InScope No13 Autumn20

2020

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A R OF TH

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The official journal of the Queensland Nurses and Midwives’ Union

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Autumn 2020

Lady lamp OF THE

OUR AGEING RAINBOW COMMUNITIES

PLUS!

The journey to conception

CPD CONTENT ON CHANGES TO MANDATORY NOTIFICATIONS, SUPPORTING CHILDREN’S PAIN MANAGEMENT AND MORE

PROFESSIONAL PRACTICE

Putting the spotlight on positive professional practice environments in nursing and midwifery

PRIZE POOL TO BE WON!

Know a nurse or midwife who’s committed to a positive practice work environment?

Now’s the time to nominate them for one or more of the four categories in the QNMU’s inaugural Professional Practice Awards:

NOMINATE NOW!

Excellence in Leadership and Governance Award Positive Practice Environment Champion Award Research and Innovation Award Early Career Award

NOMINATIONS CLOSE

FINALISTS ANNOUNCED

WINNERS ANNOUNCED

Thursday 30 April 2020

Wednesday 10 June 2020

AND GALA DINNER

20 August 2020

/qnmuofficial

2020 YEAR OF THE

www.qnmu.org.au/Awards

THE NURSE AND MIDWIFE

200 years

of making a difference

13

22

Autumn 2020

INDEPTH

Our black summer

THE OFFICIAL JOURNAL OF THE QUEENSLAND NURSES AND MIDWIVES’ UNION ISSN 2207-6018 ABN 84 382 908 052 106 Victoria Street West End Q 4101 (GPO Box 1289 Brisbane Q 4001) T 07 3840 1444 1800 177 273 (toll free) F 07 3844 9387 E inscope@qnmu.org.au W www.qnmu.org.au EDITOR Beth Mohle, Secretary, QNMU PRODUCTION QNMU Communications team: Linda Brady, Melissa Campbell, Cameron Gledhill, Stephanie Lim, Lou Robson, Luke Rutledge PUBLISHED BY The Queensland Nurses and Midwives’ Union AUTHORISED BY B. Mohle, Secretary, Queensland Nurses and Midwives' Union, 106 Victoria St West End 4101.

INDEPTH

14 18 30 34 36 40 42 45 46

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Lady of the lamp: A little history Guiding the journey to conception

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A safety haven for our ageing rainbow communities Ratios Save Lives and Money!

Phase 3 Clothes maketh the man (or woman)

REGULARS

Ending mesh pain A win for whistleblowers

54 56

The spirit of nursing

PRINTED BY Kingswood Print Signage, 80 Parramatta Rd Underwood 4119

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INSIGHT

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TEA ROOM

Supporting children's pain management

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WINS

Clarifying legislation related to cosmetic injectable products

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JUST IN

Insight. The "ah ha" bridge between an individual's past, present and future

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NOTES FROM THE NORTH

61

IN MEMORY

62

IN VIEW

64

INCOMING

66

CALENDAR

67

ADVERTISING

CPD

49 50 52

Fifty shades of greywater

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Becoming and being a nurse Normal saline instillation with endotracheal suction in the PICU Changes to mandatory notification guidelines Positive Practice Environment Standards. Safety for everyone

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.

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insight

Sally-Anne Jones QNMU President

Y

OU WILL be aware now that the World Health Organisation (WHO) has declared 2020 the International Year of the Nurse and the Midwife.

The year coincides with Florence Nightingale’s 200th birthday anniversary.

This is a landmark opportunity for us to celebrate the impact of nursing and midwifery on the health and wellbeing of our communities – not just in Queensland but across the whole world.

2020 is a year to highlight our preeminence in leadership in health care delivery, sustainability, innovation and change.

WHO is a subsidiary of the United Nations, which set a 2030 Agenda for Sustainable Development, adopted by all United Nations Member States in 2015. It provides a shared blueprint for peace and prosperity for people and the planet, now and into the future.

The 17 Sustainable Development Goals (SDG), which are an urgent call for action by all countries – developed and developing - recognise that ending poverty and other deprivations must go hand-in-hand with strategies that improve health and education, reduce inequality, and spur economic growth – all while tackling climate change and working to preserve our oceans and forests.

You can read about the health and wellbeing targets on the United Nations website at https://bit.ly/2VmWNPc Ensuring healthy lives and promoting wellbeing for all at all ages is important to building prosperous societies, which is why nurses and midwives are recognised this year as being an essential part of achieving this goal.

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Setting goals for sustainable health and wellbeing

Major progress has been made on improving the health of millions of people.

The world needs nine million more nurses and midwives if it is to achieve universal health coverage by 2030.

Maternal and child mortality rates have been reduced, life expectancy continues to increase globally, and the fight against some infectious diseases has made steady progress.

WHO and partners – including the International Confederation of Midwives (ICM), International Council of Nurses (ICN), Nursing Now, and the United Nations Population Fund (UNFPA) – have all joined in a year-long effort to celebrate the work of nurses and midwives, highlight the challenging conditions they often face, and advocate for increased investments in the nursing and midwifery workforce.

However, in other diseases such as malaria and tuberculosis, progress has slowed or stalled.

At least half the world’s population is still without access to essential health services. In rich and poor countries alike, a health emergency can push people into bankruptcy or poverty.

Lobbying for sustainable health financing, addressing the growing burden of non-communicable diseases, tackling antimicrobial resistance, and environmental factors contributing to ill health must be a major priority for us collectively as nurses, midwives and unionists.

The targets of the 2030 SDG are not so removed from our own health and wellbeing goals in Australia.

They are not just goals for developing nations. They are our goals, too.

Nurses and midwives play a vital role in providing health services.

At every life junction, we are present: offering expert care for mothers and children; giving lifesaving immunisations and health advice; providing nursing to older people, disabled and disadvantaged; delivering health education; supporting rehabilitation and recovery; and generally meeting everyday essential health needs.

Nurses and midwives can sometimes be the first and only point of health care in their communities.

The QNMU also has many activities planned throughout the year to celebrate, advocate and promote nursing and midwifery achievements, capabilities, leadership and skill.

Find our more about our plans for International Year of the Nurse and the Midwife at www.qnmu.org.au/2020 If we are to reach the 2030 SDGs and the nine million additional nurses and midwives required to achieve it, we must work hard together in solidarity across the globe in our shared experiences and vision.

QNMU COUNCIL secretary :

Beth Mohle

assistant secretary : president :

Sandra Eales

Sally-Anne Jones

vice president :

Lucynda Maskell

councillors :

Julie Burgess Christine Cocks Karen Cooke Tammy Copley Dianne Corbett Jean Crabb Michael Hall Raquel How Shelley Howe Christopher Johnson Damien Lawson David Lewis Dallas Meyers Fiona Monk Sue Pitman Melanie Price Karen Shepherd Katy Taggart Janelle Taylor Kym Volp Deborah Watt Charmaine Wicking

insight

From despair we must build hope Beth Mohle QNMU Secretary

T

HE START to 2020 has been challenging and traumatic for so many, with unprecedented bushfires raging in many states followed quickly by the need for a concerted national effort to contain the spread of Novel Coronavirus (COVID-19).

We’ve all watched in horror as so much of Australia burned – 33 lives lost, over 3,000 homes destroyed, an estimated one billion animals killed, and 12 million hectares burned.

Livelihoods have also been lost.

The scale is so phenomenal that it’s difficult to comprehend. Fear and anger were two emotions that were again at the forefront for too many people.

In Queensland we had also seen an early start to the fire season in 2019, with fires in September threatening my favourite beach holiday spot, the beautiful Peregian Beach on the Sunshine Coast.

Soon fires were also burning in the Gold Coast and Scenic Rim areas, Darling Downs, and Central Queensland.

However, a year earlier I was struck that something fundamentally different was at play when bushfires destroyed so much of the rainforest at Eungella, west of Mackay.

Fires in rainforests? Just what was going on?

Eungella, another beautiful place that holds great platypus infused holiday memories for our family. It is such a personal jolt when places that we love to visit to relax, recharge and take in the beauty of nature are under such terrible threat.

Images of people retreating to the beach at Mallacoota as bushfires turned day into night shocked the world. We could all see ourselves in

We all have a role to play in responding to the challenges that confront us, including those related to climate change. the shoes of those who were huddled on that beach.

We framed our submission from a community wellbeing perspective.

Queensland, of course, is no stranger to natural disasters.

We encouraged the Palaszczuk government to follow the lead of the New Zealand government, which delivered its first “Wellbeing Budget” in 2019.

These have been increasing in frequency and intensity in recent years. It was only just over a year ago that Townsville and north western Queensland endured extreme flooding – one of the worst natural disasters ever to affect the region.

But out of such terrible things we also see the best on display: acts of selfless courage by first responders and volunteers and such generosity by the Australian and international community.

We have seen truly inspiring acts from people who are prepared to lead – not wait for a response from governments.

What is happening with natural disasters is unprecedented and it is climate change related.

The health impacts alone are so significant – just look at the recent appalling air quality so many have endured.

Then there are the long-term mental health implications for individuals directly impacted by disasters. We must ensure they have the necessary support and resources for long term recovery.

The recent natural disasters were front of mind when the QNMU made its recent 2020 Queensland budget submission.

As the NZ Treasurer Grant Robertson highlighted when describing this new approach of putting wellbeing at its heart, governments are in power to make a difference to the wellbeing of their people, and financial prosperity alone is not a sufficient measure of wellbeing. The role of government is to keep our community safe, cohesive and fair, to embody our shared values that reflect what makes our lives worthwhile.

But we all have a role to play in responding to the challenges that confront us, including those related to climate change and the critical frontline role nurses and midwives will need to play in responding to COVID-19.

At times of crisis we can easily become overwhelmed by fear or anger.

We need to focus on the practical steps we can take to make a difference, as individuals and collectively through our union and other community activities.

This will build hope that change can happen, and it goes without saying that nurses and midwives must be part of the solution.

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tea room 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.

Requesting flexible work arrangements?

Flexible working arrangement options include working from home, job sharing, or part time hours. Members should keep in mind they have the right to request flexible working arrangements, not the automatic right to them.

The federal system (aged care, private and other)

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.

If you are employed under the Nurses Award 2010 or an Enterprise Agreement (EA) registered with the Fair Work Commission, you can apply for flexible working arrangements if you:

The following questions are frequently asked of our Member Connect call centre.

■ are a carer (under the Carer Recognition Act 2010)

■ are the parent, or have responsibility for the care, of a child who is school aged or younger

■ have a disability ■ are 55 or older ■ are experiencing family or domestic violence, or ■ provide care or support to a member of your household or immediate family who requires care and support because of family or domestic violence.

Casuals can make a request if they’ve been working for the same employer regularly and systematically for at least 12 months and have a reasonable expectation of continuing to do so.

Your request must be in writing and explain what changes are being asked for and the reasons why. Make sure you include all the relevant information and outline how any impact on your work area could be mitigated.

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

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request to allow the employer to make a decision. A written decision should be given within 21 days of the request being made.

Your employer may only refuse the request on reasonable grounds and can still negotiate with you to find alternative arrangements.

For Queensland Health employees you can find more information and a link to the application form on QHEPS.

Need assistance?

If you are not satisfied with your employer’s response to your request for flexible working arrangements, the QNMU may be able to assist.

Members can call Member Connect on 3099 3210 or 1800 177 273 (toll free outside Brisbane).

Can you claim travel time when accessing PDL? Did you know that your agreement may entitle you to reasonable travel time when accessing your Professional Development Leave (PDL)?

According to clause 30.3 of the Queensland Health EB10 agreement, “All reasonable travel time associated with accessing professional development leave is paid work time.

Employees will not be disadvantaged by the requirement to travel to attend professional development. Travel to attend professional development will be paid at the ordinary rate for the day or days of travel”.

Your employer must provide a written response to you within 21 days of your request, which outlines their decision.

Your employer can only refuse on reasonable business grounds.

In other words, Queensland Health nurses and midwives may claim reasonable travel time in addition to their PDL. Members should request this additional travel time when completing the request for PDL form.

Queensland Health and the state system (ie: local councils)

Many other private sector agreements also contain similar provisions.

Under the Industrial Relations Act 2016 you have the right to apply for flexible working arrangements for any reason.

Your request must be in writing and state the reasons for the change.

Include sufficient detail about the

Members should check their agreement on their member profile page or search at www.qnmu.org.au/wages_ conditions

wins

$160,000 recovered in night shift meal breaks

Are you receiving your qualification allowance?

IF YOU HAVE obtained a post enrolment qualification since the start of your nursing or midwifery career, it might be worth checking your enterprise agreement to see if you’re entitled to a qualification allowance.

QNMU members at various private hospitals did just that, and realised they were not receiving their entitlements.

At Gold Coast Private Hospital, one QNMU member applied for the qualification allowance when commencing employment, as per the Healthscope EA.

IT’S TAKEN since October 2018 to resolve, but members at Birribi Disability Service (CQHHS) have finally received a mammoth $160,000 in backpay in night shift meal break allowances.

Staff have now received their backpay, with members receiving between $4000 and $7000 each.

A QNMU staff member initially noticed the absence of the meal break allowance on a member’s pay slip during a routine site visit.

Management agreed to review the payslips for nine Registered Nurses, and later informed the QNMU they were owed a total of $100,000.

“It took a while getting there, but in the end we were paid what we were owed thanks to the QNMU keeping on it,” Owen said.

However, the QNMU insisted this review be extended to include ENs and AINs, who are also rostered on night shifts.

AIN and QNMU member Owen Dorocinski received his backpay just before Christmas.

“I’d advise any of my fellow members to check their payslips and at least ask their local representatives or organiser if they believe they’ve been underpaid.

“We work hard for the people in our care, and so we should be paid correctly.”

GREENSLOPES MEMBERS RECOVER THOUSANDS QNMU MEMBERS at Greenslopes Private Hospital have recovered thousands of dollars in leave loading, with $30,000 recovered from one unit alone.

Members realised management were not paying leave loading for shift workers in accordance with the enterprise agreement.

The QNMU worked with management to recover money

owed. At one stage, management claimed members who participated in a voluntary 12-hour roster were not eligible for back pay, but this was soon resolved in the members’ favour after the QNMU intervened.

Well done to members for checking their pay slips and bringing this issue to our attention!

Though initially reluctant to accept the documentation provided, her employer eventually acknowledged she did in fact qualify after the QNMU intervened, and the member is now receiving her allowance.

Meanwhile, numerous Enrolled Nurses at ICON realised they were not receiving their additional weekly qualification allowance payment. According to their EA, employees can either progress one pay point once they have obtained a post enrolment qualification or receive a fortnightly qualification allowance payment.

Management have now committed to providing nurses their correct allowance and backpay, and the QNMU will ensure they follow through with this promise.

Congrats to these members for checking their agreements and raising omissions with management.

To check if you should be receiving a qualification allowance (entitlements will vary depending on your EA), check your agreement on your member profile page or search at www.qnmu.org.au/wages_ conditions

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just in

SUPERANNUATION CHANGES 1 April – don’t be left uninsured FROM 1 APRIL, 2020, some significant changes are happening across Australia’s superannuation system – and these changes could leave you without crucial insurance coverage.

What are the changes?

If you are: ■ under 25 years of age, or ■ have a superannuation balance of less than $6,000, your insurance cover may be cancelled from 1 April 2020.

Most superannuation funds have historically offered life insurance and total and permanent disability (TPD) cover for members.

But due to legislative changes introduced by the federal government, which are designed to protect

members from having their retirement savings unnecessarily eroded by insurance premiums, superannuation providers will only be able to provide insurance to members under the age of 25 if members decide to “opt in”.

Furthermore, providers will also be required to cancel automatic insurance cover from existing super funds that have been less than $6,000 any time since 1 November 2019 (unless the member opts in to keep their cover).

What should I do?

If you are under 25 or have an account balance of under $6,000, you can opt back in to receive insurance coverage either through your superannuation fund’s website, or by contacting your superannuation fund directly.

For more information for QSuper members, visit https://qsuper.qld.gov.au/ misc/insurance-changes For more information for HESTA members, visit www.hesta.com.au/ staycovered

Need advice?

Please note, the QNMU cannot advise members regarding their superannuation arrangements other than to review your current policy and understand how these changes affect you.

If you have any issues or concerns about these changes and what they mean for you, please contact your superannuation fund directly.

THIS ARTICLE BROUGHT TO YOU BY QSUPER

Why do Australians seek financial advice?

More than one in four Australians receive it and 41% say they intend to get it.1 But what do consumers really think about financial advice?

Research released by the Australian Securities and Investments Commission (ASIC)2 shows Australians typically want advice on:

45% Investments

(such as shares and managed funds)

37% Retirement income planning 31% Growing superannuation 18% Aged care planning

Why aren’t people seeking advice?

Research found some Australians felt there were barriers preventing them from following through on getting advice. This was more likely for people in younger demographics who were less engaged with their finances.

Top barriers included cost, a belief their financial circumstances were too small to warrant advice, and enjoyment of self-managing finances. Trust in the industry was also a concern for some Australians.

