COVER STORY
WOMEN’S RIGHTS
ACTU
REGULARS
Union cooperation vital to improve health
Solidarity: the antidote to inequality
Sally McManus on the challenges facing workers
page 8
page 14
page 22
Your rights and entitlements at work Nurse Uncut – your stories What nurses and midwives said Nursing research online
COVER STORY
THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 74 NO. 8 | SEPTEMBER 2017
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CONTENTS Contacts NSW Nurses and Midwives’ Association For all membership enquiries and assistance, including Lamp subscriptions and change of address, contact our Sydney office. Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnma.asn.au W www.nswnma.asn.au Hunter Office 8-14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962 For all editorial enquiries letters and diary dates T 8595 1234 E lamp@nswnma.asn.au 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au Editorial Committee Brett Holmes, NSWNMA General Secretary Judith Kiejda, NSWNMA Assistant General Secretary Coral Levett, NSWNMA President Peg Hibbert, Hornsby Ku-ring-gai Hospital Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health Advertising Danielle Nicholson T 8595 2139 or 0429 269 750 F 9662 1414 E dnicholson@nswnma.asn.au Information & Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, Coordinator. T 8595 2175 E gensec@nswnma.asn.au The Lamp ISSN: 0047-3936 General Disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised. Privacy Statement The NSWNMA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information, please contact the NSWNMA office. If you are still not satisfied that your privacy is being maintained, you can contact the Privacy Commission. Subscriptions for 2017 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30. Individuals $82, Institutions $138, Overseas $148.
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VOLUME 74 NO. 8 | SEPTEMBER 2017
8
COVER STORY
Union cooperation vital to improve health Health unions are working closely together to improve aged care staffing and defend public hospitals, Brett Holmes told annual conference.
10 11
COVER STORY Time to challenge climate of fear
The state government’s treatment of public sector employees encourages health sector managers to flout industrial awards argues Judith Kiejda. COVER STORY
12
ged care campaign backed by solid evidence A There is mounting evidence of the need for safer staffing of nursing homes says ANMF Federal Secretary Lee Thomas. MENTAL HEALTH More beds without ratios in mental health
14
NSW Minister for Mental Health Tanya Davies used her annual conference address to restate the government’s rejection of ratios and its focus on community-based mental health.
REGULARS
5 6 6 27 33 35 37 39 41 43 45 46
Editorial Competition Your letters News in brief Ask Judith Nurse Uncut Facebook Nursing Research Online Crossword Book Club At the Movies Diary Dates
WOMEN’S RIGHTS Solidarity: the antidote to inequality
16
Globalisation, militarism and fundamentalism are driving global inequality argues Kate Lappin.
UNION ORGANISING Making leaders
20 22
Unions are organisations that transform people’s lives and help build a better world says Hahrie Han, a US expert on organising.
WAGE THEFT Underpayments rife
Underpayment of wages has become routine in parts of the workforce with recent migrants and temporary visa holders among the most exploited.
COVER STORY
WOMEN’S RIGHTS
ACTU
REGULARS
Union cooperation vital to improve health
Solidarity: the antidote to inequality
Sally McManus on the challenges facing workers
page 8
page 14
page 22
Your rights and entitlements at work Nurse Uncut – your stories What nurses and midwives said Nursing research online
COVER STORY
p.33 p.35 p.37 p.39
THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 74 NO. 8 | SEPTEMBER 2017
ACTU Ready to rumble
25
She isn’t afraid of the biff and she has a keen eye for beauty. New ACTU Secretary Sally McManus talks to The Lamp about the challenges facing working people.
SHELLHARBOUR DEBATE 12,000 say ‘Don’t sell Shellharbour hospital’
The Illawarra community has shown it is determined to keep Shellharbour Hospital in public ownership.
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EDITORIAL
Brett
Holmes GENERAL SECRETARY
Let’s take this union to another level Unity within our own ranks and with other unions and the community is the key to meeting the challenges we face. This year our annual conference had the theme of Challenge, Inspire, Change: effectively a call to arms to lift our union to another level. All the strengths of our union were on display at conference: great delegates, vigorous debate, the airing of new ideas, a sober analysis of our challenges and a strong commitment by all to make the Association better and stronger. Frankly, this isn’t a choice. We need to be better and stronger if we are to meet and face the challenges in front of us. These challenges also got a good airing at conference: improving and extending ratios, confronting the crisis in aged care, the fight against unfair workplace laws and the need to grow the union, among others. If we are going to win on these issues there is no place for complacency. We have to get better. We have to get stronger. In an interview in this month’s Lamp (pp. 22–23), ACTU Secretary Sally McManus makes the point that employers have become harder and the union movement has to get harder too if we are to repel the attacks on working conditions in Australia. This is not just happening in the private sector. Our Assistant General Secretary Judith Kiejda pointed out at conference how public sector health managers are
also taking advantage of these laws and government policies to flout industrial awards (p10). Workplace laws at both the federal and state level are skewed in favour of employers and have emboldened them to try and push back on our rights and conditions of work. This is not empty rhetoric from the union movement. Numerous economists, including inside the federal Treasury, have been vocal recently about the alarming decline in real wages while profits have continued to soar. This is a direct consequence of these unfair workplace laws that not only increases inequality but weakens our economy.
