel more comfortable interacting with other males.”

Building a workforce One of the arguments often put forward for increasing the number of males in the nursing cohort is the need for a bigger nursing workforce. In 2014 the Australia’s Future Health Workforce – Nurses report predicted Australia would face a shortfall of 85,000 nurses by 2025. According to the NMBA, only 10.8% of nurses working in Australia are men. There are many factors contributing to a nursing shortage, but just as more is being done to attract women to male dominated professions like mining, we can do more to get men to see nursing as a viable career path so that we can keep up with our growing population.

Learning from women It goes without saying that men who enter the nursing profession have as much to gain themselves as the profession has to gain from more male nurses. Dan believes his life is far richer because he has worked predominantly with women his entire career. “There are a lot of people out there whose prejudices are maintained simply because they have no experience of that which they’re prejudiced against.

“They think I’m a doctor when I come into the room.”

“It’s a very enriching experience to work with so many women, and I think that’s helped me become a better person with a broader view of the world.”

Male nurse … or just nurse?

References:

The label ‘male nurse’, and the unnecessary inclusion of ‘male’, was something most of the study’s participants identified with.

Bulsara. C., Juliff. D., & Russell. (2016). Male or Nurse what coms first? Challenges men face on their journey to nurse registration. Australian Journal of Advanced Nursing, Vol 34(2), p45-52.

“Some patients don’t really see me as a nurse sometimes,” said Daniel.

“I always try to correct that one,” Dan Prentice said. “If you’re a nurse, you’re a nurse, and it doesn’t matter what your gender or background is.”

Nursing and Midwifery Board of Australia. Registrant Data, 2016. Health Workforce Australia. Australia’s Future Health Workforce – Nurses. Detailed Report. (August 2014).

indepth CAMPAIGN

Next on the penalty rates chopping block… nurses and midwives? ■ Fair Work Commission hands down long awaited decision to cut penalty rates. ■ Up to one million retail, hospitality and fast food workers will lose money. ■ Proposed cuts to nurses’ Sunday penalty rates withdrawn thanks to community outrage. ■ This is a great win but a warning of what is to come. ■ QNMU seeking a commitment from employers to protect existing penalty rates.

It is said to be the biggest pay cut since the Great Depression. After months of agonising and despite furious campaigning from unions, Australian workers were finally dealt the blow they (almost) saw coming when the Fair Work Commission recently handed down its decision to slash penalty rates.

Under the ruling, Sunday penalty rates for retail, hospitality and fast food workers would be reduced by between 25 to 50 per cent, and fulltime employees would have public holiday rates cut by 25 per cent. It is estimated the cuts could impact nearly one million workers, with some potentially losing up to $6000 a year. Within hours of the announcement, and following local union and community campaigns, some businesses across the nation had stepped forward to announce they would not be applying the ruling made by the Commission. But for many others, the FWC’s decision will cut straight to the heart of many of Australia’s lowest income earners.

Shock, alarm and worry workers react to the cuts Many of those directly affected are our family and friends. QNMU member and personal carer Elesha Dawson witnessed firsthand

the stress the announcement caused to her friends working in the retail and hospitality sector. “They’re saying there just isn’t any point in working weekends anymore — they don’t want to give up time with their families and friends if they aren’t going to get the extra rates to make up for that,” Elesha said. “Many of my friends who are still in university can only work on the weekends and this will have a huge impact on them.” For Elesha the penalty rates decision was felt on a personal level – she was a hospitality worker for many years while studying to become a Personal Carer. “I would work three or four hours every day after class and on the weekends, and all I can say is I’m really glad I don’t work in hospitality anymore. This would have absolutely affected my ability to continue studying at the time and still make ends meet,” she said. Like many health workers, Elesha is worried these cuts will eventually spread to their professions.

CAMPAIGN indepth “We’ve already been talking about this amongst us carers and everyone said they wouldn’t want to work weekends if we weren’t going to get penalty rates,” Elesha said. “I myself currently work weekends and if I didn’t have my penalty rates I won’t make enough money to cover my bills that’s for sure.”

Slippery slope becomes a reality Our worst fears were realised when Sonic HealthPlus proposed a 25% cut to nurses’ Sunday penalty rates in their new enterprise agreement. This proposal was quickly withdrawn thanks to an overwhelming response from the community, all expressing their outrage at the idea of nurses losing their penalty rates. While this is a fantastic win for our nurses at Sonic HealthPlus and a testament to what we can achieve when we work together, it’s also a warning of what is to come. We anticipate there will be more attacks on our penalty rates from other employers in the future. As seen with the Sonic HealthPlus incident, the Commission’s decision marks the beginning of a slippery slope where employers will now be more inclined to seek to reduce penalty rates, including for all nurses and midwives who are covered by the Nurses Award 2010 (except Queensland government employees).

“But the good news is nurses and midwives still have the right to stand up and say no to any attempt to cut our penalty rates.” Elesha believes it is now more important than ever for workers to stand together to defend penalty rates. “I would really encourage people to join their union and get more involved — we all have a voice but we need to speak in numbers to be heard,” she said.

What next for penalty rates? The FWC has now called for submissions on how the cuts should be introduced, with many employer groups asking for it to be brought in quickly.

Get involved! There are a number of simple things you can do to join the campaign and help protect penalty rates. ■ Sign and share the Megaphone petition at http://bit.ly/2lr4PEl ■ Call your federal MP to voice your concern. ■ Ask a friend to join a union — the only reason we have penalty rates, let alone a minimum wage, sick leave, or annual leave, is because courageous women and men joined together and fought for them. ■ Support local businesses that choose not to reduce their employees’ penalty rates.

Beth said the QNMU would continue to work with other unions, as we have since the beginning, to protect existing agreements.

Social media reacts to penalty rate cuts SB The health industry will be in Fair Work’s sights.