41% Level of experience 38% Reputation 36% The ability to talk to

customers in a way they could understand

32% Taking the time to understand the customer and their goals Get advice Visit our website for more information. qsuper.qld.gov.au/advice

Choosing an adviser

When it came to choosing a financial adviser, respondents noted the most important attributes:

1 Australian Securities and Investments Commission (ASIC), August 2019, Financial advice: What consumers really think, Report 627, accessed 29 August 2019 at asic.gov.au 2 Media Release, 26 August 2019, Consumers see value in financial advice, but lack of trust remains an issue, at asic.gov.au. This information is provided by QInvest Limited (ABN 35 063 511 580, AFSL 238274) on behalf of the QSuper Board (ABN 32 125 059 006, AFSL 489650) as trustee for QSuper (ABN 60 905 115 063). It has been prepared for general purposes only, without taking into account your personal objectives, financial situation, or needs. All products are issued by the QSuper Board as trustee for QSuper. Consider whether the product is right for you by reading the product disclosure statement (PDS) available from our website or by calling us on 1300 360 750. While we have taken every care to ensure the information contained in this document is accurate, it should not be regarded as a guarantee of benefits and entitlements. © QSuper Board 2019. SPON-451. 02/20.

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COVID-19 CORONAVIRUS know the facts

THE CORONAVIRUS OUTBREAK is a rapidly evolving situation and as frontline health professionals it is essential we remain calm and keep abreast of developments and advice from trusted and reliable sources – especially when there is so much information circulating online and in the media.

the Coronavirus from the likes of Queensland Health and the Department of Health.

Head to www.qnmu.org.au/ coronavirus

At the time of going to print, the World Health Organisation was still referring to COVID-19 as an "epidemic" but health experts believe it is likely to be upgraded to "pandemic" as the outbreaks spread.

This webpage also includes links to information sheets for Primary and Community Health Workers and ED staff, advice on the use of Personal Protective Equipment and resources to answer your questions around your rights, entitlements, work conditions and professional practice during a global health emergency.

The QNMU has created a dedicated page on our website where you will find resources, useful links and information about

These information sheets outline what action to take for patients who meet criteria for Coronavirus and how to seek advice.

■ profile your positive professional voice ■ create culture change to improve your practice environment ■ ignite motivation to grow your profession, and

s

The course will also equip you with information and confidence to help you:

ur

Becoming a Professional Practice Advocate will encourage you to use your VOICE and make a difference in your workplace, community and, ultimately, our professions.

ho

The aim of this program is to support nurses, midwives and carers to build on your professional confidence and capacity to advocate for safer working environments and the people you care for.

D

PROGRAM

REGISTER NOW for the QNMU’s Professional Practice Advocates program – coming to a location near you.

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Professional Practice Advocates

CP

PPA

ARE YOU A PASSIONATE ADVOCATE?

■ create opportunities to share your knowledge, practice wisdom and career pathways.

This program is a base-level entry for professional activism and is suitable for all QNMU members from all sectors.

TRAINING LOCATIONS: Brisbane, Bundaberg, Cairns, Gold Coast, Hervey Bay, Ingham, Kingaroy, Longreach, Mackay, Monto, Mount Isa, Rockhampton, Roma, Sunshine Coast, Toowoomba and Townsville.

REGISTER FOR THIS FREE COURSE at www.qnmu.org.au/events simply search ‘professional practice’ to find your nearest location, then select your preferred date.

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U P C O M I

2020

N G

E V E N T S

WOW (Women of the World) Australia 2020 festival

is shaping up to be our busiest year, not least because the world is celebrating our professions through the International Year of the Nurse and the Midwife.

WOW AUSTRALIA 2020 imagines a future in which gender does not determine life’s outcomes. This three-day festival will feature over 100 guest speakers, including former Governor General Quentin Bryce and former Prime Minister Julia Gillard.

There are plenty of events coming up in the next few months, so make sure you mark your calendars.

Nurses Memorial Candlelight Vigil

APRIL

3-5

QNMU members can get discounted tickets (until sold out) by entering the code WOWPARTNER .

More info at www.wowaustralia.com.au/welcome-2020

MAY

2-4

THE ANNUAL Anzac Day Vigil is an opportunity to pay tribute to our Anzac nurses and countless others who have volunteered their services during times of conflict.

This year’s vigil will be held at Anzac Square, Brisbane. The QNMU will once again be laying a wreath on behalf of our members in honour of those who have served.

APRIL

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2020 YEAR OF THE

THE NURSE AND MIDWIFE

200 years

of making a difference

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Labour Day/ QCU Art Awards A DAY TO celebrate nursing and midwifery, and the broader union movement – Labour Day is our day!

Attendees to Labour Day events around the state will receive a free 2020 Year of the Nurse and the Midwife t-shirt. Keep an eye on our Facebook page and website for event details and locations.

And for those aspiring artists out there, the Queensland Council of Unions is holding its inaugural Labour Day Community Art Awards competition.

Promoting working people through art, there are various award categories and substantial cash prizes to be won.

For more details visit https://bit.ly/2HkTLTC

just in

U P C O M I

N G

International Day of the Midwife WE’RE MARKING this year’s midwifery celebrations with the launch of our Statewide Big Brunch.

QNMU branches around the state are encouraged to host Year of the Nurse and the Midwife (YONM) Break for Brunch events with their colleagues between 5 May and 12 May. Branches can register their event online and will receive a ‘party pack’ to help host their local event.

International Day of the Midwife is also the day we’ve earmarked to bury a QNMU time capsule at our HQ in Brisbane, preserving snippets of QNMU history for our future nursing and midwifery generations!

Visit www.qnmu.org.au/2020 for details

E V E N T S Count the Babies midwifery installation

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5-12

OCCURRING around the state in May, this visibility activity will involve branches sewing, knitting or crocheting their own baby dolls in their workplace to illustrate the need to include babies in workloads.

More info about this activity and the campaign at www.qnmu.org.au/CountTheBabies

Mother’s Day Classic fun run THIS ANNUAL fundraiser event will be held around the nation to raise vital funds and awareness for breast cancer research.

MAY

MAY

MAY

10

Register at www.mothersdayclassic.com.au

MAY

12

International Nurses Day TO CELEBRATE, the QNMU is holding a “Park to parliament walk” in Brisbane to raise awareness around the important role nurses and midwives play. Join us as we walk to Queensland’s Parliament House.

Regional members are encouraged to hold similar walks to their local MP offices.

2020 QNMU Annual Conference THIS YEAR’S conference will have an exciting line-up of dynamic speakers and an engaging professional day for you to look forward to, not to mention plenty of networking opportunities.

JULY

15-17

Registrations close 14 June.

Visit www.qnmu.org.au/ conference

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just in

BRANCHES DIG DEEP TO RAISE FUNDS FOR BUSHFIRE RELIEF QNMU MEMBERS right across the state have held morning teas and fundraising activities in their workplaces, all to raise muchneeded funds for communities affected by Australia’s devastating bushfires.

In January, the QNMU announced the union would match dollar-for-dollar any money raised from fundraising

by QNMU members or Local Branches to a list of approved organisations.

Queensland Children's Hospital

Grantley Stable Neonatal Unit nch

Cairns Paediatric Bra

The response was phenomenal. As of 9 March, QNMU members have raised over $37,000. This will be matched by the QNMU, bringing total donations to over $74,000.

Donations will be made to various organisations, including Unit the Red Cross, WIRES, le Neonatal Grantley Stab BlazeAid, Aussie Helpers, St Vincent De Paul, the Rescue Collective, and World Wildlife Fund.

Gatton Health

OVER

$74,000

TOTAL RAIS ED FOR BUSHF IRE RELIEF

iatric Branch

Cairns Paed

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Robina Health Precinct

Gatton Health

just in

Thousands support Blue Care nurses in face of cuts BLUE CARE’S response to the Aged Care Royal Commission’s interim report last year was to cut nursing hours across a number of its Queensland facilities.

Nearly 4000 nurses, midwives, careers and concerned community members signed our Blue Care petition, calling on management to stop the cuts.

Aged care AIN Sherree Clarke said Blue Care’s decision to cut nursing hours was disgraceful.

“For a non-profit organisation, they should really consider what they’re paying management, as their money isn’t flowing down to staff and actual care.”

Petition supporters hand-delivered the petition to Blue Care’s head office in late February.

What’s your favourite thing about your role?

Giving care to patients and their family. Knowing I am helping them and also looking out for my co-workers.

Samantha O’Hanlon, EN Rockhampton

I really relish the variety emergency nursing provides, and I particularly love the high-acuity case mix we see at the RBWH. Kellie Dwyer, RN Brisbane

Learning new skills to apply within the nursing and health care sector while connecting with nurses internationally.

Nicholas Tyson, student EN Gold Coast

Members’ responses were initially published on the QNMU Community’s Member Spotlight section.

Visit www.mycommunity.qnmu.org.au

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qnmu

C MMUNITY FOR QNMU MEMBERS

YOUR ISSUES YOUR SOLUTIONS YOUR COMMUNITY FOR PROFESSIONAL PRACTICE QNMU Community is a safe online space that facilitates member-to-member connections.

Share information Ask a question Find out what issues nurses and midwives are grappling with around the state Get connected.

mycommunity.qnmu.org.au

just in

Registration and renewal delays explained P

ROBLEMS bedding down a new national

registration operating model is at the heart of recent AHPRA registration delays.

ANMF Officials met with Senior AHPRA officers in December to discuss concerns about registration delays for nurses and midwives across the country, particularly new graduates.

The ANMF provided detailed examples of the issues being experienced by members, including stories from many QNMU members who had experienced delays in obtaining or renewing their registration. The meeting also covered the consequences members were facing as a result of the delays.

AHPRA acknowledged that the past 12 months had been challenging on the registration front. They said the implementation of a new national registration operating model and associated systems had taken longer to bed down than expected, significantly pushing out registration timelines. However, they were confident these implementation issues have now been addressed and the new model will deliver improvements in registration processes.

For new graduates, AHPRA has added staffing resources, significantly improved communications with applicants, and improved systems so issues can be quickly identified and addressed.

Concerns about delays assessing registration renewals where there had been disclosure on the part of the nurse or midwife were also addressed. AHPRA advised it had triaged these renewal applications according to those with the highest potential risk to public safety – namely

those related to criminal history and health impairment. However, they acknowledged this had resulted in delays in assessing disclosures with a lower risk.

No stand downs The ANMF also raised concerns about employers telling members they would be stood down if their registration was not renewed by 31 May. In response AHPRA said it will look at improving communication with employers about the expiry date on registration, so employers understand that the practitioner remains registered and can practise while their renewal of registration is still being assessed.

AHPRA CEO Martin Fletcher acknowledged the delays over the past year and committed to providing regular data to the ANMF on the progress of strategies and processes to improve timely registration and renewal. He also promised to work with the ANMF to continue improving those processes.

If members are experiencing any delays in obtaining or renewing their registration, they are advised to contact QNMU Member Connect on 3099 3210 or 1800 177 273 (toll free outside Brisbane) with the details.

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indepth

Lady lamp OF THE

A LITTLE HISTORY

O

N 12 MAY 2020, we celebrate 200 years since the birth of Florence Nightingale - a wealthy Victorian-era woman, who swapped marriage and motherhood for a filthy field hospital, and revolutionised nursing.

As a leading light in our profession, her story is one we should all know, but the busy life of a working nurse and midwife can often get in the way and with so many books, webpages and dramatisations about her life and legacy out there, where do you even start?

The answer? Right here.

2020 YEAR OF THE

THE NURSE AND MIDWIFE

200 years

of making a difference

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indepth

Who was Florence?

Florence Nightingale was born on 12 May, 1820 into a wealthy, upper class British family in Florence, Italy.

She and her sister were home schooled by their Cambridgeeducated father who, at a time when most women were discouraged from scholarship, gave them a classical education that included history and mathematics.

Florence was drawn to taking care of the ill and the poor, and at the age of about 17 she told her parents she wanted to become a nurse.

Now this was Victorian England, and nursing at the time was not the respected profession it is today.

In fact, it was considered a slightly unsavoury manual job usually associated with women of low social classes, questionable morals, alcoholism and poor wages.

Needless to say, her parents refused to allow it.

But after a decade of watching his daughter stifled by the upper-class lifestyle, rejecting suitors and persisting with her volunteer hospital work, her father finally relented and in 1850 Florence enrolled as a nursing student at the Lutheran Hospital of Pastor Fliedner in Kaiserswerth, Germany.

Three years later she became superintendent of the Institution for Sick Gentlewomen in Distressed Circumstances in London, which gave her independence from her family and the opportunity to test new health facility management practices in a scientific, secular environment.

Florence and the war machine

In 1854 and at the behest of the Minister at War, Nightingale led a team of 38 nurses to the British Barrack Hospital in Scutari, Crimea (Turkey).

Conditions at the hospital were appalling. The place was infested with vermin and cockroaches, patients

were lying in soiled sheets and their own filth on stretchers lined up in the hallways, the floors were thick with excrement and blood, and there was a severe shortage of basic supplies like soap and bandages.

It would later be discovered the hospital had been built on top of a cesspool that was contaminating the drinking water and leeching toxins, causing infections that killed more soldiers than the war wounds did.

Legend goes that Florence took one look at the horrendous conditions, purchased hundreds of scrubbing brushes, and ordered every nurse and able-bodied patient to scrub the building from top to bottom.

Over the next year Florence and her nurses completely overhauled care at the hospital. In addition to implementing routines and clinical rounds, she established a laundry for clean linens, started an invalid’s kitchen, which prepared healthy appetising food, and even set up a library.

Florence rejected the common belief that regular soldiers weren’t worthy of ‘comforts’ like clean sheets and soap, and ensured they were treated with compassion and dignity.

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Lessons and legacy News of her outstanding work caring for British soldiers soon made Florence Nightingale famous back home, where she earned the moniker ‘Lady with the Lamp’ for her habit of walking around at night to check on her patients.

But while nursing in Crimea made her a Victorian celebrity, she quickly realised this fame could be harnessed for good.

Ultimately, it was her work back in England after the war that left a legacy for our profession.

Just look at how she professionalised nursing and used her nursing expertise to be an advocate.

1855-56: Use of evidence and professional judgement Working with the Sanitary Commission, she analysed Barracks Hospital data and discovered that 16,000 of the 18,000 soldier deaths were due preventable diseases resulting from poor sanitation. In her resulting report, which used the statistical evidence to support her professional observations of Crimea, she recommended protocols for reforming other military hospitals.

Innovation Instead of using a table or list to help communicate her research results, she used a “rose diagram” - a relatively new method of communicating statistics that made it easy for people to understand the sanitary versus unsanitary death toll data. This was one of the earliest known uses of the pie chart.

Health reform advocacy Using her research evidence she successfully lobbied for a Royal Commission into the Health of the British Army, which led to a huge overhaul of the War Office administration and the development of new departments in army medicine, sanitation science and statistics.

1859: Expert voice for facility design and systemic improvements Florence published Notes on Hospitals – two essays drawing on her work in Crimea recommending protocols on everything from hospital construction (facility design) to fouled linen disposal and efficient record-keeping.

She noted the first requirement of a hospital was that ‘it should do the sick no harm’.

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1859: Nurse leadership, professional practice advocate Published her most enduring work Notes on Nursing: What It Is and What It Is Not. At the heart of this was her Environmental Theory, which defined nursing as “the act of utilising the environment of the patient to assist him in his recovery.” She argued five points were essential for patient health: “pure air, pure water, efficient drainage, cleanliness, and light.” The importance of a healthy environment for healing might be an obvious notion today, but in Florence’s time it was not. Even her simple advice like “every nurse ought to be careful to wash her hands very frequently during the day” was innovative thinking.

Universal health care Notes on Nursing also outlined ways in which people could care for sick loved ones, giving people practical information about infection control and hygiene. She was a firm believer that medical care should be readily available to all regardless of class or wealth, and to this end she established a practice of sending trained nurses into poor areas and workhouses to treat the needy.

1860: Nurse education She funded the establishment of St. Thomas’ Hospital and its secular Nightingale Training School for Nurses. This was the very first official nurse training program in England.

1870: Mentoring Nightingale mentored America’s first trained nurse Linda Richards who set up high-quality nursing schools in the US and became a nursing pioneer in her own right in the US and Japan.

1870 and 1875: Community wellbeing Nightingale successfully pushed for legislation that made it compulsory for buildings to be connected to mains drainage.

OF THE 2020 YEAR NURSE MIDWIFE AND THE

200 years of making a difference

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indepth

Guiding the journey to conception For many families the path to conceiving a child through fertility treatments can be an emotional roller coaster.

That’s where the support of a great fertility nurse like Nerea Urquiza can make all the difference.

Pictured: QNMU member Nerea Urquiza

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HERE’S no question about it.

Fertility treatment is an emotional journey for everyone involved.

Some people can feel alone and defeated in their struggle to conceive and overwhelmed by the long road ahead of them.

This is where fertility nurses like QNMU member Nerea Urquiza play a pivotal role.

“When people come in they are very unsure and can often feel confused and torn about what to do,” Nerea said.

“While they’ll consult with a doctor on a treatment plan, the key role of a fertility nurse is to provide support and education in their journey as we work through that plan.