PATIENTS AND THE ELDERLY NEED US TO BE STRONG Getting better and getting stronger is not just necessary to improve the working lives of nurses and midwives. It’s not just about us. It’s also about the people who depend on us. Patients and aged care residents also need us to be strong. ANMF Federal Secretary Lee Thomas points out in this Lamp
(p.11) how a lack of minimum staffing regulations and inappropriate skills mix is harming vulnerable elderly residents. It is our responsibility to give a voice to the elderly and their families and to fight for the care they need and deserve. They need a champion and who else is going to do it but us. The Minister for Mental Health made it clear at conference that the NSW government won’t budge on ratios. We need to be relentless in getting our message out to the community that ratios save lives and to put pressure on the government to implement them. The key to finding solutions to these problems and challenges is that we stand together and fight for what is right. We need to consolidate and build on the strong relationships we have with other unions and the community. And importantly, we need to engage and convince all nurses and midwives to join us at the NSWNMA, to challenge and to inspire, so we can bring about the change we all believe in. ■
‘ If we are going to win there is no place for complacency. We have to get better. We have to get stronger.’
THE LAMP SEPTEMBER 2017 | 5
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Let down by a system that’s supposed to protect As nurses, it’s our professional obligation to provide the best care possible to all our patients. At the same time, the NSW Ministry of Health has a duty of care to ensure all nurses and midwives are safe in the workplace at all times. On one occasion, a man repeatedly and aggressively yelled and kicked at the main entrance to Nyngan MPS, demanding the doors be opened while his intoxicated friend lay on the pavement. The man then smashed an 8mm glass panel to force his way in. Concerned for our safety, we called 000 to seek police assistance.
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After filing reports on IIMS and the NSWNMA App, raising concerns with management and passing Branch resolutions, we also provided statements to assist NSW Police. You can imagine our disappointment when we learned that this man was not charged with any offence relating to the abuse and intimidation directed towards us. The only offence he was charged with was malicious damage of the MPS. At the court hearing, to our disbelief, the magistrate dismissed the malicious damage charge, on account of the defendant’s evidence that he genuinely believed his friend was going to die. This clearly demonstrates that we, as nurses, can be subject to terrifying acts of violence with absolutely no recourse for those perpetrating that violence. What is the Ministry of Health doing to ensure nurses and midwives working in rural and remote areas are safe when we show up for our shifts, regardless of the day or time of the week? Our Branch has run a community awareness campaign highlighting that there’s NO excuse for violence, whether it is towards our nursing staff or our hospitals, but we need to know that the Ministry is doing everything possible to keep nurses and midwives safe. Paulette Meldrum, EEN, Nyngan
Working with children Can the Association give an insight into why we now have to pay for the Working with Children Check? Ianthe Paterson, Port Macquarie
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NSWNMA responds: The new WWCC regime is a legislative framework introduced by the NSW government and passed by parliament in 2012. The Bill had bipartisan support from the ALP Opposition and many on the cross benches. Part of the legislative schema was diverting responsibility (and costs) of such checks from the employer to the Children’s Guardian, who now has access to far greater material when adjudicating on any such application. At the time, public sector unions protested the legislated shift of onus and cost to the employee away from the employer. As a result of such concerns being ignored, public sector unions in conjunction with Unions NSW sought the creation of a new award in the Industrial Relations Commission of NSW to ensure that the employer remained responsible for the payment or alternatively, reimbursed the employee. Unfortunately, a Full Bench of the IRC rejected that approach and refused to make such an award. As a result, the burden and cost of obtaining the WWCC ($80 for a five-year check) remains with the individual employee. This is not dissimilar to a number of other states and territories that have a fee-paying system. The Association continues to provide support and advice to members to ensure at least the WWCC is only required in areas of legitimate children-related work and that a blanket approach is resisted.
If there’s something on your mind, send us a letter and have your say. The letter of the month will WIN a gift card
SEND YOUR LETTERS TO: Editorial Enquiries EMAIL lamp@nswnma.asn.au fax 9662 1414 MAIL 50 O’Dea Avenue, Waterloo NSW 2017. Please include a high-resolution photo along with your name, address, phone and membership number. Letters may be edited for clarity and space. Anonymous letters will not be published.
Letter of the month
Nurses best for the job Comments in the media lately stated lives are being put at risk because the Hunter’s rescue helicopter uses different types of crews for emergencies and patient transfers. This is incorrect and devalues the work of a highly skilled group of nurses. The service is a key part of the NSW Retrieval and Critical Care network, and in 2013 the NSW Health Reform plan for Aeromedical (Rotary Wing) Retrieval Services recommended the continuation of both doctor and nurse teams for interhospital retrievals, and a Doctor and Paramedic team for prehospital transfers. The doctors and nurses in the Retrieval Service provide a high level of skills, and are specifically
Fair go for grads Recently I was told of a nurse who had finished her graduate year in a Base Hospital. She had been placed in that hospital’s psychiatric unit for the entire year. Most public hospitals provide a program that encompasses experience in at least two different areas. It appears that this hospital didn’t even offer this. She had not requested this area and would have been much happier to have consolidated her university training in the general hospital setting. She has now finished her graduate year
trained in equipment, treatments and procedures that these patients require, including highly difficult ventilation issues, neurosurgical interventions, powerful drugs, paediatric high flow oxygen and non-invasive ventilation which are not part of a paramedic’s skill set. The John Hunter is the only tertiary referral centre for adults and paediatric patients in this vast area. This means that when transferring these critical care patients we are often a mobile intensive care unit, providing care that only those who work in the area of intensive care have the unique skill set to perform. The nurses on the team are highly skilled and experienced intensive care nurses who are able to transfer these skills to areas outside the intensive care unit. These are skills and experience that are different to those of paramedics, who in the Hunter region have no experience in this type of critical care transfer. By having the two different teams, response times are improved, as both the doctor and nurse team and the doctor and paramedic team can be deployed simultaneously to different situations. The nurses stand by this service and the contribution it makes to the Hunter region. Nurses of the Hunter Retrieval Service, Hunter New England and is finding that she cannot even gain a casual position as she has been told that she has had ‘no’ experience in general nursing. This is appalling. Her three years of university training will likely be wasted as she will now probably leave nursing. Ianthe Paterson, Port Macquarie NSWNMA responds: Many nurses move from the specialty of mental health to other areas. We encourage your friend not to give up hope of finding a position. The skills and expertise she has acquired in the mental health setting would be highly valued in many other areas of nursing. If your friend is a member of the Association we encourage her to get in touch as we would be interested in exploring this further.