“As nurses and midwives, we stand up for what is right and fair, and Australians have worked very hard to earn our penalty rates,” Beth said.

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NS Outrageous! Workers, now more than ever need to galvanise and stand together in the fight for fair wages and working conditions.

“This is a priority for the QNMU and we will be campaigning hard through political avenues and EB negotiations to protect your penalty rates.” The QNMU is currently seeking commitments from employers to maintain current penalty rates.

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QNMU Secretary Beth Mohle said this could make it more difficult for nurses when it comes to bargaining for enterprise agreements.

Proposed changes to Sunday penalty rates in the Hospital and Retail Awards

“Should penalty rates in the Nurses Award 2010 be reduced, it would be more difficult for the QNMU to defend our members’ current penalty rates in their enterprise agreements,” Beth said.

Hospitality Award

“The decision to cut penalty rates was made by the same Commission that creates and changes the Award that applies to all nurses and midwives, and it is this very same Commission that decides whether or not to approve enterprise agreements that apply to these nurses and midwives.

Award Full-time and part-time employees: (no change for casuals)

Sunday Penalty Rate 175 per cent  150 per cent

Fast Food Award (Level 1 employees only) Full-time and part-time employees

150 per cent  125 per cent

Casual employees

175 per cent  150 per cent

Retail Award Full-time and part-time employees

200 per cent  150 per cent

Casual employees

200 per cent  175 per cent

Pharmacy Award (7.00am - 9.00pm only) Full-time and part-time employees

200 per cent  150 per cent

Casual employees

200 per cent  175 per cent

Source: Fair Work Commission – Summary: Penalty rates case decision

indepth FEATURE

At the heart of nursing

Margaret Fontana and her husband Gid

ENROLLED NURSE AND QNMU MEMBER MARGARET FONTANA HAS CARRIED THE HEART OF NURSING INTO HER RETIREMENT, DEDICATING HER TIME TO RAISING MUCHNEEDED FUNDS FOR CHARITIES.

OR THE past five years 63-yearold Margaret and her husband Gid have opened up their home and gardens in Silkwood to host an annual fundraiser, with proceeds donated to Lifeline, the Drought Appeal, the Animal Refuge and other charities.

years we’ve been able to expand and donate to more and more charities.

Margaret initiated the annual High Tea Fundraiser shortly after she tragically lost both her daughters and unborn grandchild.

Aside from offering guests an elegant high tea experience, the fundraiser also boasts a myriad of stalls selling bric-abrac, books, fresh produce, plants, and even an art exhibition.

Her daughter Rachael was 38 weeks pregnant when she died in an accident on her way to a prenatal appointment at the Innisfail Hospital. Rachel’s older sister Tania sadly took her own life two years later. For Margaret, the fundraiser is something positive that has come from the tragedy of her daughters’ passing. “We had to do something to ease the pain. This is just my small way of helping others and showing them there is support out there for them,” Margaret said.

Photos: Anne Wilkinson

“Initially, the fundraiser was to raise money for Lifeline but in recent

“In our very first year, we had 120 to 150 people attend the fundraiser and raised $3,000. This past year, we managed to raise $14,000 with around 400 people in attendance.”

Margaret said her community rallied to support the fundraiser, lending their time to staffing the stalls and generously donating items to be raffled to help raise money. “We live in a small town in Innisfail so it was wonderful to see people get behind the cause and donate clothes, artwork, plants — everything really!” she said. “We have never asked local businesses for donations and have been helped by friends and family. “We get more and more people attending each year so we’re

FEATURE indepth constantly doing the dishes and food is always coming out of the kitchen!” In honour of her daughter’s memory, Margaret also generously funds two bursaries to help students at Rachel’s alma mater, the University of Southern Queensland. They are the Rachael Fontana Memorial Bursaries for the Arts and for financial hardship. “Rachael derived joy from affording pleasure to others and the bursaries reflect her passion for art and her compassion toward others,” she said. “I’m glad that these bursaries are now helping others in their time of need, and in a lot of ways that is at the very heart of nursing.” Margaret’s passion for helping others comes as no surprise. As an Enrolled Nurse of more than four decades, she threw herself into caring for people when her nursing career began in 1975 at the age of 20.

Margaret (right) and her friend Pam Burns from Cairns at Margaret’s High Tea Fundraiser.

With her mother and both sisters already Registered Nurses, Margaret knew there could be no other career path for her. “They certainly had a big influence on my decision to pursue nursing. It very much runs in the family,” Margaret said. Having worked in a small hospital in Innisfail, Margaret reflected it was often the little things that made a difference to her patients. “Over the years you often see the same people and they just love to see a face they know.

Midwives’ Union was the one constant that helped her through. “I was struggling both emotionally and financially after the death of my daughters and the QNMU supported me through these dark times.

“The day I retired I cried as I have loved being a nurse.”

“I think it’s really important for people to join their union. You never know when you may need help and it’s the security of knowing there is help and support there if you ever need it.”

Margaret thinks fondly on her time as an EN, saying the social aspect of her work is what she will miss most.

Despite recently stepping into retirement, Margaret has no intention of slowing down.

“Whether it’s with your colleagues or with patients, nursing is all about human interaction and I love that,” she said.

“Now that I’m retired I can contribute even more time toward my annual fundraiser,” she said.

“I was only an EN but I have loved the human touch of nursing like a back rub, hot pack and a cup of tea.

“However, the one thing I won’t miss is computers! I know we need them but they are a struggle some days.” Through the difficult times, Margaret said the Queensland Nurses and

“The work is constant — when one fundraiser ends we begin planning for the next right away. “I intend to continue hosting the fundraiser every year until I’m too exhausted to continue!”