“Fertility nursing very much captures what I term the ‘mental’ side of nursing – making sure our patients are mentally and emotionally okay, well-educated on their options, and feel supported and comfortable throughout their journey.”

A multi-faceted team Fertility nurses, sometimes known as reproductive nurses, care for individuals, couples or families who are seeking treatment options for issues related to reproductive health.

This can include anything from low sperm count affecting men, to medical issues like polycystic ovaries or endometriosis in women.

“I think many people who are trying to have a baby don’t often consider that they might have difficulty conceiving. It can be hard for them to come to terms with it and accept they might need help,” Nerea said.

“We assist people from a variety of backgrounds and at different stages of life – anyone from single women to gay couples – so it’s really important that we’re open-minded, nonjudgemental and tactful so we can support them in the best way.”

Image courtesy of Queensland Fertility Group

As Nerea describes, every individual’s conception journey is different, which makes for diverse cases that require a multi-faceted approach.

At the Queensland Fertility Group (QFG), Nerea works closely with other fertility nurses, doctors, psychologists, scientists and embryologists to bring it all together for patients.

“It’s definitely a big team effort and everyone works really hard,” she said.

“Every couple is different, every person is different, so we have to be flexible to their needs. Some might require more support than others and our psychologists provide counselling for those who are having a hard time with the process.”

Full circle A diverse caseload is certainly something Nerea is familiar with, having previously worked in a surgical ward at a busy private hospital.

Her interest in fertility and women’s health was first piqued while caring for patients with ovarian hyperstimulation syndrome, a complication of in vitro fertilisation (IVF) caused by excessive stimulation of the ovaries.

Now, after over a decade in fertility nursing and having supported countless families, Nerea is more passionate than ever about her work.

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G N SI Y O MA CL 4

QNMU Scholarships open soon The QNMU’s scholarship program provides financial assistance to members to help progress their studies, professional development and research, and grow our nursing and midwifery professions.

SCHOLARSHIPS OPENING MONDAY 6 APRIL: ■ Mentoring or peer support scholarship - $5000 awarded whole or in part to assist QNMU members to undertake an accredited course in nursing or midwifery mentoring, peer support or clinical supervision.

■ Regional member development and engagement scholarship – $5000 awarded whole or in part to assist QNMU members in Cairns or Townsville to develop knowledge, skills and capacity in professional advocacy on behalf of other members.

■ Pat Nicholls scholarship – $500 to advance diabetes education and promotion by supporting a QNMU member in this field.

■ Undergraduate book bursary – 8 x $500 book bursaries to undergraduate nursing and midwifery students, with the aim of relieving some financial pressure for these students.

■ Postgraduate book bursary – 1 x $500 book bursary to a Registered Nurse undertaking post-registration nursing studies at a university in Queensland or interstate.

Apply online at www.qnmu.org.au/scholarships APPLICATIONS CLOSE MONDAY 4 MAY

indepth Fertility nursing very much “We can be supporting patients through months, even years, so we get to know them quite well,” she said.

“We become engaged in their journey as we’re seeking the best outcome for them, which is hopefully to walk away with a baby.

“Sometimes that doesn’t happen and that’s devastating but all we can do is be there for them, be strong for them, and try and make their journey a little easier.”

While Nerea has shared in the heartache of some of her patients’ unsuccessful treatments, on the flipside, it’s a joyous moment when the treatments work.

“One of the best parts of the job is hearing that a patient has finally conceived,” she said.

“This is where their journey with us ends but we make sure to follow up with them when they’ve had their baby to find out how everything went.

“It’s absolutely lovely when some patients bring their babies back in to see us. We really enjoy that because it’s like coming full circle, and sometimes we even get to help them conceive their second child!”

An evolving field As with any medical field, the fertility and reproduction field is constantly evolving with new research and technologies.

It is vital fertility nurses stay up to date with developments.

“Our patients may often begin treatment feeling scared and uncertain. They’re looking to us for answers so we definitely need to be well-versed in the field,” Nerea said.

“We seek to empower them with knowledge about what they’re going through. When our patients walk out that door feeling confident because we’ve been able to help them understand things a bit better, to me that’s what’s rewarding about this job.”

Nerea encouraged others who were looking into fertility nursing as a career pathway to be open to learning, and to gain as much experience in the field as possible beforehand.

captures what I term the ‘mental’ side of nursing – making sure our patients are mentally and emotionally okay, welleducated on their options, and feel supported and comfortable throughout their journey.

Nerea Urquiza, Registered Nurse, Queensland Fertility Group

“I definitely think you need to have a bit of experience in basic nursing first and become familiar with gynaecology and fertility,” she said.

“While I did have a bit of background knowledge as a gynaecology surgery nurse, I actually learnt a lot on the job.

“There’s plenty of educational support for us. The Fertility Society of Australia (FSA) and Fertility Nurses of Australasia (FNA) frequently have education sessions and yearly seminars to help us keep up to date.”

Nerea said there’s also always support in the form of the QNMU. “The union is amazing, I love the union!” she said.

“We didn’t have an enterprise agreement when I first started working at QFG, and the union worked with us and with QFG to create one through a working group.

“It’s helped make our workplace so much more transparent and fair for both the employer and employee, and allowed us to have a voice. I can’t speak more highly of the union.”

References

Nurse.org. 2017. Fertility And Reproductive Nursing: Helping Family Dreams Come True. https://nurse.org/articles/fertility-nursecareer-guide/

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OUR BLACK SUMMER

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The kindness of strangers

A

S RHONDA DAVIS drove into the fire blackened Victorian community of Genoa last month, she felt like she was entering another world.

“It was eerie,” she said, “like a war zone.”

“When we first got into New South Wales, yes, the trees were burnt, but they still had some leaves and branches. But when we got into Victoria, into Genoa, there’s just sticks, and the ground is thick with gray ash. I’ve never seen anything like it.”

Join the bushfire discussion in mycommunity. qnmu.org.au

An emergency nurse for 35 years and now a clinical nurse in gastroenterology, Rhonda and her partner Andy Burnet were the first volunteers to make it into Genoa after the bushfires passed.

The QNMU member had been expecting to serve as midwife to a heavily pregnant woman reportedly waiting among the ruins, but to Rhonda’s relief the army had airlifted the mum-to-be out the night before.

“I probably last did maternity in 1985, but when I was asked to go I thought yup, I can do that – I mean, what else could I say?”

On the road Rhonda’s willingness to pitch in without a second thought pretty much describes how she and Andy ended up in the fire zone in the first place.

“We’d just dropped our son off to the Brisbane airport for a Boys Brigade Camp and the rural firefighters happened to be on the same flight heading to Eden,” she said.

free, the couple packed their bags and hit the road.

“Look, I didn’t realise how far it was, but it’s a blimming long way!”

Rhonda admitted.

They broke their journey after the first 830km dropping in at the Macquarie Koala Hospital, where they met the vet and made a donation before continuing their journey along the east coast and the A1 to Bega.

“You get there and it’s just black. It’s just burnt. Like you see it on the news, but you don’t really understand the extent of it. Just miles, and miles, and miles. It’s eerie because that smoke is still hovering around and the army is everywhere.

The fire trucks are everywhere.

And there

Rhonda Davis

“It was very emotional watching those volunteer firefighters getting on that plane with the boys. It was just a really lovely thing.

“And that’s when I decided. I said to Andy, ’We’ve got to go to Eden.’”

So instead of a week or so exploring the Sunshine Coast kid-

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indepth

RHONDA AND ANDY, THANKS VERY MUCH FOR ALL YOUR HELP AND HAVE A SAFE TRIP HOME. GENEROUS PEOPLE LIKE YOU ARE THE BACKBONE OF THIS NATION.

OUR BLACK SUMMER

Ron and Jacqui, Genoa Boarding Kennel via Facebook.

Rhonda and Andy entering the property of the boarding kennels.

aren’t that many cars on the road either,” Rhonda recalled.

“You go through all these little towns like Cobargo and there’s only chimneys left… they were once beautiful little towns, it was so sad to see.”

In the right place The original plan was for Rhonda to help out at the hospital or aged care home in Bega, but by the time they got there, reinforcements had already arrived.

One of the locals instead asked if they would continue through to Eden and check in on the owner of the local café who’d lost her home to the blaze but was still trying to run her business.

When they pulled into the Rusty Plough café they were met with what would become the first of many tears and hugs over the next few days.

“Oh we were hopeless!” Rhonda said.

“There were a lot of tears, it was a very emotional time you know, you could see people were so tired and worried.

“We told them, ‘We’re here and we’re on call whenever you need us - I’m an emergency nurse, my partner’s a mechanic… just call us.’”

The couple checked in to the local caravan park which should have been heaving with holiday makers, but had been evacuated when the skies turned orange and was now ghostly quiet.

Their phone rang first thing next morning. It was café owner Joy-Anne desperate for someone to help sort out the donations flooding in from around the state.

“I didn’t even hesitate I just said yup, righto, we’re there,” Rhonda said.

Rhonda said she quickly learned that sometimes helping out is simply about being in the right place at the right time.

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“I really thought I would be working at the medical centres. But I never got back there. Oh, my gosh, it was just the best thing.”

Pitching in Over the next few days the pair worked dawn to dusk and beyond.

Andy pitched in making repairs to one of the fire trucks and Rhonda did welfare checks on elderly residents. They ran water and treats up to the exhausted firefighters and helped stock up the food bank run by the local Uniting Church.

And when word came that the army had cleared the road to Genoa, Rhonda and Andy were assigned to go and check on the residents.

“The minute we drove in people just came running,” Rhonda said.

“There’s like eight houses. None were burnt, but the historic bridge was burnt and so were their cars… so they’d been completely cut off.”

Aside from the army dropping water off the day before, the residents had seen no-one for about a week. They’d also been without communication and power.

“They [asked us] if we’d brought any fuel,” Rhonda said.

“I told them we didn’t and they said, ’Well, we’re all solar… and when there’s a fire and there’s clouds we don’t get solar, so we have no power.’

“We didn’t even think of that.”

So with the only functional vehicle around, Rhonda and Andy jumped back in their car for a 90 minute round trip returning with their boot and backseat chock-full of fuel, fresh fruit and vegetables, water and groceries.

Their supply run was a particular relief for boarding kennel owners Ron and Jacqui who

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By the numbers*

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PEOPLE KILLED including three volunteer firefighters and three American firefighters

5900 BUILDINGS destroyed including about 2800 HOMES 18.6 million

were running out of dog and cat food and Ron’s emphysema medication.

“We were amazed they’d survived because everything else around them had been destroyed,” Rhonda said, adding the fire near the kennels appeared to have been more ferocious than in the township.

“We saw a lot of burnt-out cars, but I never saw a one like theirs that was actually melted in time. It looked like it had been dripping,” Rhonda said.

The couple and the animals in their care apparently waited out the inferno in a fire-resistant bunker Ron built seven years ago.

“Apparently they didn’t have time to get out so, they all went into there – him, his wife, his two Great Danes, five other dogs, and three cats were in there for 45 minutes listening to the fire raging outside.

“I can’t imagine what that must have been like.”

Survival and resilience During their time in Eden, Rhonda heard many extraordinary stories of survival and resilience but the thing that struck her most was the kindness and generosity of the people she met.

“They’d all been through so much, suffered so much loss, but not one person was rude or awful, or even angry – it was remarkable,” she said.

“People were really lovely and you saw so much generosity and so many people willing to help.

“When we left Brisbane I was expecting to go full-on nursing, but there you go. It was more important that we were there, to do simple things, offer a hand, make a cup of tea…

We just opened ourselves up and that’s the path we took.”

Now back in Maryborough with a soot covered car and a little piece of burnt wood sitting on a shelf as a memento, Rhonda wishes she could have stayed longer.

“I wouldn’t hesitate to do it again, it was such a humbling experience – yup, I’d do it again in a heartbeat.”

HECTARES BURNED (186,000 square km)

1 billion

Estimated animals and reptiles killed At the peak of the crisis in

150 fires

NSW almost were burning across NSW with a fire front about

6000km long

2019 declared Australia’s

hottest year on record

(Bureau of Meteorology)

Tourism revenue in Australia has already fallen by

$1 billion

Cost of dealing with the bushfires is expected to be well in excess of the

$4.4 billion

cost of the 2009 Black Saturday fires NASA estimates the fires emitted about

306 million

TONNES OF CARBON DIOXIDE into the atmosphere

*Statistics as at 14 January 2020.

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indepth

Beyond the black summer: understanding its effects LONG AFTER the headlines fade from the front pages and the eucalypts begin to cover their scars with regrowth, many who survived this year’s black summer will still be living in its shadow.

The long-term mental health implications of a traumatic event like this summer’s bushfires can linger for years.

OUR BLACK SUMMER

A six-year study released after the 2009 Black Saturday fires in Victoria showed a quarter of study participants from high-impact bushfire areas still suffered serious mental health problems three or four years after the event.

Rhonda and Andy with Mallacoota burning in the background.

The Beyond Bushfires report surveyed more than 1000 survivors and found 26% of the people whose communities were heavily affected by the fires showed signs of mental health problems like depression and post-traumatic stress at levels which might require professional support.

The figures are double the levels usually found in populations not affected by disaster.

While these levels fell to about 21% by the five-year mark, there was also evidence of delayed onset of individual mental problems – particularly PTSD – around five years after the fires.

A boot full of supplies for the folk in Genoa.

Individuals who had been separated from close loved ones during and immediately after the fire were at particular risk, especially those initially unaware of their loved one’s fate.

Meanwhile the capacity for people to recover from trauma was linked not only to how they coped with the fire event itself, but also with the aftermath such as changes in relationships, financial security or living arrangements.

How well an individual's, family, social circles and communities recovered from the fire disaster or were able to adapt to the changed life and environment also affected that individual’s resilience and recovery.

Where climate change fits in THANKS to climate change Australia’s temperature has risen by about 1 degree since the turn of the century, and in addition to experiencing some of the hottest summers and years on record in the past decade, we are also seeing a drop-off in cool season rainfall across the southern states.

As a result of this, our drought and dry seasons have intensified and become longer and hotter, and more of our land is covered in very dry fuel and hot soil.

This longer, hotter dry season

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means we have less opportunity, a smaller window to undertake backburning and fuel reduction burns, even though more reduction work than ever is needed.

Furthermore, government failure to acknowledge climate change’s effect on extreme weather means there has been little thought into boosting our aerial firefighting capabilities.

This means when a fire does take hold, our capacity to bring it under control is restricted.

References

Climate Council of Australia, www.climatecouncil.org.au Lee, H., 2019. Time Magazine, Bushfires Release Over Half Australia’s Annual Carbon Emissions. United States.

University of Melbourne, 2016. Beyond Bushfires. https://mspgh.unimelb. edu.au/__data/assets/ pdf_file/0008/3043187/ Beyond-Bushfires-FinalReport-2016.pdf

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Queensland's silent disaster W

HILE we’ve watched in horror as great swathes of our country has been ravaged by recent bushfires, other parts of Australia remain in the grip of another crisis that’s all but slipped to the back pages of the news.

January 2017

Entire districts across eastern Australia have endured severe drought conditions for years. In some areas, it has dragged on for up to seven years, making it the worst drought in living memory for many local communities.

For many of these drought-stricken communities, this bushfire season has been an anxious time, with little to no water available to contain any potential fires.

And while much of Queensland has experienced relief in recent weeks thanks to much-needed rain, it hasn’t been enough for many areas.

‘Baked, desiccated, waiting to burn’ QNMU member Laura Lynch, CN, works as a contract nurse and lives in The Summit, north of Stanthorpe. She spoke to the QNMU about the drought in January, and although the situation has marginally improved since then, Laura later reported that her town was still “in the grip of drought”.

Farm dam in Ballandean

“Thunderstorms are now dry, and instead of bringing joy they bring fear, as we wonder if lightning has started another fire,” Laura said.

“Before any bushfire inquiry, we really need a drought management inquiry because unprecedented drought has led to unprecedented fire.

“We are baked, desiccated, and waiting to burn with no water to defend ourselves or live a normal life.

“When we get to the point where you’ve got rainforests burning, you know we’re in serious trouble.”

July 2019

Applethorpe was the first to experience severe bushfires as early as August 2019, which resulted in

Photos: Jenny Hillman

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THIS IS NOT BECAUSE AUSTRALIA IS BURNING. THIS IS WHY AUSTRALIA IS BURNING.

OUR BLACK SUMMER

QNMU member Laura Lynch

loss of homes and habitat across the Granite Belt district.

Local communities endured months of air pollution thanks to a blanket of thick smoke and dust – pollution that eventually found its way to major cities and finally made national and international headlines.

“It would be useful to compare the current respiratory status of the community to what it was prior to the bushfires, because we’ve essentially had 12 to 24 months of dust,” Laura said.

“There is red dust falling from the air that we are breathing in all the time.”

Today’s reality The town of Stanthorpe officially ran out of water last year. While recent rainfall has brought the dam level up to just over 19%, this is still insufficient to supply an entire town, especially considering the Bureau of Meteorology has predicted a dryer than usual Autumn.

People are still relying on either the water carting project run by local and state governments or donated supplies at depots run by volunteers.