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THE LAMP SEPTEMBER 2017 | 7
COVER STORY
Union cooperation vital to improve health Health unions are working closely together to improve aged care staffing and defend public hospitals, Brett Holmes told annual conference.
S
tronger cooperation among health unions has aided the battle to protect regional public hospitals and will be vital in advancing other campaigns such as better staffing of aged care, said NSWNMA General Secretary Brett Holmes. Brett told the 2017 annual conference the NSWNMA had reached an agreement with the Health Services Union (HSU) on coverage of assistants in nursing (AiNs) and care service employees (CSEs). “We recently signed a memorandum of understanding that sets out each of our union’s understanding of coverage issues and a way of dealing with disputes that have dogged us on and off over the last 17 years since the creation of the CSE category,” he said. “This has kept us from being truly able to work together in aged care campaigns and has at times hampered our respective bargaining efforts. “Nothing is ever solved overnight but I have hope. “Our ability to truly work in coalition with other unions like HSU and the Doctors’ Union and the community is absolutely essential if we are to have any chance of winning. “And we are seeing some of those wins in the fightback against the privatisation of regional hospitals.” Brett said the NSWNMA joined forces with the HSU, the Doctors’ Union and Unions NSW to force the state government to back down on the privatisation of Goulburn, Bowral and Wyong hospitals. “This campaign has certainly been one of strength in unity – with the community joining us at forums and rallies to reinforce the outrage and send a clear, strong message to the
8 | THE LAMP SEPTEMBER 2017
government that it is not okay to privatise our public hospitals. “We forced Liberal MPs in Shellharbour and Bowral to listen to us and abandon their mission of finding the most ‘efficient’ model, and to promise they would do the right thing by the community. “We influenced the narrative and changed the government’s own line of hospitals being delivered ‘faster, bigger and better’ to make this issue less about efficiency and more about the local community.”
THE FIGHT AGAINST PRIVATISATION IS NOT OVER Brett said health unions would keep fighting to stop the privatisation of Maitland and Shellharbour hospitals. He said delegates should not be swayed by the government’s recent announcement that it would seek a not-for-profit organisation to build and run the new Maitland Hospital. “Although it is not a private profit-based corporation do not be fooled – this is the same deal. “The government still hasn’t got it that ratios save lives, and the private sector for profit or not-for-profit simply don’t get it either.” Brett said the new understanding with the HSU would allow the NSWNMA to focus on a national campaign to improve staffing and skills mix in aged care facilities. He said the campaign to be launched later this year would focus on achieving staffing wins at a nationwide level. “It is a big battle, delegates, and we will need each one of you to help the community understand that they can demand our government and our politicians step up to deliver the care our elders need and deserve.” ■
COVER STORY
‘ The government still hasn’t got it that ratios save lives, and the private sector for profit or not-for-profit simply don’t get it either.’
More members, more gains General Secretary Brett Holmes has urged union members to encourage their work colleagues to join the NSWNMA in order to strengthen the campaign for improved and extended nurse-to-patient ratios. He told the national conference the union’s campaign for improved ratios was achievable “if we draw on our collective strength. We won some ratios in 2011 and now – while the state budget is in surplus – is the time to demand the government take public health seriously and plan for our future. “We know that the politicians will start listening when the next state election is near. “We need a commitment from you, our members, to take action in 2018 and 2019 if we are to achieve a better outcome. “There is strength in numbers but whether we make change is dependent on you, as delegates, to stand up with your colleagues, speak out when there is injustice – even if it seems it does not directly impact on your lives – and make sure the people working beside you are members. “Sign them up, organise them and try to transform them into active and engaged members.” TIME TO REPAIR THE FAIR WORK ACT Brett said nurses needed greater workplace bargaining power to overcome biased industrial laws.
The Fair Work Commission’s decision to cut penalty rates for some of Australia’s lowest-paid workers early this year showed how national industrial law has been rewritten to favour employers. “We have already had attempts from two aged care operators to reduce weekend pay in their enterprise agreements. “The so-called Fair Work Act is broken. There are now at least six legal processes with traps all along the way before we can force the employer to the table to bargain for an enterprise agreement in the federal system. “Even then, they can sit there and simply say ‘no’. “It is not an even playing field to negotiate on your behalf when governments have created an imbalance of power in favour of the employer.” ■
‘ It is not an even playing field to negotiate on your behalf when governments have created an imbalance of power in favour of the employer.’ — Brett Holmes THE LAMP SEPTEMBER 2017 | 9
COVER STORY
Time to challenge climate of fear The state government’s treatment of public sector employees encourages health sector managers to flout industrial awards argues Judith Kiejda.