The day I retired I cried as I have loved being a nurse. Annual High Tea Fundraiser Margaret’s annual High Tea Fundraiser will be held in the ﬁrst week of September in Silkwood, Innisfail. Tickets cost $10 for adults and $5 for children. Margaret welcomes donations for sale at the fundraiser and can be contacted on mgfontana81@gmail.com

infocus CPD HERE ARE no laws in Australia that require mandatory reporting of elder abuse generally.

However, the Aged Care Act 1997 imposes compulsory reporting requirements upon approved providers who care for recipients of funded aged care, whether that care is provided in the person’s own home or in a residential facility. Elder abuse is more than just physical abuse. It encompasses any act or omission that results in some form of harm or detriment to the older person. This can be through physical, sexual, financial, psychological and social abuse. It also includes the neglect of the person, particularly regarding their care needs. Registered and Enrolled Nurses and Assistants in Nursing (however titled) have a responsibility to report instances, or suspicions, of elder abuse to their employer. Reportable assaults are fairly obvious to those who work in aged care. They include the unnecessary or unlawful use of force, such as restraint or sexual contact without consent.

Elder abuse: RECOGNISE AND REPORT IT

Providers are required to educate their staff about what is a reportable assault and how to report it to the police and the Department of Health (the Department) within the mandatory 24 hour timeframe.

Abuse not always obvious Other forms of elder abuse can be more subtle. Financial abuse can result from a friend or family member having access to, or control over, the older person’s bank accounts. This most often occurs to enable the caring friend or relative to pay the older person’s bills, or buy their groceries. But occasionally the freedom to access money can lead to temptation. Suspected financial abuse can also be reported to the Department and to the police. Neglect is also a significant contributor to elder abuse and can be the end product of ‘missed care’ (i.e. care that could not be completed because management did not provide sufficient staff).

CPD infocus Neglect can also result from delayed care, such as a resident waiting a long time to have their cares attended to.

Staffing and Skills Mix Report Project. See page 26 for our article on this report.

To calculate the skill mix, half of those staff should be AINs – in this case 9 — with 6 RNs and 3 ENs (as a minimum).

The biggest contributor to elder abuse

Calculating staffing and skill mix

In today’s aged care sector, staff are stretched beyond their limits and simply cannot keep up with the demands of caring for large numbers of residents, especially when most of them require frequent and complex health care.

All RNs should consider the number of nursing hours being put into their facility and compare it with the evidence base.

See table 1 (over page) for the evidence-based minimum staffing level and skill mix on each shift for residential aged care facilities of various sizes.

Many QNMU aged care members report going home exhausted, knowing they could have done more to care for their residents if management had provided appropriate staffing levels. As a result, missed and delayed care could well be the biggest contributors to elder abuse. However, they are often not acknowledged as such and go unreported. When aged care staff report instances of missed or delayed care to their employer it is often received in the context of a workload issue and then becomes an industrial matter about adequate staffing. Even worse, members are falsely accused of not managing their time better.

This calculation is easy to do. Simply add up all the direct care hours put into each shift over a 24 hour period and divide this figure by the number of residents. For example, a facility with 100 residents should have 430 hours of direct care rostered over a 24 hour period. This equates to just fewer than 54 eight-hour shifts. If equally divided between each shift then we would have 18 staff on each shift for 100 residents.

If we calculated that night shift required only 70% of the recommended staffing number, then the numbers in the above table would be even higher for day and afternoon shifts.

Back to reality… Unfortunately we are well aware residential facilities are staffed well below these recommended levels. That is why the QNMU and the ANMF are lobbying government departments, including the Aged Care Financing Authority, to conduct a comprehensive review of aged care funding. We’re also campaigning for legislated ratios in aged care.

Care staff must keep in mind that the end product of excessive workloads, created by the employer’s failure to provide an evidence-based staffing model, is missed or delayed care — in other words, elder abuse. RNs and ENs also have a statutory duty to provide high quality care. This duty arises from the Code of Professional Conduct for nurses and the relevant Standards for Practice. Nurses also have a duty to engage evidence-based practice when providing nursing care to people. RNs must also consider the staffing and skill mix in their area of practice and whether it is sufficient to provide quality care. The current evidence-base for care staff numbers in residential aged care is as follows: ■ Minimum nursing hours per resident day: 4.3 ■ Skill mix: 30% RN, 20% EN and 50% AIN. The above figures have been taken from the ANMF’s recent Aged Care

infocus CPD

TABLE 1:

REFLECTIVE QUESTIONS

Minimum staffing level and skill mix on each shift (numbers distributed equally across each shift)

Resident number

AIN

120

140

200

*NB: fractions are rounded up to the nearest whole number

Recent news items from regional Queensland highlighted the missed care that can occur when facilities do not provide appropriate staffing and skill mix.

Until such time as providers acknowledge that missed care is not just a workload issue but also a legal issue relevant to abuse, there will be little incentive to make effective change.

A resident left to sit in their own faeces waiting for a relative to arrive to clean them is grossly unacceptable and should be condemned.

Your role

Yet managers try to justify the staffing levels and skill mix despite this neglect occurring. The fact that such facilities can gain accreditation as an approved residential aged care facility is evidence that the accreditation system is fundamentally flawed and needs a total overhaul. Governments and providers must accept that where residents require complex health care, they require nursing care. The law in every state and territory requires that nursing care must comply with the Codes and Guidelines of the NMBA. If these maxims are accepted, and it is difficult to argue against them, then it must be acknowledged by all parties that quality aged care can only occur if it meets the standards of the nursing profession. Such standards require minimum nursing hours per resident day, expressed as a nurse-to-resident ratio, and a skill mix percentage that meets the evidence-based research. The QNMU has campaigned long and hard for improved staffing and skill mix in aged care. We will not waver from that course.