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“The council asked us to shower once every three days, but it’s pretty hot and sweaty in summer and it’s incredibly dusty.

“I saw one lady on the news say her family were showering once every two or three days into a bucket. The water in that bucket is then used to wash their clothing and flush their toilets.

“We don’t flush our toilets until absolutely necessary. That’s the reality.”

A food shortage also means many families, including farmers, are relying on food donations to survive.

“Many families have little to no income from failing agriculture,” Laura said.

“We’ve got graziers who have had to euthanise animals due to lack of food and water, which is obviously heartbreaking for anyone, let alone the farmer, who relies financially on that beast.”

Mental health While the situation has obviously taken a financial toll on these communities, the psychological toll is just as serious.

Water rations limit a family of four to 50 litres of drinking water per week.

Australian Bureau of Statistics data from 2018 showed the national suicide rate was the highest in a decade, with drought listed as one of the possible contributing factors to this increase.

“People lining up for weekly water rations is mind-boggling to me,” Laura said.

Laura, who has worked for many decades as a mental health nurse, said years of drought were

November 2016

CPD

A local cattle farm

October 2019 Photos: Jenny Hillman

certainly having an affect on the communities’ psychological state.

“Just because you’re not cropping doesn’t mean the bills stop, I think that’s what people miss,” Laura said.

“This is accumulative, it’s not just the immediate devastation of the bushfires, these farmers have been struggling for years.

MAKE A DIFFERENCE TODAY

“And while some greenery from recent rain has been a psychological positive and the immediate bushfire threat has retreated, our agriculture industry continues to slowly die.”

Donate food, water and other living essentials – Granite Belt Drought Relief Centre (contact through Facebook at https://bit.ly/37fAmyB).

Time for action

Make a financial donation:

But there is hope, because there are actions we can all take today to help these communities that have been forgotten for so long.

■ Red Cross www.redcross.org.au/campaigns/ disaster-relief-and-recovery

“I think every single individual in Australia is in a place to make a difference, but as nurses we do have a bit more clout in putting forward health concerns,” Laura said.

■ Drought Angels www.droughtangels.org.au

“I want to use my primary health care experience to advocate for political policy change – I’m doing lots of lobbying myself, contacting local politicians and making it clear that infrastructure for secure, sufficient, and affordable water must be a priority.

“But in terms of the basic day to day living right now, full water tanks would do wonders for so many people.

“Many farmers have water in tanks and their dams, but are waiting to see if there is more follow-up rain before risking planting a crop

■ Buy a bale www.buyabale.com.au ■ Granite Belt Wildlife Carers www.gbwildlifecarers.org.au Please do not donate articles of clothing.

Contact your local politicians – let them know reliable water infrastructure for regional communities is a voting issue.

“The best thing people can do is donate food and water.”

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A SAFE HAVEN FOR OUR AGEING RAINBOW COMMUNITIES

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indepth There’s something unique about Arcare Parkwood aged care facility on the Gold Coast.

Upon entering, there’s nothing overtly different about the facility or staff, or even the residents themselves.

Yet Parkwood is leading the way in Queensland when it comes to health care delivery for our elderly LGBTI communities.

H

AVING witnessed her relative vilified for their sexuality for much of their elderly life, Trudi Murray decided to sell a block of land to aged care provider Arcare, on the condition they build a facility with a dedicated LGBTI focus.

In November 2019, the facility opened its doors to residents from both the LGBTI communities and the broader community. Sixty of its 90 beds are dedicated to members of the LGBTI communities. The facility is the first of its kind in Queensland.

Arcare Parkwood Facility Manager Sue Falzon said the idea behind the facility was to create a safe space where residents could feel comfortable being who they are.

“It’s about providing a safe and inclusive environment,” Sue said.

aware that this is who we’re catering for.

“So if they move in with their partner, people aren’t going to look at them or think differently of them or say anything if one puts their arms around their partner.”

GETTING THE RIGHT ADVICE Faced with the task of building a facility that catered to a population that has historically endured social, legal and health discrimination, Arcare established an advisory committee consisting of representatives from various organisations and walks of life.

AIN and QNMU member Nick Tyson was one of 12 members on that advisory committee. He said his focus

“Residents who come from that community know staff don’t have any issues and the residents – whether they’re LGBTI or straight – they’re all

IT’S ABOUT PROVIDING A SAFE AND INCLUSIVE ENVIRONMENT. Sue Falzon, Arcare Parkwood Facility Manager

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indepth was to ensure Arcare understood the significance of what they were doing.

“The one thing I advocated for strongly while a part of this advisory committee is that we come out of the closet, we live our lives, only to often have to go back into the closet in an aged care facility,” Nick said.

“Obviously, we should have that equality to not have to even worry about the issue, but unfortunately the reality is that in some places that just isn’t there.

“A lot of elderly LGBTI people do clam up and feel concerned. Some of the questions posed were, how can I be sure that other residents are okay with me being gay? Will I be in a safe zone?”

The committee advised on other issues, including wording on documentation, the facility décor, and staff training.

“We advised on the wording for the resident application forms, including one of the standard questions of how you identify, including what are your pronouns,” Nick said.

“Another focus was recognising people who had gone through certain violence issues in the past and how the nursing staff should approach that.

“We also focused a lot on the needs of transgender and gender diverse people and made sure the facility was acceptable for the whole community and ensured staff were properly trained.”

TRAINING AND HEALTH Many may assume the health needs of our elderly LGBTI communities are no different to those of the broader elderly population. But closer observation shows this is not necessarily the case.

Rainbow Pride at Work Co-ordinator at the Queensland Council for LGBTI Health (formerly the Queensland AIDS Council) Sami Stewart said many elderly LGBTI people faced unique health and social challenges that nursing staff needed to understand in order to care for these residents appropriately.

“A statement I hear all the time in the aged care sector in the training that we deliver is, ‘I treat everyone the same’,” Sami said.

“It comes from a good place, but treating everyone the same when it comes to our LGBTI communities can’t be a one-size-fits-all approach.

“Many of these people going into residential aged care facilities grew up in a time when homosexuality was criminalised and there was much more stigma and exclusion when it came to issues like gender diversity.

“As a result, there is often a lack of family structures, a lot of these elderly

IF IT WAS A GENERATION AWAY, I THINK IT WOULD BE MORE ACCEPTING, BUT IN 2020, I DEFINITELY THINK THERE IS STILL A SPECIFIC NEED FOR THE LGBTI AGEING COMMUNITIES.” Nick Tyson, QNMU member

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people don’t have kids to take care of them when they get older, and they can be left to navigate things on their own, particularly if they don’t have partners.”

In contrast to this, some residents may be leaving behind strong support networks that have been built over the years.

“They might be entering an environment where they’re losing their ability to have control over both their health and their social connections, which can result in isolation and is a big contributing factor for having to go back into the closet, so to speak.

“Other health issues for some people include the long-term effects of living with HIV, which is associated with a lot of neurological disorders such as dementia, and a lot of the medications are linked to cardiovascular issues.”

SILVER RAINBOW So many of these unique challenges have historically been either silenced or ignored.

But fortunately, a shift in societal attitudes in recent times has also coincided with recognition and a concerted effort from governments, the aged care sector and other organisations to meet the health care needs of our elderly LGBTI population.

Some of those initiatives have been at the legislative level. In mid-2012, for example, the Aged Care Act 1997 was amended to include LGBTI people as a special needs group.

And in response to the federal government’s National LGBTI Ageing and Aged Care Strategy (also released in 2012), the National LGBTI Health Alliance established the ‘Silver Rainbow’ training program, which continues to be delivered in Queensland today by the Queensland Council for LGBTI Health (QC).

All Arcare Parkwood staff undergo this training as part of their induction.

Sami said the course educates staff on how to create a safe and inclusive environment for aged care residents.

“When we’re talking about the changes to workplace practice

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that nursing staff can make on an individual level, our main recommendations are inclusive language and how they can celebrate and understand an LGBTI elder person’s identity,” Sami said.

made dramatic progress in societal attitudes.

meets the needs of all our residents and patients.

But we cannot deny the stigma that was once so entrenched does not still linger today.

“In terms of health, it’s about autonomy and choice when it comes to the type of care you want to access,” said Sami.

“It’s about working towards creating and fostering supportive environments where people can live and celebrate their authentic lives.”

Nick Tyson said his experience working in aged care had left him with the impression that homophobia, transphobia and intersexism still exist.

Sami said QC’s partnership with Arcare was exciting because it created an opportunity for ongoing learning that could extend across the rest of the aged care sector.

“Currently, at the age of 43 and as a gay man, if I was to look into an aged care facility I would be extremely hesitant,” Nick said.

“This kind of change isn’t just training that the staff do every six months and then it’s done and dusted, it’s an ongoing process with continual learning and lessons for the rest of the sector,” she said.

“So even though other services may not have a LGBTI focus, they can ensure they’re creating a more inclusive environment for all residents.”

WHERE DO WE STAND IN 2020?

Many may find it difficult to believe there is even a need for a facility like Arcare Parkwood in 2020, particularly in a society that has achieved marriage equality and

“I think it’s a generational thing – if it was a generation away, I think it would be more accepting, but in 2020, I definitely think there is still a specific need for the LGBTI ageing communities.”

Sami agreed, adding that the misconception that discrimination does not exist today suggests we still have a way to go.

“We know through research that people – from young LGBTI people all the way through to older people – are still experiencing stigma, discrimination and even violence,” Sami said.

As nurses, midwives and carers, we have an important role to play in delivering health care in a way that

“Whether that’s LGBTI specific care or whether it’s mainstream care, we all deserve the power of choice so that our histories, our bodies, our relationships and identities are all treated with the care we deserve.”

FURTHER RESOURCES Queensland Council for LGBTI Health: https://quac.org.au/wellbeing/ageing/ Australian Government Department of Health – working with diverse groups in aged care: https://bit.ly/2STta5z End of Life Directions for Aged Care (ELDAC) – Australia’s ageing LGBTI population: https://bit.ly/31Zaaqg

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PHASE 3 STRENGTHENING AND EXPANDING THE CARE GUARANTEE

I

T’S FRIDAY AFTERNOON and a central Brisbane Emergency Department (ED) is full to overflowing.

Every bed is occupied, including those in several makeshift rooms staff have created to meet rapid and everincreasing demand. Six patients wait on plastic chairs in the corridor and five ambulance stretchers have been ramped in a neat row near admissions.

BREAKING NEWS We saw a ray of hope from the Royal Commission into aged care quality and safety last month when Peter Rozen QC, the Senior Counsel Assisting the Royal Commission, called for legally enforceable staffing ratios including the mandatory provision of a Registered Nurse on every shift.

During hearings in Adelaide, Mr Rozen outlined five recommendations around aged care staffing including legally enforceable minimum staffing ratios and minimum times for care, including a minimum 30 minutes of RN care per resident. He also recommended making staffing levels publicly available.

We certainly welcome Mr Rozen’s recommendations given how closely they reflect our own Ratios campaign asks, but the challenge now is getting the Federal Government to step up and make them law.

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A single paramedic waits silently behind each reclining patient, occasionally checking on those in their care, while nurses and doctors quietly and swiftly cross the linoleum in a bid to meet patients’ needs.

It’s chaos. One man, wearing a neck brace and lying disturbingly still, cries silently on a trolley while a shirtless youth completes yet another lap of the ED, his eyes wild and gestures increasingly manic.

In the hallway, a woman experiencing rolling panic attacks fights for breath while a man holds an ice pack to an egg-sized bump in the middle of his forehead. Machines beep, an alarm sounds sending a flurry of staff to a nearby bed and the patients keep coming.

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“This is what it’s like now,” says a young nurse, who somehow finds the time to make a cup of tea for the panicked woman.

numbers and resources remain, in comparison, dangerously low.

“In the face of population growth and understaffing, this is the new reality for Queensland EDs. But it’s got to change.”

We agree. Which is why we’ve launched Phase 3 of the QNMU’s Ratios Save Lives and Money campaign.

We are determined to see nurseto-patient ratios expanded to cover all nursing and midwifery services – public, private and aged care.

Phase 1 of our ratios campaign successfully secured legislated ratios in prescribed acute medical and surgical wards in 2016.

Phase 2 saw legislated ratios extended to designated public acute mental health wards, and minimum nursing hours legislated for Queensland’s 16 State Aged Care Facilities.

We’ve recently launched Phase 3 of our Ratios Save Lives and Money campaign. It focuses first on securing nurse-to-patient ratios in Queensland’s public emergency, operating theatre and maternity departments.

These departments are currently experiencing chronic understaffing due to a range of circumstances including population growth and issues linked to the federal government’s funding model.

Presentations have increased well beyond forecast figures while staff

“Research conducted as part of Ratios Save Lives Phases 1 and 2 shows ratios have saved 145 lives and up to $81 million,” QNMU Secretary Beth Mohle said.

“But our members are right, much more still needs to be done.”

Ms Mohle said this year the QNMU would also target private hospitals and private aged care facilities where there are no rules around staffing levels.

In Australia, there is no federal legal requirement that one Registered Nurse (RN) be on site at an aged care facility at any time. This means it is not illegal to leave elderly Australians without an RN overnight, or during the day. And mandated nurse-topatient ratios do not exist in private hospitals.

As part of Phase 3, the QNMU will call on employers, funders, insurers and accreditors to work with nurses and midwives to: ■ further refine and expand legislated minimum ratios in the public sector ■ further improve application and compliance with the Business Planning Framework (BPF) in the public sector ■ mandate minimum ratios in the private and private aged care sector

in public, private and aged care sectors, and ■ mandate minimum positive practice environment standards in public, private and aged care sectors.

We will also work with the government to implement recent legislative changes to increase transparency and public reporting in both the public and private sectors.

Yes, it’s an ambitious agenda, but we know the safety and wellbeing of our patients, residents and ourselves depends so much on our workloads.

“Being left to wait in the corridor for five hours while I was experiencing rolling panic attacks and shortness of breath was an experience I’ll never forget,” said a female patient who waited in the Brisbane ED on the day described above.

“I credit the staff for doing what they could, but I feel the system is letting Queenslanders down. My mental state was such I was not in control, and if I was alone, I could have walked out and placed myself in harm at any stage because there simply weren’t enough nurses and doctors there.

“I fear for others arriving in similar circumstances because when it’s that busy, and they are that short staffed, anything could happen. I genuinely fear for people’s lives.”

■ refine and expand legislated public reporting of safety and quality performance to include indicators specific to nursing and midwifery

You can read all about our campaign, as well as download the latest resources, on our ratios website. Visit www.RatiosSaveLives.com.au

Since legislated minimum nurse-to-patient ratios were introduced in July 2016, there have been:

145 deaths avoided

255

readmissions avoided

29,200 hospital days avoided

Up to

$81m saved

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indepth

Clothes

MAKETH THE MAN (OR WOMAN)

Pictured: The Kindess Pyjama Project (Princess Alexandra Hospital) Image supplied by: Metro South Health

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Clothing is ultimately the suit of armour in which we battle the world.

Sophia Amoruso, fashion entrepreneur

T

he way we dress is intrinsically linked to our emotions.

It’s time to say farewell to unflattering hospital gowns. A growing number of hospitals are

Studies have shown our mood can be affected by what we wear and similarly, how we feel can also affect our choice of clothing and subsequent mood.

So it’s no wonder we all feel a little glum in hospital if all we’ve got to wear is a less-than-comfortable robe that may feel a little draughty in the back.

helping patients access

But the days of frumpy hospital gowns may be numbered.

free, clean clothing

A hospital in Sydney recently gained media attention for a new support service offering free clothing to patients in its psychiatric ward.

during their time of need.

Keith’s Closet was launched just last year at the Prince of Wales Hospital, the brainchild of clinical nurse specialist Keith Donnelly.

In between patient rooms, a walkin wardrobe is fitted with full-length mirrors, offering various items of donated clothing, including dresses, sportswear, suits and shoes.

Keith said many patients in the hospital’s psychiatric ward (Kiloh Centre) might have been picked up on the streets of Sydney and have no spare clothing to wear during their hospital stay. “[Before Keith’s Closet] we might have [given clients] some clothing that might have been left here by other clients… or they might just have some sort of robe to wear at times, which isn’t the way forward at all,” Keith told the media.

“I wanted to change that.”

Keith said the service has been successful in helping build rapport between clinicians and patients, and lifting the feeling of the ward.

But it isn’t just Keith’s Closet that’s making a difference to the lives of patients.

Across Queensland’s hospitals, similar initiatives aim to improve patient wellbeing by providing access to essential items like clothing.

Let’s take a look at some of them…

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indepth

The

Kindness

Pyjama Project

PRINCESS ALEXANDRA HOSPITAL THERE’S nothing better than a comfy pair of jammies when you’re not feeling your best.

Launched early this year, the PA Hospital’s Kindness Pyjama Project provides patients with a pair of pyjamas to keep as their own.

PA Hospital Cancer Services Acting Nurse Manager Monique Richter said some patients may have been admitted to hospital unexpectedly and appreciate having something comfortable to wear.

“It all began when one of our partners saw a patient in the foyer in one of our purple hospital gowns,” she said.