P
ublic sector nurses need to stand together and “hold management to account” when managers disregard industrial laws, Assistant Secretary Judith Kiejda told the NSWNMA’s 2017 national conference. She said the state government has created a climate that allowed managers of public employees – nurses, midwives, police, firefighters, paramedics and others – to “rule with fear and threats”. The government has capped wage increases at 2.5 per cent which it insisted should also cover improvements such as better staffing ratios. It changed workplace health and safety laws to disadvantage injured workers and “rendered impotent” the Industrial Relations Commission – supposedly the independent umpire – to make it a “rubber stamp” for the government. “That climate then gave managers working in public health the idea that they didn’t have to pay attention to the Award – they could flout the rules with no comeback. “We know what the issues are but as ACTU president Ged Kearney said recently, ‘we don’t just need to wise up we need to rise up.’ We need to change those rules back to a more balanced work environment.”
MANAGEMENT NEEDS TO BE HELD TO ACCOUNT Judith said management needed to be held to account, particularly on staffing levels. “The skill mix is wrong on so many shifts and the numbers are not much better. “It doesn’t matter if you are a 6 NHPPD hospital or a 5 NHPPD hospital or an aged care facility – if you haven’t got what you need to do the job we must advocate for those in our care.” Judith praised recent actions by NSWNMA branches at Nyngan Hospital, Dubbo Base Hospital and Hornsby Hospitals. “Look at how Hornsby Branch arced up when management decided they were going to put AiNs in mental health ICU. “We need to see that level of commitment right across 10 | THE LAMP SEPTEMBER 2017
‘ If you can’t get the staff you need to deliver safe care, get angry about it.’ — Judith Kiejda
the state in every facility where our professional standards are compromised because we are not allowed to have the resources we need. “If you can’t get the staff you need to deliver safe care, get angry about it. Maybe you need to close some beds or refuse admissions until the staff requirements are adequate – just like Belmont Hospital has done this past week. “If you can’t get off duty on time don’t just accept it – put in for your overtime. Too bad if it’s not allowed, take back control. “If they don’t backfill leave in the community health centre don’t pick up the slack; if you can’t get your mandatory education done in work time, don’t do it. “The only rule in any of this is you can’t do it on your own. You need the power of numbers – whether it’s your unit or your total facility – or maybe take some action on a different day for each unit. “Wear ribbons, sit down for 15 minutes – there are so many ways to make them understand that you are serious.” ■
COVER STORY
Aged care campaign backed by solid evidence There is mounting evidence of the need for safer staffing of nursing homes says ANMF Federal Secretary Lee Thomas.
A
national campaign for safer nursing homes will rest on disturbing evidence that a lack of minimum staffing regulations and inappropriate skills mix is harming vulnerable elderly patients. The Australian Nursing and Midwifery Federation’s Federal Secretary, Lee Thomas, told the NSWNMA annual conference the evidence is outlined in three recent studies. The Australian Law Reform Commission’s report, Elder Abuse – A National Legal Response, found that the proportion of registered and enrolled nurses has decreased and the proportion of assistants in nursing/personal care workers has increased. The report released in June said 70 per cent of direct care workers in residential care are AiNs/PCWs, some of whom have no minimum qualifications. “The report outlined how staff tolerate a level of staffing and staff mix in aged care that would close wards in the acute system,” Lee said. “Despite years of discussion and criticism it is still possible to work with extremely vulnerable older people while having no relevant qualification. This should be an outrage.” The report included evidence from ANMF members that a lack of staffing can lead to instances of “inadvertent abuse of elders.” The number of residents in aged care had almost doubled since 1995
‘ We now have the case for reforms needed in aged care and we are determined to see action.’ — Lee Thomas
but governments had failed to do anything to ensure that nursing homes had the right number of staff with the right skills to care for them.
the release of university research commissioned by the ANMF, which showed an urgent need for more staff in residential aged care.
Nursing home resources, human and otherwise, were becoming so scarce that “on many occasions it is just not possible for residents to be cared for safely, or even humanely”.
The report found guaranteed staff ratios and mandated nursing and care hours for each resident are needed to ensure safe staffing.
A Senate inquiry into Australia’s aged care workforce in June found that current nurse-to-patient ratios in aged care were “too low and risked compromising the quality of care delivered” and recommended providers publish their workforce ratios “in order to facilitate informed decision making by aged care consumers”.
ELDERLY ONLY GETTING TWO THIRDS OF CARE THEY NEED The Senate findings followed
“For the first time ever, we have academically rigorous evidence to demonstrate how dangerously inadequate current staffing levels are in residential aged care across Australia,” Lee said. “We also know that residents need 4.3 hours of care per day, but typically receive only 2.84 hours. “This means that on average across the country the frail elderly living in aged care only get twothirds of the care they need every day.” ■ THE LAMP SEPTEMBER 2017 | 11
MENTAL HEALTH
More beds without ratios in mental health NSW Minister for Mental Health Tanya Davies used her annual conference address to restate the government’s rejection of ratios and its focus on community-based mental health.