Members working in aged care can assist our campaign for quality aged care. If your facility does not compare to the above table then it is likely missed or delayed care is occurring. Wherever missed or delayed care occurs because there is insufficient time or resources to complete the activity, the employer is at fault. Members should report such occurrences to their facility manager as a quality care issue. For RNs and ENs, this is a mandatory requirement under the nursing professional practice framework. Being forced by your employer into a position where care is missed or delayed is professionally and morally unacceptable. Report it to your care manager or Registered Nurse and lead the way to quality care in aged care.

1. The NMBAâ&#x20AC;&#x2122;s Code of Ethics for Nurses gives clear advice on your nursing obligation to provide quality care. Read Value Statement One and consider how that might apply to your work in aged care. What actions could you take in your facility to ensure you have complied with that statement? 2. If you have occasion to defer some care activities on to the next shift, what does that say about staffing in your facility? What can you do about it? Visit www.qnmu.org.au/ workloads and review the QNMUâ&#x20AC;&#x2122;s information regarding staffing and workloads and write down a plan of action for addressing such instances of missed or delayed care. 3. If you are reluctant to report instances of missed or delayed care to your supervisor, what other actions could you take to address the concerns? How can the QNMU help with quality care issues at your facility? 4. AINs and carers also have obligations, in that they are required to provide safe and ethical care under their National Code of Conduct. As an AIN or carer, think about how you would articulate your concerns regarding missed or delayed care to the registered nurse. To assist you, read the NMBA Code of Ethics for Nurses so that you will fully understand what your National Code of Conduct means when it states you must provide safe and ethical care.

The QNMU has campaigned long and hard for improved staffing and skill mix in aged care. We will not waver from that course.

CPD infocus

ACTIVE PATIENT PARTICIPATION IN BEDSIDE HANDOVER BY GEORGIA TOBIANO RN BN (HONS) PHD. NURSE RESEARCHER, GOLD COAST UNIVERSITY HOSPITAL

HANDOVER is a high risk communication process, with miscommunication being the second leading cause of sentinel events in hospitals. Active patient participation in handover is increasingly advocated as a vital strategy to improve the safety and quality of health care. Patients value bedside handover, wanting the opportunity to access information and meet their nurse, but it does not always occur (Tobiano et al., 2016).

The study Our team investigated patients’ and nurses’ preferences for bedside handover and the barriers to its occurrence (Whitty et al., 2016). We surveyed 400 patients and 200 nurses at two hospitals, one public and one private in Queensland and Victoria. We found striking similarities between patients’ and nurses’ responses to many questions. Both agreed that the most important aspect of bedside handover was inviting patients to participate. The second most important aspect for both parties was active patient participation (the patient listens, asks questions and speaks up). However, there were some differences. Having a family member/friend/ carer present was important for patients, whereas for nurses it was of little importance. Patients had a weak preference for how sensitive information was

Georgia Tobiano administering survey to patient on iPad.

handled but nurses expressed a strong dislike for disclosing sensitive information quietly at the bedside. A more accepted preference for nurses was to point to written sensitive information during handover. Nurses identified three main barriers to bedside handover. First, they were concerned about patients and third-parties hearing sensitive information. Second, they thought patients, family members and other nurses disrupted the flow of information. Finally, they stated that individual patient and nurse views or capabilities hindered bedside handover.

Key messages Patients and nurses want patients to be invited to actively participate in bedside handover. However, they can be viewed as ‘disruptive’. The treatment of sensitive information may be of greater concern to nurses than patients. Finally, there is no one-size-fitsall approach. Patients are unique in terms of their conditions and preferences. Using clinical judgement and conversing with patients to check if they want bedside handover ensures we are patient-centred nurses.

REFLECTIVE QUESTIONS 1. On reflection, do you encourage patient participation in bedside handover? 2. What information can patients contribute to bedside handover? 3. What strategies could you undertake to encourage patient involvement in bedside handover? 4. How do you deal with confidential and/or sensitive information during bedside handover? 5. Do you and colleagues on your unit have a consistent approach for dealing with sensitive and/or confidential information during bedside handover? 6. How would you approach a situation where you deem it inappropriate to conduct handover at the bedside?

References Tobiano, G., Marshall, A., Bucknall, T., Chaboyer, W., 2016. Activities patients and nurses undertake to promote patient participation. Journal of Nursing Scholarship 48 (4), 362-370. Whitty, J.A., Spinks, J., Bucknall, T., Tobiano, G., Chaboyer, W., 2016. Patient and nurse preferences for implementation of bedside handover: Do they agree? Findings from a discrete choice experiment. Health Expectations 2016.

RESEARCH TEAM: JENNIFER WHITTY, JEAN SPINKS, TRACEY BUCKNALL, GEORGIA TOBIANO, WENDY CHABOYER

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SHIFT HANDOVER – DON’T DISREGARD YOUR DUTY OF CARE

It is not unusual for a nurse or midwife to leave their shift early for one reason or another. HOWEVER, a recent decision by the NSW Health Care Complaints Commission (HCCC) Professional Standards Committee (PSC) should be noted by all nurses and midwives. The matter concerned an experienced Registered Nurse who was working overtime on a unit on the early shift and was rostered to work their usual afternoon shift at a hospital in the same service nearby. The nurse didn’t mention the afternoon shift to the team leader until after lunch, asking if they could leave early at 2.15pm to allow sufficient time to get to the other shift, which was due to start at 2.30pm. The team leader advised the nurse to leave at 3pm. However, the nurse left the unit at 2.35pm without seeking the team leader’s permission. They had also neglected to complete the 2pm and 2.30pm observations and documentation on one of their patients. The PSC emphasised the critical importance of discussing such matters at the start of a shift during handover. This discussion would have notified the team leader of the later shift and informed other staff that there may be additional duties to cover towards the end of shift. The PCS was also critical of the nurse for their casual approach to the overtime shift, stating, “It should not

be the case that a Registered Nurse would take the attitude that one shift is less or more important than another”.