“The gown was fairly bare-backed, didn’t quite cover them, and left them with little dignity. They thought ‘there’s got to be a better way’ so they started doing a bit of research

into how these gowns might affect patients.”

A literature search revealed hospital gowns actually led to poorer patient outcomes due to an increased risk of falling, increased pressure injuries on the skin, and increased sedentary behaviour in patients due to a reluctance to mobilise.

“The aim of the Kindness Pyjama Project was to improve dignity and wellbeing for patients and empower them in their recovery,” Monique explained.

“This actually led to a hospital-wide kindness group being established, with other little projects in the works to address things like hospital food, improving the patients’ waiting area and more.”

Cancer Services Nurse Manager Sue Schoonbeek was integral in getting the

Empowering

Pyjama Project up and running, developing partnerships with community organisations to receive donations of pyjamas.

While the project was originally conceived in the Cancer Services Team, it’s spread hospital- wide and each floor of the PA Hospital now hosts a fully stocked cupboard of pyjamas for patients.

“We’re still in the early stages of the project but feedback from staff has been very positive,” Monique said.

“We even had a gentleman who came to the launch of the project who ended up donating three hours of his day to helping us fold and bag the donated pyjamas. He said to us ‘well, you never know when I might need it!’”

patients with dignity

GOLD COAST UNIVERSITY HOSPITAL

GOLD COAST UNIVERSITY HOSPITAL (GCUH) has been working to empower patients with dignity by making essential clothing readily available.

GCUH Mental Health Nurse Michelle Stankiewicz said the mental health ward boasts a clothing cupboard stocked with lost or donated clothes for all patients to access.

“Often patients come in with just the clothes on their backs and they might have been living a little rough,” Michelle said.

“I think just being able to put on some fresh clothes after a hot shower can do amazing things for people and they are so grateful.

“I often see patients walking around in my daughter’s clothes which is lovely, I love seeing her clothes being put to good use.”

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But it’s not just the mental health ward at GCUH that’s giving used clothes a new lease on life.

In 2012, the hospital’s emergency department launched the Discharge with Dignity initiative which, as its name suggests, aims to give patients a dignified exit from hospital.

Michelle said the ED first conceived the initiative in response to a growing number of patients who were being discharged in hospital gowns and without shoes.

“Not only was it undignified for the patients it was also greatly distressing for their treating nurses and allied health professionals, who often felt powerless to provide them with a more dignified discharge from the ED,” Michelle said.

Eight years on, and the initiative has taken root hospital-wide with clothing

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Supporting

domestic violence survivors MAREEBA HOSPITAL has long been a safe haven for women at their most vulnerable.

“It’s a short-term measure, but it might help get them through the next few days.”

Not only has it sheltered domestic violence survivors through their most desperate moments, but for the past three years the hospital has also supported women and their babies with donations of essential items and baby clothes.

The initiative first began in support of one of the hospital’s social workers, who had a particular interest in helping domestic violence survivors relocate and find housing.

Mareeba Hospital Maternity Department Nurse Unit Manager Michelle Bombardieri said the hospital sadly encounters high incidences of domestic and family violence cases. r igenous Liaison Office Mareeba Hospital Ind ell, rnw Ba ia nth Cy ENAS Ann Janette Idaho, ardieri NUM Michelle Bomb

donations being accessed by wards throughout the facility.

Clothes are generously donated by staff and the community, including an over 60s fitness group who collected more than 200 pairs of thongs last year and 300 ladies’ underpants the year before.

“Everyone in the hospital does their bit to contribute to helping out our patients when they need it,” Michelle said.

“During my stint in the mother and baby unit, we received a large donation of baby clothes from the hospital foundation shop to distribute among the mums and bubs.

“Our Robina campus hosts a little sale of donated clothing every now and then, selling them for 50 cents or a dollar, and those proceeds are put back into purchasing resources for the ward.

“One of our social workers also collects thongs for people who may come into the ED barefoot.”

MAREEBA HOSPITAL

“Women in domestic violence situations are in an incredibly difficult place,” Michelle said.

“Some of them are unable to go home and have to find emergency housing. They often turn up at our hospital with nothing, so to be able to give them something – even if it’s just a few comfort items – we hope can help make that step easier and is one less thing they have to worry about.

The Maternity Department put a call out to the entire hospital for essential items, and the donations came flooding in from generous staff members.

“We’ve got toiletries, clothes, sanitary products… We organise them here in the maternity department and they can be accessed by the whole hospital,” Michelle said.

“The community has also always been really good at donating second-hand baby clothes. We work out what we can use here at the hospital and donate the rest back to mums and families in the community who may not be able to afford their own.

“People are often overwhelmed and can’t believe we’ve done this for them.”

If you need help or support Nurse & Midwife Support 1800 667 877 www.nmsupport.org.au

Lifeline 13 11 14 www.lifeline.org.au

Beyond Blue 1300 224 636 www.beyondblue.org.au

References

ABC News, 2019. Free clothes at Keith’s Closet allow psychiatric ward patients to say goodbye to hospital gowns. https://www.abc.net.au/ news/2019-10-23/free-clothes-allow-patientsto-say-goodbye-to-hospital-robes/11627536 The Sydney Morning Herald, 2015. Fashion and mood: How clothes affect your emotions. https:// www.smh.com.au/lifestyle/fashion-and-moodhow-clothes-affect-your-emotions-20150717giei1f.html

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C

LIMATE CHANGE is a real and

critical threat, not just to human health but to our planet’s very

existence. If we are to have any hope of turning the tide we need to step up and be part of the solution.

Over the next few editions of InScope we will focus on big ticket items that you and your household can embrace to help make a difference to our planet.

In this edition we look at greywater recycling.

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indepth AFTER two decades of back-to-back drought, Queenslanders are no strangers to the concept of conserving water. Even cityslickers know to take shorter showers, fix leaks and turn the tap off when they shave.

But it’s time to go beyond that.

It’s time to rethink our relationship with water.

And reusing grey water is one of the best ways we can maximise the use of the water we draw, and reduce the need to tap into our precious and often limited fresh water supplies.

WHAT IS GREYWATER? Greywater is the water that runs off from having a shower or washing your hands or clothes. It is distinct from dishwater, which is usually considered dark grey because of the high content of fats and organic matter, and black water which is water from toilets.

WHAT ARE THE BENEFITS OF GREYWATER? Greywater is easy to collect and use and can be a good source of garden irrigation all year round.

And if you use the right products, it can be a good source of nutrients for your plants.

Untreated greywater should not be used on herbs or vegetables that will be eaten raw – but it’s fine to use on lawns, non-edible plants and trees (including fruit trees).

If done well, about half of all household water used could be recycled as greywater, saving hundreds of litres of water every day.

BUCKETING AND HOSING The most affordable greywater reuse system is simply to collect the untreated water from your washing machine or shower.

You can do this either by using buckets to collect water from your shower or washing machine and pouring it untreated straight on to your garden, or by connecting a greywater hose to your washing

machine water outlet and letting it run out on to your garden or lawn.

major element in fertiliser, but many Australian native plants don’t like it.

In most council areas you don’t need approval to do this, but you should make sure the water doesn’t run off into your neighbour’s yard.

So, it is really important to read detergent labels well and chose low-phosphorous options not just pick products that claim to be environmentally friendly.

TIPS: Position the hose so the water runs downhill and drains freely from your machine.

Avoid using this method if the ground is already soaked from heavy rain.

You can also collect the clean water that runs while your shower water warms up to flush the toilet instead of using the cistern.

GREYWATER DIVERSION Diversion systems in their simplest form direct water into a collection tank then into a sub-surface irrigation system (buried about 1 metre underground) for your garden or lawn.

The collection tanks are selfdraining because most councils have regulations against keeping untreated greywater for more than a day because it can breed bacteria and start to smell.

Most diversion systems can also be fitted with a diverter valve that allows you to redirect water into the sewer if the ground is already too saturated. Most also have filters that stop debris like hair clogging the irrigation pipes.

These systems generally require installation by a licenced plumber.

GETTING IT RIGHT The most common problem associated with diverting grey water into the garden is that it adds phosphorous to the soil, the potential increase in salinity, and possible increase in soil pH levels making the ground more alkaline.

Small amounts of phosphorous is good for plants. In fact, it is a

TIPS: If your soil pH is too high, add a splash of vinegar to the greywater to lower the pH. To maintain the health of your garden and its critters, give your garden a good soak with fresh water every few weeks.

Adding organic matter like compost or mulch also helps counteract the effects of salt and lowers the soil pH.

GREYWATER TREATMENT If you are concerned about using untreated greywater on your garden you may want to consider a treatment system.

Treatment systems can cost anywhere between $4000 for a basic system, which filters solids like lint and hair, to as much as $20,000 for sophisticated filtration, which filters chemicals and pathogens through chemical or microbial treatment, and may even include disinfection though chlorination or the use of ultraviolet light.

This treated water can often be plumbed back into toilets and washing machines but is still not considered ‘potable’ or drinkable water.

FOR MORE INFORMATION Visit Choice magazine’s “Guide to greywater systems” www.choice.com.au/homeimprovement/water/savingwater/articles/guide-togreywater-systems You should also check with your local council about the greywater rules in your area.

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Pictured: Queensland Pelvic Mesh Service Clinical Nurse Consultants Jennifer Rayner (left) and Melissa Smith (right) and Clinical Nurse Researcher Anne-Marie Feary (middle).

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indepth After enduring years of constant pain from pelvic mesh complications, women across Queensland are finally able to access the treatment and support they so desperately need through a public state-wide service.

L

AUNCHED in April 2019, the Queensland Pelvic Mesh Service (QPMS) is a multidisciplinary health service set up to assist women with management and treatment of pelvic mesh complications.

Before the QPMS was conceived, services for mesh affected women were fragmented and often difficult to access.

Now, the service acts as a one-stop shop by providing access to medical, nursing and allied health specialists coupled with a comprehensive and interdisciplinary team approach to patient-centred care.

Central to the team are QNMU members and Clinical Nurse Consultants Jennifer Rayner and Melissa Smith, and Clinical Nurse Researcher Anne-Marie Feary.

As part of their roles, Jennifer and Melissa triage referrals to the service, conduct assessments and work with patients to co-ordinate a care plan for their treatment.

Designing a consumer-led service Melissa said the service was uniquely designed in collaboration with a multidisciplinary group of clinicians, health service managers and consumers who had experienced pelvic mesh complications.

“The service was set up with a consumer group to be consumer-led – both in design and implementation – so mesh affected women had extensive input into the environment and layout of the service,” she said.

“Consumer feedback was key to understanding the level of distress and the ongoing effect of mesh injury on women’s lives.

“This made a difference in the way the service was designed, and facilitated the project team to deliver a ground-breaking service.”

While this level of consumer engagement is relatively new to urogynaecology clinicians, the team embraced the opportunity to work with consumers.

“Consumers felt that up until recently, pelvic mesh complications were not identified as a real issue,” Jennifer said.

“It was challenging for them to find clinicians who are specialised in pelvic mesh and mesh removal. Ongoing health care costs were also a factor because many women have been affected to the point of being unable to continue work.

“So to have this unique multidisciplinary service that we have here at QPMS has been of great benefit.”

Since the service commenced, the team has received 169 referrals, provided over 590 multidisciplinary appointments and facilitated pelvic mesh removal for 12 women.

Feedback of the service shows patients are getting the help they require.

In a recent survey, 95% of patients said they would recommend the service to other women with pelvic mesh complications.

“The biggest thing we’re hearing is that the management of their treatment is no longer fractured, they don’t have to go to five or six different health care facilities,” Anne-Marie said.

“After tackling these issues for so long women now feel they have a voice and someone is listening to them, and they’re very grateful.”

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indepth Clinicians and consumers of the Queensland Pelvic Mesh Service (QPMS)

The pelvic mesh debacle –

WHAT HAPPENED?

Image courtesy of Gold Coast Health

PELVIC MESH (also known as transvaginal mesh) is a manufactured, polypropylene, net-like product.

I’m really proud of the care we’re able to provide these women.

A lot of our patients suffer from chronic pain and we’re really trying to assist them to improve their health and wellbeing.

Jennifer Rayner, Queensland Pelvic Mesh Service Clinical Nurse Consultant

Making a difference for women The QPMS team was recently recognised at the Queensland Health Awards for Excellence, taking home the Consumer Engagement Award for their collaborative approach.

“I’m really proud of the care we’re able to provide these women. A lot of our patients suffer from chronic pain and we’re really trying to assist them to improve their health and wellbeing,” Jennifer said.

The QPMS has also established a Research Working Group which will investigate the care and treatment of women with pelvic mesh complications to improve best practice care and treatment.

Clinical Nurse Researcher Anne-Marie monitors and reports patient outcomes before and throughout the course of their treatment.

“We have a really dynamic team who are very passionate about women’s health and outcomes, and ensuring patients have a voice by providing patient-centred care,” she said.

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“While we’ve been successful in helping many women, we’re still trying to get the word out about the service to make sure all women who are affected by pelvic mesh get the opportunity to access the QPMS.” The QPMS is based at the Varsity Lakes Day Hospital on the Gold Coast, however its services are available to women throughout the state.

Women who are experiencing complications from pelvic mesh should see a GP or treating specialist to arrange a referral to the QPMS. Find out more about the QPMS at http://bit.ly/3auKIg9

References

ABC News. 2019. Pelvic mesh maker Johnson and Johnson loses class action suit. https://www.abc. net.au/news/2019-11-21/johnson-and-johnsonloses-pelvic-mesh-class-action/11724152 Queensland Government, Queensland Pelvic Mesh Service. 2019. About pelvic mesh and complications. https://www.qld.gov.au/health/ services/specialists/pelvic-mesh-service/aboutpelvic-mesh-and-complications The Guardian. 2017. What does pelvic mesh do and why are women suing over it?. https://www. theguardian.com/society/2017/aug/31/vaginalpelvic-mesh-explainer

It was first promoted to women more than a decade ago as a less invasive alternative to traditional surgical approaches for treating urinary incontinence and prolapse, common conditions that can occur after childbirth.

The implant was created by medical company Ethicon and its subsidiaries, which is owned by global giant Johnson & Johnson.

It was not properly tested for safety before being allowed on the Australian market, and Johnson & Johnson downplayed its risk to both surgeons and patients.

An estimated 150,000 Australian women have had pelvic mesh used in surgery in the last 20 years.

Thousands of women who received the implant suffered devastating side effects from complications including chronic pelvic pain, mesh exposure, infection, bleeding, pain during sexual intercourse, difficulty sitting and walking, difficulty passing urine or incontinence, and organ perforation.

This led to one of the largest women’s health class action lawsuits in Australia’s history, where Johnson & Johnson was found to have been negligent.

The suit was won on behalf of 1350 women who had been impacted by pelvic mesh complications.

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A win for whistleblowers

whistleblower (noun) Pronunciation /ˈ(h)wisəl ˌblō(ə)r/ /ˈ(h)wɪsəl ˌbloʊ(ə)r/ A person who informs on a person or organisation engaged in an illicit, unethical, unsafe, wrong or negligent activity.

R

ESEARCH shows that around four in every five whistleblowers experience negative repercussions from speaking out about wrongdoing in the workplace (Brown et al., 2019).

This startling statistic is sadly not a surprise.

Our news feeds are filled with stories of whistleblowers being stigmatised and vilified, from American politics where whistleblowers are labelled as spies and treasonous, to stories closer to home where nurses have blown the whistle on patient safety concerns and suffered professionally, personally and financially for exposing the truth.

There are those who see whistleblowers as troublemakers or snitches as they unsettle the work environment.

And that’s a fair point.

Whistleblowers do disrupt the status quo.

But isn’t that better than keeping your head in the sand?

Disclosing an unsafe, illegal or immoral practice is acting in the best interests of you and your workplace and it takes courage.

It’s long overdue for whistleblowers to be supported and protected, and not punished and admonished.

From 1 January 2020, the Treasury Laws Amendment (Enhancing Whistleblower Protections) Act 2019 has made important changes to assist whistleblowers.

It means that for those nurses and midwives who work in the private and aged care sector, there will be greater whistleblower protection.

This legislation is designed to bring the corporate sector into line with whistleblower legislation in the public sector.

These changes encourage whistleblowing and hold employers accountable for protecting eligible whistleblowers.

In a nutshell, the changes mean: ■ Whistleblowers can openly OR anonymously report their concerns around illegal, unethical or otherwise improper conduct.

■ Whistleblowers will now have strengthened immunity so the information they disclose is not admissible in evidence against them in a prosecution.

■ More people are eligible ‘to be’ whistleblowers.

■ More people are eligible to ‘receive’ whistleblower disclosures.

■ All public and large proprietary companies are required to have whistleblowing policies.

■ The policies must demonstrate how the company will ‘support and protect’ those who speak up before they begin to experience any detrimental effects.

■ If they do not have a support plan companies can be held liable.

With this new legislation comes the opportunity to change the way we work and create a culture that supports transparency.

It is time to value whistleblowers and their courage to speak out.

