InScope No2 Winter 2017 by Queensland Nurses and Midwives' Union

The official journal of the Queensland Nurses and Midwives’ Union

Winter 2017

LOVE YOUR LEFTOVERS, SAVE THE PLANET SOCIAL MEDIA CPD: ALL FUN AND GAMES ‘TIL THE BOSS FINDS OUT

PLUS! QNMU LEADS THE WAY ON LABOUR DAY

D R D N U O R

Applications open soon for QNMU Scholarships We’re pleased to announce the next opportunities in our 2017 scholarship program.

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

SCHOLARSHIPS AVAILABLE FROM MONDAY 4 SEPTEMBER 2017: ■ Assistant in Nursing or Personal Carer Scholarship – Up to $3000 awarded in whole or in part for QNMU members to undertake study of a healthcare course, or to attend a relevant conference or seminar. ■ Postgraduate Enrolled Nurse Scholarship – 2 x $1500 awarded in whole or in part for QNMU members to undertake an accredited course in nursing or midwifery, or to attend a relevant conference or seminar. ■ Postgraduate Registered Nurse or Registered Midwife Scholarship – 4 x $1500 awarded in whole or in part for QNMU members to undertake an accredited course in nursing or midwifery, or to attend a relevant conference or seminar. ■ Leadership Development Scholarship – Up to $5000 awarded in whole or in part for QNMU members to undertake an accredited or postgraduate course in leadership. All financial QNMU members are welcome to apply for the scholarships.

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

APPLICATIONS CLOSE FRIDAY 13 OCTOBER 2017.

INDEPTH

Waste not, want not. Save the planet

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) 07 3840 1444 1800 177 273 (toll free) F 07 3844 9387 E inscope@qnmu.org.au W www.qnmu.org.au T

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

Winter 2017

INDEPTH

IN FOCUS – CPD

12 15 16 19 22 25 28 30 34 36 37

40 43 44

Social media: It’s all fun and games until the boss finds out

The way forward to professional strength and personal wellbeing

What to do when you are assaulted at work

FEATURE

Navigating patients through a complex health system FEATURE

The caring never stops FEATURE

Waste not, want not. Save the planet PROFILE

Refugee camp nurse Deb Rays

What’s involved in a CPD Audit? Central venous access deviceassociated skin impairment (CASI)

REGULARS

INSIGHT

TEA ROOM

WINS

JUST IN

CALENDAR

Towards activism … valuing the collective

IN MEMORY

FEATURE

IN VIEW

INCOMING

ADVERTISING

CAMPAIGN

Keeping the care in public hands FEATURE

Good to know: Federal Budget 2017

OPINION

If we want to make a difference, we need to rewrite the rules CAMPAIGN

Aged care: more than just a job PROFILE

HIPS and GEDI: Nurses leading improvements in geriatric care PROFILE

The midwifery bond: Improving health outcomes for Indigenous mums and bubs

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

insight

Time for change in aged care Sally-Anne Jones QNMU President

DESPITE THE fact that Australians are living longer and enjoying good health for an increasing number of those extra years, the fact remains that not all folk are going to be able to live at home — even with support during the sunset years of their lives. An increasing number of people will require focused and skilled nursing care during their later years in residential facilities. During the paradigm shift over the past few decades towards the appellation and function of “residential aged care facilities” (RACFs) and away from the term nursing home, something important has been lost. Perhaps during the early part of that transition to focusing on residential care, the frail older person required support, supervision or assistance with activities of daily living. Now, however, the people who find themselves eligible for residential care require more than this. RACFs are no longer a place where someone lives, it’s a place where someone lives to be nursed. A higher level of skilled clinical nursing is required to support their needs such as use and management of percutaneous endoscopic gastrostomies; management of fistulae for dialysis; portacaths; maintaining IVs for antibiotics; suprapubic catheters and management of complex behavioural disorders, to name a few. The use of RACFs is difficult to gauge, however, it has been estimated that up to 7% of the population aged 65 and over used Residential Aged Care in 2010-11 with 5.6% being permanent residents. The use of Residential Aged Care is more common in the last year of life, with 54% of people aged 65 and

over who died in 2010-11 having used Residential Aged Care within their last year of life (AIHW, 2015). There have been numerous Productivity Reports and Senate Inquiries which have consistently recommended there is a need to establish a method of determining safe staffing levels and skills mix in the aged care sector. Despite these recommendations, there has been a monumental failure of successive governments to establish and legislate evidence based staffing levels and skills mix that provide a minimum safe standard of quality care to vulnerable older Australians. A growing body of national and international research and evidence clearly demonstrates that inadequate levels of qualified nursing staff leads to an increase in negative outcomes for those in RACFs — both in costs and in quality of life and health status for the older person. Recognising the apparent gap in evidence based staffing and skill mix research for the aged care sector, the ANMF Federal Executive funded and commissioned Stage 2 of the National Aged Care Staffing and Skills Mix Research. The ANMF (of which the QNMU is a Branch) is committed to continuing to develop the evidence that demonstrates the impact of the appropriate number and mix of skilled and experienced staff — which includes RNs, ENs, and Assistants in Nursing/ Personal Care workers on the older population that require more than support for activities of daily living. The QNMU has also commenced work in implementing an Aged Care Sector strategy, aimed at building community and government support

for lobbying for change in the aged care sector. Recent budget decisions, along with the implementation of consumerdirected care from 2017 onwards, are further issues affecting aged care. The ANMF is building a campaign heading into the next federal election on issues relating to this sector. It’s time to recognise that residential aged care facilities provide more than a place to live when independent living is not possible… it is a place where residents live because they need nursing!

The QNMU has also commenced work in implementing an Aged Care Sector strategy, aimed at building community and government support for lobbying for change in the aged care sector. Reference Australia’s Welfare 2015, Australian Institute of Health and Welfare, 2015

QNMU COUNCIL SECRETARY :

Beth Mohle

ASSISTANT SECRETARY : PRESIDENT :

Sandra Eales

Sally-Anne Jones

VICE PRESIDENT :

Lucynda Maskell

COUNCILLORS :

Janet Baillie Christine Cocks Karen Cooke Tammy Copley Jean Crabb Dianne Corbett Maddi Heathfield Shelley Howe Leanne Jiggins 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

One for the history books Beth Mohle QNMU Secretary

THIS YEAR nurses and midwives proudly led Labour Day marches across Queensland. It was the first time in our union’s history we’d been selected to lead this important celebration of the many achievements of organised workers. As 1 May is International Workers’ Day, the Queensland Labour Day public holiday has traditionally been celebrated on the first Monday in May. The attempt by the Newman government to shift the Labour Day long weekend to October was vigorously opposed by Queensland unions because our history and traditions matter to us. In Queensland, we have a long and proud history of celebrating Labour Day in May — and the day was thankfully reinstated to its rightful place last year. Labour Day is celebrated internationally and had its origins in the eight hour day/40 hour week movement that arose from the industrial revolution during the 1800s. This was a time when child labour and unsafe working conditions were common and the working day commonly ranged from 10 to 16 hours a day, six days a week.

The objective of unions and others in the eight hour movement was to achieve eight hours for work, eight hours for recreation and eight hours for rest. It took many decades of struggle to achieve this in Australia, just as it took many years to abolish child labour and bring about other improvements in wages and working conditions. Improvements like this don’t just happen — they take collective action by committed people, usually over many years. Perseverance, passion and a plan are fundamental to successfully achieve such important improvements. These advances are not universal. There are many places in the world where working standards are appalling low. Even in countries such as Australia where these advances have been fought for and won many years ago, we must remain vigilant and continue to protect the hard-won achievements of those who have come before us. We also have many more improvements to make, be it closing the gender pay equity gap or ensuring safe workloads for all.

Our struggle to advance the values and interests of Queensland’s nurses and midwives is a never ending job. It’s therefore important to not only take the time to reflect upon and celebrate the past achievements of unions on Labour Day, but to also highlight current critical issues. In leading this year’s march, we took the opportunity to celebrate our recent name change to the QNMU. We also highlighted how critical it is to defend the penalty rates of all workers who work unsociable hours. Nurses and midwives know too well that losing or cutting penalty rates in the hospitality and retail sectors is almost certain to flow on to other areas. Given penalty rates can make up to 25-30% of nurses and midwives’ pay, this is a vitally important industrial and broader economic issue that is incredibly relevant to our professions. Queenslanders proudly celebrate their working achievements in a way that is unrivalled by the rest of Australia. A fun family atmosphere is present in marches and other celebrations that take place in our local communities across the state. As the largest union in Queensland, a record number of QNMU members attended this year’s celebrations … and we looked a treat in our bright pink, blue and purple t-shirts that showed off our new name and brand. We know we are stronger when we work together, but we also know our work will never be done.

QNMU leading the Labour Day march in Brisbane.

We build upon the work of others over the centuries and we celebrate this on Labour Day each year.

tea room m Q A

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

he QNMU recently had a terrific win this Easter regarding the Easter Sunday public holiday. However, what you should receive for working (or not working) this public holiday — as well as future Easter public holidays — will depend on where you work.

For public sector members: The QNMU recently filed an application to the Queensland Industrial Relations Commission to have Easter Sunday added to the list of “special” public holidays, which attract a benefit of double time and a half. This means RNs, ENs and AINs who work on Easter Sunday now get paid double time and a half, bringing this public holiday in line with Easter Saturday, Labour Day and Christmas Day. Note that your Award refers to Show Day as the fourth ‘special’ day. However, this was swapped to Christmas Day in EB7, and is reflected in your current agreement.

If I normally work Sundays but was not rostered on this Easter Sunday, what will I get paid?

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

If you are a shift worker (ie: not a Monday to Friday worker) but you were rostered off this Easter Sunday, you will be paid an additional day’s wage at ordinary rate.

When will this extra pay show up on my payslip? The decision to add Easter Sunday to the list of ‘special’ holidays was only confirmed the Thursday before the Easter weekend in April. Queensland Health has informed us they are currently updating their system to reflect this increased entitlement, and this should be completed in June.

At the time of printing we expect this payment to be processed on one of your June pay days (either 14 or 28 June … so you may have already received it).

For private sector members (including private hospitals, aged care facilities and other workplaces): Easter Sunday was added to the list of public holidays in the Queensland Holidays Act, meaning many nurses and midwives now get an extra public holiday.

What do nurses and midwives now get paid for working Easter Sunday? Nurses and midwives will generally be paid double time for working on Easter Sunday, instead of the time and three quarters normally paid for Sunday work. However, this is subject to particular provisions in your enterprise agreement.

If I normally work Sundays but was not rostered on this Easter Sunday, what will I get paid? Depending on your enterprise agreement or award, full time employees may get paid an additional day’s pay if they did not work on Easter Sunday. Part-time employees may be entitled to be paid for Easter Sunday if they did not work that day but normally do work on Sundays. You will need to check you enterprise agreement or award for details of your public holiday pay entitlements. Visit www.qnmu.org.au/ wages_conditions

wins

Member WINS against unsubstantiated allegations by employer

QNMU MEMBER and Registered Nurse Cherise Matthews has emerged victorious after her employer — a large aged care provider — hit her with unwarranted disciplinary action. Cherise had lodged workload reporting forms due to an unmanageable workload and concerns about the unsafe level of staffing in her workplace. Despite 45 workload reporting forms being lodged, her employer took little action. Cherise had no choice but to refuse to engage in an unsafe oncall roster. “It was dangerous. Management were asking us to be on call for three different facilities — two of which we didn’t work at so would not have any understanding of patient needs or of staff skills,” Cherise explained. “My shift would be for 2pm to 10pm but I would also be rostered to be on call from 4pm to 6am and I was the only RN on duty. This means if I had been called away there would be no RN at our facility not to mention our staff would be short another person.” Due to her refusal to engage in an unsafe on-call roster, Cherise received a call from her workplace saying she

had been stood down from work. This went on for six weeks. Cherise was also called to a disciplinary meeting where management levelled a number of other unsubstantiated allegations against her. “I was under extreme stress. I was already dealing with a horrendous workload and this was just unnecessary stress on top of that,” she said. QNMU attended all disciplinary meetings Cherise was called to and represented her interests in disciplinary matters with her employer. We were successful in having allegations against Cherise dropped on the grounds that they were unsubstantiated. “I wouldn’t have been able to manage without the help of the union as there isn’t any support like this within the workplace. I wouldn’t have known what to do,” Cherise said. “I want to remind anyone reading, especially aged care nurses, that it is critical we follow AHPRA guidelines and don’t just believe everything management says. “If I had just gone along with the unsafe on-call roster I could easily have lost my registration.”

I wouldn’t have been able to manage without the help of the union as there isn’t any support like this within the workplace. Her workplace has advised they will be working toward adding a Registered Nurse to the night shift position at Cherise’s workplace and will work with the QNMU to review their on-call arrangements. This is a big win for Cherise, who is now back at work with a more manageable workload, and a win too for residents and her colleagues.

wins

$800,000

RECOVERED FOR AINS IN STERILISING SERVICES

UP UNTIL October 2016, many AINs working in Queensland Health sterilising services (STEs) were being incorrectly paid shift and Sunday penalty rates applicable to Enrolled Nurses. This resulted in significant underpayments over many years. After filing an application in the Industrial Magistrates Court in January 2017 on behalf of six members as a test case, the QNMU and QH finally reached a settlement. As a result it, all AIN STEs who were incorrectly paid will be back paid the correct entitlements to January 2011 (this is the six year time limit on wage claims). This means a whopping $800,000 will be paid to this group of AINs! QH has committed to the backpay going into members’ pays in June. Thanks to those members who put themselves forward to be part of the test case and for their assistance in putting together the claims. While this win only applies to AINs currently working at QH, we’ll now turn our attention to filing a similar case for former QH employees.

$65,000 recovered for AINs and ENs

AINS AND Enrolled Nurses at Eventide Charters Towers recently had a fantastic win — the QNMU managed to recover $65,000 in unpaid or underpaid laundry and special allowances, as well as recognition of AINs with a Cert 3 qualification. This worked out to be an average of $1000 paid to each member! After noticing inaccuracies on their payslips, members got together to collect information and approached the QNMU, who took it up with management. Following a lengthy 12-month process of negotiations and calculations, we finally won! Well done to our extraordinary members for a job well done. It really does pay to check your payslips!

Nurses secure safe ratio at Prince Charles ED QNMU EMERGENCY Department nurses at the Prince Charles Hospital have succeeded in getting management to agree to a ratio of one nurse to three patients in the overflow area of ED. Previously some nurses had been assigned up to 20 patients with some having to care for their patients in the corridor. As a result QNMU members began submitting workload reporting forms. The grievances ultimately escalated to stage 4 of the formal escalation process (a specialist panel). Management worked with QNMU officials and representatives, and commited to an agreed ratio of 1:3 in the overflow area. A range of other recommendations will be submitted to the ED members for consideration before the specialist panel concludes. Since commencing the workload grievance process, an additional 21 FTEs have been recruited to the ED, which mostly includes RNs and CNs. While it should not have taken a formal grievance to fix such a situation, this is nevertheless a great outcome that prioritises the safety of patients and nurses.

wins

Working to advance our nurses

Public holiday confusion averted for UnitingCare Health members PRIOR TO the Easter public holidays, management at UnitingCare Health told full-time staff they would not be paid a day’s wage if they were rostered off on a public holiday. Fortunately, QNMU members went to their agreement and found that management’s claim was the opposite to what their agreement actually states. The QNMU called an urgent meeting with management. Management eventually informed us they would pay the correct entitlement in accordance with the enterprise agreement. So it pays to know your agreement! Remember, QNMU members can check their individual agreements on our website at www.qnmu.org.au/ wages_conditions.

NEARLY 230 Enrolled Nurses in Queensland Health will now have the opportunity to advance their careers. In a new commitment the QNMU achieved through EB9, Queensland Health has committed to converting an existing 228 EN (Nurse Grade 3) positions into EN Advanced Skill (Nurse Grade 4) positions (ENAS) by 30 March 2018. The conversion process is being overseen by the Nurses and Midwives Implementation Group (NaMIG) and the first stage of this process has now been completed. A working group established by NaMIG has developed Principles, Business Rules, a Recruitment Guide and a template ENAS role description to ensure consistency across all HHSs. The QNMU and Queensland Health are working closely together to ensure a transparent conversion process. Some ENs have already been successfully converted. All proposed new ENAS positions and the proposed

recruitment process for each of these positions must be tabled at each HHS’s Nursing and Midwifery Consultative Forum, the joint peak consultative forum for the HHS. Where new ENAS positions are identified, a closed merit recruitment process will take place. That means only ENs in the service or unit where the newly converted positions exist will have the opportunity to apply for the positions. QH is committed to finding ENs in the service with the requisite skills to fulfil the newly created NG4 roles. If necessary, additional training will be offered to bring ENs up to speed so they can successfully seek the newly converted position within six months. Importantly, an EN position converted to ENAS will permanently remain at ENAS, even after EB9 is finished. For more information, please contact your Local Organiser or NMCF representative.