Members should be aware that an additional or overtime shift should always be treated with the same importance as your regular shift.

Further criticism arose because the nurse left the ward without giving an adequate handover, did not complete observations, did not ask another staff member to complete them, and made inadequate clinical notes.

Helping your colleagues by covering a shortage on a shift does not mean you can take it easy. Your professional accountability is just as alive as at any other time.

The RN was reprimanded and quite restrictive conditions were imposed for 12 months, including: ■ Must not work two consecutive shifts ■ Must not work for a nursing agency ■ Must not work for more than one employer where there is a risk of competing shift arrangements ■ Must not practice nursing except under the supervision of a Registered Nurse, who must be on-site, work in close proximity and oversee their practice ■ Must be supervised by a CNC who will oversee the nurse’s supervisors and provide three-monthly reports to the Nursing and Midwifery Council of NSW ■ Must have face to face weekly meetings with the CNC ■ Must not be a shift or team leader ■ Employer and supervisor to report any concerns about the nurse’s practice or any breach of conditions.

If you are leaving your shift early you should always get your team leader’s permission and document the time and permission on your time sheet. Just as significant is the need to complete any observations you have and handover the care of your patients to another competent Registered Nurse before you leave.

REFLECTIVE QUESTIONS 1. Review the NMBA’s Code of Professional Conduct for Nurses in Australia. What does it say about your accountability to your patients or residents? 2. If your colleague decided, or was approved, to leave the shift early, what matters would you raise in your conversation with them before they left? 3. Does your facility have a policy about leaving shift early? Do you think it should? What would be the critical content of that policy?

CPD infocus

NURSES LEADING GLOBAL RESEARCH IN PARTNERSHIP WITH CLINICIANS AND HEALTH CONSUMERS BY DR RACHEL WALKER, RN, BN, BA, MA (RESEARCH), PHD RESEARCH FELLOW, NATIONAL CENTRE OF RESEARCH EXCELLENCE IN NURSING (NCREN), GRIFFITH UNIVERSITY AND DIVISION OF SURGERY, PRINCESS ALEXANDRA HOSPITAL

LAST YEAR I attended the Sigma Theta Tau International Nursing Research Congress in South Africa titled Leading Global Research: Advance, Practice, Advocacy and Policy. While acknowledging the fundamental care-role inherent in nursing, the congress highlighted the nursing role beyond the local and the clinical to encompass national and international issues and audiences. The objectives of the congress were to identify opportunities for collaboration within nursing and beyond, enhance nursing knowledge via research and evidence-based practice, translate evidence into practice, and interpret and evaluate the influence of evidence on practice and policy (STTI, 2016).

So, what is knowledge translation? Put simply, knowledge translation is putting knowledge into action. It is defined as “a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve health” (CHIR, 2016). This process takes place in a complex system of interactions between researchers and key stakeholders to understand the context and enable the development of interventions that improve health services. An example of this approach is a NCREN pilot project where researchers have been working collaboratively with clinicians, health consumer and family member

representatives in participating wards in two Queensland Health facilities. The study’s objectives include: 1. Understanding the barriers and facilitators to timely reporting and intervention in patient clinical deterioration 2. Developing a tailored, multifaceted behaviour change intervention in partnership with clinicians using the results from focus groups and individual interviews to implement in the ward 3. Assessing whether a local intervention developed in partnership with clinicians and health consumer and family member representatives holds promise for improving timely reporting and intervention of clinical deterioration in patients. The Knowledge to Action Cycle (KTA) has underpinned the design of the study (Graham & Tetroe, 2010), providing a flexible framework that can be adapted to a particular setting or group. Understanding the context and the type of interactions between all individuals within it (clinicians, researchers, health consumers and family members) is important when trying to understand what helps or hinders a particular practice or process. It’s also important to understand this when developing ways of modifying the context or behaviours that contribute to the barriers. Analysis of data gathered during this project is currently underway.

REFLECTIVE QUESTIONS 1. Think about the specific features of your clinical setting. Are there social, policy, or environment (i.e., the physical layout) aspects that help or hinder certain clinical practices or communication processes? 2. When implementing changes in your clinical setting, do you consult with all of the key stakeholders within the environment (such as other members of the health team, patients and family members)? Do you think their perspective and ideas could improve intervention roll-out?

References Canadian Institute of Health Research [CIHR], (2016). About us: Knowledge Translation: http://www.cihr-irsc. gc.ca/e/29418.html#2 Graham ID, Tetroe JM. (2010).The Knowledge to Action Framework. In: Models and Frameworks for Implementing Evidence-Based Practice: Linking Evidence to Action. West Sussex, UK: John Wiley & Sons Ltd and Sigma Theta Tau International Honor Society of Nursing; p. 207-21. Sigma Theta Tau International [STTI], (2016). 27th International Nursing Research Congress Program, Cape Town South Africa, 21-25 July: https://issuu. com/stti/docs/2016_congress_digital_ program_book?e=15279701/37158491

Acknowledgements Funding for this project was received from the Queensland Government’s Health Innovation, Investment and Research Office, Griffith Health Institute and NCREN.

infocus CPD

Wellbeing at work IN MY PAST few columns I have been writing about building a better work environment. We need to understand the system we operate in and realise how we can change it. At the same time we must understand that we as individuals also operate as a system which impacts the work we do. For the next 12 months the focus of my article will shift from review of the external system to the internal one which impacts our work and wellbeing, and look at professional growth through self-care and selfawareness. The “resilient nurse” has been an emerging concept in professional literature in recent years. Self-care as a profession as well as individually is essential to the practice of nursing and midwifery. There is wide recognition that nurse/midwife wellbeing directly impacts on patient experience and outcomes so we have a professional responsibility to be well and feel good.