T
he NSW government continues to reject ratios as a way forward for mental health as it shifts its focus further into a community-based system called ‘Living Well’. At our annual conference, NSW Minister for Mental Health, Tanya Davies, outlined details of the government’s ongoing Living Well plan and ruled out supporting ratios in hospital-based mental health services to focus on “prevention” at the community level. “In terms of your ratios, I know that is a project that your Association has been running on and pushing,” she said. “Again, the NSW Government believes that the current system in terms of nursing unit patient hours is the appropriate, more nimble and more flexible way to enable appropriate response to community needs and to hospital needs.
‘ The focus is – it has to be – on prevention.’ — Tanya Davies
12 | THE LAMP SEPTEMBER 2017
MENTAL HEALTH
ANNUAL CONFERENCE
ND
ROSEHILL GARDENS » 19-21 JULY 2017
“The focus needs to be on sustaining people with a mental illness to live well in their community,” she said. “As a government we need to respond to that by ensuring that appropriate support services are in place – accommodation, support services, connected groups such as clubhouses. Places where people with mental illness can go and feel that they’re welcomed, like a family-type network.”
A FOCUS ON COMMUNITY HEALTH The minister said the NSW government is providing $1.9 billion in mental health funding in this year’s budget with an additional $20 million to help support the Living Well program, which runs from 2014–2024. “It is about transferring the focus, the attention, the services and the programs to a community-based mental health system, while ensuring that the acute hospital-based mental health services are still appropriate and necessary for that community. The focus is – it has to be – on prevention.” The minister believes that over time, efforts to enhance supports in the community will reduce the incidence, frequency, and length of hospitalisations for many mental health consumers, which directly leads to an enhanced quality of life for the consumer and greatly assists those working in a hospital system. Lack of beds for mental health patients will also be assessed as the minister explained that the state budget contains a large component for “planning works for infrastructure delivery in mental health”. “A part of that will be looking at the needs within LHDs across NSW growing populations as to what
‘ We do hope the government wakes up one day and says – ratios save lives’ — Brett Holmes additional beds we need to deliver in our communities, but not just in the acute setting, it’s actually stepping down all the way back into the community,” she said.
CHALLENGE.Inspire.CHANG .
S O N RS O P S NSW Nurses and Midwives’ Association gratefully acknowledges the sponsorship provided by the following companies for our Annual Conference held at Rosehill Gardens 19 – 21 July 2017
Nurses & Midwives Health First State Super HESTA Rydges Sydney Central Commonwealth Bank PMP Limited Scott & Broad Fuji Xerox Angel MahChut Architects Chifley Financial Services ME Bank Phil Gilbert Motor Group Hester Communications Telstra
“Because we know that there is a gap in the system for sufficient community-based step-down accommodation facilities, and that can contribute to people not being able to be released out of hospital settings. So there is comprehensive work that’s being done in that space.” Under the recently released state budget, the current spending in health over the next 12 months will be $21.7 billion, up by $1 billion from last year, she said. In reply to the minister’s presentation, NSWNMA General Secretary Brett Holmes restated the Association’s clear position on staffing in mental health as in all parts of the public health system. “We do hope that the government wakes up one day and says: ‘Ratios save lives’,” he said. ■
The Association also thanks the following companies for their contribution and assistance Cetaphil Crabtree & Evelyn DB Health DU’IT Tough Hands Ferndale JILA mini mints Garnier SkinActive Hamilton Skinactive Lindt & Sprungli THE LAMP SEPTEMBER 2017 | 13
WOMEN’S RIGHTS
Solidarity: the antidote to inequality Globalisation, militarism and fundamentalism are driving global inequality argues Kate Lappin.
“
Capital is not held in the hands of women,” Kate Lappin, a leading women’s rights activist, told this year’s NSWNMA annual conference. She noted that half of the world’s wealth is owned by just eight men, as a recent report from Oxfam found. Lappin is the regional coordinator for the Asia Pacific Forum on Women, Law and Development (APWLD), an organisation that represents 200 women’s rights organisations. She spoke at this year’s annual conference about the links between neoliberalism and inequality. In recent decades, neoliberal ideology has seen the “barriers to foreign corporations and foreign investment moving across borders progressively dismantled”. The process has occurred in both developed and developing countries, she noted, resulting in “unchecked economic exploitation that has allowed inequality to prosper”. As Lappin explained, neoliberalism has allowed companies to source cheap labour around the world. And this process has not only increased inequality between developed and developing countries; it has also led to increased inequality within countries. Lappin noted that “in 1965 the ratio of a CEO salary in Australia was 14 | THE LAMP SEPTEMBER 2017
20 times that of an average worker, now it is 113 times. In the US it is 345 times”. The economic changes introduced by neoliberalism means the wealth of Amancio Ortega, the founder of the clothing chain Zara, is “82 million times more” than what a Bangladeshi garment worker who makes clothes for his company can make in a year, she said.
RATIO OF CEO SALARIES TO AVERAGE WORKERS UNITED STATES 2017
345x
WEALTH CONCENTRATED IN THE HANDS OF CORPORATIONS Recent decades have seen global wealth concentrated in corporations: now 69 of the world’s largest economies are corporations, Lappin told NSWNMA annual conference. And 10 of the world’s wealthiest corporations together have more wealth than 180 countries combined.
AUSTRALIA 2017
113x 1965
This concentration of capital in corporations has given business disproportionate power in the political and social decision making of individual countries. “Capital gives you power – democratic power, economic power or personal power,” observed Lappin.
clean up environmental contamination are just two examples of corporations trying to exert power over nations.