If you have any concerns you have still not received your correct entitlement, please contact Member Connect.

Temporary nurses and midwives in CQ made permanent TOGETHER with Central Queensland Hospital and Health Service and working with other unions, we embarked on a process to review temporary to permanent positions across the HHS in all streams. To date we have successfully converted 23 temporary positions into permanent – 18 of which are within the nursing and midwifery stream. The process was undertaken in good faith and is a testament to what we can achieve through good collaboration and consultation. CQHHS will continue to review temporary to permanent positions as they become aware of them.

just in

Celebrating our efforts and achievements on… International Day of the Midwife and International Nurses’ Day NURSES and midwives play an invaluable role in our community so it’s only fitting our hard work is recognised and celebrated around the globe on International Day of the Midwife (5 May) and International Nurses’ Day (12 May).

THE QNMU’S Annual Conference will be held on 19 – 21 July, and for the first time all members are invited to attend the Professional Day on 21 July 9am to 4pm (Brisbane Convention and Exhibition Centre). Come join us on the final day of our conference and hear from a great range of guest speakers on nursing, midwifery, the union movement, including. Attendance can count towards your CPD hours.

We’re glad to see members enjoyed the special celebratory cakes we delivered to workplaces across Queensland! Thanks to our members who’ve sent us some wonderful celebratory snaps – take a look on page 54.

Join us at our Professional Day!

For more information or to RSVP, visit www.qnmu.org. au/conference2017

Midwives in Beaudesert celebrating IDM

QNMU ANNUAL CONFERENCE making a difference Last chance to have your say on ratios

Robina ED nurses celebrating IND

Labour Day 2017 THANK YOU to the hundreds of nurses and midwives who came out for the 2017 Labour Day marches right across Queensland! For the very first time, nurses and midwives led the march, and this year that also meant leading the call to protect our penalty rates. The Brisbane event was our biggest Labour Day turnout ever, well done all! And we looked pretty schmick in our new brand and beautiful colours… if we do say so ourselves! Check out page 52 for some great snaps from marches across the state.

MEMBERS have one last chance to have their say on new legislated nurse-to-patient ratios now that it’s been about a year since implementation. If your workplace has legislated ratios, have your say on what you think is working well and what needs further attention. If you work in a private hospital or an area that does not have legislated ratios, you’re still encouraged to complete the survey. The survey is confidential and will take about 20 minutes to complete. Check your emails for the survey link.

just in

Australia’s most outstanding nurses and midwives recognised

InScope named top union journal! Hooray! Our very first issue of InScope has snagged Best Union Journal at the 2017 Queensland Labour Day Awards.

AUSTRALIA’S most outstanding nurses and midwives have been recognised at the 2017 HESTA Nursing and Midwifery Awards.

Thank you to all members who continue to read and support our journal! We always welcome members’ feedback and suggestions, so pen your thoughts to inscope@qnmu.org.au and you could be featured on our pages.

In its 11th year, the annual Awards recognise the outstanding contributions of graduates, individuals and teams for their professionalism, innovation and care across a range of health settings.

Congratulations to the winners: ■ Nurse of the Year: Sarah Brown from Western Desert Dialysis (The Purple Truck) ■ Team Excellence: The Mater (Sydney) Pre-admissions Midwife Appointment Program ■ Outstanding Graduate: Rebecca Rich (Perth Clinic) And a big thumbs up to the finalists from Queensland, who have certainly done us proud:

QNMU Occupational Health and Safety Officer James Gilbert speaking on Worker’s Memorial Day.

In memory of Queenslanders who have died at work ON WORKER’S Memorial Day (28 April), QNMU gathered with other unions in remembrance of those who have been injured or killed at work. QNMU Occupational Health and Safety Officer James Gilbert spoke of our shared commitment as unionists to campaign for safer and healthier workplaces for Queensland workers and their families. On the same day, QNMU Council met to pass a resolution reaffirming this commitment: http://bit.ly/2pa26kI

■ QNMU member Andrea Mitchell for Nurse/Midwife of the Year ■ Gladstone Palliative Care Team (Gladstone Hospital) for Team Excellence.

2017 HESTA Nursing and Midwifery Award finalists including QNMU member Andrea Mitchell (3rd from right).

just in

Rural and remote conference QNMU Secretary Beth Mohle recently spoke at the National Rural Health Pre Conference event in Cairns, which focused on workload management. We need to hear from nurses and midwives in rural and remote areas about issues of concern to you. Last year the QNMU established a Rural and Remote Nurses Reference Group to help shape the union’s policies and direction around issues facing these members. If you’d like to get involved in our reference group please email cgraham@qnmu.org.au

Regional Ice summit hears from nurses NURSES from across regional Queensland, including QNMU members, recently came together in Rockhampton to help shape the state government’s strategy to tackle the drug Ice. As frontline health professionals, nurses and midwives often see the devastating effects of drug and alcohol addiction, and we should be part of the process to develop solutions. More regional Ice summits will take place across the state. If you’d like to get involved, please contact gsiddle@qnmu.org.au

Membership fee changes TO ENSURE we continue to be a professional and collective voice for all Queensland nurses and midwives, membership fees for the 2017-18 financial year have increased slightly. This small increase of 2.5% is necessary for us to continue to support you in your working life, from defending your rights and conditions and providing legal representation, to professional advocacy, free CPD resources, training and more. Your QNMU membership also includes professional indemnity insurance cover, which is a legal requirement for registration, and your fees are fully tax deductible. If you have any queries please contact QNMU Membership on (07) 3840 1440 or toll-free outside Brisbane on 1800 177 273.

QCU Townsville Delegate of the Year CONGRATULATIONS to QNMU member representative and Townsville Hospital branch delegate Jo Konings, who has been awarded the Queensland Council of Unions’ Townsville Delegate of the Year! Jo works tirelessly for her branch and is involved in numerous campaigns to help improve the

lives of working Aussies, not least her nurse and midwife colleagues. Most recently, Jo has been campaigning for legislated ratios and protecting penalty rates. This is a well-deserved win for Jo and we couldn’t be prouder! Pictured above: Jo (far right) with her Branch friends and colleagues.

Members having a say THE QNMU’S reference groups provide members with an opportunity to get involved in important work life issues and speak up about what’s important to them. We recently formed our Newly Qualified and Early Career Nurses and Midwives Reference Group, made up of new grads with zero to three years working experience, post registration. Group members will be providing input on topics like availability of employment and recruitment opportunities. Our Rural and Remote Reference Group has been working to create a safe work environment for our nurses and midwives in remote communities. This includes eliminating single nurse posts so no nurse ever works alone. And if you want to have your say on current aged care issues, get involved in our Aged Care Reference Group and help guide our strategy and direction for improving the working life of aged care workers. Discussions often focus around staffing, skill mix, and your professional practice. To find out more about the QNMU’s reference groups, contact Cindy Graham on 3840 1444 or cgraham@qnmu.org.au

just in

Social planning for retirement pays off BY PROFESSOR CATHERINE HASLAM AND DR BEN LAM, UNIVERSITY OF QUEENSLAND, WITH ADDITIONAL MATERIAL BY QNMU

RETIREMENT is one of the major life changes we experience. It sweeps aside routine leaving us free of deadlines and rosters, but it can also take us away from things like workmates and responsibilities which might give us purpose and identity. There are about 3 million retirees in Australia and while most people find the transition to retirement positive, about 25% find it hard to adjust and experience a marked decline in their health and wellbeing as a result. New research suggests that the key to a positive transition to retirement is forming new friendships with groups of other people (community groups, interest groups, voluntary groups, etc) and with other retirees. Investigating the importance of these social factors in the retirement transition are a team of researchers at the University of Queensland, University of Kansas (in the US) and Jiangxi University of Finance and Economics (in China). The team recently conducted a study with QNMU members and other retirees in Australia and New Zealand to determine whether our relationships with groups of people contributed to health and wellbeing in retirement, and whether they were more important than other factors we usually associate with better retirement health, such as financial planning, marital status, retirement aspirations, or physical health.

The research The researchers conducted an online survey of 302 retirees who were asked to respond to questions

about their social group relationships, the usual retirement factors (e.g., financial factors), retirement adjustment, and wellbeing. The findings confirmed that social factors did indeed contribute to better retirement adjustment and wellbeing, but interestingly, it was the social group relationships that people gained after retirement that proved most beneficial — particularly those with other retirees. It turns out social groups were more important than financial resources and marital status, and just as important as physical health. These findings are consistent with research showing that a person’s health, particularly their mental health, is often linked to their sense of identity, their sense of self – much of which is shaped by key social groups (work team, workplace, family, profession, community group) to which we belong and that give us a sense of meaning and purpose. Retiring often involves loss of professional and other groups that have been central to our sense of selfidentity, and there is a risk that their loss can compromise our sense of self to the detriment of our mental and physical health. The survey results so far indicate that for health and wellbeing, there is a real need for retirees to either maintain the social group relationships they’ve developed during their working life, or develop new ones into retirement. UQs ongoing research into the retirement transition supports this with some striking statistics. A UQ study published last year suggests that retirees who had

two key group memberships before retirement had only a 2% risk of early death within 6 years of retirement. This risk increased to 5% if they lost one group and 12% if they lost both groups. As these findings show, if we want to live well into retirement then we need to prioritise social group activity in the transition by joining new social groups and embracing a positive retiree identity. While financial planning is certainly important and has largely dominated the retirement experience to this point, it is clear we need to turn our attention more to social planning.

Contact the team This research would not have been possible without the interest and support of QNMU members and so the team want to send their thanks to everyone who took part. If you would like to be involved in the ongoing research, are interested in learning more or wish to take part in other studies, please visit www.groups4health.com/ g4r/ or contact Ben Lam at ben.lam@uq.edu.au References Haslam, C., Holme, A., Haslam, S.A., Iyer, A., Jetten, J., & Williams, W.H. (2008). Maintaining group membership: Identity continuity and well-being after stroke. Neuropsychological Rehabilitation, 18, 671-691. doi: 10.1080/09602010701643449 Steffens, N. K., Cruwys, T., Haslam, C., Jetten, J., & Haslam, S. A. (2016). Social group memberships in retirement are associated with reduced risk of premature death: evidence from a longitudinal cohort study. BMJ Open, 6:e010164. doi:10.1136/bmjopen-2015-010164

indepth FEATURE

Navigating patients through a complex health system

MAGINE being a patient in Queensland’s complex health system. Throughout your journey you’ll make contact with many health services, both in the hospital and the community, and be required to navigate what can be an incredibly complicated and challenging health system.

Enter the Nurse Navigator, a new position created by the Palaszczuk government after QNMU lobbying which is now being rolled out across Queensland’s Hospital and Health Services. While the Nurse Navigator role is a new position to Australia, it has been around for many years in various overseas health systems where it is sometimes referred to as Patient Navigator. As the name suggests, the general role of the Nurse Navigator is to help patients navigate the intricacies of the health system and the services they need.

Nurse Navigators explained

Katrina Cox

Dalby Hospital Registered Nurse Katrina Cox was one of the first Nurse Navigators to be employed in the government’s four-year rollout of 400 positions. She describes the Nurse Navigator as a “puzzle master”, working across all areas of health. “The patient is at the centre, and all the puzzle pieces sit outside and they’re all fragmented, and then the Nurse Navigator comes in and picks up those pieces and puts them all together to make one big puzzle,” Katrina said. “We provide care co-ordination across the patient journey.

I didn’t quite realise how complex our health system was until I stepped into the Nurse Navigator role. Katrina Cox

FEATURE indepth

The role of the Nurse Navigator is to: ■ Monitor high needs patients, identify actions required to manage their health care and direct patients to the right service. ■ Provide an end-to-end care and coordination service along a patient’s entire health care journey ■ Educate and help patients better understand their health conditions and enable them to self-manage or participate in decisions about their health care.

“We facilitate the delivery of their care, and we try to keep all the services working together and talking to each other so that the patient has one person they can go to — the Nurse Navigator.”

A one-stop contact “I didn’t quite realise how complex our health system was until I stepped into the Nurse Navigator role,” Katrina said. “It’s complex for us nurses and midwives to navigate through and find the correct services and get patients from here to there — and we’re the ones who work in the health service. “So it must be really daunting for a patient coming in who doesn’t have any experience with the system.” The benefits of having Nurse Navigators are twofold: it creates a far more streamlined and simpler experience for the patient; and it is better for the health system operationally as it improves relationships between the community and health services, and results in fewer admissions. “(For example) the mother of one of my patients was told to get a ‘giving set’,” Katrina said. “To get that she had to go to the dietitian, and then the dietician told her to go somewhere else, and so on.” “So by the time she rang me she’d been through five different people. It took me 10 minutes to find the correct process. “Things like that are very daunting for a patient and their family, and they can easily give up.” Katrina said her role also involved a lot of travel to and from patients’ homes, which helped to reduce hospital admissions. “We bring services to patients, rather than the patient coming to hospital, and we provide them education to improve their health literacy,” Katrina said. “Patients come to EDs and acute wards when things aren’t going well, but we can get the services to the patients before things happen.” Aline Mweze 13

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A Nurse Navigator can “make a significant contribution to health reform by working towards patient-centred care wherein patients receive timely, seamless, culturally appropriate guidance and support for developing health literacy”. A McMurray & H Cooper, 2017

Bridging the gap for culturally diverse patients

coming from culturally diverse backgrounds,” said Aline.

Some Nurse Navigators are employed to fill particular gaps in our health care system.

Originally from the Congo and Rwanda in Africa and with English as her second language, Aline said she is able to relate to a lot of her patients’ challenges.

Aline Mweze is a Multicultural Nurse Navigator at QEII Hospital who cares for patients from culturally and linguistically diverse backgrounds. Many of these patients present their own unique challenges, including language barriers, low health literacy levels, higher representation rates, and longer lengths of stay. “Metro South is the most culturally diverse hospital and health service in Queensland, and QEII is the most culturally diverse hospital, with close to 25% of our hospital admissions

“I’ve been a patient myself, and so I am aware of the challenges that these patients face, as well as the challenges health care providers face with providing care to those patients.” Trust is another important issue for patients from culturally diverse backgrounds. “Patients want to know they can trust our health care system, and sometimes given their history it may not have been the case in their previous health system.”

Aline said one of her patients was a newly-arrived refugee who ended up in hospital on his second day in Australia. “He was in a new country with no English and didn’t understand how the Australian health care system worked, so you could imagine the level of anxiety he had,” Aline said. “It was also difficult for the hospital, as there was obviously no GP to give us his medical history. “When I enrolled him in the Nurse Navigator — Multicultural service I was able to assist him in the hospital and also follow-up in the community by linking him to a GP and other primary health services. “It’s been great seeing him grow from not understanding our health system or what his condition was to him now being able to manage his own health, access his GP, call to request an interpreter and attend his outpatients specialist appointments at the hospital. That’s a great outcome for him.”

Governing principles for Nurse Navigators ■ Coordinate patient care ■ Create partnerships ■ Improve patient outcomes ■ Facilitate system improvements

Reference: McMurray, A. & Cooper, H. (2017). The nurse navigator: An evolving model of care. Collegian: The Australian Journal of Nursing Practice, Scholarship & Research. 24(2), p. 205-212.

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The caring never stops WHEN IT comes to being charitable, it seems nurses and midwives don’t stop caring when they clock off. Statistics from the ATO show nurses and midwives are among the highest contributors to charities in Australia. The 2015 deductable giving statistics, released last month, show Registered Nurses claimed $46.6 million in charitable donations, the largest contribution made by any health profession. About 47% of Registered Nurses listed charitable donations in their 2015 tax return and the ATO suggests many more make donations they do not claim. But that’s not all! In addition to Registered Nurses, 53% of midwives make donations, adding a further $3.8 million to charity coffers, while Nurse Educators and Researchers (53.7%) and Nurse Managers (54.8%) chip in another $2.35 million combined which is an excellent contribution from just under 4500 donors. And none of this includes the donations made by others in our nursing and midwifery profession which weren’t captured by the ATO statistics. These percentages put nurses and midwives squarely above the Australian average (34.58%) in the generosity stakes. But more importantly, these millions of dollars help fund a huge range of deserving organisations and activities, from medical research and health awareness campaigns to poverty alleviation, human rights advocacy, animal welfare, conservation projects and many more. In 2015, 4.57 million Australian taxpayers claimed an $3.1 billion as tax-deductible donations which is a 15% increase – $464 million — from the previous year and is the highest amount ever recorded. And the average tax-deductible donation made in 2015 was $674.14, an increase of 17.11% compared to the previous year ($575.54). So hats off to all you generous donors and let’s keep sharing the love!

About 47% of Registered Nurses listed charitable donations in their 2015 tax return...

Donate from your paypacket It is now becoming common for employers to allow staff to make donations through workplace giving, via an ongoing deduction each pay period. Employees who contribute this way receive the tax benefit immediately rather than waiting until the end of financial year. For example, if you donate $20, the full amount goes to the charity, but it will only cost you about $12.60. In some cases, employers will match staff donations, so the value of your donation to the charity of your choice doubles to $40. Why not check and see if your employer has a scheme like this in place?