Current context and research paints a bleak picture A retrospective mortality study in Australia, 2001 -2012 showed that suicide by nurses was four times more likely than those in other occupations (MJA 2016). In September 2016 it was reported that nurses across France went on strike or were wearing black

armbands to protest unbearable working conditions that had seen five nurses commit suicide that year.

midwifery, and the danger if we get disconnected from that because of workload or culture.

Research published by Griffith University in September 2016 concluded midwives carry a high psychological burden with one in five midwives meeting the criteria for post-traumatic stress disorder. (Milner et al.)

■ Building sustaining relationships — the importance of social support at work and at home, collegiality, mentoring care and kindness to each other — formal professional processes as well as the informal social.

Findings of Monash Business School (2016) nurses and midwives’ wellbeing survey told us that almost a third of Australia’s nurses are thinking of leaving the profession because they are overworked, undervalued and in danger of burning out.

■ Managing stress and healthy habits around shiftwork — including sleep, diet, physical exercise and mindfulness practice to deal with grief and loss in the workplace.

Building individual resilience and strengthening the collective As nurses and midwives burn out and leave, the profession grows weaker. The collective relies on the strength of individuals. This year’s series of articles will explore the elements of our internal system which we can activate to ensure we are creating the culture within and without to sustain and strengthen us.

Burnout leads to lack of care and we have to take responsibility for that — as individuals and as a profession. We set and maintain the standards that prevail in our personal and professional lives. References Business Insight. 2016. Monash business school. [ONLINE] Available at: https://business. monash.edu/business-insights/australiannurses-and-midwives-contemplate-leavingprofession-as-workloads-bite-survey. [Accessed 6 March 2017]. Milner, A, Maheen, H, Bismark, M, Spittal, M. 2016. Suicide by health professionals: a retrospective mortality study in Australia, 2001–2012. MJA, 205(6), 260-265.

Healthy habits we can cultivate and will explore in future include: ■ Practice of reflection and self awareness - understanding our strengths, weaknesses and motivations, recognising the intrinsic reward of nursing and

Sandra Eales QNMU Assistant Secretary

CPD infocus

GOOD FOOD MEANS BETTER HEALTH FOR SHIFT WORKERS

HEALTHY eating is an important issue for nurses and midwives, particularly those working shift work. There are a plethora of studies on shift workers – including a literature review by Zhao and Turner (2008) – which confirm the relationship between shift work and negative health outcomes, such as poor diet and obesity. All shift working nurses and midwives know the difficulty in organising a healthy meal to take to work with all of life’s competing priorities. Rather than eating unhealthy snacks on the go or skipping meals altogether, having access to a vending machine offering a healthy food range is an option we support. The QNMU recently met with representatives of a local company that provides vending machines to hospitals. These vending machines provide a variety of healthy food choices — such as salads, pasta, risotto and soup — rather than the usual unhealthy options, particularly for staff who perform shift work and find it difficult to access a healthier alternative. While the QNMU is unable to endorse a particular company, we believe nurses and midwives working shift work and weekends should be afforded every opportunity to access healthy food in the workplace and it appears this kind of well-considered vending machine service can help fill that need. But it’s not only the type of food a shift worker eats that can affect their health, it’s also when they eat during their shift– particularly during night shift. While it’s not ideal to eat when the body’s circadian rhythms say we should be sleeping, there are strategies you can employ to minimise how this affects your general health. What’s more, at a very basic level, eating well and at the right times can also assist in managing fatigue.

Tips for eating healthy Workplace Health and Safety Queensland, which is the state’s safety regulator, in conjunction with Diabetes Australia, provides the following advice to reduce the effects shift work has on a night worker’s diet: ■ AFTER SHIFT AND BEFORE SLEEPING – small breakfast to help you sleep and stop you from waking due to hunger ■ AFTER YOU SLEEP – lunch meal to provide you with energy for the day ■ NIGHT TIME MEAL BREAK: ◆ Early in your shift – small dinner, meal or snack (including protein) ◆ Late in your shift – a small snack every few hours to keep you alert and energised. It is important to note that for these rules to be effective, all meals should be a healthy balanced diet — so ditch the junk food! And even though it may be difficult, they also recommend avoiding caffeine at least six hours before sleeping. The full document is available at http://bit.ly/2o0YaTd

Reference Turner. C. & Zhao. I. (2008) The impact of shift work on people’s daily health habits and adverse health outcomes. Australian Journal of Advanced Nursing, Vol 25(3), p8-22.

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CHECK OUT WHAT PEOPLE ARE SAYING ON SOCIAL MEDIA

JOIN THE CONVERSATION

ON PENALTY RATES CO This is a major blow to a lot of people who work hard and give up their lives to serve others. Like · Reply

CJD The health system will stop if they cut penalty rates for nurses on Sunday and public holidays. Find one nurse that will work for that flat rate. It won’t happen I hope.

Follow our social media pages and be a part of the conversation on hot topics and what’s important to nurses and midwives.

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/qnmuofficial HH With the stress and pressure that nurses and midwives work under, they will not turn up to work or be in the profession if penalty rates are cut. You look at the statistics of nurses and midwives looking to leave the profession, not to mention expertise that you’d lose.

On male midwives

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TS If they cut nurse and midwifery penalty rates, watch the number of staff dwindle on weekends and holidays. Like · Reply

On aged care facilities CO Unless the government legislates nurse-to-patient ratios this abuse of our elders will continue. The nurses that work in aged care need to stand together and say they are not going to take this anymore and so force change. Like · Reply

CW So sad that it still remains profit over care. The work that our aged care colleagues do is strenuous, heavy and emotional. There needs to be extra time so that quality 1:1 time can be spent as well as getting the routine tasks attended to with dignity and care. Like · Reply

On workplace bullying

On mandated minimum midwife-to-patient ratios KM Putting on more graduates isn’t going to help the current situation. The government needs to improve the working conditions for our experienced, senior nurses to ensure they stay. Having too many junior staff entering the workplace and the senior staff leaving because they are sick of the conditions only compounds the issues.