For more information read the QNMU whistleblower policy at www.qnmu.org.au/policysheets

References

Brown, A J et al, Clean as a whistle: a five step guide to better whistleblowing policy and practice in business and government. Key findings and actions of Whistling While They Work 2, Brisbane: Griffith University, August 2019.

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indepth

t i r i p s

The

of

nursing

I

T TAKES a special kind of love for nursing to return to the profession after a period of semi-retirement. But it takes a certain something else to write a book about it.

Which is exactly what Denise Petersen, now 71 and still nursing, has done.

2020 YEAR OF THE

THE NURSE AND MIDWIFE

200 years

of making a difference

46

indepth After spending the best part of 11 years writing about her nursing adventures both in Australia and abroad, Denise took extended leave to dedicate her time to finishing her book.

And despite her dyslexia, which Denise was told as a child would prevent her from becoming a nurse, Denise has finally self-published her autobiography A Nurse like Aunty Mavis.

The memoir details how nursing changed and shaped her life – how she grew with her profession and allowed it to open doors that took her right around the world.

She dedicates the book in part to the ‘spirit of nursing’, which, as she writes, “gets into your system from an early age and lingers forever”.

But this isn’t just Denise’s personal story. It’s a story about the remarkable transformation nursing has undergone over the decades – from occupation to profession.

“Nurses weren’t allowed to be engaged back then, men distracted you,” Denise said.

“You had to live in the nursing quarters and be in every night by 9.30pm, except for one night a month you could go to a dance but be back by midnight.

“We would have to sign in with the night nurse, then go to our room but often we would jump out the window and go back to the party.”

Many nurses today would shudder to hear what they might have been expected to do back in the sixties.

“Just after I finished my training, I ran a small hospital out at Nullarbor with another new nurse. Once a patient who was a ringer – or stockman – wanted me to pull out a decayed tooth,” Denise said.

“I said, ‘Well I’m a nurse, I’ve never pulled a tooth.’ He said, ‘I don’t care, just pull it out.’

“I thought, ‘It can’t be that hard,’ and we’d found dental utensils. ’ “We sterilised the pliers and I tried pulling it out but it didn’t budge.

“The local Catholic priest arrived and started saying a prayer, the ringer commented he’d rather have a beer and be sent somewhere to have the tooth out.

“So we stopped the next train and sent the ringer and priest to a dentist at Port Augusta. We never heard if that fella had his tooth out.”

Outback to PNG It was in 1970 when Denise moved her life to Papua New Guinea, where she would spend the next 20 years working as a nursing patrol officer.

“We’d carry our equipment and medicines in patrol boxes, walking for over an hour to a village, set up, weigh all the babies and check the mothers,” Denise said.

“I’d go to the school and check whether the toilets were sanitary, check the kids’ hearts and hearing.

“If a mother was in labour, we’d stop and deliver the baby.”

Returning to Australia 30 years ago, Denise discovered a passion for caring for children with cancer and their families. She now works at Cairns Hospital as a children’s oncology case manager.

“I’ve given chemo to children, helped parents go through the trial of having their child die,” she said.

“Many people come up to me in Woolworths and hug me, even 20 years later.

We’d carry our equipment and medicines in patrol boxes, walking for over an hour to a village, set up, weigh all the babies and check the mothers.

Denisse Petersen

A Nurse like Aunty Mavis

by Denise Petersen can be purchased through Amazon.com at https://amzn.to/2RCtzcR

“One of my favourite things about nursing is that you can really help a family through that very difficult journey.”

Nursing identity But it wasn’t until Denise knuckled down to finish her book that she realised just how much all these experiences have shaped her sense of identity.

“I was on long service leave when writing the book and planning on retiring, and I just thought, ‘Who am I? I’m a nurse, and I’ve lost my identity,’” Denise said.

“I couldn’t think who I’d be if I wasn’t a nurse, so I decided to cancel my leave and return to nursing.”

Denise hopes her memoir will encourage other nurses and midwives to take advantage of the unique opportunities and adventures that can arise from a career in health.

“To be a nurse is a wonderful career, you can just about work the world over,” she said.

“There’s not many jobs where you can have such adventures in your life and do so much, not only for yourself, but for other people.”

47

Notes

from the

North

Lucynda Maskell QNMU Vice President

N

URSES AND MIDWIVES can seriously pull together in the event of a crisis.

The drought and subsequent bushfires come to mind, and the areas hardest hit are often those in rural areas with fewer resources.

Celebrate

the rural spirit of nursing and midwifery in 2020

... to all those nurses and midwives across Queensland who work tirelessly with community

The hospitals and clinics in these areas often have HHS support teams, such as IT support and building and engineering off site, but these can potentially be hundreds of kilometres away.

to prevent and mitigate

These events can also affect small private nursing homes and multipurpose health facilities which home vulnerable populations that may be difficult to evacuate and whose health needs are complex.

efforts. Thank you.

health risks during times of crisis - we celebrate you and your collective

and volatile situations. This will not be forgotten.

It is often the nurses (with support from other local staff) who rally together, ensuring supplies for potential disasters are adequate, and ensure health messages are relayed to the community.

We acknowledge the ongoing work of nurses, midwives and Indigenous health workers in Aurukun and other communities where displaced people have fled, and we recognise the extreme workloads and difficulties you continue to face.

Many nurses and midwives grew up in these rural areas or set down roots, and these colleagues are often personally affected as well as professionally.

There are no other professionals in the health workforce who could honestly write on their CVs that they are the ’go to person’ for their communities.

So, to all those nurses and midwives across Queensland who work tirelessly with community to prevent and mitigate health risks during times of crisis - we celebrate you and your collective efforts. Thank you.

Nurses are frequently the coordinators of the workforce and communities when necessities such as power, water and/or telecommunications are lost.

Care in community Closer to my home on the western shoreline of Queensland we have been devastated to learn of the tragic loss of life and homes in the neighbouring community of Aurukun.

Aurukun staff continue to provide care and compassion in frightening

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Power and water are the essential services needed for our communities and clients to stay healthy.

For example, some patients require power and water for their dialysis machines to survive.

To further compound the complexity of these disasters in rural and isolated areas, the experts we are required to call on (if telecommunications are up

and running!) are generally not based in the community.

This means knowing what and when to escalate can be imperative for a whole community. These ‘unwritten duties’ add to the ever-evolving duty list for the rural and isolated nurse!

Cyclones are another example of these situations.

Isolated nurses helping to coordinate the evacuation of clients on haemodialysis in remote Aboriginal communities is one that comes to mind.

And of course, this is not done in isolation – teams in urban areas preparing to receive and assist the community members is paramount.

The challenges we face across our state can’t be understated, and the hard work of nurses and midwives continues to improve safety in the workplace.

I challenge you now, in 2020, to make the time (even with all these pressures, regardless of remote, regional or metropolitan location) to connect with other nurses and midwives.

Help re-energise and celebrate what has been achieved in 200 years and share stories about your own (or your team’s collective) contribution to community wellbeing.

Hold a fundraiser (always a good way to socialise and capitalise for a shared cause), attend a Labour Day march, an International Nurses or Midwives Day event, or create your own!

Take time to celebrate wherever you are in 2020!

OF THE 2020 YEAR NURSE MIDWIFE AND THE

200 years of making a difference

CPD

Supporting children’s pain management

BY DR ELIZABETH FORSTER GRIFFITH UNIVERSITY SCHOOL OF NURSING & MIDWIFERY, CATHERINE KOTZUR NURSE PRACTITIONER, ACUTE PAIN SERVICE, QLD CHILDREN’S HOSPITAL & JULIANNE RICHARDS NURSE PRACTITIONER, ACUTE PAIN SERVICE QLD CHILDREN’S HOSPITAL

D

ESPITE the availability of validated pain assessment tools and appropriate pharmacological and non-pharmacological pain management strategies, unrelieved pain remains a global issue for paediatric patients1.

The gold standard for pain assessment is self-report, however, for paediatric patients this is not always possible and clinician assessment using a validated paediatric pain assessment tool alongside parental input will be considered2.

Nurses caring for children also need to take into account their age and developmental stage, clinical condition and history.

For infants to three years, the FLACC scale is used and you need to observe the infant’s activity when awake for two-five minutes and five minutes if asleep.

Image: L to R Julianne Richards, Elizabeth Forster, Catherine Kotzur

For children aged three to seven, the Faces Pain Scale (Revised) or the Wong Baker Faces Pain Scale is used.

For children over the age of seven years a numeric or visual analogue scale can be used, provided the child can understand the chronological order of numbers2.

Dr Elizabeth Forster from Griffith University School of Nursing and Midwifery has been conducting research with Nurse Practitioners Catherine Kotzur and Julianne Richards to investigate pain among paediatric patients post discharge, and to explore parent perceptions of the support received from the NpAPS.

With shorter hospital stays and early discharge, parents are responsible for managing their child’s pain post discharge and require support and education to do this.

This research revealed that caring for their child following discharge from hospital is an emotive experience for parents who experience fear, anxiety and distress.

Nurses caring for paediatric patients are integral to ensuring parents receive a clear plan for their child’s pain management and follow up contacts.

Parents are also uncertain about managing their child’s pain, particularly in the first 24 hours post discharge.

The Nurse Practitioner Acute Pain Service (NpAPS) at Queensland Children’s Hospital sees more than 300 children annually for inpatient and post discharge management of acute pain as a result of surgery, trauma or illness.

As a result of this research, the NpAPS has introduced a text messaging service for parents, which allows them to text if they have questions or concerns following discharge in addition to the regular phone follow up service provided by the NpAPS.

References

1. Twycross, A., Forgeron, P. & Williams, A, 2015, Paediatric nurses’ postoperative pain management practices in hospital based non-critical care settings: A narrative review. International journal of nursing studies, 52, p. 836-863.

2. Forster, E. and Kotzur, C, 2018, Pain Assessment and Management. In: Forster, E. & Fraser, J.A. Paediatric Nursing Skills for Australian Nurses. Port Melbourne VIC: Cambridge University Press. p. 146-166.

REFLECTIVE QUESTIONS 1. What are the considerations when assessing pain in a paediatric patient?

2. Reflecting upon your clinical context, how might you support and educate parents regarding their child’s pain management prior to and following discharge?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

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CPD

Clarifying legislation related to cosmetic injectable products

BY THE AUSTRALIAN GOVERNMENT DEPARTMENT OF HEALTH, THERAPEUTIC GOODS ADMINISTRATION

50

CPD

A

USTRALIA’S Therapeutic Goods Administration (TGA) regulates all medicines, medical devices and biologicals under the Therapeutic Goods Act 1989 (the Act).

The Act prohibits the import, export, manufacture, supply and advertising of unapproved therapeutic goods for human use, which have not been subject to approvals, exemptions, or permits.

Unless a specific exemption applies, therapeutic goods must be entered on the Australian Register of Therapeutic Goods (ARTG), or they cannot be supplied in Australia.

Only legal sponsors are permitted to lawfully import therapeutic goods. A sponsor is a person or company who is legally responsible for supplying goods on the ARTG in Australia.

Cosmetic injectables are regulated as Schedule 4 substances (prescription only medicines).

You cannot publish a public advertisement about therapeutic goods that contains a statement referring to goods, or substances or preparations containing goods, included in Schedules 3, 4 or 8 of the Poisons Standard.

Health professionals and cosmetic or beauty clinics are not permitted to advertise references to the active ingredients in cosmetic injections.

Abbreviations of either the trade or ingredient names are also unacceptable.

Further information on advertising cosmetic injections is available at www.tga.gov. au/book-page/advertisingtherapeutic-goods-relatedservices#cosmetic Cosmetic injections require a prescription from an accredited professional, and can only be stored and administered by qualified, authorised practitioners.

You need to be aware of your obligations under State and Territory legislation for storage of Schedule 4 substances.

Cosmetic injectables are considered high risk products and clients must be

assessed by a medical professional before their use.

The TGA takes action against illegal activity The TGA investigates suspected illegal activity relating to therapeutic goods, including unlawfully supplied products.

Appropriate regulatory action is taken where necessary, ranging from education and support through to seizure and destruction of unapproved therapeutic goods, fines and court proceedings.

Targeting legislative noncompliance disrupts the illegal trading of unapproved and counterfeit therapeutic goods in the domestic market.

The TGA encourages the reporting of illegal cosmetic injectable procedures in Australia. These reports can prevent potentially serious consequences and safeguard the health of the Australian community.

If you suspect non-compliance regarding cosmetic injectable products, you can report illegal or questionable practices anonymously online to the TGA, or by calling 1800 020 653.

You can also report suspected supply of counterfeit medicines and medical devices. Information provided should include sufficient details for further enquires to be undertaken.

Advertising complaints can also be made online. Any person, including businesses, must comply with the TGA requirements for advertising.

The Australian Health Practitioner Regulation Agency (AHPRA) can be notified if you have concerns about practitioners.

Visit the Therapeutic Goods Administration website – www.tga.gov.au – for more information.

REFLECTIVE QUESTIONS 1. Why is the Therapeutic Goods Administration (TGA) important to the safety of Australian consumers and in particular, healthcare consumers, in your area of practice?

2. What does the Therapeutic Goods Act 1989 (the Act) prohibit, in healthcare? Provide some specific examples of where this has already occurred in Australian health or aged care.

3. Who are legal sponsors under the Act? Provide some specific examples in Australian health or aged care.

4. Why are health professionals and cosmetic or beauty clinics able to advertise to the public about therapeutic goods?

5. Why do cosmetic injections require a prescription, and how does this impact on nursing scope of practice?

6. Who is responsible for investigating illegal activity relating to therapeutic goods?

Can you find any examples where investigations have occurred in relation to cosmetic injectables in Australia?

7. What is the notification process to report a suspicion of illegal cosmetic injectable procedures in Australia?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

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CPD

Insight The “ah ha” bridge between an individual’s past, present and future

BY DR WENDY H MCINTOSH PHD, RN, GRAD DIP MH, MN, MACN.

I

REMEMBER early on in my psychiatric nurse training one of our lecturers being very clear with us, “You are not here to get your own therapy, you will not use the patients for that purpose, you need therapy ... you go pay for it”.

Few of us had any understanding about what she meant, however at various stages in our training and careers most of us have had an experience that gave us that “ah ha” moment.

For me insight is that “ah ha” moment.

I appreciate the “ah ha” moments I have, even the ones in which I experience great discomfort.

Each insight can be an integral piece to an intrapsychic bridge between past and present experiences. According to the APA Dictionary of Psychology, intrapsychic is defined as “pertaining to impulses, ideas, conflicts or other psychological phenomena that arise or occur within the psych or mind”.

Each insight offers the potential to change. Change in terms of internal scripts and self-messaging.

Change in terms of relationship with oneself. Change in terms of

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relationships with others, be those professional or personal.

for individual education, supervision or mentoring.

That same lecturer also wanted our student group to be very clear about our reasons for becoming psychiatric nursing students.

There are various definitions of insight offered in the literature.

“Get to know the real reason you are here,” she would say to us. It took me about 10 years to get very clear on why I was there.

My journey of self-awareness and insight has not been an easy process.

Yet I value every learning gained, painful and troubling as some of the revelations have been.

I have learnt and appreciate the importance of slowing down, of taking time to consider what I am saying and doing in relationship to my interactions with other people.

Now when I go to work, I am clear on my purpose and intent.

I have learnt the importance of preparing for the day ahead, preparing to work with the client I will be spending time with.

If I hurry the work I do, I am not fully considerate of the relationships I am having with my clients, be that in the workshops I deliver, in the group supervision I conduct or, in the oneto-one work with professionals I see

The one that has most meaning for me in the work I do and for my own ongoing learning, is that offered in the Cambridge Dictionary where insight is defined as “the ability to have a clear, deep and sometimes sudden understanding of a complicated problem or situation”.

Professionally, I recognise the importance of insight to enable individuals to process an incident that has occurred in the workplace.

The incident may have involved a relationship to a colleague, patient or patient’s family members.

The incident may have been a professional boundary transgression, unethical practice or unprofessional conduct.

I use a number of educational approaches, such as face-to-face sessions which include experiential learning and role play, a series of reflective questions (written and in conversation), viewing recommended videos and reading recommended articles to help professionals reflect on what has occurred, and to help them to analyse an incident and

CPD their part in that incident through an objective observer role.

Chiarella & Vernon (2019) analysed 712 complaint files from a nursing regulatory authority.

They found that insight occurred when nurses took ownership and responsibility for their actions and sought education or mentorship to assist improve their practice.

Nurses who showed remorse for their actions were also considered to have insight.

Conversely, Chiarella & Vernon (2019) found that nurses who did not understand what had occurred, who took no ownership or responsibility for their actions and made no attempt to change their behaviour or practice demonstrated little or no insight.

When addressing a professional boundary transgression for example, I have no doubt that when an individual experiences insight about what occurred between them and

I HAVE LEARNT AND APPRECIATE THE IMPORTANCE OF SLOWING DOWN, OF TAKING TIME TO CONSIDER WHAT I AM SAYING AND DOING IN RELATIONSHIP TO MY INTERACTIONS WITH OTHER PEOPLE.

a patient, they become much more discerning about what to do to change their behaviours and to change their style of interaction or role responses to other people or to stressful situations at work.