QNMU chipping in Did you know the QNMU council makes a number of donations to a variety of deserving causes each year which align with the social objectives of our union? These donations can be one-off cash donations or support in the shape of raffle prizes. We have a handful of regular charities we support including: ■ Sisters Inside – advocates for the human rights of women in the criminal justice system. ■ Thai Burma Shan Health Clinic - provides free medical assistance to refugees who have fled war and repression in Burma. ■ Aussie Helpers – which supports mental health initiatives for farming families ■ The Zonta Club for their safe birthing kits ■ APHEDA Union Aid Abroad – the union run charity that supports regions affected by poverty, injustice and human rights abuses.

Source: https://www.qut.edu.au/business/about/research-centres/australian-centre-forphilanthropy-and-nonprofit-studies/publications-and-resources/resources

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Waste not,

want not.

SAVE THE PLANET YOU KNOW HOW IT GOES. You’re rummaging around in the fridge deciding what to cook for dinner and before you know it, you’ve tossed out half a bag of slimy baby spinach leaves, a wrinkled zucchini, a Tupperware container of leftover fried rice and half a carton of forgotten sour cream that’s now sporting grey-green fur. Add that to the half-eaten sandwich in your kid’s lunchbox and the uneaten mash you’ll scrape off your dinner plate because you’re full and that’s a heck of a lot of food waste for a day. And yet, that’s only the tip of the iceberg lettuce. 16

The hard truth is the average Australian family wastes about 20% of the food they buy every year, at a cost of about $3500 (wow!). National broadcaster ABC is currently airing a program called War on Waste, hosted by Chaser satirist Craig Reucassel. While Reucassel is looking at Australia’s overall consumption on everything from takeaway coffee cups to non-biodegradable shopping bags, his first episode was dedicated to food waste. The food waste figures he revealed for households, and within the food supply and retail chain are horrendous. For example: ■ Australia produces enough food every year to feed 60 million people — 2.5 times our population, yet two million Australians struggle to put food on the table every day. ■ 3.3 million tonnes of food is wasted each year — enough to fill the MCG six times over.

That’s an awful lot when we consider that a good deal of food is wasted simply because supermarkets say it’s the wrong shape, or because we bought too much, stored it poorly or forgot about it. As a nation, we accept food waste as part and parcel of our busy lives, and unlike the millions who go hungry, food for us is plentiful and we have the means to absorb the cost of what we throw out. Most of us also are well removed from the food production process, so we simply don’t know the huge amount of resources it takes to grow or make our food. For example did you know it takes about 1000 litres of water to make just one litre of milk! But aside from the ethical and financial aspects, this excessive food waste also has implications that sit squarely within our professional agenda as nurses and midwives. Food waste is making our world sick.

FEATURE indepth DOESN'T FOOD WASTE JUST ROT AWAY? When food gets thrown to the dump in such large quantities and is mixed in with general waste it can’t break down properly and it releases methane gas. Methane is a greenhouse gas that’s about 25 times more toxic to our atmosphere than the carbon dioxide from your car. Greenhouse gases in our atmosphere work like, well a greenhouse — they trap the sun’s heat, allowing it to warm the earth and preventing it from escaping our atmosphere into space. It’s a finely balanced system, giving us just the right amount of warmth we need. But the increase in man-made greenhouse gasses like carbon dioxide and methane is intensifying the process, trapping too much heat — which we call global warming. If the key to reducing global warming is reducing greenhouse gas emissions then, among other things, we need to address food waste. And it’s not just the waste’s methane we need to look at. If food is wasted, it means that all the resources used in the production, harvesting, transporting, storing, and packaging of that food are also lost. And at a global level that’s estimated to be a whopping 3.3 billion metric tons of carbon dioxide — at least. This means that if food waste was a country, it would be the third biggest greenhouse emitter behind China and the US. The QNMU and our Federal body the ANMF take the issue of climate change seriously. We look at it from a public health perspective.

CLIMATE AND HEALTH In 2002 the World Health Organisation estimated that in the year 2000, climate change had been responsible for 154,0000 deaths, and millions of productive lives cut short by impairments caused by diarrhoeal disease, malaria, malnutrition and flooding triggered by climate change.

While most of these deaths were in low income countries, to think it will not, or does not affect affluent countries like Australia is a mistake. In 2003, 14,800 people, mostly elderly people living in Paris, died during a record heat wave that swept across Europe bringing eight consecutive days of temperatures over 40 degrees to areas ill-prepared for hot weather. More recently, the Intergovernmental Panel on Climate Change (IPCC) has warned that diseases like tick borne encephalitis and Lyme disease are expected to expand into North America and Europe in response to climate change. And then there are predictions of a worldwide increase in cardiorespiratory diseases directly linked to the air quality getting worse as ground level ozone increases. Like the rest of the world, Australia is not immune to the health risks associated with the extreme weather resulting from climate change. We’ve had our fair share of unseasonal floods, fires and storms, and as nurses and midwives we know how that hurts our communities — we know how vulnerable our elderly are to extreme heat, how crop failures can affect the mental health of farmers, and how contaminated water can spread disease. Acting Secretary Sandra Eales said the QNMU’s position in support of climate change initiatives was a natural fit for our professions and that included supporting individual and community initiatives to control food waste. “We are the largest component of the health care workforce and this puts us at the forefront of providing care to communities and people affected by climate change,” Sandra said. “Even as it stands, the treatment of climate change-related health conditions puts added pressure on our health system and our workforce, so it stands to reason we would support sound public policy and community efforts to reduce emissions and reverse the climate change trajectory.”

KNOW YOUR DATE MARKINGS As health professionals the last thing we want is people getting sick from eating food that is no longer fit for consumption. But according to Food Standards Australia and New Zealand one way you can reduce your food waste and still eat safely is understanding the shelf life of food by learning about food date stamps. ■ USE BY: Found on foods that must be eaten before a certain time for health or safety reasons. Usually very perishable and have a short shelf life. Only buy what you need and are likely to consume quickly. ■ BEST BEFORE: This is the one that really trips people up and contributes quite a bit to landfill waste. The FSANZ says you can still eat foods for a while after the best before date as they should be safe but they may have lost some quality. So check it before you toss it. ■ BAKED ON/BAKED FOR: This is usually only for bread and bakery items with a shelf life of less than seven days. Best consumed fresh on the day it is baked, but ok for few days after. (Will keep longer in the fridge or freezer). ■ (NO DATE): Think tinned food and other foods like sugar that have a shelf life of two years or more. This is because it is difficult to give an accurate guide as to how long these foods will keep. Once opened, treat their shelf life as you would their uncanned equivalent (ie treat tinned carrots as cooked leftover fresh carrot).

RE O F E B T S 17 E 0 B 2 / 7 25/0 17

indepth FEATURE SO WHAT CAN I DO? Well nurses and midwives are trusted professionals and with our science background and excellent communication skills we are well placed to lead the way and encourage our families, peers, friends and communities to wage their own wars on waste. For many of us, talking people through lifestyle changes for better health is something we do every day. What’s more this is a movement everyone can get behind as there are so many angles to motivate them. While we health professionals might be moved by the health and wellness aspect, others might be more motivated by the environmental impact, and then of course there is the financial benefit — who wouldn’t want an extra $3500 in their pocket? To help you on your way we’ve added some handy tip boxes and resources to this page that might help you reduce your food waste and lead others along the same path — check ‘em out!

WHAT'S IN OUR FOOD WASTE?

33%

FRESH FOOD D

9% DRINKS

27% LEFTOVERS

15%

PACKAGED FOOD

FROZEN FOOD

TAKEAWAYS

STORE IT RIGHT A good deal of the food we throw out has spoiled because of poor storage habits. Read the labels on your food and pay attention to special conditions like ‘refrigerate after opening’ or ‘store in a cool dry area’. This will ensure you get maximum shelf life from your food. For example, did you know honey and sugar will keep indefinitely if stored properly? Did you know you should wrap herbs in paper towel to keep them fresh longer? Did you know onions and potatoes should be stored separately because onions can cause potatoes to sprout?

For resources on how to store food correctly try: ■ Brisbane City Council is a Love Food Hate Waste campaign which has some great resources on their webpage including a really good section on smart food storage. www.brisbane.qld.gov.au/ environment-waste/rubbish-tipsbins/recycling-reducing-waste/ love-food-hate-waste ■ makedirtnotwaste.org which has a great comprehensive downloadable A-Z food storage guide. ■ www.huffingtonpost.com.au/ entry/food-waste-storagetips_n_6341538 Huffington’s Post tips which aren’t extensive but do explain why particular storage methods work best.

TIPS FOR REDUCING FOOD WASTE: ■ PLAN: Plan meals for most of the week and with use-by dates in mind, make a shopping list, and check what you already have. ■ BUY BETTER: Buy only what you need, avoid bulk buys, don’t buy what you can’t store properly, buy wonky fruit and veg so it doesn’t get binned.

References: ■ www.foodwise.com.au/ ■ www.ozharvest.org/what-we-do/ environment-facts/ ■ www.foodwise.com.au/foodwaste/foodwaste-fast-facts/ ■ www.thinkeatsave.org ■ watchmywaste.com.au ■ http://iview.abc.net.au/programs/war-onwaste ■ http://davidsuzuki.org/issues/climate-change/ science/climate-change-basics/greenhousegases/ ■ http://news.nationalgeographic.com/ news/2015/01/150122-food-waste-climatechange-hunger/

■ STORE BETTER: Store food according to pack instructions or best practice (see other box), keep your fridge between 1-5˚c. Know what’s in your pantry and fridge – don’t overstuff, ■ COOK LESS: Reduce portion sizes, halve recipes, learn exactly how much rice, pasta, vegies etc you need for a family meal without leftovers. Eat slowly. ■ LOVE YOUR LEFTOVERS: Freeze, take ‘em for lunch, go online and find new recipes for them. ■ CHECK OUT: www.lovefoodhatewaste.com/recipes or https://greatist.com/health/leftovers-meals-healthy-recipes ■ RECYCLE: Get busy with compost, worm farms or chooks! Great for your garden and will allow waste to break down without producing bad gasses. If 1% of the country composted instead of binning their food waste we could save 45 million kg of CO2.

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Saving lives, one post at a time

ESLEY Hospital RN and QNMU member Deb Rays loves Facebook.

She can spend hours on there every day and has more than 1700 Facebook friends. But you won’t find any cheezburger cats, food porn or duckface selfies on her timeline. You see Deb spends all her annual leave in refugee camps abroad, and she uses Facebook to save lives. “On my second morning in the Katsikas camp in Greece someone told me there was a really sick little kid,” Deb said. “We searched about 100 tents and when we found him he was lying on a blanket on rough stones and it was one of the worst things you could see up in the remote mountains with hardly any medical backup — his abdomen was swollen, he was groaning with pain, he was breathing rapidly and he was scratching himself all over, so I figured it was his liver…and he was blue.” When the boy’s medical evacuation fell through, Deb and her friends hit Facebook and, boosted by a group of Spanish firefighter volunteers who whipped up a petition of 191,000 signatures, managed to get the boy medical treatment in Spain. “He needed a liver transplant and so did his brother — after some months, we got them both out,” she said. The boy’s story went viral and prompted dozens of volunteers, including nurses and midwives to volunteer for the Greek camps. “We had young people pulling up in VWs, and arriving from all over Europe, Spain, the US,” Deb said. “It was amazing and by the time I got back to Australia I had half a dozen people asking to go back with me.”

... Deb spends all her annual leave in refugee camps abroad, and she uses Facebook to save lives.

Deb’s journey to refugee activism began about 4½ years ago when she opened her home to two boys — one Rohingyan and one Afghan — under the Federal government’s homestay program helping refugee migrants integrate into the Australian community. “When they came I started writing a blog on the Homestay website …

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Deb with the family she helped evacuate from the Katsikas camp, with the Spanish medical team who are treating the boys’ liver problems.

I was just sort of using it as a way to vent, talking about my day-to-day.”

the week — but I didn’t know that ‘til afterwards!” she said.

how absolutely lifesaving they could be,” she said.

“But then the head of Homestay publicity rang me at work and said ‘I want to tell you I’ve just pulled over in the car and read your blog today and I’m crying’.”

“But I did paint my skin brown and put on a full hijab because I knew a blond haired blue eyed lady was a bit of a neon sign.

“At that time I was going tent to tent with a backpack and a translator finding out whether anybody was sick, or old or pregnant, or didn’t have medications, or had wounds…and I’d try to get a visual on the toddlers to check their condition. If I did find anybody who was quite sick I’d send a text message to the English doctors who’d join me, and take a look.

“She asked me to keep writing because many people were reading it, and some were signing up.” So Deb continued to write about her experience of hosting refugees and occasionally shared snippets on her Facebook page. “Facebook is like this big world’s noticeboard and as I wrote, people involved in the refugee movement from all over the world kept friending me,” she said. It was on this global noticeboard that she wrote about the Rohingyan boy’s family and the difficulties they faced trapped on the border of Bangladesh. The more she shared their story, the more she was moved by their plight, and eventually she jumped on a plane to find them. “It was a real shock for an Australian, encountering the abject poverty in Bangladesh, I had to traverse a 42 kilometre highway frequented by robber gangs that torture, rape, rob and kill any day of

“Eventually I did find the family and was able to take them a couple of suitcases of food and medicine… that sort of got me hooked.” When a similar venture to meet the Afghan boy’s family in Iran was delayed because of a visa issue, Deb decided to head to the refugee camps in Greece, using her Facebook network to find out where her nursing skills might be most useful. And so she found herself in the Katsikas camp in Western Greece, which was little more than rocks and tents.

“One minute I’d be calling them about someone who had been without epileptic medication for six months and was fitting almost everyday… and then I’d go to another man who’d been tortured by the Taliban and was so traumatised with severe PTSD that we’d be online, trying to get him to Germany for treatment.”

“I quickly realised how valuable even my most basic nursing skills were —

“I’d also dress wounds, take blood sugars, blood pressure and

It was a real shock for an Australian, encountering the abject poverty in Bangladesh...

PROFILE indepth temperatures, take them back to the army doctors at the clinic, get them to a hospital for X-rays and generally advocate for access to medical treatment. “It’s all the things we do as nurses here, but it’s so desperately needed.” Deb has been overseas twice since that first trip, and now, in addition to dispensing critical health care, she coordinates volunteer placements with in-country NGOs. “I did start out doing this work independently but I find you are much more useful when you tie-in with existing resources,” she said. Each time she heads overseas Deb takes as many medical and hygiene supplies as she can carry, and is usually leading a troop of willing volunteers. On her latest visit in February she took volunteers from nine countries including 30 doctors, nurses and other health professionals. She deployed them to 17 camps and NGOs throughout Greece including urban clinics near Athens, and on the islands meeting the boat landings from Turkey. But en route to Greece she detoured to Serbia where to her surprise, she found a community of homeless unaccompanied Afghan children, who she is determined to help. “It was terrible, these were kids of 10, 11, 12 living in this abandoned warehouse in Belgrade,” she said. “Their parents had sent them away out of desperation because the Taliban would come to their village and threaten to kill family members, trying to enlist the boys.” “So these boys have journeyed from Afghanistan into Iran, then Turkey, Bulgaria, Macedonia, Serbia, and Hungary to try and get to England because they think that’s the promised land — but they end up on the street with no-one looking after them,” she said. “I’ve recorded their stories of horrific treatment from the border guards in four countries. They were beaten and tasered inside police stations and attacked by border police dogs – they’ve shown me the dog bites. They were forced to sit in their

underwear in the snow for two hours with cold water poured over them…. and then forced to walk for hours in their underwear in the snow through icy rivers, and back across the border as a deterrent. “On the Iranian border they were shot at. One boy told me that a pair of eight year olds were shot dead beside him with their blood spraying up on his t-shirt. “These boys — they don’t even shave yet and they’ve been through all this horror.” Deb’s volunteers now support an independent medical clinic in Belgrade providing health care to refugees living rough in the nearby forests and on the streets, but Deb wants to do more for the vulnerable youngsters. She said the children won’t stay voluntarily in the organised camps where they might have access to food and medical care, because they are waiting for people smugglers to spirit them away to England. “They’ve made their way here from Afghanistan, but they are now at great risk of falling prey to organ donor smugglers, drug dealers and the sex trade because they’ve run out of money.” “(But) I think there is an opportunity to have a sort of ‘Grandmother’s House’ — a half-way point that might be less confronting where they can be helped by volunteer professionals, given support to register with authorities and be put into foster care until their asylum status is sorted out.” “We have to go back and look at that.” Deb admits it can be pretty tough moving on after a placement is over, but she says she takes heart from the knowledge that she is doing some good every day she’s on the ground. “In some ways it is heart-breaking work, but it’s just so valuable, your skills are so useful and the people are so needy and so unwell in many cases,” she said. “And when I come home, I do a lot of work online trying to get sick people out from some of these risky countries,

Deb working with refugee children at a camp in Greece.

to get them proper medical treatment though our contact network of doctors and lawyers.” “I’m not a big political person, I don’t go to protests and stuff, but I do try to help individuals behind the scenes.” “As far as I’m concerned, human beings are human beings and if you can see illness and recognise trauma, it doesn’t really matter what country you are in, it doesn’t really matter who they are, or if they don’t speak English — you can still care.”