MH I had the most marvellous midwife in Canberra almost 30 years ago now. His name was John and he was Portuguese, I often wonder if he continued on as a midwife as he was a student at the time. A very gentle and caring man. Like · Reply

TI We certainly need to break down barriers. Some of the most caring midwives I’ve met are male. Not to mention that their critical thinking skills in the clinical setting were exceptional and (as a student) taught me a lot in a very short space of time. Like · Reply

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AA It’s not so much the lack of midwives, it’s the lack of money willing to be spent to pay enough of them to do the work. Babies are not counted in the midwife-to-patient ratio, yet they usually take more of the midwife’s time. So on paper of 1:5 it looks ok, but in reality it’s 1:10. That’s where the problem is! Like · Reply

On midwifery led models of care WM The midwife led model is evidence based and proven successful. Any experienced midwife will know when assistance is needed. Midwives are specialist practitioners, with women and baby 100%. Like · Reply

TO I had an issue with repeated bullying in the workplace. This affected my physical & emotional health which ultimately impacted on my clinical practice as a Registered Nurse. The QNU provided invaluable support during the grievance process. I cannot thank the QNU enough. Like · Reply

On Blue Care CM It’s good to see the Queensland Nurses’ Union calling a bad EB for what it is. Members TRUST Unions to do exactly this, not cave in the face of what might become from the Un-Fair Work Commission! Like · Reply

MK Midwifery is an art that is a woman-focused approach and midwives have the ability to observe, interpret and support women in child birth. Like · Reply

incoming WIN

Letter to the Editor Dear Beth, As of today I have retired from nursing, I was only an EEN but have loved the human touch of nursing like a back rub, hot pack and a cup of tea. These little things often make a difference and make a patient more comfortable. In a small hospital over the years you often see the same people and they love to see a face they know. I cried as I have loved nursing with both my sister and mother being nurses as well. My husband has not been in the best health for a few years and now it’s our time. Thank you to the Nurses’ Union as you have helped financially and supported me through the loss of two daughters and unborn grandchild and after both cyclones. I wish you all the best in the New Year. Kind regards, Margaret Fontana Check out page 36 to see what Margaret has been up to in her retirement.

Editor’s response: Wishing you a lovely and happy retirement Margaret. As an EEN you contributed so very much — so you can replace the word ‘only’ with ‘proudly’! Beth Mohle

A BOOK FOR YOUR FAB PHOTO

We even have a book prize for the best one — you get to choose ONE of these titles.

on the Moon, the nation’s only marsupialbased Walkley award-winning cartoonist, and brilliant mind behind creations like the ABC Interpretive Dance Bandicoot and Ian the Climate Denialist Potato.

Outback Midwife by Beth McRae:

A Mother’s Story by Rosie Batty: In this

The story of Beth McRae’s 40 years as a midwife, from her ‘terrifying’ first day witnessing birth as a naïve student nurse to a long career delivering babies from the city to the bush and a remote Aboriginal community in Arnhem Land.

brave book Rosie Battie shares her story of grief, pain and resilience detailing years of family violence and how she navigated the horror and anger that followed her son’s murder at the hands of his father, to become an outspoken crusader against domestic violence.

Righto people, get those smartphones and cameras snapping because we want your pics! Yes we are keen to share photos of our members’ activities — everything from training days and morning teas to fundraisers and everything in between.

A Treasury of Cartoons, by First Dog on the Moon: A glorious collection of cartoons by The Guardian’s First Dog

Email full-size pics and image details to inscope@qnmu.org.au

What is the most rewarding aspect of being a midwife?

Peta Zupp

Chris Boynton

Lyn Barrett

MUM (Toowoomba)

Acting MUM (Townsville)

Midwife/NUM (Ipswich)

The thing I most enjoy from my leadership role is supporting the staff to advocate for midwives and work really hard to get the right people in the right place every day.

I love the impact you can have on a new family. Seeing people beginning their families and that moment when a mother sees her baby for the first time is incredibly rewarding.

I love being a midwife because of the reward you get from seeing a mum and bub go home, with the woman feeling confident and competent to be a mother.

in view

We stood with mums, dads, bubs, midwives and nurses at Maternity Consumer Networkâ&#x20AC;&#x2122;s rally in support of midwives across Queensland.

A big welcome to all our new nursing and midwifery graduates! The QNMU was excited to be at orientation days across Queensland to meet and support our new grads.

We were outside the Fair Work Commission with other unions standing up to save penalty rates for all Australians as we waited for a decision to be handed down. See page 34 for details.

in view The Prince Charles Hospital QNMU Branch hosted their first ever professional seminar on 8 March. Thanks to the branch, particularly Moira Purcell, and Organiser Kim Ramsdale for coordinating the event, which was a great success!

Midwives heard from qualified wellness experts and learned practical tips on taking care of ourselves at the recent Midwifery Wellness Event. More info on page 9.

SEND US YOUR PICS AND WIN!

Got a great pic of nurses and midwives? Send it to us at inscope@qnmu.org.au for a chance to win a book prize. See page 47 for details.