The insight may relate to childhood experiences, current personal relationship difficulties or stressful workplace factors.

The “ah ha” of the connection between what occurred at work and old patterns of behaviour for the individual is experienced in an audible sigh of relief throughout their body.

In my experience, with insight the individual is much more prepared to address what occurred in a thoughtful and progressive manner.

REFLECTIVE QUESTIONS 1. What is your understanding of insight?

2. Has you understanding of insight changed from reading the article? If so briefly discuss.

3. What purpose does insight have to guide nursing practice?

4. How can insight be developed as an important part of nursing?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

References

It is like their professional self “wakes up”.

APA – American Psychological Association accessed 10 Feb 2020 https://dictionary.apa.org/intrapsychic

Nurses are accountable and responsible to patients and their families.

https://www.slideshare.net/9Lenses/14-quotesslideshare

Nurses are responsible and accountable to their regulatory authority in the countries in which they are registered.

Cambridge Dictionary – accessed 04/02/2020 https://dictionary.cambridge.org/dictionary/ english/insight Chiarella, M., & Vernon. R. (2019). Insights into insight: analysis of case files of nurses and midwife registrant performance complaints.

Collegian, 26 (3), 341-347.

Nurses are responsible and accountable to their colleagues, peers and their employers. Perhaps more important is the insight that nurses are responsible and accountable to themselves.

In understanding the ideas, beliefs and motivations for the actions they take, personally and professionally, individual nurses can have a greater appreciation of their professional role.

In insight, nurses can ask questions of themselves and reflect on the motivations for their actions and also the potential influencing factors for those motivations.

Insight engages each individual to consider two questions.

Share your ‘ah-ha’ moments in mycommunity.qnmu.org.au

What has been the most significant learning for me here and what is my next step?

As Albert Einstein said in 1947, “Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop learning”.

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Becoming and being a nurse A research-informed theory to guide contemporary university and industry approaches to preparing and supporting graduate nurses.

BY DR NATASHA REEDY, SCHOOL OF HEALTH, NURSING AND MIDWIFERY, UNIVERSITY OF SOUTHERN QUEENSLAND

A

LL ACROSS the world, nursing shortages exist, placing the health and wellbeing of patients at risk.

Furthermore, first-year nurses have a high attrition rate, which exacerbates this workforce shortage.

The problem is double-sided in that the health and wellbeing of new nurses, who are responsible for the health care of individuals and communities, is at risk.

Despite the seriousness of this problem, there is little research being undertaken to explore the contributing stress factors, in order to align education and support to help nurses retain their health and wellbeing, and enable them to be effective carers.

However, Graduate Registered Nurses (GRN) are uniquely positioned to help address this by providing insight and sharing their first-year experiences.

As such, this study addressed the knowledge gap by exploring the experience of first-year GRNs’ work,

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study and personal life (developed and defined in this study as the Load Triad) through mixed methods research, and identified the factors that affect their Load Triad and overall life balance.

Findings revealed the GRNs’ first year was ‘hard’ causing them to question their level of preparedness for the reality of work and life as a nurse.

The experience of lacking broader preparedness, led to the identification of several negative and positive indicators impacting the GRNs’ first year and its relationship to thoughts of either attrition (leaving) and/or retention (staying).

Negative indicators included GRNs being situated within a workforce in juxtaposition to the ‘world of nursing’ values, GRNs prioritising their work role over their personal life and self-care roles, creating a life not in balance, experiencing a decline in their overall personal sense of wellbeing, and a lack of and/or absence of targeted and tailored holistic support.

GRNs in the throes of this ‘hard’ year also demonstrated resilience and thus we also saw positive indicators leading to resilience and retention.

These positive indicators included GRNs being situated within a workforce that mirrors the ‘world of nursing’ values, GRNs possessing a temperament towards a strong work ethic and resolve, intertwined with similar qualities during previous undergraduate studies, a strong sense of fellow GRN peer friendship within the workplace, and personal qualities such as agency and internal locus of control. This is a personal belief system that a person controls their own life. Meaning, a person is in control of their own experiences, so their success is attributed to their effort and ability.

A set of recommendations are provided to help improve nursing preparation and transition support.

A key recommendation of this research is to improve the coordination, collaboration and

communication between key nursing stakeholders through the use of reiterative feedback loops, formal annual reports and timely sharing of these reports to direct continual quality improvements to nurses’ education and transition support.

Additionally, this study recommends inviting GRNs to ‘partner’ with higher education institutions, health organisations and governance bodies, to contribute to decision making and discussions about the delivery and evaluation of nurses’ preparation and transition support.

Furthermore, the overarching proposition derived through this research is that education and transition support for future and in-practice nurses must exist and be nuanced and informed by the ‘Becoming and being a nurse’ transition theory, ‘Nursing preparedness’ and ‘21st-century life career preparedness’ theory.

REFLECTIVE QUESTIONS 1. Reflecting on your past and present workplace culture practices that should support a smooth transition for student nurses from becoming to being a nurse, what would you keep doing and what would you change to support their transition and improve their experience?

2. From your reflections, what facilitators and or barriers exist and what could you do to enhance the facilitators and manage (minimise) the barriers, to improve the transition of student nurses from becoming to being a RN? 3. Reflecting on your own firstyear experiences as a GRN, what would you do personally to support the GRN and improve their experience in being a nurse?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

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QNMU member and new graduate Celia Woodbridge 55

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Normal saline instillation with endotracheal suction in the PICU NORMAL SALINE DOES MORE HARM THAN GOOD, OR DOES IT?

BY JESSICA SCHULTS RN, PHD CANDIDATE, ASSOCIATE PROFESSOR DEBBIE LONG RN, PHD, PROFESSOR MARIE COOKE RN, PHD AND PROFESSOR MARION MITCHELL RN, PHD.

U

P TO 40% of children admitted to the paediatric intensive care unit (PICU) require tracheal intubation and mechanical ventilation1.

For these children, endotracheal suction (ETS) is a fundamental procedure to maintain airway patency, preventing complications associated with retained secretions such as diffusion impairment or alveolar collapse.

Despite its necessity, ETS is a noxious airway procedure, with 50% of children suctioned experiencing a suction related adverse event (e.g. desaturation)2.

These complications can prolong children’s length of ventilation, PICU admission and contribute to the development of secondary morbidities such as ventilator associated pneumonia (VAP).

ETS practice is varied in Queensland, with factors such as lung pathology, lack of practice recommendations and inconclusive trial data contributing to nurses uncertainty regarding ETS best practice3.

Normal saline is commonly used in paediatrics with ETS. However, its use is widely debated in the literature.

In adult populations saline with ETS is no longer recommended6, however the practice remains in paediatrics.

So should we suction with saline?

Unfortunately, there is no easy answer to this question.

Our research has shown that PICU nurses continue to use normal saline due to clinician preference and children’s perceived need for saline due to anatomical differences such as smaller internal diameter airways5.

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Saline instillation with endotracheal tube (ETT) suction leads to greater, more significant desaturations post ETT suction. However, the clinical significance of these desaturation events remains poorly understood2.

Furthermore, the role normal saline plays in improving secretion clearance and minimising the development of VAP has not been investigated.

Consequently, in partnership with Queensland Children’s Hospital PICU, we conducted a pilot trial (NARES trial) to examine the impact of normal saline with ETT suction on important clinical endpoints such as ventilator associated pneumonia, lung mechanics, and oxygenation.

This study will provide us with important preliminary information that can be used to conduct a definitive clinical trial.

The next step in our research is to develop an ETS guideline using appropriate use criteria methods.

This step involves gathering international PICU experts to review the evidence and make practice recommendations for ETS interventions use (e.g. saline).

Development of these guidelines will provide consensus derived guidance for when it may be beneficial to apply ETS interventions in clinical practice, with respect to lung pathology, age and disease progression.

This study will also help us identify important areas for practice improvement and drive future research.

If you would like more information, or would like to get involved please contact Jess Schults on j.schults@griffith.edu.au

CPD

REFLECTIVE QUESTIONS 1. What patient populations may benefit from the use of normal saline with ETT suction and what consequences would you be worried about – for example atelectasis, indicated by what clinical observation?

2. How would normal saline instillation help reduce the incidence of PICU acquired ventilator associated pneumonia?

3. What is the clinical significance of a two-point desaturation (e.g. 95% to 93%) for five minutes, and does this risk outweigh the benefit of improved lung mechanics (e.g. dynamic compliance)?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

References

1. ANZICS Centre for Outcome and Resource Evaluation. (2017). Report of the Australian and New Zealand Paediatric Intensive Care Registry 2017 Victoria, AUS: ANZICS CORE Retrieved from https://www.anzics.com.au/wp-content/ uploads/2018/10/ANZICS-CORE-Annual-Report-2017.pdf.

2. Schults, J., Long, D., Mitchell, M., Cooke, M., Gibbons, K., Pearson, K., & Schibler, A. (2019). Adverse events and practice variability associated with paediatric endotracheal suction: An observational study. Australian Critical Care. doi:https:// doi.org/10.1016/j.aucc.2019.08.002 3. Schults, J., Mitchell, M., Cooke, M., Long, D., Ferguson, A., & Morrow, B. M. (2019).

Endotracheal suction interventions in mechanically ventilated pediatric patients: A systematic review to inform evidence based practice. Australian Critical Care (under review).

4. Schults, J., Mitchell, M. L., Cooke, M., & Schibler, A. (2018). Efficacy and safety of normal saline instillation and paediatric endotracheal suction: An integrative review. Australian Critical Care, 31(1), 3-9. doi:10.1016/j.aucc.2017.02.069 5. Schults, J. A., Cooke, M., Long, D., & Mitchell, M. L. (2019). “When no-one’s looking,” the application of lung recruitment and normal saline instillation with paediatric endotracheal suction: An exploratory study of nursing practice. Australian Critical Care, 32(1), 13-19. doi:10.1016/j.aucc.2018.03.002 6. Wang, C. H., Tsai, J. C., Chen, S. F., Su, C. L., Chen, L., Lin, C. C., & Tam, K. W. (2017).

Normal saline instillation before suctioning: A meta-analysis of randomized controlled trials. Australian Critical Care, 30(5), 260-265. doi:10.1016/j. aucc.2016.11.001

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CPD

CHANGES

TO

MANDATORY NOTIFICATION GUIDELINES F

OR SOME YEARS, the QNMU has been lobbying the government and regulators for clearer advice on when it is appropriate, or not necessary, to make a mandatory notification about another registered health practitioner.

These amended guidelines took effect from 1 March 2020 in all states and territories except Western Australia.

from accepted professional standards, you must also consider whether this is placing the public at substantial risk of harm.

The changes improve the advice given to nurses and midwives about if or when they should report health practitioners (including colleagues) who are receiving health care, including mental health care.

However, a lower threshold for making a mandatory notification applies for sexual misconduct. If you have the reasonable belief that your practitioner-patient has engaged, is engaging or is at risk of engaging in sexual misconduct in connection with their practice, you must report that.

NOTIFIABLE CONDUCT We requested AHPRA provide an improved explanation of ‘reasonable belief’ and a better understanding of what is considered a ‘substantial’ risk of harm to the public.

The request relates to concerns that some health practitioners may be hesitant to seek treatment of a condition, for fear of being reported to AHPRA, or if in Queensland, the Health Ombudsman.

In early 2019, the Queensland Government passed amendments to the Health Practitioner Regulation National Law Act 2009 (‘the National Law’) that gave registered health practitioners some clarity about when it is not necessary to make a notification about another health practitioner who is seeking or receiving healthcare from them.

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As a nurse or midwife, you are only required to make a notification if your colleague or patient/client is a registered health practitioner and you form a reasonable belief that they are: ■ practising with an impairment, or ■ practising while intoxicated by alcohol or drugs, or ■ practising in a way that significantly departs from accepted professional standards, or ■ engaging in sexual misconduct in connection with their practice, AND they pose a substantial risk of harm to the public.

So, if you are concerned about a practitioner practising with an impairment, practising while intoxicated, or significantly departing

REASONABLE BELIEF To form a reasonable belief, you generally need direct knowledge (not just a suspicion) of the incident or behaviour that led to a concern. As a practitioner, you are most likely to do this when you directly observe the incident or behaviour. Speculation, rumours, gossip or innuendo are not enough to form a reasonable belief.

Your professional background, level of insight, experience and expertise will help you form a reasonable belief.

Mandatory notifications should be based on personal knowledge of trustworthy facts or circumstances that would justify a person of reasonable caution, acting in good faith, to believe that the concern and a risk to the public exists.

CPD

REFLECTIVE QUESTIONS Begin by reviewing the draft guidelines on the AHPRA website at: www.ahpra.gov. au/Notifications/ mandatorynotifications/ Revised-guidelines.aspx

SUBSTANTIAL RISK A substantial risk of harm is a very high threshold for reporting risk of harm to the public. This allows health practitioners to seek and have treatment for conditions without fearing a mandatory notification.

Examples: 1. A nurse who is your colleague, or your patient, has a mental health condition, which is stable. They are engaged in and complying with treatment, so there is no substantial risk of harm to the public. This would not trigger a mandatory notification.

2. A nurse who is your colleague, or your patient, tells you that they once failed to follow protocol and made a substantial error with medicines.

They took remedial steps as part of a performance management plan, and their practice is now closely monitored. Although their practice may have departed significantly from professional standards, the risk of harm to the public is rare because there are adequate controls and strategies. You do not need to make a mandatory notification.

3. While at a party over the weekend, you see a colleague with a group of people smoking marijuana. You wonder if this is also going on at work. As you have

not formed a reasonable belief that your colleague is intoxicated at work, there is no need to make a mandatory notification.

Compare that with seeing your colleague coming back from a long lunch smelling of alcohol and a bit unsteady on their feet. Their speech is slurred. Because you have directly observed signs of intoxication and you have formed the reasonable belief that they are intoxicated while at work, you make a mandatory notification.

Then compare that a nurse colleague or patient who discloses to you that they once practised while intoxicated.

However, they do not have issues with drug or alcohol misuse, the incident occurred several years ago, no harm occurred, and it was an isolated incident unlikely to occur again.

Therefore, there is no substantial risk of harm to the public and you do not need to make a mandatory notification.

The QNMU recommends to all members that they should call our Member Connect hotline before making a notification or complaint to AHPRA or the Health Ombudsman. This is because we can give you experienced advice on whether your concerns meet the threshold of a notification and advise you on the best course of action.

1. You overhear nurses in the tearoom talking about a colleague who reportedly boasted about kissing the parent of a child who has regular visits to your unit. What do you do? Explain your reason/s.

2. You notice a colleague failing to follow protocol and only just manage to stop her from making a serious medication error.

Your colleague thanks you, but places the blame for her near-miss on another colleague who had been assisting her.

She says she’ll pay more attention in future. A few weeks later you notice her again taking shortcuts with medication protocols.

What do you do? Explain your reason/s.

3. Your colleague discloses that she is taking prescribed medication, but its making her nauseous. During her shift she takes more bathroom breaks that usual to try and manage it. What do you do?

Explain your reason/s.

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

59

CPD

STANDARDS Sandra Eales QNMU Assistant Secretary

T

HE UNION is invested in ensuring safe systems of work for our members which is why we have developed the Positive Practice Environment standards based on extensive research and consultation.

We know that just fixing nurse/ midwife-to-patient ratios won’t ensure safety for either patients or the nurses and midwives who are responsible for their care, though appropriate workloads are a key component of safety. We also know the psychological safety of nurses and midwives directly affects patient safety. The work environment must provide the elements that make it safe to properly function as a nurse or midwife. The critical elements are: ■ safe staffing levels ■ physical and psychological safety ■ autonomous and collaborative practice ■ shared governance and decisionmaking ■ organisational commitment to safety and quality ■ research and innovation, and ■ transformational leadership.

Apart from patient outcomes there are significant costs to employers, individual workers, families, and society when our workforce is exposed to unsafe work environments. It is estimated that workplace bullying costs the Australian economy more than $6 billion annually1.

In a recent ACTU survey, to which 25,000 workers responded, 61% said they had experienced mental illness because of ongoing issues in the workplace which were not addressed by their employer.

A stress response is the mental, physical and/or emotional reaction that occurs when a worker perceives

60

Safety for everyone

the demands of their work exceed their ability or resources to cope.

If prolonged and/or severe, workrelated stress can cause both psychological and physical injury2.

Download the Positive Practice Environment standards at www.qnmu.org. au/standards

Psychosocial hazards or factors are anything in the design or management of work that increases the risk of work-related stress. Nurses and midwives are likely to be exposed to a combination of psychosocial hazards; some may always be present, while others only occasionally. Common psychosocial hazards and factors are listed in SafeWork Australia - National Guidance document3.

Known risks include high workload (physical or emotional labour), low control and lack of voice in workplace, high stakes or blame culture and poor relationships. As we identify hazards we also know ways to mitigate the risks and prevent harm.

Everyone is responsible for creating the practice environment – individual workers on the frontline, unit managers and executive players in the system must recognise their individual role and responsibility to create and maintain a safe working environment For each of the critical elements this PPE standards document outlines the behavioural cues at each level of worker or individual culture creator.