Lappin pointed to corporations using legal action to protect profits in developing countries. A French company suing Egypt for raising the minimum wage, and Chevron suing Ecuador for a bill of $9.5 billion to
Unfettered by national boundaries and restrictions on investment and employment, land in developing countries has also increasingly been purchased by big agri-business, she said.
20x
WOMEN’S RIGHTS
This “land grab” has disproportionately affected women, who’ve previously made a living out of local plots. Now these workers are being “pushed into the production chain for low wages”. With so much capital in the hands of large corporations, governments have become indebted to powerful interests. Big corporations seeking low tax havens have successfully pushed for advantageous tax systems in developing countries, Lappin said. The low tax ratios of Asian countries average 14.8 per cent, compared to Australia’s tax ratio of 27.8 per cent and an OECD average 34.2 per cent. Relatively low taxation means less money for basic health and education services, which disproportionately impacts women. And as the gender pay gap widens, families focus more of their money and resources on boys, who are seen to have a greater earning potential. Lappin said the APWLD has estimated that a truly sustainable future requires a major investment in services. The APWLD is calling for “663 million more health care workers and 340 million child care workers globally”.
NEOLIBERALISM DRIVES INEQUALITY With women overrepresented amongst the world’s poorest, the links between capitalism and patriarchy are clear to her member organisations, Lappin said. The APWLD sees a link between neoliberalism, growing inequality and issues such as a rise in women being trafficked. In thinking about systems that “drive inequality”, Lappin said APWLD member organisations “have identified a nexus of three global structures that work with patriarchy to drive inequality, and that is globalisation, militarism and fundamentalism”. Together, these trends are leading us not just to a crisis of gender inequality, but to an environmental crisis, Lappin said. “When we organise the global economy through GDP only, and consumption is the only way we can imagine that we can increase living standards, we will end up with both the climate itself changing and people increasingly pushed off their land.” Encouragingly, Lappin said the feminist movement in the Asia Pacific is organising with other social movements to challenge globalisation on behalf of women in the region. She said the way forward can be found in the history of solidarity strikes that changed the world. Lappin pointed to the Australian maritime workers who boycotted Dutch vessels between 1945 and 1949 in support of Indonesia independence, the international strikes against apartheid, the Sydney Green Bans in the 1970s and, more recently, the Polish women’s strike against abortion bans. “If patriarchy is the system that uses fear and threats to create a kind of global economic political and social order, what is the opposite of patriarchy?” Lappin asked. “For us, it is solidarity.” ■
‘ Relatively low taxation means less money for basic health and education services, which disproportionately impacts women.’ — Kate Lappin THE LAMP SEPTEMBER 2017 | 15
UNION ORGANISING
Making leaders Unions are organisations that transform people’s lives and help build a better world says Hahrie Han, a US expert on organising.
P
olitical science professor Hahrie Han, the daughter of Korean immigrants who migrated to the US with no money or work, understands social change from a perspective that is both personal and professional. Han’s parents found work and eventually moved to a middle-class suburb. Han completed a PhD at Stanford University, and she became a policy adviser to the Obama election campaign and wrote a defining book about Obama’s mobilisation of millions of grassroots volunteers. “Transformation is a core part of what we do as humans”, Han told an audience at the NSWNMA annual conference in July. But if change is a constant part of life, what really matters is “whether people feel like they have a capacity to act or not”. And according to Han, this is where social movements and organisations such as unions come in: it’s these organisations that harness transformations in people’s lives to build a better world. “In any big social change in the past – the civil rights and women’s rights movement – [what is important is] organisations that can channel that transformative power and make social change,” she said.
WHY WE SHOULD WE CARE ABOUT ORGANISING “Organising is about building a set of structures through which people can build their own capacity,” said Han, an expert in political organising and collective action. Han said unions and other social movements work most effectively when they can harness the disconnect people feel between “the world that I want” and “the world as it is”, and use the anger people feel to “fuel the fight” for something better. Unions and leaders of social movements help people to see that “I am able to take charge of my own life, to build a life that I want.” “That agency, that capacity to act, is at the core of 16 | THE LAMP SEPTEMBER 2017
what organising is; it’s the core of what a movement is.” When Han talks about “leaders”, she’s not referring to a handful of people at the top; instead it’s the many behind-the-scenes organisers who are crucial to successful social movements. Effective organisations develop leaders in each community, “modelling in a powerful way [so] that people begin to develop the transformative capacities to make the change they want”. Speaking from the floor, NSWNMA member Bernadette Roberts described a local example of effective organising, the “I Care for Palliative Care” campaign. The nine-month campaign led to the state government promising $100 million for palliative care just prior to the state budget coming out this year. “A lot of that [campaign] was using principles of getting people involved. We had 20,000 advocates across NSW, 100 really active, and 15,000 pledges.” “The most influential part was having the leaders,” Roberts said. “When people who didn’t know much about palliative care heard from people who understood the issue and felt really passionate about it, it really made a difference in terms of getting people to support the campaign and to understand they could have an impact,” Roberts said.