CALENDAR

April QNMU toolkit talks (webinar) 20 April – Collegial Generosity Mary Chiarella www.qnmu.org.au/education

Lung Health Promotion Centre at The Alfred 20–21 April 2017 Managing COPD 27-28 April 2017 Spirometry Principles & Practice P: (03) 9076 2382 E: lunghealth@alfred.org.au

QNMU training 26 April: Aged Care - Rosters, workloads and consultation, Brisbane 27 April: Aged Care and Private Hospitals - Getting prepared for our next agreement, Brisbane www.qnmu.org.au/education

11 May: Creating a safe workplace (WH&S), Cairns 16-18 May: Workplace Representatives 1, Brisbane 24 May: QH - BPF for NUM’s and MUM’s, Brisbane 30-31 May: Knowing your entitlements and understanding the Award!, Townsville www.qnmu.org.au/education

International Day of the Midwife 5 May

Holistic Nurses/Midwives Retreat Bali 8-13 May 2017, Sanur, Bali http://nurses-healing.com/ holistic-nurses-retreat-balimay-2017/

Nursing and Midwifery in the Tropics – Expanding your Horizons Symposium 11-12 May 2017, Cairns, Qld www.bit.ly/NurseSymposium

14th National Rural Health International Nurses Day Conference 26-29 April 2017, Cairns, Qld www.ruralhealth.org.au/14nrhc

Nurses and Midwives Wellness Conference 27 April 2017, Melbourne http://bit.ly/ANMFevents

Health and Environmental Sustainability Conference 28 April 2017, Melbourne http://bit.ly/ANMFevents

May Lung Health Promotion Centre at The Alfred Respiratory Course (Modules A & B) 1–4 May 2017 – Respiratory Course (Module A) 1–2 May 2017 – Respiratory Course (Module B) 3–4 May 2017 – Asthma Update 26 May 2017 P: (03) 9076 2382 E: lunghealth@alfred.org.au

QNMU Meeting of Delegates 3 May - Rockhampton 4 May – Mackay 10 May – Townsville 11 May - Cairns 18 May – Toowoomba

QNMU training 4 May: QH - Consultative Committees - How to make them work, Brisbane 9 May: Assertiveness Skills (VM Learning), Cairns 10 May: No excuse for abuse!, Cairns

12 May

QNMU toolkit talks (webinar) 16 May – The Barrett Inquiry Sally Rob and Judy Simpson Keep an eye out in qnews for the link to register.

15 June: Creating a safe workplace (WH&S), Gold Coast 19-23 June: Health & Safety Representative training for nurses and midwives, Brisbane www.qnmu.org.au/education

Lung Health Promotion Centre at The Alfred 5-6 June 2017 – Spirometry Principles & Practice 26 June 2017 – Paediatric Respiratory Update 30 June 2017 – Theory & Practice of Non Invasive Ventilation (Bi-Level & CPAP Management) P: (03) 9076 2382 E: lunghealth@alfred.org.au

20th Cancer Nurses Society of Australia Annual Congress Evolving cancer care: Enhancing quality Embracing innovation 15-17 June 2017, Adelaide, SA www.cnsacongress.com.au

13th Conference of the European Council of Enterostomal Therapists Building bridges – from west to east, from south to north Ostomy – Continence – Wound 18-21 June 2017 Berlin, Germany. www.ecet2017.org

31st International Confederation of Midwives Triennial Congress Midwives - Making a difference in the world 18-22 June, Toronto, Canada www.midwives2017.org/

QNMU toolkit talks (webinar) 20 June – Building a learning circle – Sam Woodhouse www.qnmu.org.au/education

ANMF (Victorian Branch) Annual Delegates Conference 22-23 June 2017, Melbourne http://bit.ly/ANMFevents

First Epworth PCNL Masterclass in Supine and Prone PCNL and miniPCNL 24 June 2017, Melbourne www.ivvy.com/event/PCNL17/

July QNMU Annual Conference 19-21 July, Brisbane

Undergraduate Student Nurse and Midwife Study Day 19 May 2017, Melbourne http://bit.ly/ANMFevents

National Sorry Day 26 May 2017

International Council of Nurses (ICN) Congress 27 May-1 June, Barcelona, Spain ttp://www.icn.ch/

National Reconciliation Week 27 May-3 June 2017 www.reconciliation.org.au/nrw/

June QNMU training 1 June: QH Rostering - Equity & work life balance, Townsville 14 June: Aged Care and Private Hospitals - Everything you wanted to know about your agreement but were afraid to ask!, Brisbane 15 June: Aged Care and Private Hospitals - How to raise issues and feel safe, Brisbane 14 June: QH - How to make the BPF work for nurses and midwives, Gold Coast

If you would like to see your conference or event on this page, let us know by emailing the details to inscope@qnmu.org.au

More for QNMU members. In the past, members have enjoyed:

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Previously The official journal of the Queensland Nurses and Midwives’ Union

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“It’s good to know that QSuper are taking care of it. When I was at the academy, QSuper came to speak to us about our superannuation – salary sacrificing, consolidating all our funds in the one account and also Member Online. They were very helpful and informative, and it was really convenient that they came to us.” April, QSuper member

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OUR RECORD SPEAKS FOR ITSELF... In the past

Recovered

$8.75 million for nurses and midwives.

Championed patient safety by securing legislated nurse/midwife-topatient

RATIOS 140

Made submissions at state and federal levels on a range of nursing, midwifery and broader health issues.

BE PART JOIN OF IT! NOW

3 years we’ve...

Negotiated better wages and conditions for nurses and midwives through

82 new enterprise agreements. Taken on more than

5500 new legal cases, including workers’ compensation and occupational health and safety matters.

Assisted more than

53,500 members through our QNU Connect call centre.

Conducted 22 education and training courses across Queensland for

3600 nurses and midwives.

QNMU: Making a difference for you No other organisation does as much as we do to support, protect and strengthen Queensland’s nurses and midwives. MEMBERSHIP FEES ARE TAX DEDUCTIBLE

(07) 3840 1444 1800 177 273 (toll free for outside Brisbane) www.qnmu.org.au