These are signals that indicate the standard is being met.

It is easy when we are in a system under pressure, signalled by high anxiety, bullying or high blame culture, to suggest it is someone else’s job to fix it, but we must all play our part even when it might seem no-one else is doing their bit.

It is well established that the practice environment affects clinical outcomes for patients as well as health outcomes for the clinicians working in it.

STANDARDS

for Nursing and Midw

ifery

Acknowledgements:

The QNMU gratefully acknowledges nurse and midwife reviewed the document and utilised their professional members who have valuable feedback in judgement in providing the development of these standards for and unregulated care all nurses, midwives workers wherever they work in health and aged care.

Citation:

Queensland Nurses and Midwives’ Union.

(2020). Positive Practice Standards for Nursing Environment and Midwifery. Brisbane: QNMU Office.

References

1. Work Safe Australia (2018) Work-related psychological health and safety: A systematic approach to meeting your duties 2. ACTU (2019) Work Shouldn’t Hurt https://www.actu. org.au/media/1385647/work-shouldnt-hurt-reportclean-final.pdf 3. SafeWork Australia - National Guidance document https://www.safeworkaustralia.gov.au/doc/ work-related-psychological-health-and-safetysystematic-approach-meeting-your-duties

REFLECTIVE QUESTIONS 1. Consider your own workplace and refer to the PPE standards.

2. Do you think your workplace meets the standards?

3. If so what are it’s strengths and how are these standards maintained, and by whom?

4. If not, what are the weak areas, whose responsibility is it to improve these areas and how might that be done?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

in memory

Vale Aunty Pamela Mam On 17 January 2020, Queensland lost a pioneer of Aboriginal and Torres Strait Islander health care with the passing of Aunty Pamela Mam, aged 82.

Farewell

from QNMU’s First Nations Reference Group Aunty,

Your passage has left a deafening unrepairable silence as we comprehend the magnitude of your 60-year career, our newfound responsibility.

Kuku Yalanji peoples gifted you to us off country.

The assimilation policy stole your mother, however Palm island provided a safe haven in the early years.

Townsville Base brought you to us, granting permission for you to embark on nursing training, to join the fraternity.

A stroke of a pen enabled a future of endless possibility. Igniting a flame, not understanding you soon become not only one of our first aboriginal nurses, a catalyst for conversation, knowledge sharer, a change agent.

Alongside completing a midwifery qualification, you gave birth to the primary health network, that survived not only by your family but a service providing 47 years of care through ATSICHS.

Thank you for a spirit that provided hope and opportunity.

Thank you for understanding and providing empathy while we caught up, sharing your worldly vision of how it MUST be.

Thank you for confidence and trust we will be courageous, to speak up, and challenge the status quo.

We undoubtably feel comfort and confidence that in passing your work will continue not only through ATSICHS but Griffith University’s scholarship in your honour.

We promise, I promise to be loud and proud and speak up for mob and continue on the path to better care for mob.

Aunty, sister, mother, daughter, grandmother, great grandmother, great great grandmother, elder, peer, colleague and recently Doctor.

We acknowledge the custody roles bestowed during your entity a true pillar of strength.

In our hearts you remain.

In peace and solidarity.

Aunty Pam Mam’s place in nursing and midwifery history A DESCENDANT of the Kuku Yalanji peoples of the Cooktown area, Aunty Pam was one of Queensland’s first Aboriginal nurses, and for more than 60 years championed quality health care for first nations people through a culture of respect and understanding.

She was born in Richmond, Western Queensland in 1938 and started her career as a Nurse Aid at Palm Island Hospital.

She started her formal training as a nurse at Townsville Hospital, becoming one of the first Aboriginal nurses in the state, and later moved to Brisbane to study midwifery at the Royal Women’s Hospital.

In 1973 she advocated for, and became a co-founder of, the Brisbane Aboriginal and Torres Strait Islander Community Health Service (ATSICHS) – a vital service operated for and by the indigenous community.

In 2015, Griffith University and ATSICHS Brisbane established the Aunty Pamela Mam Indigenous Nursing Scholarship to support Aboriginal and Torres Strait Islander nursing and midwifery students.

Aunty Pam was also awarded an honorary doctorate from Griffith University in 2018.

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Cairns

in view

Kudos to our next generation A very warm welcome to all our new graduates who we loved meeting at orientation days across Queensland.

We wish you all the best as you embark on your nursing and midwifery careers!

Rockhampton

Cairns

Gold Coast

Rockhampton

Rockhampton

Townsville

Townsville

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Townsville

Townsville

Townsville

Gold Coast

Gold Coast

Telling depression to #getflossed For the third year running, Gold Coast University Hospital ED staff helped raise awareness about mental health illness among hospital staff through Loud Shirt Fairy Floss Friday.

Nurses donned bright shirts and distributed free pink fairy floss to encourage everyone to support each other, have conversations about mental health and tell depression to #getflossed! www.fairyflossfriday.com

in view

BOOK PRIZE WINN ER

Working toward solutions QNMU members and delegates recently participated in education sessions around Interest Based Problem Solving (IBPS).

Hosted by the QNMU and Queensland Health as part of our EB10 commitments, participants learned the key concepts of the IBPS method including creative problem solving and communication skills.

Feedback has been positive and more sessions will be rolled out in the coming months.

Let’s start the celebrations

Mt Lofty Heights Nursing Home

Our Metro North combined QNMU Branches recently marked the beginning of our 2020 Year of the Nurse and Midwife celebrations with a Smoking Ceremony, which was led by local traditional owners.

We’ve got heaps of other events lined up to celebrate our year, so keep an eye out on www.qnmu.org.au/2020

Darling Downs HHS

63

incoming

2020 YEAR OF THE

NURSE MIDWIFE AND THE

200 years

of making a difference

ONTH COMMENT OF THE M I’ve been a full-time nurse for 38 years and it’s been a great job. Of course, it’s had its ups and downs but I’d do it all again… The key to survival is to look after yourself first. Take your breaks, don’t “be guilted” into excessive overtime, think about reducing hours if it all gets too much [and] take your holidays! Think about how you can change the way you think about work and you will be fine. ❤ AL

On the difficulties nurses face QNMU member Ainsley Stock

On 2020 being Year of the Nurse and the Midwife DMS Let’s make this the year of legislated nurse-to-patient ratios!

Wouldn’t that be the best gift?

Like · Reply

Like · Reply

LK After 30 years nursing and being a QNMU member, 2019 was my last in this profession. Keep being strong for each other and do not sacrifice your integrity and health for the job. Happy and healthy 2020 everyone.

TC It takes twice as long, costs a lot more and the expectations are higher for newer nurses to get the experience required for the positions the older nurses are leaving.

Like · Reply

AMF Happy New Year QNMU, it’s going to be a great year.

It’s our year 2020!

Like · Reply

On violence in our hospitals NL Each episode of violence should be reported to the police. It took me two months to report what happened but the police were fantastic, very supportive and caring.

They were both shocked and saddened to hear that so many episodes go unreported to them. Report it to the police each time.

Like · Reply

64

CM Older, experienced nurses are leaving in droves. There are a number of reasons. All these reasons need to be addressed so our newer nurses don’t feel the same.

TS It should never be tolerated! It happens more than people realise. It impacts not just us but our families and friends. Ask yourself, would you consider violence to be a normal part of your work day? Sadly, most nurses will tell you rather matter-of-factly it’s now an everyday event.

Like · Reply

DP Unfortunately a lot of the physical attacks are by people who have dementia or related conditions, and no one will report them.

KW I have had my life threatened, had ex-patients waiting in the car park and physically threatening me. It’s very difficult when all you are trying to do is care for people.

Like · Reply

Like · Reply

I’m an older nurse but came to nursing later in life and I feel like I’ve been told my career goals are not possible without extensive, expensive further study.

It’s exhausting enough working full time with patients, add study to the mix and the exhaustion becomes overwhelming.

Like · Reply

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

/qnmuofficial

incoming On our new nursing and midwifery grads KB Wishing you all an amazing life in the world of nursing. đ&#x;˜?

Like ¡ Reply

LH What a year to start your nursing careers.

Like ¡ Reply

SD Congratulations to you all. May you enjoy many happy years of nursing and midwifery in the years ahead. What a year to start in the Year of the Nurse and Midwife 2020!

Like ¡ Reply

TJ Congratulations to you all, we look forward to seeing you all out and about. đ&#x;˜Š Like ¡ Reply

Letter to the Editor RECENTLY I was in the CBD to have lunch with my husband. I had some spare time, so I decided to check out the headquarters for Blue Care in Brisbane.

These are the things that visitors see. And unless they look beneath the surface, they are unlikely to really understand the standard of care their loved one is truly receiving.

Firstly, their offices are located in a grade A commercial building, only recently completed.

I do hope the QNMU exposes Blue Care, their headquarters and their working conditions to the public.

I understand that this building commands some of the highest leases in Brisbane. It is a very opulent building with like offices.

I feel like screaming from the rooftops about the injustice of this situation.

Blue Care should remember the saying “what goes around comes around�.

My point here is: why is Blue Care able to have such expensive offices, yet still continues to cut nursing hours for our elderly so they receive sub-standard care?

Rosemary Dunmill, RN and QNMU member

Couldn’t Blue Care have had more modest offices and put those savings toward more hours of nursing care?

Unfortunately, most people don’t know or cannot recognise good nursing care.

New grads and QNMU members Joshua Seawright, Kristina Rybisar, Rory Carolan

WIN

They think good nursing care is having fresh flowers, fresh curtains, and new carpeting in an aged care facility.

Read about how Blue Care is cutting nursing hours on page 11.

ONE OF THESE GREAT BOOKS FOR YOUR FAB PHOTO

Dark Emu by Bruce Pascoe Bruce Pascoe’s award winning Dark Emu injects a profound authenticity into the conversation about how we Australians understand our continent. It argues that the hunter-gatherer tag for pre-colonial Aboriginal Australians was a convenient lie, and that Aboriginal people were using effective farming and irrigation practices long before the arrival of Europeans.

Bad Girls Throughout History: 100 Remarkable Women by Ann Shen Bad Girls Throughout History is a vibrantly illustrated volume featuring 100 women who were bad in the best sense of the word: they challenged the status quo and changed the rules for all who followed. Each entry features a portrait rendered in author Ann Shen's distinctive, bold watercolor style.

A Nurse like Aunty Mavis by Denise Petersen From when she was four years old, QNMU member Denise Petersen wanted to be “a nurse like Aunty Mavis� – a woman who told amazing and funny stories of her nursing adventures and wonderful travels. In this humorous and insightful autobiography Denise writes about her life of sailing yachts on vast oceans, finding romance in Papua New Guinea, and a long career as a Midwife and Registered Nurse.

Email full-size pics and image details to inscope@qnmu.org.au for our 'in view' pages for your chance to win

65

CALENDAR

2020 YEAR OF THE

NURSE MIDWIFE AND THE

200 years

of making a difference

International Day of the Midwife 5 May - Nationwide

Global Academic Programs (GAP) Conference

New Frontiers – Leading Inspired Cancer Care 11-13 May, Melbourne www.gap2020.com.au/

International Nurses Day 12 May - Nationwide

World Nursing Congress 2020

Integrating the Milestones in Nuirsing and Healthcare 13-14 May, Tokyo, Japan https://nursingcongress. nursingconference.com/

Visit www.qnmu.org.au/2020 for the latest on all events

15th Annual Critical Care Conference in the Vineyards

April

6th World Health Professional Regulation Conference

QNMU Education

1 April - Workplace Representatives 1 - Toowoomba 21 April - Workplace Representatives 1 - Townsville 23 April- Professional Culpability: Where do I stand? - Townsville 28 April - QH Rostering - Brisbane 29 April - QH: How to make the BPF work - Brisbane 30 April - Creating a safe and healthy workplace - Brisbane www.qnmu.org.au/events

Professional Practice Advocates Program 2 April, Townsville 29 April, Rockhampton www.qnmu.org.au/events

Meeting of Delegates 7 April, Bundaberg 8 April, Maryborough www.qnmu.org.au/mod

Australian College of Nursing

13-15 May, Lovedale, NSW https://criticalcarevineyards.com.au/

16 May, Geneva www.whpa.org/events/whprc-2020

QNMU Education

20 May - Workplace Representatives 1 - Brisbane 28 May - Workplace Representatives 1 - Rockhampton www.qnmu.org.au/events

21 May - Mount Isa 28 May - Cairns www.qnmu.org.au/events

Australian Primary Health Care Nurses 2020 APNA National Conference 21-23 May, Sydney www.apna.asn.au/conference

7 Rural and Remote Health Scientific Symposium th

International Council of Nurses (ICN) Workforce Forum

ACORN 2020 International Conference

23 April, Brisbane www.qnmu.org.au/events

May Palliative Care Nurses Australia Conference 2020 who year of the nurse, celebrating palliative care nursing 3-4 May, Melbourne www.pcna2020.org/

Labour Day 4 May

66

18-20 June, Rome, Italy https://magnusconferences.com/ nutrition-research/

23rd Cancer Nurses Society of Australia Annual Congress

Precision Care Everywhere 18-20 June, Brisbane www.cnsa.org.au/congressevents/ cnsa-annual-congress

Renal Society of Australasia Annual Conference

Unite and Ignite Renal Care: The next decade 25-27 June, Melbourne www.renalsociety.org/ education/2020-annual-conference/

PRIZE POOL TO BE WON!

WINNERS ANNOUNCED AND GALA DINNER

20 August 2020

Naidoc Week

5-12 July 2020 https://www.naidoc.org.au/

September Mackay Base Hospital Maternity Ward Reunion

annual conference 15-17 July 2020, Brisbane www.qnmu.org.au/conference

QNU Annual Conference 15-17 July 2020

19 September 2020 Souths Leagues Club, 181 Milton St, Mackay Contact Sue Seymour to register: sueseymour@hotmail.com or 0438 580 821

Professional Practice Advocates Program 22 September, Hervey Bay www.qnmu.org.au/events

Meeting of Delegates

29 September - Brisbane www.qnmu.org.au/mod

October Meeting of Delegates

1 October - Gold Coast 6 October - Bundaberg 7 October - Hervey Bay 15 October - Toowoomba 20 October - Rockhampton 21 October - Mackay 26 October - Townsville 27 October - Cairns www.qnmu.org.au/mod

Vision for the Future 28-30 May, Sydney www.acorn.org.au/conference-2020

June Professional Practice Advocates Program

November

3 June - Kingaroy 10 June - Mackay www.qnmu.org.au/events

2 June - Workplace Representatives 1 - Gold Coast 4 June - Ethical decision making Gold Coast 9 June - Professional Culpability: Where do I stand? - Brisbane 16 June - Knowing your entitlements - Cairns 17 June - Workplace Representatives 1 - Cairns 24 June - Workplace Representatives 1 - Mackay 25 June - Ethical decision making Brisbane www.qnmu.org.au/events

$20,000

www.qnmu.org.au/ Awards

July

27 May - 3 June 2019 www.reconciliation.org.au/nationalreconciliation-week/

QNMU Education

PROFESSIONAL PRACTICE

International Conference on Nutrition Research

Shaping the Future’ 25-26 May, Alice Springs www.ruralhealth.org.au/7rrhss/

National Reconciliation Week

TPCH Professional Practice Seminar

Mayhem, Momentum, Method and Mixing it up 4-5 June, Brisbane nextcarehealthconference.com.au/

Professional Practice Advocates Program

Nursing & Health Expo 4 April, Melbourne www.acn.edu.au/events/nursinghealth-expo

State of the World’s Nursing and Year of the Nurse 21-22 April, Stockholm www.icn.ch/events/workforceforum-april-2020

#Nextcare Health Conference 2020

August PROFESSIONAL PRACTICE 20 August 2020, Brisbane www.qnmu.org.au/PPAwards2020

ACRA 2020 Conference

10 - 12 August 2020 www.acra.net.au/acra-2020-asm

Meeting of Delegates

5 November - Sunshine Coast www.qnmu.org.au/mod

National Conference of Wounds Australia Connect, Collaborate, Innovate 4-7 November 2020, Brisbane https://wounds2020.com.au/

2020 Indigenous Allied Health Australia National Conference

Making a difference in Allied Health 29 November – 3 December, Sunshine Coast https://iaha.com.au/2020-nationalconference-save-the-date/

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

IT’S GOOD TO KNOW YOU’RE IN SAFE HANDS QNMU members benefit from FREE hotline support with Member Connect when you need assistance.

Our Member Connect team are all nurses or midwives with extensive experience and backgrounds in midwifery, mental health, aged care, education, paediatrics, surgical and cardiac nursing.

MEET SOME OF THE TEAM!

(07) 3099 3210 or 1800 177 273

Nelda Lucy Anna Danielle Emily

Terri

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Dianne

In the past three years, we’ve assisted more than 53,500 members through our Member Connect call centre on professional and industrial issues such as medication management, workload concerns, wages, leave allowances, bullying and more.

(toll-free outside Brisbane)

Karyn Each and every day we’re making a difference for nurses and midwives.

Be part of the strongest and most experienced voice around.

BE PART JOIN OF IT! NOW

www.qnmu.org.au 67

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