TRANSFORMATION NEEDS TO BE AT THE HEART OF ORGANISING A paradox of political organising, Han reminded the audience, is that people who need change most often don’t have the capacity or resources to make the change they need. “When we think about the toughest problems that we have in health, the vulnerable populations where we see deprivations and diseases, a lot of those problems at the core are about power.” Organising is therefore about changing the way resources are used. Building a sustainable movement depends on transforming individual leaders, and
EDUCATION@NSWNMA
COVER STORY
‘ When we think about the toughest problems that we have in health, the vulnerable populations where we see deprivations and diseases, a lot of those problems at the core are about power.’
then creating structures through which those leaders can act. Organisations that do this well are ones that distribute “leadership capacity and authority throughout the organisation” to teams and leaders working out in the communities, Han said. Becoming a leader means learning how to organise and work with others, and knowing how to “face rejection”. She added that leaders are “made, not born”. Effective organisations also tend to have many diffuse leaders working interdependently, Han said: “they find ways to put people into connection with each other and make people part of decision making within the organisation”. Change can lead people to respond with either fear or hope. Donald Trump, Han observed, is an expert at mobilising the former emotion, “creating a whole movement around fear of the other”. But Han urged activists to focus on people’s potential for positive emotion.
HAHRIE HAN’S THREE KEYS TO ORGANISING • change comes about when we decide to act • strength is built on our relationships with those we want to act with • strong relationships are founded on shared values and goals Hahrie Han is the author of How Organisations Build Activists: Civic Associations and Leadership in the 21st Century
what’s ON AGED CARE NURSES’ FORUM REGIST NOW &ER SAVE T H DATE! E
Elder Abuse FRIDAY 20 OCTOBER
9am to 4pm NSWNMA, 50 O’Dea Avenue, Waterloo For RNs, ENs and AiNs in residential, community and hospital aged care settings, across private and public sectors. Hear from a range of speakers and network with colleagues from residential, community and hospital aged care settings, across private and public sectors. DRAFT PROGRAM*: Aged care update What is abuse: recognising and responding to abuse Impact of elder abuse on the worker Legal issues Mindfulness – looking after yourself in times of stress. COST: members $30 / non-members $60 Lunch and refreshments provided *We reserve the right to change the program without notice
Register online
bit.ly/ NSWNMAeducation For enquiries contact NSWNMA Metro: 8595 1234 Rural:THE 1300 367 962 2017 | 17 LAMP SEPTEMBER
Delegates enjoying the dancefloor
ANNUAL CONFERENCE 2017 THE EXQUISITE DÉCOR OF THE WESTIN HOTEL’S GRAND BALLROOM OFFERED A SOPHISTICATED AMBIENCE FOR THIS YEAR’S GRAND GALA BLACK TIE ANNUAL CONFERENCE DINNER AS DELEGATES SWAPPED SCRUBS AND CIVVIES FOR MORE GLAMOROUS ATTIRE.
18 | THE LAMP SEPTEMBER 2017
Clowning around: delegates in costume
BEST GROUP Black Tie, Top Hats – Angela Ditrich, Heather Howlett, Gail Card, Vicki Martin and Margaret Barden
BEST MALE Left, Warren Isaac, Armidale Community Health Centre and right, Charles Linsell Life Member
NSWNMA Councillors
Delegates with creative interpretations of Black Tie
BEST FEMALE Sylvia Moons, Wagga Wagga Rural Referral Hospital
THE LAMP SEPTEMBER 2017 | 19
WAGE THEFT
Underpayments rife Underpayment of wages has become routine in parts of the workforce with recent migrants and temporary visa holders among the most exploited.
U
nions NSW has launched a campaign to reduce the deliberate underpayment of wages, which it calls wage theft. The organisation, which represents most of the state’s unions, has carried out an audit of job advertisements on Chinese, Korean and Spanish language websites. It found 78 per cent of businesses advertised rates of pay below the minimum Award wage. Unions NSW has published its findings and set up a website including a “wage thieves register” (http://www.wagethieves.com.au/wp/). The site allows the public to anonymously report employers who underpay wages. “The current approach to redressing migrant worker underpayment and Fair Work Act protections are not working,” the report says. “The system relies heavily on individuals reporting underpayments to unions or the Fair Work Ombudsman. There is no recognition of how difficult and dangerous it is to take this first step.” The report says workers from non-English-speaking backgrounds including those on temporary work visas often face language barriers and are unaware of their workplace rights. “They must also consider how a complaint could threaten their visa or residency status. “There is a flourishing culture of underpayments in some sections of the workforce where businesses ignore Awards and instead defer to unregulated ‘local wage markets’ to determine the rates of pay for their staff. “Unions have been restricted from accessing these workplaces to investigate and rectify underpayments.”
IMPROVED UNION ACCESS PART OF THE SOLUTION Unions NSW calls for a new approach to uncovering and investigating wage theft. 20 | THE LAMP SEPTEMBER 2017
‘ There is a flourishing culture of underpayments in some sections of the workforce.’ — Unions NSW It wants to change the Fair Work Act, which now restricts unions from conducting workplace checks on businesses suspected of underpaying and exploiting workers. Unions are now only able to check the pay records of union members. It wants higher penalties for employers found to have knowingly or intentionally underpaid their staff, including criminal penalties and restrictions on individual offenders from managing a corporation. Companies found to have underpaid workers should be named and shamed on a national public register of employers. The Unions NSW audit targeted the “extensive network of websites and social media pages directed at people from specific nationalities and language groups who are new to a particular city or town.” On Chinese, Korean and Spanish language websites it found “overwhelming” rates of underpayment for jobs in hospitality, cleaning, transport, construction and retail. “Employers in these industries who have been caught underpaying workers have often claimed they were guided by an artificial wage market within their industry/geographical area,” the report says. On average, underpaid jobs were advertised at $14.03 an hour, representing an average underpayment of $5.28 an hour when compared
2 0 WAGE THEFT 10 11
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Advertised hourly rate of pay in AUD
Figure seven
Underpayments by language group
20 19
Average award rate
18
Average advertised rate of below Award advertisements
Rate in AUD
17 16 15 14 13 12 11 10
Spanish language (18 ads)
Korean language (61 ads)
Chinese language (78 ads)
6 to the relevant minimum awards. The lowest rates of pay were $4.20 an hour for a nanny (minimum award $18.91 in 2015–16) and $9 an hour for an office clerk (minimum award $18.38 in 2015–16).