Want to volunteer? Jump on Facebook or Google Deb Rays on Facebook: www.facebook.com/ deborah.kandic

Or go directly to: Syrian American Medical Society (SAMS): www.sams-usa.net Adventist Help Group (Greece): www.adventisthelp. org/about-us CERST (Greek-based NGO): www.facebook.com/ chiosesrt/ InfoPark (Serbian NGO in Belgrade): www.facebook. com/infoparkserbia/ Jesuit Refugee Centre, Violeta Markovic (safe house for minors in Belgrade): www.facebook.com/JRSsee/

indepth CAMPAIGN

Keeping the care in public hands HE NEW state-of-the-art $1.8 billion Sunshine Coast University Hospital (SCUH) is finally a reality and was officially opened by Premier Annastacia Palaszczuk and Health Minister Cameron Dick on 19 April.

SCUH is the first new tertiary hospital to be built in Australia in 20 years and will significantly boost health services in the Sunshine Coast region. But before it even opened its doors, the hospital came dangerously close to landing in the hands of a private service provider when the Newman government announced four years ago it would be putting everything up for sale, including health service delivery.

Members rally around the hospital Sunshine Coast members were incensed and concerned about then Premier Newman’s plans, and with the help of the QNMU, immediately launched a campaign to keep SCUH in public hands. QNMU members, Registered Nurses and Sunshine Coast locals Julie Burgess and Christine Cocks led the campaign with gusto, undertaking letterbox drops, petition signings, and community and public rallies. “I felt I could not sit by and let the future health needs of the Sunshine Coast be stripped before it even had a chance,” Julie said. “The motivation of the private sector is driven by profit for shareholders and not the needs of the community. Loss of the hospital to private hands would have been devastating for our region.”

Christine said the focus of the campaign was to educate the community that privatisation of SCUH was a slippery slope towards the Americanisation of our health system, turning what was initially planned as a public, access-forall facility into a made-for-profit business. “Many community members we spoke to had no idea the impact this could have on our health services,” Christine explained. “They thought it wouldn’t concern them if they had private health insurance. We had to point out there was a possibility that seeing the doctor, radiology and pathology services could incur a co-payment under a private health service.” Julie, Christine and other QNMU members were joined by a dedicated group of concerned community members. Together they set up

CAMPAIGN indepth

How it all came to be... 2006 State government announces plans to build $1.8 billion hospital on the Sunshine Coast.

January/ February 2013 State government announces it is considering the sale of SCUH to a private health service provider.

March 2013 QNMU and members discuss strategies to keep SCUH in public hands. Community action group to oppose the sale is formed. Members continue their efforts.

March - November 2013 Campaign begins. A petition to keep SCUH in public hands is launched. Flyers handed out to the community and offices of key politicians. Community and public rallies take place on the Sunshine Coast.

Nambour Community meeting

November 2013 We present our petition, signed by over 10,000 members of the public, to Parliament.

Sunshine Coast rally, August 2013

December 2013 Success!! State government decides against privatising SCUH.

March 2017 The new Sunshine Coast University Hospital officially opens to the public!

Site tour, 2015

indepth CAMPAIGN market stalls, attended sporting and community events and spoke to thousands of Sunshine Coast residents to encourage the signing of a petition.

Victory for QNMU members After eight long months of targeted campaigning we presented our petition — signed by more than 10,000 members of the community — to Parliament. Not long after, the state government relented to public pressure and overwhelming evidence, and decided against privatising SCUH and its core clinical services. The news was met with relief and joy among those who had worked so hard during the campaign. “It was a fantastic win and I could hardly believe it, but we were so determined not to let this happen so we had done absolutely everything we could,” Christine said. Julie said winning the campaign highlighted the strength of unionism and what we can achieve when we work together. “This is a perfect example of where collectivism really holds itself strong,” she said. “Being part of a union means becoming a protector of Australia’s future. The 38-hour work week, holiday and sick leave, workplace

health and safety, equal rights for women (to name a few) are all campaigns won by unions in the past. “This is why it is so important for any employee to join their union today.”

SCUH already making strides Despite only being open for a few months, Sunshine Coast residents and health workers are already reaping the rewards of the public hospital.

In recognition of her hard work and efforts in campaigning to keep SCUH in public hands, Julie Burgess was awarded the Emma Miller Award in 2015. The award recognises the contribution of union women and pays homage to Emma Miller, a seamstress by trade who helped form the first women’s union in Brisbane in 1890. Christine Cocks was also awarded an Emma Miller Award in 2014.

“The public hospital is a boost for jobs growth and a boost for the university’s development of undergraduate and postgraduate education,” Julie said.

Julie Burgess

“The expansion of services increases the delivery of nursing on the Sunshine Coast as well as access to services for patients.” The new facility adds to the public health services already provided by Sunshine Coast Hospital and Health Service hospitals in Nambour, Gympie, Caloundra and Maleny. It is anticipated about 10,000 Sunshine Coast residents who previously visited Brisbane for treatment will now be able to receive their treatment on the Sunshine Coast with friends and family nearby.

It was a fantastic win and I could hardly believe it, but we were so determined not to let this happen so we had done absolutely everything we could. Christine Cocks

Winning efforts

Christine Cocks (right) with QNMU Secretary Beth Mohle

FEATURE indepth

Good to know:

FEDERAL 2017 HE FEDERAL budget has come and gone for another year and as usual it’s been picked over by commentators and columnists on both sides of the political spectrum.

It has been dubbed a Labor budget or Labor-lite by some analysts largely because of its big ticket education, health and banking measures which borrow heavily from Labor and the Greens, and are a clear shift away from the heavy handed budget cuts of 2016. It’s a deliberate political strategy of course, designed to solidify support for both PM Turnbull and his government, and to wrong-foot the opposition into voting against measures it ideologically supports. But political machinations aside, Federal budget outcomes do have an impact on the daily lives of Australians, and to this end there are a couple of key issues we believe are worth looking at which may intersect with our professions and our lives.

Cuts to paid parental leave quietly scrapped AFTER a tumultuous seven years of paid parental leave uncertainty, parents across Australia heaved a collective sigh of relief when proposed changes to the current scheme were scrapped as part of the 2017 federal budget. Or they would have if they’d known about it. Buried in the back pages of the budget (and unannounced) was the opposition’s formal abandonment of its most recent paid parental leave policy, which would have prevented ‘double dipping’ from those receiving both government and employerprovided leave.

QNMU member and Registered Nurse Caress Creed was one of them. Caress welcomed newborn son Heath to the world in early March, and was stunned to discover the proposed scaling back of paid parental leave a month before she was due to start maternity leave. “I heard the news on the tv and my first reaction was one of worry,” she said.

While the proposed changes did include an extension of the scheme from 18 to 20 weeks, about 68,000 parents would have had their payments reduced under the new plan, while another 4000 would have had their payments cut altogether. Until recently, the threat of these cuts remained a source of worry to expectant mums and families across the nation.

Caress Creed with her partner Kurt and son Heath

indepth FEATURE “I had planned on taking 12 months off after having my baby and I was counting on that money to see us through that time. “Having to drop down to only my husband’s income would already be stressful but I was also really concerned about having to go back to work four months early and having to send my son to day care at only seven months old. “This came at a time when I really just wanted to be spending time with our new baby and as a family.” A study of more than 5000 Australian women found maternity leave boosts the mental and physical health of new mothers. Furthermore, reduced stress from having a secure income and

less pressure to return to work may also be behind improved mental health. With plans to grow her family with a second child, Caress said it was a relief to know the existing paid parental leave scheme would not change. “I think it’s only fair and working families deserve a bit of extra time off to spend with our children,” she said. “We’ve worked hard all our lives and I think of this as a small reward for us.” The QNMU worked closely with other unions to prevent cuts to the existing paid parental leave scheme, and made a formal submission in opposition to these cuts.

I think it’s only fair and working families deserve a bit of extra time off to spend with our children Caress Creed

An unprecedented blow for nursing students THE SUBSTANTIAL funding cuts to universities announced under the federal budget means university students will be slugged with higher fees which they will have to pay back sooner at a time when they can least afford it. A 7.5% tuition fee hike (phased in over four years beginning in 2018) will see students forking out thousands of dollars more to fulfil their dream of becoming a nurse or midwife. Uni grads will also have to start repaying their loans once they earn above $42,000, instead of the current $52,000. As a nursing student at Griffith University, QNMU member Brittany Gon-Chee is due to graduate from her Bachelor of Nursing at the end of next year. And with a one year-old daughter, this is a blow to her finances she cannot afford. “This will definitely have a big impact on me. Next semester I’ll be doing three subjects on top of work placement,” she said. “If I got a job as well to start planning ahead

and paying off my uni fees I wouldn’t be able to look after my daughter. That means I’ll have to fork out for childcare fees and it’s just too much.” The lowering of the HECS repayment threshold would also impact on Brittany’s plans to undertake further study to become a midwife. “I plan on getting a job as a nurse while I study to become a midwife but I may have to rethink this,” she said. “We’re trying to save up to purchase a house so having to pay back my uni debt when I’m earning less will definitely affect my plans.” Universities Australia chief executive Belinda Robinson told the media universities and students have already done more than their fair share of budget repair. “In this context, it is difficult to justify further cuts that would affect student affordability and put at risk the quality of education and research on which Australia’s prosperity depends,” she said. Universities Australia recently released a report which found universities and their students had already contributed almost $4 billion to budget repair since 2011.

FEATURE indepth

Defrosting the Medicare rebate freeze THE TURNBULL government has finally agreed to lift the Medicare rebate freeze but will take three years to do so.

Aged Care noticeably absent ONCE AGAIN one of the big losers in this year’s budget is aged care. There is virtually nothing in the federal budget for the aged care sector, one area of healthcare that desperately needs the support of our government. As ANMF Federal Secretary Lee Thomas noted Australia faces a shortage of 20,000 aged care nurses, but the government failed to address this.

Under the budget provisions, the rebate freeze for GPs will be lifted first, then the rebates for specialists and medical procedures would be lifted over the next three years. QNMU Secretary Beth Mohle said the staggered ‘defrost’ process means patients who visit the their local GP or need a specialist consultation will continue to be slugged with increasing out of pocket costs for their healthcare for the next two years. “We know the Medicare freeze is particularly tough on low-income earners who are already struggling to make ends meet — some of them forgo seeking medical assistance altogether because they have to pay more at the end of a consult,” she said. “If the Coalition government was genuine about easing the cost of healthcare, it would have put an end

to the freeze on GP rebates once and for all.” Rebates were frozen in 2014. At the time the coalition government proposed a number of measures to reform Medicare including a $7 co-payment for GP, pathology and imaging services to offset a proposed $5 reduction in Medicare rebates for common GP consultations. It was a thinly veiled attempt by the government to cut back on the money it spends on Medicare and extricate itself from the responsibility of public health. The proposals were roundly condemned and eventually dropped — all except the rebate freeze which was extended and formally came into effect in July 2014. Our concern now is that by lifting the freeze the government will look at other cuts within health to make up for the $3 billion it expects to lose from unfreezing Medicare rebates.

“There’s been no reversal of the crippling $1.2 billion in funding cuts, no regulations for mandated, safe staffing ratios for nurses and carers. “Nurses and AINs are finding it harder and harder to cope with dangerously high workloads and there’s been a notable rise in the number of missed care episodes at aged care facilities across the country.”

A reminder about rebates

Without adequate targeted funding the care they can provide to their residents continues to be compromised.

■ The Medicare Benefits Schedule (MBS) lists the services the Federal government will provide a rebate for.

The Budget does provide $1.9 million over two years to establish and support an industry-led aged care workforce taskforce, but this is not new money — it’s simply being drawn from resources already within the Department of Health.

■ Medicare rebates do not cover the full cost of medical services and are usually paid as a percentage of the Medicare schedule fee. ■ GPs who bulk bill agree to charge the Medicare schedule fee and are directly reimbursed by

government. Those who don’t bulk bill are free to set their own prices for services. Patients pay for their treatment and receive a rebate from Medicare. ■ There is often a gap between what patients pay for services and the amount that Medicare reimburses ($37 for a GP consultation, for example) this is called the out-ofpocket expense which patients pay for themselves.

Source: www.abc.net.au

indepth OPINION

If we want to make a difference, we need to rewrite the rules BY SALLY MCMANUS, SECRETARY, AUSTRALIAN COUNCIL OF TRADE UNIONS

UST A generation ago a young person could finish school and have a good chance of getting a good, steady job in nursing or midwifery when they wanted one. This job would be enough to support them to buy a house, start a family and have enough time off to enjoy a decent standard of living. Today, nurses and midwives are less secure in their work, living costs are rising and the protections and rights afforded to them are just not strong enough – particularly for the growing number now employed in casual or short-term jobs, often working long or unpredictable hours without a paid holiday or sick leave. But while working nurses and midwives are grappling with these challenges, big corporations use their power to rewrite the rules in their favor. The top one per cent own more wealth than the bottom 70 per cent of Australians combined, underpaying workers is a new business model for too many employers — from fast food multinational chains to celebrity chefs — and 679 of our biggest corporations pay not one cent of tax making it even harder to invest in the health and education systems we need. Our strike laws are out of step with international law, our bargaining laws are inadequate and unable to deal with the new and ever changing business models being adopted by the big end of town; and on top of all that, the Fair Work Commission (FWC) makes decisions to cut the wages and conditions of workers, including

penalty rates for retail, hospitality, fast food and pharmacy workers. The ACTU received legal advice in the wake of the FWC decision that showed all industries who received penalty rates were at risk from the precedent set by the penalty rate cuts, not just the aforementioned sectors. We even saw a private healthcare provider try to cut its Registered Nurses’ Sunday penalty rates in line with the cuts within weeks of them being handed down for award workers — The QNMU was able to thankfully stop this. Our Federal Government has refused to act and now supports and upholds the penalty rates decision. The impact is severe. We will see $70 a week taken out of the pay packets of our lowest paid Australians. When you are earning $783.30 a week and the average rent in Australia is $485 a week, that is one quarter of your remaining income. In contrast, the Budget measures implemented by this government will see our Prime Minister receive a $140 a week tax cut. We are literally taking money out the hands of the people who need it most and giving it to the people who need it least. And the recent Federal Budget made things worse for nurses and the broader health sector by recommitting Australia to crippling $1.2 billion cuts to aged care which is making it harder and harder for nurses and AINs to cope with dangerously high workloads. Students have also been impacted by an

increase in the cost of university degrees and being forced to repay their HECS debt much sooner with the cut the income threshold reduced in the Budget to just $42,000. The result of all this is that inequality in our country is the worst it has been for 76 years. If things keep going the way they are, the gap between the very rich and everyone else will continue to grow making it harder for Australian workers to build a better future for themselves and the next generation. High inequality has a negative effect on the whole economy. In the past few years even the conservative international policy institutions such as the IMF and the OECD have recognised that higher levels of income inequality can hamper economic growth and employment. It is estimated that rising inequality, could cost up to $500 per person by 2019-2020. A report from the Chifley Foundation suggested that if no action is taken to reduce inequality, it would eventually cost Australia three per cent of GDP over the next 25 years. But we can change things and there is strength in numbers. Australian unions are leading a movement to rewrite the rules, bring back fairness and unite working people to demand things change. We have won before: we won changes that improved our living standards like minimum wages, paid leave, the weekend, Medicare and defending people against unfair dismissal.

OPINION indepth

... we can change things and there is strength in numbers. Australian unions are leading a movement to rewrite the rules, bring back fairness and unite working people to demand things change.

Now we need to do it again to keep corporate power in check and to protect our jobs and living standards. No matter where you work or what you do, your work is important. You deserve fair day’s pay for a fair day’s work, security in your job and you deserve to be treated with dignity and respect. We must start by rewriting the rules at work to catch up with the way companies are operating and the power they have so there are strong enough rights and protections for working people. We also need to increase the number of good steady jobs, and recognise this is the foundation of a secure and cohesive society. And we must make big corporations abide by the rules and pay a fair tax contribution to fund the services like hospitals and schools we all rely on. If we do nothing, the shift in power from working Australian to big corporations and the very rich will continue and get worse — further undermining our living standards and our way of life. But it is not inevitable. Working together we can win back secure jobs, stronger workplace rights and better living standards for all Australians. I can’t do it without all of the amazing nurses out there who are the strength of our movement – if you’re a union member, please continue to get involved, and for our friends that are not currently members, please join — we need you now more than ever.

indepth CAMPAIGN

Aged care: more than just a job Let’s face it – working in aged care can be a tough gig. The hours are long, there are never enough staff around, the pay is below average and by the end of a shift your feet are aching so badly you wonder if they might be permanently disfigured. But for many nurses who work in aged care, providing quality care for our community’s most vulnerable is the epitome of putting nursing values into practice. Having live-in residents you care for every day for months and even years offers a different set of challenges and experiences to hospital or clinic based nursing. But the difficulty of the work and the low pay means the number of nurses

opting to take up aged care nursing is falling, and that’s something we can ill afford. The fact of the matter is Queensland is now faced with an ageing population. According to projections by the Australian Bureau of Statistics, our state faces the prospect of one in five people being aged 65 years or over by 2031 — that’s just over a decade away. In addition to this life expectancy is on the rise and people are living longer, which also means they are entering aged care at a later stage in life when they require more care.

Then there is the largely sectorspecific challenge of dementia. With half of all aged care residents estimated to suffer from the disease, there is an increasing number of residents requiring high-care. So if we are to recruit more nurses to safety and appropriately care for this growing population, as well as looking at systemic changes to funding and models of care, it is also worth asking those who work in the industry why they do it.

Empathy at the forefront of care According to QNMU members and aged care workers — Registered Nurse

CAMPAIGN indepth JC Busque, AIN Rhonda Orreal and Enrolled Nurse Jo Keillor — it’s the people they care for that make it all worthwhile, unanimously and without a doubt. “I know it sounds like a cliché but the main positive about working in aged care is the relationship I share with my residents,” JC said. “I work in a dementia unit and we’re dealing with the most basic needs of a person — I am their support person and they rely on me so it’s impossible not to form a bond.” Having worked in aged care for more than 24 years, Jo said her residents have become a close-knit second family.

Putting it into perspective THE DEMAND Australia currently has about 2,800 residential aged care facilities providing care to more than 160,000 elderly people.

years

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160,000

250,000

“You absolutely get attached,” Jo said. “We’re with them day after day and we look after them from the very second they come into the facility until the day they pass on. “They look to us for help and when they’re lonely I hold their hand and sit with them. It’s beautiful to see the smiles on their faces when I come in the next day and they’re delighted I’m back at work.” It’s the same for Rhonda, whose residents have all become surrogate grandparents. “My own grandparents both died when I was fairly young and I lost both my parents when I was 18,” she explained. “Working in aged care makes me feel as though I’m surrounded by many grandmothers and grandfathers.”

The big picture According to JC — who has also worked as a Registered Nurse in a hospital setting — looking after the elderly presents its own unique set of care requirements.

It is estimated around half of aged care residents suffer from dementia and the number of people who develop the condition will increase from 220,000 currently to 730,000 in 2050.

730,000 IN 2050

220,000 IN 2016

■■■ VERSUS ■■■ THE SUPPLY In comparison, the number of Registered Nurses in aged care in Australia fell from 21 per cent to 17 per cent between 2003 and 2007.

“You have to have a broader perspective of your resident’s care and look beyond their symptoms,” JC said. “You have to consider what their life was like before they came into aged care — their routines, their likes and dislikes, their habits and hobbies — it’s having the whole perspective

Over the next decade, the number of residents is projected to reach more than 250,000 and the highest area of growth will be among residents aged 95 or over.

21% 17%

The average age of aged care nurses is now around 50 years, and they are increasingly required to supervise more residents and staff members across multiple sites.

YEARS OLD Source: HealthTimes, 2015

indepth CAMPAIGN of a human being and that’s the care that needs to be considered here.” For Rhonda, it’s the little things that lend satisfaction and joy to the job. “I really believe you get back what you give and it’s a lovely feeling when they thank you for what you’re doing for them,” she said. “When they see me, they have a big smile on their faces and want to talk about what I’ve done today and where I’ve been. I am often pressed for time but it’s important to me to make the time to sit with them — just five minutes out of my day to chat to them makes them feel so happy.”

Something’s gotta give Nonetheless, it can’t be denied (on many a day) working in aged care requires commitment and an iron will.

In Queensland, we’re one of the few jurisdictions in the world to have legislated ratios in prescribed public health facilities, but we’re still campaigning hard for ratios in the aged care sector — specifically, a requirement for an RN on-site 24/7 and set nursing hours. Adequate staffing and skill mix in aged care facilities will ensure our elderly receive quality care and our aged care workers have manageable workloads.

All for the residents The relationship an aged care worker shares with his or her residents is undeniably the driving force that keeps staff going. The recent death of one of JC’s residents was a huge blow and one he’s still trying to come to terms with.

“I had a resident who passed away very recently at the age of 90. I looked after her for two years and she was just such a character,” he said. “When her family came to the facility I tried to keep my distance but upon seeing them we just cried and hugged. It was very difficult for me.” While the going can get tough some days, Jo said there’s no doubt she loves what she does. “I love my job. It helps that I’m very lucky to have good management,” she said. “But you absolutely do it for the residents. Maybe I’m too empathetic but myself and my staff will go out of our way to do little things for our residents so they know we care about them.”

Our aged care workers are run off their feet because there aren’t enough nurses to provide quality care to residents. “It’s really ironic that we keep upgrading the care for residents to achieve more funding, but that funding does not equate to more nursing hours,” JC said. “We have four staff for 30 residents. If just one of those residents needs more care but the number of staff doesn’t increase we’re left with a gap.” Amid increasing workloads, Jo said it was critical aged care workers support each other and work as a team to deliver the care their residents deserve. “We’re always encouraging each other and that’s how we maintain a good, happy environment because everyone pitches in and helps out,” Jo said. “We also try to make it fun — we laugh and have a joke. Sometimes in aged care it can be terribly sad to see residents who are sick and bedridden and it helps to have humour to make the job a bit lighter.” While the federal government’s recent announcement of a review into the aged care accreditation process is a step in the right direction, more needs to be done and soon.

I really believe you get back what you give and it’s a lovely feeling when they thank you for what you’re doing for them. Rhonda Orreal, AIN

CAMPAIGN indepth

JC, Rhonda and Jo talk aged care…

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JC BUSQUE

RHONDA ORREAL

JO KEILLOR

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On residents’ personalities

JC: There are always going to be those few residents you often think of because their personality is so distinguishable from the rest.

Rhonda: There are always the special ones that stand out.

Jo: I have a bit of a soft spot for the ones who have a bit of a spark in them.

On the biggest challenges facing aged care

JC: We need to have ratios. That should solve many issues but employers value profit over care and that is the problem.

Rhonda: We need ratios, of course. Residents are coming in with higher needs and you just don’t have the time to get to everyone without the extra staff that’s required.

Jo: I think you’ll never find a facility that’s got enough staff in aged care. It’s all about funding and it doesn’t matter who you work for — I’ve not known anybody that’s been happy with the level of staffing in their facility.

On getting older and going into aged care

JC: I don’t think we have many options aside from going into aged care. But I do think aged care in the near future will improve.

Rhonda: I think I’m going to be working until I’m 80! I keep pushing thoughts of retirement further down the track but I don’t have any concerns about going into a nursing home.

Jo: Oh my gosh I pity anyone that has to look after me, haha! I’m thinking about doing up my own care plan but if you don’t have a choice then aged care it is.

Aged Care Quality Review announced ON 1 MAY, Federal Minister for Aged Care, Ken Wyatt, announced an independent review of the Commonwealth’s aged care quality regulatory processes. The announcement came after the failures of care at Oakden (a South Australian aged care mental health service) became evident shortly after the facility had received full accreditation from the Australian Aged Care Quality Agency. The Terms of Reference for the review have been developed and include: ■ Why quality processes did not identify the failures at Oakden.

■ What improvements to regulatory process would increase the likelihood of immediate detection and swift remediation, particularly: ◆ the legislative framework ◆ the policies of the government, the complaints commissioner and the quality agency ◆ reporting requirements for staff and care professionals ◆ the engagement between aged care regulatory agencies and other healthcare regulatory bodies ◆ any other measures that may strengthen the protection of residents.

Minister Wyatt has appointed Ms Kate Carnell AO to lead the Review in conjunction with Professor Ron Paterson ONZM. Ms Carnell is currently the Australian Small Business and Family Enterprise Ombudsman and a former ACT Chief Minister. Professor Paterson, a distinguished lawyer, is an international expert on patients’ rights, complaints, health care quality and the regulation of healthcare professions. The review panel is required to report back to the Minister by 31 August. The QNMU, through the ANMF, will seek input into the review.

indepth PROFILE

Towards activism … VALUING THE COLLECTIVE BY JANET BAILLIE

S NURSES and midwives, we’re in a unique position to make a difference.

Whether it be at the workplace or society level, we can choose what kind of activist we want to be. Registered Nurse and QNMU member Janet Baillie is one activist who is making a difference in her local community. After attending a Queensland Community Alliance training event last year, Janet is now advocating for a fairer Queensland through her involvement in the Alliance. Janet has also recently broadened her involvement in the union, having been elected to the QNMU Council. And last year Janet — represented by the QNMU — won a lengthy adverse action court case against the Red Cross Blood Service, a win that has strengthened her resolve to advocate for positive change in nursing and the broader society. Janet shares her personal reflections on her nursing and community work, highlighting the values that underpin her activism.

The road to nursing A restless traveller out of work, out of money and wanting to stay abroad, I studied small print in newspapers and magazines, searching for another job in London during the winter of 1984. Five years after school my resume included random retail, admin, hospitality positions and intermittent study towards an almost finished Arts degree with some experience in backpacking. On the way to a new employer, I remember being somewhat resigned to drudgery during a grey train trip. However, a frail Englishwoman ultimately determined the focus of my working life. Disabled by the effects of a stroke, she took a risk and welcomed me into her home as a personal care attendant. An unfamiliar role for me, I was surprised to find this humble work immensely satisfying.

PROFILE indepth A cartoonist could record my epiphany: a peaceful image of us, jeans and tweeds following her walking frame along a gloomy hall on her way to bed. Above my head a thought bubble with a halogen torch, “That’s what I’ll do when I get home. I’ll study nursing.”

Joining our union I joined the QNMU when an Organiser spoke to our class of 60 beginners at the Princess Alexandra Hospital. Our union has a long history of valuing professional development, nurse education and social justice. I love a good quote and these words embody my enduring respect for the QNMU.

…unions are not narrow, self-seeking groups… Through collective bargaining and grievance procedures, they have brought justice and democracy … John F. Kennedy 30 August 1960

Apart from one year home full time with tiny children, I’ve maintained union membership and continuing nursing employment for over 30 years. I’m delighted now to have been elected to the QNMU Council. During my term as a councillor, I hope to listen well and learn a lot about advocating for nurses and midwives as we manage ever present and varied changes influencing our care.

The Queensland Community Alliance is a coalition of community, faith and union groups aiming to provide local communities with a voice to express common values and aspiration for a fair and just Queensland.

Another meaningful benefit of leaving the Blood Service is that I’m now a community nurse with Micah Projects, an exemplary organisation devoted to social justice.

Last year I attended a QCA course titled Foundations of Community Organising which outlined a method for nurses and midwives advocating for changes across our communities and health services.

In the Mater Hospital Homeless to Home program alongside Micah’s dedicated teams, nurses provide health care on city streets, in public places, in parks for those sleeping rough, and for other vulnerable people.

I found the course motivating. Enthusiastically presented over two days, we learnt processes for community action on social justice issues.

My Blood Service battle experience confirms the belief that it’s crucial to fight for what’s right.

Current examples include QCA lobbying for more affordable hospital visitor parking and work around improving civic safety and public transport. Something I’ve learned from my short time with the QCA is that calls to action for issues of concern are successful when priorities are decided by people who share their stories.

Catalysts for change Having moved a lot with an adventurous family and repeatedly starting afresh in new towns and countries, I was thankful to finally settle in Brisbane, where I embraced the nursing roles at the Australian Red Cross Blood Service. Here I valued camaraderie with my colleagues and the generosity of donors. Hence my unhappiness when, with more than twelve years of service, I left the organisation. This was due to ongoing adverse action taken against me throughout 2013/14 during my time as QNU Blood Service Branch Secretary. My union commendably took the Red Cross to court for the illegal conduct of their managers.

Getting involved with the QCA

In October 2016 the long awaited, air punching verdict was handed down, a validating outcome for me and other Blood Service nurses.

I work part time and like others blessed with spare hours and good health, I have the gently nagging need for meaningful interests.

The unwavering support of our union in standing up for me directly influenced my becoming more active within the QNMU.

Community work continues

Indeed, since the court case I’ve campaigned for refugees and people seeking asylum, joining those who actively oppose punitive migration laws. I’m part of a group regularly visiting longsuffering people, including families for whom starting afresh presents seemingly insurmountable challenges due to being illegally, indefinitely detained. Early last year I saw on the QNMU’s Facebook page a call to attend rallies to support what became the 10 day vigil for Baby Asha. I met generous people from a cohesive social justice network including our union and the QCA. An idea arose for nurses and midwives to also form a group joining those advocating for a compassionate response. The QNMU welcomed this suggestion and under our wide social justice umbrella a special interest group was established: Nurses and Midwifes for Refugees and Asylum Seekers (NAMRAS).

Making a difference The QNMU and QCA partnership welcomes all who are keen to work towards the common good. As is the focus for Morningsong – the community choir to which I have the joy of belonging – the purpose of activism is to create harmony. My story is one of so many told by nurses and midwives committed to our professions. In taking action together towards justice and social harmony, we certainly create a good collective story.

indepth FEATURE

Photo: Sarah Pye, Sustainable Promotions

HIPS and GEDI Nurses leading improvements in geriatric care NURSES ON the Sunshine Coast are helping deliver better health care for the elderly through an innovative new program that creates direct links between patients and families, aged care facilities and Emergency Departments. The Australia-first program, known as CEDRiC (care coordination between emergency departments, residential aged care, and primary health care collaboration), is designed to reduce the time elderly patients wait in EDs, reduce the unnecessary transfers of aged care residents to EDs, and improve interactions between nursing homes and health care sectors. It’s a program that relies heavily on the skill and professionalism of nurses — not only drawing on their nursing knowledge, but also their skills as communicators and leaders. CEDRiC has been operating successfully at Nambour General Hospital and Sundale Aged Care for the past three years and now also operates at the newly-opened Sunshine Coast University Hospital where it is already showing great results.

How does CEDRiC work? There are two main elements to the CEDRiC program: ■ Health Intervention Projects for Seniors (HIPS) – an intervention model whereby a Nurse Practitioner helps the residential aged care facility (RACF) provide an advanced level of care in order to avoid hospitalisation when possible. This includes developing advanced

care plans for residents, better coordination of GP care in the RACF, and training for RACF staff. ■ Geriatric Emergency Department Intervention (GEDI) — an ED intervention model to maximise the quality of care for older people who present to ED. The GEDI nurses provide frontload assessment, communication, care coordination, and appropriate discharge planning, with the aim of streamlining and fast tracking patients through the ED. Registered Nurse, CEDRiC Project Manager and QNMU member Dr Alison Craswell said the HIPS element of the program essentially increased the level of primary care provided in the aged care facility. “The Nurse Practitioner, and in our trial this was Ms Kaye Coates, provides a much more advanced assessment than the RN can,” Dr Craswell said. “The Nurse Practitioner liaises with the General Practitioner and together they make a care plan, which is then led by the RN and carried out by the care team at the RACF. “If a transfer is required then the Nurse Practitioner speaks to the GEDI nurse at the ED to let them know a patient is coming.” This transfer process is made easier by the Nurse Practitioner sharing the patient’s information and medical history with the GEDI nurses. “It saves the hospital from having to do all the investigative work themselves,” Dr Craswell said. QNMU member Andrea Taylor, who leads the GEDI Clinical Nurse team at

Nambour ED, said the GEDI program is all about being “patient focused and goal driven”. “We communicate with the physicians to establish a mutual goal for everyone: Why are you here? What do you want? Where do you want to be, and how can we best get you out of ED?” Ms Taylor said. “ED physicians are very medically driven and looking for a diagnosis... so rather than looking from a medical diagnosis perspective, the GEDI nurse identifies what the patient and family needs and wants and responds appropriately. “It’s all decision support for the ED physician to assist in getting the patient out quickly. The benefit is all for the patient, feeling their needs have been listened to and are being addressed.” Dr Craswell said both the HIPS and GEDI programs were seeing reduced costs to the health service thanks to a decrease in lengths of stay in both the ED and hospital (if admitted). With other health services already expressing interest in the program, it is certainly an initiative the QNMU supports being rolled out across Queensland. Official results and data are due to be published later in the year by the research team headed by Professor Marianne Wallis of the University of the Sunshine Coast. To read more about the program, visit www.cedric.org.au

PROFILE indepth

The midwifery bond IMPROVING HEALTH OUTCOMES FOR INDIGENOUS MUMS AND BUBS THEY’RE my girls.

e r ’ y e Th . s l r i g my

That’s how QNMU member Andrea Mitchell speaks of the Aboriginal women of the remote Indigenous Doomadgee and Mornington Island communities. As an Outreach Caseload Clinical Midwife for Queensland Health in Mount Isa, Andrea provides an integral service to Aboriginal mothers and expectant mums-to-be in Indigenous communities, travelling great distances to provide antenatal, intrapartum and postnatal care. Her work has significantly helped to improve health outcomes for women in these communities, and Andrea

says it’s the strength of the bond she has with these women that has made all the difference. “I believe one of the biggest road blocks we face is the culture of shyness among the Indigenous community in seeking health treatments like pap smears,” Andrea said. “To be fair, I wouldn’t get a pap smear done by someone who knew me either! But having formed such a strong bond with these women has helped in overcoming much of that shyness. “Because I’m known in the communities they tend to feel a little

indepth PROFILE bit more comfortable around me but the approach I take is really important. “Cultural sensitivity is key and I also communicate with them through touch. I’ll often link arms with them and we’ll have a bit of a giggle, or I’ll put my hand on their arm while I’m speaking to them and it just makes them feel that little bit more comfortable with me.” As a Mount Isa local, Andrea has the added advantage of having gone to school with some of her patients’ mothers. “I’m helping birth my old schoolmates’ grandchildren and it’s really something quite special,” she said. “When I first became a nurse I remember sitting in the special care nursery and longing for the day I could walk my girls through those double doors to be part of birthing their babies. “I had two children of my own who are now grown and I always wished I

had more. I guess being a midwife is kind of like a surrogacy and makes up for that!”

Stepping out of the comfort zone For many Aboriginal women who are pregnant, going into the clinic or hospital for check-ups or to birth their babies marks the very first time they have ever left their communities. Some of the women travel up to 1000km to have their babies. “They generally have to come into the hospital at 36 weeks for the birth so they’re away from home for a long time. It can be extremely nervewracking for them to step out of their comfort zone in such a big way,” Andrea said. “We do as much as we can to support them. If they are under 17 years of age, they are required to have an escort with them when

taking a plane to the hospital, and this can be a family member. We supply them with accommodation and a transport service that takes them to their appointments and back. “Continuity of care is really important here in building trust — I do all the antenatal care and aim to sit in on all their appointments and scans, and continue to see them in their community when they come in for a sit down sometime around 36 or 37 weeks gestation. “I am generally there for the birth and I provide care for up to 6 weeks postnatally.” This also means that Andrea is on call a lot. “I have amazing support from my wonderful colleagues in the maternity ward who look after my girls when I am away on outreach,” she said. “Sometimes when I’m pretty tired I think about taking myself off call but I can’t bring myself to do it — my girls rely on me and I want to be there for them. “I recently had to miss a birth because I was away in Mornington and I felt so disheartened because I’d been seeing her since she was eight weeks pregnant.”

Tackling challenges head-on Many of Andrea’s patients have high risk pregnancies, and it can be worrying when the women don’t attend their appointments. “I’ve had some of my girls say they don’t come in for antenatal appointments because they’re not sick and don’t need to see anyone. I have to explain to them that their baby still needs to be listened to every couple of weeks,” Andrea said.

I’ve bought a camera and some props, and I’ve started taking photos of the babies at two or three days old dressed up in little lady bug or princess outfits. 38

But she’s come up with a novel way to encourage the women to attend their appointments. “I’ve bought a camera and some props, and I’ve started taking photos of the babies at two or three days old dressed up in little lady bug or princess outfits,” Andrea shared. “The pictures are precious and the women pick their favourite photo of their child and I blow it up for them.

PROFILE indepth and I can also take more supplies out with me if need be.” At the end of the day it’s about better health outcomes for Aboriginal women and empowering them to seek care. Andrea believes education for both the women and midwives plays a key factor in improving healthcare for Indigenous communities. “It’s about cultural awareness and understanding their needs. If they don’t want to engage with you, don’t force them into doing something they aren’t comfortable with,” she said.

Babies born to Aboriginal mothers were twice as likely to be born prematurely as those to nonAboriginal mothers.

“I’ve acquired many communication techniques throughout my career that has helped me become better at communicating with my girls.”

13% of babies born to Indigenous women were of low birth weight. Only 6% of non-Aboriginal babies were of low birth weight.

Andrea has completed training in screening and diagnostics, and rural and remote isolated practices.

But Andrea also faces the challenge of accessing technology in the remote areas of Mornington and Doomadgee. “It can be frustrating and scary because we use a system that houses all our notes online — if I haven’t had a chance to print them out beforehand and the internet is offline I just have to go by my memory,” she said. “If I’m ever unsure of anything or one of my girls requires immediate help and it’s out of my scope I do a video link with the doctors in Mount Isa. If that doesn’t connect we just use the good ol’ mobile phone call.”

Kicking goals For Andrea, it’s all about setting small goals and working toward them. “One of my key goals is to get my babies weighing over 2.5kg and since I’ve been doing this I have only had three under this weight and that’s because two of them were born early. “I’m also in the process of trying to get a new ultrasound machine to stay in Doomadgee so I don’t have to carry that with me all the time as I’m only allowed 10kg on the plane. “It’ll make a big difference to my girls as it means they spend less time away from their families and the community going to Mount Isa for appointments,

“I can also do Implanon insertions and now pap smears, and 18 months ago I undertook a basic ultrasound course for dating scans,” she said. “These are all the little things that help you work independently as a midwife and that makes the world of difference when working in remote and rural communities.”

Numbers of Aboriginal teenage mothers decreased from 10% in 1991 to 8% in 2004.

Source: Indigenous Mothers and their Babies 2001-2004 report

Closing the gap In Australia, many health services are not as accessible and userfriendly for Aboriginal and Torres Strait Islander people as they are for non-Indigenous people. One of the key factors is that onefifth of the Aboriginal and Torres Strait Islander population live in remote or very remote areas where not all health services are offered. 1 While the Prime Minister’s Closing the Gap Report indicates there have been some improvements in health care access, it also points out that Australia is not on track to close the gap in life expectancy between Indigenous and non-Indigenous Australians within a generation (by 2031) and more needs to be done at a national level to accelerate progress. Read the report at www.closingthegap.pmc. gov.au

10% 8%

The Aboriginal and Torres Strait Islander definition of health is much more than physical — it’s social, emotional, cultural and spiritual wellbeing of the individual and the community. The connection to country and family lies at the heart of Indigenous wellbeing. Closing the Gap, Prime Minister’s Report 2017

References 1 Australian Indigenous HealthInfoNet (2016) Summary of Aboriginal and Torres Strait Islander health, 2015. http://www.healthinfonet.ecu.edu. au/health-facts/summary. [Accessed 28 April 2017]

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SOCIAL MEDIA: IT’S ALL FUN AND GAMES UNTIL THE BOSS FINDS OUT

The employment relationship is at particular risk of being damaged when employees and employers fail to use social media appropriately. When used well, social media can offer significant benefits in the employment context. More efficient communication with colleagues, a sense of common purpose within the workplace, and peer-based learning are some of the benefits of using social media as an employee and a nursing or midwifery professional. However, improper use of social media can result in disciplinary action (including termination of employment) or other legal action being taken by the employer or, in some cases, AHPRA. This article will outline the sources of law and other guidance around social media and the employment relationship. The professional obligations of nurses and midwives are also explored. For the purposes of this article, we will use the NMBA’s definition of social media:

HE HAZARDS of inappropriate or careless social media use are well documented in the media. From cyber bullying to sexting and trolling, the risks of damage to reputations and relationships from poor social media habits can be significant.

‘Social media’ describes the online and mobile tools that people use to share opinions, information, experiences, images, and video or audio clips and includes websites and applications used for social networking. This includes platforms such as Facebook, Twitter, Instagram, WOMO and similar review sites, YouTube and discussion forums and message boards. Social media ‘content’ is often defined quite broadly, and may include status updates, comments on other’s pages or comments, reactions (including ‘likes’ and comments) on news articles or blogs. Sometimes, mere membership of a particular social media ‘group’ that an employer considers inappropriate or in conflict with the organisation’s culture or views, may suffice to prompt consider disciplinary action. There are multiple sources of regulation and guidance on employment and professional obligations regarding social media: ■ Employer policies Most large and some medium-sized employers will have their own social media policy. For members in the public sector, individual Hospital and Health Services will have their own policy. These policies are generally accessible through your employer’s intranet or your local HR office. It is the responsibility of the employer to make their social media policy available and to provide reasonable training to employees. It is important that employees familiarise themselves with these policies. ■ Public Service Commission Directives For nurses and midwives working in the Queensland Public Sector, the Queensland Government Code of Conduct contains some (very broad) guidance that may be applied to

CPD infocus inappropriate social media use. The Code of Conduct states: Like any other citizen, we have the right to contribute to public discussions on community and social issues in our private capacity. In doing so, we will: ◆ take reasonable steps to ensure that any comment we make will be understood as representing our personal views, not those of government ◆ maintain the confidentiality of information we have access to due to our roles, that is not publicly available ◆ be aware that personal comments about a public issue may compromise our capacity to perform the duties of our role in an independent, unbiased manner. A finding that a public sector employee has breached the above clauses in posting comments on social media may result in disciplinary action. For nurses and midwives in particular, the issue of patient confidentiality is critical. ■ Recent case law In the absence of specific legislation governing social media and employment, case law is also developing as a source of guidance

around the issue. Various unfair dismissal matters, public sector disciplinary appeals, discrimination and workplace bullying cases provide some guidance to employers and employees on acceptable social media practices. Some recent decisions include: ◆ In an unfair dismissal matter where an employee was fired for posting on Facebook (from home and outside office hours) he “wonders how the f**k work can be so f***ing useless and mess up my pay again. C***s are going down tomorrow”, the employee argued that he had restricted the payroll manager from seeing his posts. However, his Facebook privacy settings meant that many co-workers could read the post, and this constituted a breach of the company’s policies on workplace bullying. The Commission upheld the termination for serious misconduct.1 ◆ A hairdresser posted the following criticism of her employer on her Facebook page: “…‘bonus’ along side a job warning, followed by no holiday pay!!! Whoooooo! The Hairdressing Industry rocks man!!! AWSOME!!! [sic]” . In that case, the Fair Work Commission made the following important observations: “…a Facebook posting, while initially undertaken outside

working hours, does not stop once work recommences. It remains on Facebook until removed, for anyone with permission to access the site to see…It would be foolish of employees to think they may say as they wish on their Facebook page with total immunity from any consequences.”2

PROFESSIONAL OBLIGATIONS IN USING SOCIAL MEDIA: The Nursing and Midwifery Board of Australia (‘NMBA’) Social Media Policy provides the following professional guidance around social media use for nurses and midwives. The policy can be found here: www.nursingmidwiferyboard. gov.au/Codes-GuidelinesStatements/Policies/Socialmedia-policy.aspx In summary, nurses and midwives should only post information that is not in breach of the National Law, the NMBA code of ethics and professional conduct and the guidelines for advertising regulated health services. They should ■ comply with professional obligations ■ comply with confidentiality and privacy obligations (such as by not discussing patients or posting

Sometimes, mere membership of a particular social media ‘group’ that an employer considers inappropriate or in conflict with the organisation’s culture or views, may suffice to prompt consider disciplinary action.

infocus CPD pictures of procedures, case studies, patients, or sensitive material which may enable patients to be identified without having obtained consent in appropriate situations) ■ present information in an unbiased evidence-based context, and ■ not make unsubstantiated claims It is also crucial that, when nurses and midwives post on social media regarding nursing, medical or health –related matters, they ensure that the content they present is unbiased and evidence-based.

THE PRIVACY MYTH It is important to quell one of the great myths of social media – the myth of privacy and anonymity. Quite simply, social media is a public forum. In addition, the courts have made it quite clear that they will generally not entertain the argument that an employee posting an inappropriate social media content did not understand how social media ‘privacy settings’ work. It is also a mistake to believe that material that you post in your personal time is exempt from scrutiny by the employer and that the content you post may be accessible by individuals other than your own Facebook ‘friends’, Instagram or Twitter ‘followers’ or LinkedIn ‘connections’, despite your privacy settings. Some ideas for keeping your social media presence as private as possible are included towards the end of this article.

WHOSE VIEWS ARE YOU REPRESENTING? A common argument from employers in disciplining employees for allegedly inappropriate social media activity is that that the employee has damaged the employer ‘brand’, or that a reasonable person reading the social media content would believe that their (the employee’s) views are those of the employer. This problem is magnified when the employee either directly or indirectly identifies their employer on their personal social media postings. For these reasons it is crucial that employees state that the views

they post, share, like, or otherwise comment on (particularly if they conflict with the values and policies of the employer) are their own.

COMMON ISSUES FOR MEMBERS In addition to specific issues contained in Codes of Conduct, laws or Guidelines, QNMU members should consider the following practical matters when they use social media: ■ Refrain from posting, sharing or ‘liking’ controversial, offensive or discriminatory material3, or material that conflicts with your professional obligations as established by the NMBA. ■ Be aware that ‘private groups’ on social media sites are often much less private than group members would like. It is worth considering that private groups may include members who do not fully share your views. Any of these members may then reveal otherwise ‘private’ group content to an employer (for example, through screenshots).

REFLECTIVE QUESTIONS ■ Has this article made you review how you use and view social media? Explain.

■ Unfortunately, despite group members desiring a safe and private space to discuss sensitive work matters, the risk that those discussions can easily be made public has led some employers to consider private group discussions part of the public sphere. While the case law is not conclusive on the matter, caution is advised in using these forums to air workplace grievances or discuss sensitive or controversial matters either related to your profession or your workplace.

■ Is social media use incompatible with jobs where maintaining professional privacy is a core principal? Explain. ■ What steps would you take if you saw a colleague posting material online which might be in breach of your employer’s social media policies? Remember to record your reflections for registration purposes using the framework on page 51 or by using the QNMU Record of CPD which is available at www.qnmu.org.au/cpdrecord

■ Check your privacy settings and set them as high as possible ■ Consider removing references to your employer on your personal social media page. This might include editing your profile details to exclude your employer’s name, and removing pictures of you at work or wearing your uniform. ■ Consider the risk that content you post on social media may be picked up and re-published in another forum, thereby increasing the audience significantly and placing your comments outside your control.

References 1

O’Keefe v William Muir Pty Ltd t/as The Good Guys [2011] FWA 5311

2 Fitzgerald v Smith t/a Escape Hair Design [2010] FWA 7358 at [52] 3 The Anti-Discrimination Act 1999 (Qld) makes it unlawful to discriminate on the basis of sex, pregnancy, parental status, breastfeeding, race, impairment, religion, age and other protected attributes

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What’s involved in a CPD Audit? CONTINUING Professional Development (CPD) for nurses and midwives is a mandatory requirement for continued registration as a health practitioner with the Nursing and Midwivery Board of Australia (NMBA). This registration standard may be audited from time to time.

Audits of your compliance with CPD can go back as far as five years, so you should keep comprehensive records of all activities which contributed to CPD and maintain a file for each year’s records. An audit year is from 1 June to 31 May the following year. The QNMU provides members with access to a downloadable CPD Record booklet, based on the NMBA’s template, which enables you to keep a record of your CPD activities for each registration year in the one place in case you are audited. Our booklet also describes the types of activities that can contribute to CPD, including many members may not be aware of. We occasionally assist members who believe they have not complied with their CPD requirements, only to discover that they have done a range of activities that they did not realise contributed to CPD. If you maintain an electronic copy of the CPD record, we recommend you always create a backup each time you make a new entry and print it out at the end of each registration period (31 May each year) for your files.

three months in which to become compliant. With regard to audits, AHPRA and the National Boards have developed a nationally consistent approach to auditing health practitioners’ compliance with mandatory registration standards Random audits are conducted throughout the year, not just after renewal of registration. You could be audited at any time for any registration period over the preceding five years. If you declare on your renewal form that you have met the standard and you are audited, AHPRA will ask you to provide evidence of compliance within 28 days. Members should expect to be audited at least once during their career. When you are selected for an audit, you will receive a letter from AHPRA advising that you are being audited for compliance with one or more of the registration standards, with a checklist that outlines the supporting documentation you must send to them.

When it comes time to renew your registration, it is very important that you make a truthful declaration on your application form, because if you are audited and you have not met the standard, the NMBA could take action against you for making a false declaration.

Evidence of CPD compliance can include the completed CPD booklet and certificates of attendance at training courses which contributed to CPD.

However, in most instances where members have declared they have not met the CPD standard, AHPRA has allowed the member an additional

If you are audited by AHPRA, it can be a stressful experience.

In your booklet you will need to have correctly and sufficiently filled out each column of the template.

If you are unsure about the process or what evidence to provide, we

recommend you contact QNMU as soon as possible so one of our experienced officials can provide you with advice. The NMBA has a process for nurses and midwives who seek an exemption from meeting the CPD Standard for one reason or another. However, the QNMU advises all members that if they are intending to seek an exemption from CPD compliance, they should contact QNMU first to seek advice and ensure an exemption application will not jeopardise or impede their registration renewal process. Visit the NMBA website for information about your Registration Standard, CPD guidelines and fact sheet: www.nursingmidwiferyboard. gov.au/RegistrationStandards/Continuingprofessional-development. aspx

MAKE IT COUNT Reading this article and the NMBA content can count towards your CPD hours for registration compliance. Turn to page 51 for an example of how you might effectively record your CPD reading and reflections. or by using the QNMU Record of CPD which is available at www.qnmu.org.au/cpdrecord

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Central venous access deviceassociated skin impairment (CASI) BY KAYE ROLLS RN BSC PROF DOC (PENDING): KNOWLEDGE TRANSLATOR AND AMANDA ULLMAN RN MAPPSCI PHD CENTAUR FELLOW; SENIOR LECTURER AND DIRECTOR PAEDIATRIC AND NEONATES THE ALLIANCE FOR VASCULAR ACCESS TEACHING AND RESEARCH GROUP, NATIONAL CENTRE OF RESEARCH EXCELLENCE IN NURSING, GRIFFITH UNIVERSITY.

CENTRAL venous access devices (CVAD) are a vital medical device, used commonly across various acute care settings (Ullman, Marsh, Mihala, Cooke, & Rickard, 2015). Central to maintaining CVAD functionality are clinical practices aimed at preventing complications such as infection (chlorohexidine and alcohol antisepsis, chlorhexidine impregnated dressings) or dislodgement (sutures, medical grade glue and securement devices).

Building on evidence related to medical adhesive-related skin injuries (McNichol, Lund, Rosen, & Gray, 2013) CASI is defined as the “occurrence of drainage, erythema, and/or other manifestation of cutaneous abnormality, including but not limited to vesicle, bulla, erosion or tear, at a CVAD site in the underlying area of a dressing, which persists 30 minutes or more after removal of the dressing.” (Broadhurst et al., 2017, p. 213).

However, the application and reapplication of devices and antiseptics can result in significant skin irritation and injury surrounding the CVAD site, causing patient discomfort and potentially CVAD dysfunction.

There are four types of CASI including:

Using established consensus methods a group of skin and wound care, and vascular access experts have developed an evidence based algorithm to classify CVAD-associated skin impairment (CASI) and provide clinicians with expert advice on treatment options (see Figure on next page) (Broadhurst, Moureau, & Ullman, 2017).

1. Exit-site infection; 2. Skin injury (skin stripping, skin tears or tension blister) where the skin layers are removed or separated due to tension or force applied during removal of adhesive tape or dressings; 3. Skin irritation (irritant or allergic contact dermatitis) due to application of chemical irritant); and 4. Non-infections weeping or oozing (clear amber, pink or red, or cloudy or milky)

REFLECTIVE QUESTIONS ■ After reading this article, what improvements might be made in your clinical practice with respect to reducing patient discomfort during the use of CVADs? ■ Explain how this assessment process might be deployed in your workplace. Remember to record your reflections for registration purposes using the formula on page 51 or by using the QNMU Record of CPD which is available at www.qnmu.org.au/cpdrecord

Applying the CASI algorithm: An example Tony, an 18yo man, was discharged from intensive care yesterday. Three days ago he was involved in a motor vehicle accident and sustained a closed head injury, lacerated spleen, and a fractured right femur. He has a CVAD in his right subclavian being used for maintenance fluid, pain relief and antibiotics. Overnight his central line dressing was replaced due to lifting. Soon after handover Tony calls you because his central line site ‘is itching’. You note that there is a red rash under the dressing which is circumscribed by the area immediately under the dressing. Tony says this happened in intensive care and they said it would go away. He also confesses to scratching at the previous dressing because it was itching.

What complication is Tony experiencing and what will you do next? Using the CASI algorithm you assess that Tony probably has skin irritation due to the chlorhexidine antiseptic. You decide that at the next dressing change you would ensure the antiseptic is allowed to dry completely, and apply a skin barrier film to provide some skin protection. You tell Tony to let you know if the itchiness continues and to refrain from scratching at the dressing. You make detailed notes in Tony’s medical record to alert your colleagues especially regarding the possibility of a developing allergic reaction to chlorhexidine and the possible need to modify the dressing regimen to prevent further skin damage.

References: Broadhurst, D., Moureau, N., & Ullman, A. J. (2017). Management of Central Venous Access Device-Associated Skin Impairment: An Evidence-Based Algorithm. Journal of Wound Ostomy & Continence Nursing, 44(3), 211220. Retrieved from http://journals.lww.com/ jwocnonline/Fulltext/2017/05000/Management_ of_Central_Venous_Access.2.aspx doi:10.1097/ WON.0000000000000322 McNichol, L., Lund, C., Rosen, T., & Gray, M. (2013). Medical adhesives and patient safety: state of the science: consensus statements for the assessment, prevention, and treatment of adhesive-related skin injuries. Orthop Nurs, 32(5), 267-281. doi:10.1097/NOR.0b013e3182a39caf Ullman, A. J., Marsh, N., Mihala, G., Cooke, M., & Rickard, C., M. (2015). Complications of central venous access devices: a systematic review. Pediatrics, 136(5). doi:10.1542/peds.2015-1507

2. Protect Skin and Provide Comfort

1. Assess Patient

•

Alginate (also has hemostatic properties)

Antimicrobial dressing***

if skin flap is present

•

Skin glue (2-octylcyanoacrylate alcohol-free topical bandage) + Cover Dressing

• •

Foam (silicone or low-tack)

•

Absorbent clear acrylic

Hydrocolloid (do not apply directly on CVAD exit site)

•

Transparent film •

•

(e.g., tear/blister)

Skin Injury

•

Yes

Drainage Skin Able to Irritation Low Med High see site

***Assess manufacturer’s contraindications. Recommend consult wound/skin specialist and/or physician.

**Does not provide a microbial barrier

*Stabilize catheter with securement device/dressing

• If exudate leakage, use a different dressing with higher fluid handling capacity

• If skin damage/drainage is away from the exit site, isolate wound and exudate from exit site: apply absorbent dressing over area of injury and transparent dressing over exit site and prepped skin.

• Apply sterile alcohol-free skin barrier film prior to dressing (let dry before applying dressing)

• Identify patients at risk and take precautions with site care (e.g., malnutrition, dehydration, elderly/neonates, dermatologic conditions, low/high humidity, radiation therapy, medications [chemotherapy, anti-inflammatories, including long-term corticosteroid use, anticoagulants])

• Educate staff and/or patients/caregivers on proper dressing selection, atraumatic application/removal, site care

• If no improvement within 3–7 days, consult wound/skin specialist

- If no improvement to sites with suspected contact dermatitis, consider short-term use of topical corticosteroid (do not apply directly on exit site)

• Assess irritated skin every 24 hrs; monitor for signs and symptoms of infection

Non-adherent non-woven gauze** (if skin intact or topical agent applied)

Dressing

- Change type/concentration of cleansing solution (see Fig. 1) - Ensure solution and barrier film are allowed to dry fully before dressing application - If no resolution, change brand/type of dressing - Consider open application test of dressing/antiseptic solution on unaffected skin (see Fig. 2)

• Identify and avoid suspected irritant:

WEEPING/OOZING

• Apply non-alcohol barrier film and absorbent dressing

• Control bleeding: pressure at site, alginate and/or hemostatic agent under dressing

Assess color, consistency, odor, amount and location of exudate

(Non-infectious)

1. Apply product to forearm 2. Monitor for 30–60 min. 3. Reassess in 3–4 days for signs of dermatitis

Fig. 2 – Open Application Test

Try sterile normal saline

No Improvement?

Try Povidone Iodine

No improvement?

Try CHG w/o alcohol

Fig. 1 – Reaction to CHG w/ Alcohol

• Rule out infiltration/extravasation, thrombophlebitis and other skin conditions (e.g., eczema, impetigo)

• Consider anti-inflammatory, anti-pruritic agents and/or analgesics; cool compresses (applied on top of dressing)

Dressing Usage Guide for CVAD Skin Impairment Management

† Confirm compatibility with dressing and catheter

• Consider cauterizing exuberant granulation tissue at site of long-term CVAD

• If there is no resolution with topical therapy or it is accompanied by purulent drainage, start systemic antibiotics

• Topical antimicrobial agent† (based on culture results) or consider non-CHG antimicrobial dressing

SKIN IRRITATION/CONTACT DERMATITIS Skin color change (red, dark, shiny, dull) persisting 30 min. after dressing change (often mimics shape of dressing) and/or burning, itchy skin and/or lesions (macules, papules, vesicles, bullae)

• Apply alcohol-free barrier film and appropriate dressing

• If skin flap present, approximate viable skin flap edges prior to dressing application

• Culture site and draw blood cultures

• Collaborate with practitioner; may need to remove catheter

• Consider non-alcohol antiseptic agent

If Exit Site Infection is Suspected:

• Tears: Partial or full thickness tension blisters

SKIN INJURY • Stripping: Shallow irregular lesions; shiny skin

EXIT SITE INFECTION

Redness, induration (hard), and/or tenderness within 2 cm of the catheter exit site; possibly with other signs and symptoms of infection, such as fever or purulent drainage at exit site, concomitant bloodstream infections

CVAD– Associated Skin Impairment (CASI) Algorithm

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The CASI article is open-access (creative common license) and available at http://journals.lww.com/jwocnonline/ Fulltext/2017/05000/Management_of_Central_Venous_Access.2.aspx

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The way forward to professional strength and personal wellbeing REFLECTION is an essential component of strong professional practice for nurses and midwives and is our individual and collective responsibility. We know that the pressure to act — not to stop and think — is the everyday reality of nurses and midwives and we can get lost in this busyness. If we don’t take the time to slow down amidst the relentless action and reaction in our jobs we risk losing control over our practice.

Sandra Eales QNMU Assistant Secretary

CPD infocus Practice of reflection and self awareness for individual wellbeing

GCS is a horizontal peer activity – i.e. nurse to nurse – with a neutral facilitator and no hierarchy.

A process of reflection helps us understand and integrate our experiences and sharing or telling our story may assist others facing similar challenges.

The chief domain is restorative promoting colleague/social support and stress relief.

We can build personal resilience through understanding our strengths, weaknesses, motivations and cultivating mindfulness. Our work is social and emotional and based in the relationship we have with our patients and colleagues. Nurses and midwives engage with people at a vulnerable time in their lives when the smallest things can be very important or memorable. If that ability to connect meaningfully is interrupted or denied we experience loss of the intrinsic reward in the practice of our professions. It is important to recognise the danger to us and our profession if we lose that because of unsafe workloads or culture. Interpersonal conflict is a recognised risk in nursing and midwifery practice which affects the wellbeing of staff as well as patient safety. It is vital to maintain supportive collegial relationships and connection through reflective storytelling and informal debrief with workmates. Group Clinical Supervision (GCS) has been identified as an organisational practice that fosters team building and collegial support. Formal reflective processes may involve several levels of peer review e.g. multi-disciplinary case conferencing or incident debrief, group or individual clinical supervision. Peer review is fundamental to a strong professional practice, and is key to continuous quality improvement and functions in three domains: ■ Normative: Promotes professional accountability through clinical audit and critical analysis ■ Formative: Skill and knowledge development ■ Restorative: Colleague/social support and stress relief

There will also be some normative and formative effect as midwives teach and learn from each other in a safe environment. GCS is a mechanism for supporting clinical governance by enabling practitioners to examine their practice, skills, knowledge, attitudes and values in a safe environment. Clinical Supervision (CS) is known to have positive effects on nurses’ experience of well-being (Begat et al 2005) job satisfaction, burnout and quality of care (Hyrkas et al 2006; Alleyne & Jumaa 2007). It has been used as strategy to enhance professional practice development, job satisfaction and improve retention rates. CS has been used as a tool for building the capacity for evidence based clinical nursing leadership (Alleyne & Jumaa 2007) and has been identified as a stimulus for positive change in practice development (Chiarella 2007).

Reflective practice is our professional responsibility Reflective practice is a strategy of empowerment and emancipation (Emden 1991) which we need to build into our way of being nurses and midwives. Midwives and nurses need to ensure they regularly take time out for this important aspect of their professional role. We must carve out space and time in our busy work day to attend to it — for our own health and wellbeing as well as for the protection of the patients who depend on our practice. Managers need to recognise that this must be built into any consideration of ‘workload management’. The time to sit, think, reflect and plan is as important as the hands-on physical tasks that we do as part of our daily work. We cannot develop our practice or our profession without it.

REFLECTIVE QUESTIONS 1. What informal or formal reflective practice processes did you participate in last month? 2. Who is responsible for the professional nursing or midwifery culture in your work unit? 3. What formal peer review processes are scheduled in your work unit? Is participation prioritised or encouraged? Is there a culture within your work unit which fosters safe practice development? What makes it safe or unsafe? What can you do to improve it? 4. How do you intend to cultivate reflective practice habits within your work and life? 5. Are you aware of or interested in any skills training available for mentoring, coaching or facilitation of clinical supervision? Remember to record your reflections for registration purposes using the framework on page 51 or by using the QNMU Record of CPD which is available at www.qnmu.org.au/cpdrecord

References Alleyne, J & Jumaa, MO 2007, ‘Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient services’, Journal of Nursing Management, vol. 15, pp. 230-243 Begat, I, Ellefsen, B & Severinsson E 2005, ‘Nurses’ satisfaction with their work environment and the outcomes of clinical supervision on nurses’ experiences of well-being – a Norwegian study’, Journal of Nursing Management, vol. 13, pp. 221-230 Chiarella, EM 2007, ‘Redesigning models of patient care delivery and organization: building collegial generosity in response to workplace challenges’. Australian Health Review, vol 31, no. 1, pp.S109 - S115 Emden, C 1991, ‘Becoming a reflective practitioner’, in G Gray & R Pratt (Eds), Towards a discipline of nursing, Churchill Livingstone, Melbourne, pp. 335 -47 Hyrkas, K, Appelqvist-Schmidlechner, K & Haataja, R 2006, ‘Efficacy of clinical supervision: influence on job satisfaction, burnout and quality of care’ Journal of Advanced Nursing, vol. 55, no. 4, pp. 521-535

infocus CPD

What to do when you are assaulted at work T

HE QNMU, together with other Australian Nursing and Midwifery Federation (ANMF) state branches, all recognise that violence in the healthcare environment is having a serious impact on our members. This is why we have a special focus on working with employers to tackle violence at work. Itâ&#x20AC;&#x2122;s an issue that needs to be addressed by stakeholders working together. In a positive step forward, Queensland Health and its HHSs are looking to implement all the recommendations from

the May 2016 report collated by the Occupational Violence Prevention in the Queensland Hospital and Health Service Taskforce. These recommendations include, but are not limited to training initiatives, improved reporting, new safety technologies and boosting staff support. In the meantime, members often ask QNMU what their rights are if they are assaulted or if they fear they could be assaulted at work. So letâ&#x20AC;&#x2122;s take a look.

CPD infocus

What is assault?

WORKERS COMPENSATION

The Criminal Code 1899, section 245 defines assault as: A person who strikes, touches, or moves, or otherwise applies force of any kind to, the person of another, either directly or indirectly, without the other person’s consent, or with the other person’s consent if the consent is obtained by fraud, or who by any bodily act or gesture attempts or threatens to apply force of any kind to the person of another without the other person’s consent, under such circumstances that the person making the attempt or threat has actually or apparently a present ability to effect the person’s purpose, is said to assault that other person, and the act is called an assault. For a person assaulted while working as a public officer (i.e. nurse employed in a Hospital and Health Service) the perpetrator may be considered to have committed a serious assault which carries heavier potential penalties then the lesser offence of common assault.

REPORTING AN assault If you are the subject of an assault wherever you work you are entitled to make a complaint to the police. This will require you to contact the police. Depending on your condition and the type of assault, the police can attend your workplace or alternatively you can attend the relevant police station. You should be aware that your manager (or any other official) cannot obstruct you from seeking to lodge a formal complaint. To pursue a formal complaint you will be required to complete a police incident form and from this, the police will look to take a detailed statement to gather the perpetrator’s particulars, the circumstances surrounding the assault and any witnesses who may be able to assist. Keep in mind however, that if you have sustained an injury requiring medical treatment, this should be your first priority before contacting police.

Should you be assaulted but do not wish to make a complaint to the police, we recommend, at the very minimum, you report the incident.

If you are the subject of an assault wherever you work you are entitled to make a complaint to the police. THE COURT PROCESS If the police believe there is sufficient evidence to proceed with your complaint, the perpetrator may be charged (it is important to remember that the police cannot stop you making a complaint). The decision whether to proceed to court is then made by the Department of Public Prosecutions (DPP) after they have reviewed the material provided by the police. Should the DPP choose to proceed you may be required to appear in the magistrate’s court or district court depending on the severity of the charges brought. If you have been assaulted by someone who is deemed to be suffering a mental health condition at the time of the assault, their matter will be referred to the mental health court. The QNMU’s position is that if you are assaulted at work, your attendance for police matters and court proceedings should be in paid time. It is worth noting that Queensland Health is currently looking at the feasibility of a dedicated central unit to assist members through this process.

The QNMU has assisted many members who have been assaulted but do not suffer the physical or psychological effects in the immediate aftermath of the incident, who do however experience both long term physical and psychological problems later. Having the incident documented at the time it occur, helps significantly if you decide to pursue a Workers’ Compensation Claim at a later date.

YOUR RIGHT TO WITHDRAW The Work Health and Safety Act 2011 at section 84 permits a workers to refuse to carry out work if they have a reasonable concern that carrying out the work would expose them to a serious risk to their health or safety due to an immediate or imminent exposure to a hazard. This means no matter where you work, if you have a reasonable belief you could be assaulted when performing a particular task, you can cease that activity until such time that you are satisfied your employer has instituted measures to decrease the risk. When exercising this right you are required to notify your employer and remain available to perform other relevant work.

REFLECTIVE QUESTION 1. Does a nurses’ duty of care require you to place yourself in a situation that could result in you being assaulted? Explain the reasons for your answer. Remember to record your reflections for registration purposes using the framework on page 51 or by using the QNMU Record of CPD which is available at www.qnmu.org.au/cpdrecord

CALENDAR World Hepatitis Day

July

28 July http://worldhepatitisday.org/

NAIDOC Week

Swan Hill Nurses’ Conference

2-9 July 2017 www.naidoc.org.au/

27–28 Jul 2017, Swan Hill www.ausmed.com.au/course/swanhill-nurses-conference

Day Surgery Nursing and Minor Procedures 6–7 Jul 2017, Adelaide www.ausmed.com.au/course/ day-surgery-nursing-and-minorprocedures

Tradies National Health Month

Health, Medicine, and Society: Challenge and Change 11-15 July, Melbourne www.dcconferences.com.au/ hom2017

1-7 August www.homelessnessaustralia.org.au

Lung Health Promotion Centre at The Alfred Asthma Educator’s Course 19-21 July 2017

QNMU Annual Conference 19-21 July, Brisbane

Evidence based Relaxation Therapy: Physiological & Psychological Benefits 21 July 2017, Sydney http://artandscienceofrelaxation. com/seminars/evidence-basedrelaxation-therapy.html

5th Annual World Wide Nursing Conference

World Indigenous Peoples Conference on Education A Celebration of Resilience 24-29 July, Toronto Canada www.wipce2017.com/

Respiratory Update

CONTINUING PROFESSIONAL DEVELOPMENT

28 July 2017 P: (03) 9076 2382 E: lunghealth@alfred.org.au

Inaugural International Conference on Non Communicable Diseases

National Homelessness Prevention Week

14 July 2017, Melbourne http://bit.ly/ANMFevents

The Role of Nursing in Leading and Advancing Global Health 24-25 July, Singapore http://nursing-conf.org/

www.tradieshealth.com.au

Global Responses to a Global Epidemic 1-2 August, Kuala Lumpur, Malaysia http://ncdcongress.co/

ANMF Enrolled Nurse Student Study Day

12th National Allied Health Conference

9 August www.un.org/en/events/ indigenousday/

Allied Health: Stronger Together 26-29 August, Sydney https://secure.hotelnetwork.com.au /12thnationalalliedhealthconferen ce/home

Australian Viral Hepatitis Elimination Conference

National Legacy Week

10-11 August, Cairns www.avhec.com.au

August

Australia and New Zealand Society of the History of Medicine 15th Biennial Conference

International Day of the World’s Indigenous People

Lung Health Promotion Centre at The Alfred Smoking Cessation Course 3-4 August 2017: Influencing Behaviour Change – a formula 10-11 August 2017: Influencing Behaviour Change – Theory & Practice 10 August: Influencing Behaviour Change – Intensive Workshop/Case Studies 11 August: Spirometry Principles & Practice 14–15 August 2017 P: (03) 9076 2382 E: lunghealth@alfred.org.au

Drug and Alcohol Nurses of Australia Forum Endurance 11 August, Sydney www.danaonline.org/2017-danaendurance-forum/

Evidence based Relaxation Therapy: Physiological & Psychological Benefits 11 August 2017, Canberra http://artandscienceofrelaxation. com/seminars/evidence-basedrelaxation-therapy.html

12th New Zealand Dermatology Nurses Conference 17-18 August 2017, Queenstown New Zealand www.nzdermatologynurses.nz/

25th Annual Scientific Conference on Diving and Hyperbaric Medicine Back to the beginning 17-19 August, Adelaide www.htna.com.au

Vietnam Veterans Day (Long Tan Day) 18 August www.vietnamvetsmuseum.org/node/ vietnam-veterans-day-long-tan-day

National Aboriginal and Torres Strait Islander Children’s Day (NATICD)

Australian College of Nursing National Nursing Forum

4 August www.snaicc.org.au/children

Make Change Happen 21-23 August 2017, Sydney www.acn.edu.au/nnf2017

25th Health Informatics Conference

National Daffodil Day (Cancer Council Australia)

6-9 August, Brisbane www.hisa.org.au/hic/

25 August www.daffodilday.com.au

Australian New Zealand Intensive Care Society - Safety and Quality Conference: The Deteriorating Patient

Annual Foundation for Prada Willis Research Conference

7–8 August, Sydney www.sqao-anzics.com

Dream Believe Achieve 25-27 August, Indiana, USA www.fpwr.org/ events/2017annualconference/

27 August-2 September www.legacy.com.au/LegacyWeek

Endocrine Nurses’ Society of Australasia Annual Symposium Endocrinology: A problem of too much or too little 28 August, Perth www.ensa.org.au/ensa2017/

Aeromedical Society of Australasia and Flight Nurses Australia 29th Conference Aeromedicine. Learning from the past - Adapting for the future 30 August-1 September, Sydney www.aeromedconference.com

Australian Diabetes Society and Australian Diabetes Educators Association Annual Scientific Meeting 30 August-1 September, Perth http://ads-adea.org.au/

2018 Reunion: Prince Henry, Prince of Wales and Eastern Suburbs hospitals NEC of UNSW Reunion planned for the February 1973 intake of PTS 17 February 2018, 6pm Malabar (Randwick) Golf Club Expressions of interest to: Roslyn Kerr phone: 0447472968 email: gert2@optusnet.com.au or Patricia Marshall (Purdy) email tapric135@bigpond.com

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

The Nursing and Midwifery Board of Australia requires all nurses and midwives to complete a minimum of 20 hours CPD per registration year for each profession for which they hold current registration. Time spent reading and reflecting on the CPD articles in this journal can contribute to your hours. However in order to satisfy NMBA that your learning has been effective you need to keep a record of your activity. The following table is an example of how you might record your CPD hours. The following is an example only of a record of CPD hours (based on the ANMF continuing education packages): Date

Source or provider details

Identified learning needs

Action Plan Type of activity

01-092017

InScope Journal

Increase knowledge re Delegation & Supervision

Read article and answer reflective questions

Description of topic/s covered during activity and outcome

SelfCriteria and resources directed relevant to delegation and required levels of supervision. Increased knowledge re delegation and supervision of EN/ AIN.

Reflection on activity and specification to practice

No./Title/ Description of evidence provided

CPD hours

Answered reflective exercise questions. Read relevant NMBA codes & guidelines. Translated knowledge into practice and discussed with colleagues.

Journal article with reflective exercise questions.

2.5 hrs

Please refer to www.nursingmidwiferyboard.gov.au/Registration-Standards.aspx for full details of CPD requirements.

in memory At age sixty, Kay decided to reduce her working hours and when Surgicentre was amalgamated with Pacific Private Day Hospital (along with Allamanda Hospital which is now part of the Healthscope company) Kay took on the role of Admissions Nurse at Pacific Private and continued the great relationships she had built up over her career with patients, doctors and nursing colleagues.

Kay Connolly FAMILY, friends and colleagues are mourning the loss of Healthscope nurse Eileen Kay Connolly.

Kay was a loyal employee, who spent the final thirty-eight years of her nursing career with the same hospital group. Kay’s practical, caring and funloving personality will be greatly missed.

She began her nursing training at Royal Newcastle Hospital in New South Wales in 1966. At the time, the “very good training” took three years and nine months, and students worked five and a half days a week based on the true English regimented style.

Kay and Tom moved to the Gold Coast after Tom’s retirement from the Air Force. In 1979, Kay became a foundation staff member at the newly opened Allamanda Private Hospital. Her roles there included recovery, anaesthetics and even CSSD. In 1986, Kay had the honour of setting up Brockway House Day Surgery, the first free standing day surgery in Australia. Tasked with equipping, staffing and the day to day running of the unit, Kay was recognised as a pioneer in this new field of short stay hospital care. After Brockway House was sold, Kay and her staff moved to the Allamanda Surgicentre where she was Nurse Unit Manager for several years. Kay also worked at the IVF clinic at Allamanda Hospital, one of the first on the Gold Coast.

Chris would say she worked simply as a “nurse” but her career was varied and colourful. She worked in disabilities — a disadvantaged and poorly recognised area for years, where she provided the most thorough and thoughtful care to her patients, treating them as equals and working to encourage and facilitate their rights as members of the community. Once registered, Chris also worked in a cardiac ICU for a decade in NZ. She moved to Australia and began Surgical Nursing, where she dedicated her nursing skills to contribute to the care of patients in the most vulnerable of positions.

Kay was a dedicated nurse whose career spanned nearly half a century.

One year into her training, Kay met her future husband Tom at a dance at the RAAF base. They married in 1968 and their daughter Elizabeth was born in early 1971.

Chris cared for many people throughout her career. Whilst her patients were her priority in her work, she cared deeply for her nursing colleagues too. She aspired to educate and support nurses in their work.

Chris was awarded “top nurse” for the Princess Alexandra Hospital just before her death. She had also been awarded a badge in 2014 in recognition of her contribution to nursing practice from the International Nurses’ Association.

Christine Higgins FAMILY and friends mourn the passing of QNMU member and proud nurse, Christine Higgins. Chris was passionate about serving others in her community and caring for others through her work and life. She completed her Enrolled Nurse training through Auckland Hospital School of Nursing in 1982. In 1992, she was awarded a Diploma in teaching people with disabilities from Auckland College of Education and she went on to complete her Registered Nurse training via UNITEC and became a Registered Comprehensive Nurse in 1998, fulfilling a life-long dream.

An active member of the QNMU, Chris understood the value of advocacy and respected the processes in place to ensure fair and safe practice was upheld, be it in patient care or nursing politics. She was able to support nurses to take responsibility for their practice and to facilitate positive change in workplaces to enhance the safety and quality of patient-centred care. Chris will be remembered by her family as Chrissy, by her children a mother with much love, a grandmother generous of heart, a sister full of vivacity, a daughter whole of being and a friend who was dependable and fun. She will be dearly missed by her family and friends.

Most recently, Chris had been working toward attaining a Masters in Clinical Nursing via ACU, and was only three weeks from completion at the time of her death.

For the very first time, nurses and midwives led Labour Day marches across the state. We reckon we looked pretty good in our new brand and colours, but you can be the judge!

in view

Cairns

Thursday Island Townsville

Cairns

Townsville

Bundaberg

Rockhampton

Bundaberg

Townsville

Rockhampton

Toowoomba

Brisbane Labour Day march

in view

We celebrated International Day of the Midwife (5 May) and International Nurses’ Day (12 May) in one of our favourite ways… with cake! Check out these great celebratory snaps from our members across Queensland.

in view

Eventide Aged Care Facility CQHHS

Newly endorsed Royal Brisbane and Women’s Hospital Maternity branch delegates

Hervey Bay

Nambour Hospital

Redland Hospital perioperative nurses

Brygon Creek Gold Coast

RBWH

The Townsville Hospital QNMU Branch held a Domestic Violence Awareness Donation Drive to raise awareness on domestic violence. More than 1000 items were donated to be made into care packs for those affected by domestic violence. Pictured left to right: Sheryl Redgen (QNMU member), Carol Roberts (QNMU member), Cathy Crawford (Townsville Women’s Centre) and Jo Konings (QNMU member)

Post Acute Care Service - Chermside

Thornlands Surgery

St Vincent’s Private Hospital Toowoomba Clermont NQ

Baillie Henderson

On behalf of all our members we laid a wreath at the Nurses Memorial Candlelight Vigil at Anzac Square, in remembrance and honour of our Anzac nurses and countless other women who volunteered their services during times of conflict.

in view

Nurses walked in the shoes of our Anzac heroes (literally) when they got into costume for the Anzac Day Parade in Townsville.

BOOK PRIZE ER WINN

SEND US YOUR PICS AND WIN!

Got a great pic of nurses and midwives? Send it to us at inscope@qnmu.org.au for a chance to win a book prize. Choose between May Angelouâ&#x20AC;&#x2122;s A letter to my daughter or Saroo Brierleyâ&#x20AC;&#x2122;s Lion.

incoming

CHECK OUT WHAT PEOPLE ARE SAYING ON SOCIAL MEDIA

ON OUR NEW NAME AND LOOK! SM Love the new makeover... the old and the new... where our future lies. Like · Reply

BJ Fabulous. So many years at conference this was discussed. Thank you for finally recognising midwifery, and that midwives are not nurses. Like · Reply

KS Well done... What people need to note is a nurse is a nurse whether psych, theatre or neonatal. However a midwife is not necessarily a nurse and has a separate registration.

On proposed penalty rate cuts to Sonic HealthPlus nurses IH Just spent 2 weeks in hospital. The nursing professionals do an extraordinary job, daily taking on tougher tasks than most people could imagine. Cutting penalty rates for these people is a crime. Like · Reply

MS Hooray! Thank you. I know a lot of hard work went into making this happen.

LW Going to be hundreds of nurses leave the profession if employers take away our penalty rates! Who’s going to be working on a Sunday or do night shift? Definitely not me!

Like · Reply

GB Yay! I’m an EEN soon to be a midwife so I’m pleased to see this change being a union member.

RF You can’t do this to workers, you need them and so do the aged! They are worth their weight in gold to be doing what they do.

Like · Reply

On racism in the health workforce WD Unfortunately heaps of racism from patients. I brush it off. Sadly I’m used to it as a kid growing up. Support should be there if you need it. Like · Reply

DM Unfortunately...Yes it happens a lot here and even in my native land of Aotearoa (NZ), speaking from personal experience. But let that build character and charm. Believe me there is greater reward in rising above those misconceptions and proving people wrong. 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

On honouring our Anzac nurses LT Thank you very much for laying the wreath. As a current SCN working it’s lovely to see that we still honour and remember those brave nurses that were there to look after and treat those injured. It’s very appreciated.  Like · Reply

EH They were equal heroes to all the men who served. Like · Reply

EM Thank god for those nurses. Lest We Forget. Like · Reply

JS Cutting our pay rates in one fell swoop when they have been hard won over years of negotiation and industrial action? Surely this is unconstitutional? Unlawful, at the very least - where are the ‘checks & balances’? Obviously ‘integrity’ is missing =\ Like · Reply

incoming Letter to the Editor Premier thanks nurses and midwives Friends, I want to join with you in celebrating this year’s International Day of the Midwife and International Nurses’ Day. These are important occasions to acknowledge the leadership of nurses and midwives in health care here in Queensland and across the world. This week I am reminded of the values that drive your professional practice.

On Labour Day BB Thanks QNMU for the front of the march spot - it was about time. Like · Reply

AH Thanks Queensland Nurses and Midwives’ Union. What a brilliant march, loved our t-shirts Like · Reply

JH Great turnout, perfect weather, wonderful people, proud to be union always have been, always will be. Like · Reply

MM Fantastic... So proud to be part of this great organisation. Like · Reply

TC The BEST march EVER! So proud of #QNMU and our nurses and midwives and their families. Like · Reply

KC Fabulous! Very proud of our Qld Nurses & Midwives’ Union being up front for the May Day march. Like · Reply

What continues to impress me is how these values are ensuring the delivery of safe, quality health care. This is why my government has legislated for safe nurse-to-patient ratios. I know these ratios mean better patient outcomes and safer workloads. I have supported the coordinating role of Nurse Navigators and refreshed the nursing workforce with new graduates, rebuilding from the job cuts imposed under the LNP. I will be thinking of you and the important work you do for our communities as you celebrate your day with your colleagues and family. On behalf of all Queenslanders, thank you for caring. Warm regards, Annastacia Palaszczuk MP Premier of Queensland and Minister for the Arts

Why are penalty rates so important to nurses and midwives?

Sharon Wilcox

Deejaye Symss

Rosemary Whimp

EN (Innisfail)

EN (Bundaberg)

RN (Brisbane)

I think if we are giving up our nights and weekends, and time with our families we should be compensated for that. There will be a mass exodus in the nursing force if we lost our penalty rates.

I think penalty rates are so important to us because they make up the majority of our pay. The base award rate that we receive isn’t adequate enough to survive in our growing economy.

If penalty rates were taken away I would feel the community does not value the work I do, and I would be unable to properly save for my retirement.

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!

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Daniel

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Dianne

Terri

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.

(07) 3099 3210 or 1800 177 273 (toll-free outside Brisbane)

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

BETTER OUTCOMES START WITH BETTER COMMUNICATION. Motivational interviewing is a means by which health care professionals can engage with clients in ways proven to support and initiate behaviour change. For more information on Veriti’s motivational interviewing training programs go to www.veriti.com.au/events/

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