ALP promises to get tough NSW Labor leader Luke Foley has pledged an ALP government will introduce the toughest fines in Australia to crack down on wage theft. Foley said Labor would punish businesses that repeatedly engage in wage theft, including those who pay workers half the legal minimum wage, or pay for only half the hours worked. “When there is systematic exploitation of workers in the workplace, government has a responsibility to intervene,” Foley said. “Vulnerable young workers are being cheated out of a staggering amount of wages by unscrupulous bosses and it has to stop.” Across Australia, youth unemployment is sitting at 13.3 per cent, significantly higher than the overall unemployment rate of 5.9 per cent.
REPEAT OFFENDERS ARE COMMON Unions NSW says audits by the Fair Work Ombudsman have revealed repeat offenders, who despite being caught and fined, continue to underpay workers. Just this year, Fire and Stone Restaurant faced $72,000 in penalties for its second offence of underpaying workers, while packing service Rapid Pak underpaid workers $23,479 and had previously underpaid workers $60,000. Gold Coast restaurant Samurai’s Paradise was found to have paid a worker as little as $8 an hour. Immediately following the payment of back pay, it reverted to the $8 rate. A 2016 survey of 1433 international students and 959 local students from Sydney, found 87 per cent of international students and 43 per cent of local students who worked in hospitality were underpaid for weekday work. The Unions NSW campaign follows a joint Fairfax Media/ ABC investigation of 7/11 convenience stores, which showed the franchise business model relied on the underpayment of workers. An elaborate scheme of book-keeping forgery and threats to staff was used to hide rampant underpayment of workers, mostly on temporary work visas. A recent Four Corners investigation found use of blackmail to underpay and silence workers was rampant on farms and factories across Australia. The Fair Work Ombudsman has only 240 inspectors nationwide to cover Australia’s 12 million workers. ■
‘ Vulnerable young workers are being cheated out of a staggering amount of wages.’ — Luke Foley
THE LAMP SEPTEMBER 2017 | 21
Q&A: SALLY McMANUS
Ready to rumble She isn’t afraid of the biff and she has a keen eye for beauty. New ACTU Secretary Sally McManus talks to The Lamp about the challenges facing working people.
YOU’VE BEEN ACTU SECRETARY FOR 6 MONTHS NOW. WHAT’S YOUR ASSESSMENT OF THE HEALTH OF THE UNION MOVEMENT? The union movement is on the front foot and growing in confidence. You can feel that wherever you go across the country. I spend a lot of time talking to members and what I get from them is that they are sick of a system that’s stacked against them. They are hurting at work with pressure on wages and employers having too much power. They are feeling inspired to be part of a movement that is going to change the rules.
BUT UNION MEMBERSHIP HAS BEEN IN DECLINE FOR SOME TIME NOW. HOW ARE WE GOING TO TURN THIS AROUND? Joining a union or standing up for your rights or better is a hard decision if you are a casual worker or labour hire, or if you are on a temporary work visa. Workplace laws have changed 22 | THE LAMP SEPTEMBER 2017
and allowed employers to exploit the loopholes to make workers insecure. We can do something about this simply by changing our workplace laws and making them fair again. I think that will make a difference to people wanting to join a union. We’re also looking at technology to make it easier to join a union. We are progressing some technological innovations that will enable that.
WHAT ARE THE BURNING ISSUES THAT THE UNION MOVEMENT HAS TO CONFRONT? Our main focus is on the issue of inequality, which is at a 70-year high. To address this there needs to be fairer distribution of wealth. Since the GFC most of the wealth has gone to the top 1 per cent. There are two important ways of doing something about that. The first is making sure people have strong enough rights in order to win pay rises from their employers so wealth is being distributed fairly. Secondly, it is important to change the tax laws. The fact that many profitable corporations paid no
tax in Australia last year is appalling and the fact that millionaires don’t even pay the Medicare levy is unacceptable.
DO YOU THINK THE UNION MOVEMENT HAS BEEN A BIT TOO “POLITE” IN DEALING WITH POLITICIANS AND BUSINESS – THAT WE NEED TO DEVELOP A HARDER EDGE? Things have changed really rapidly. A lot of employers in our country are big multinational corporations. They don’t think about social responsibility and they are much harder in the way they make money. They will move things offshore to make bigger profits. They don’t care about the consequences when they do that. They have become harder edged and we absolutely need to become harder or else we will just get walked over. We can’t operate like before when we all sat around the board table and everyone respected everyone’s position. They not only don’t want us at the board table; they don’t want us to exist at all.
Q&A: SALLY McMANUS
YOU’VE SAID NEOLIBERALISM “HAS RUN ITS COURSE”. WHAT’S YOUR VISION FOR AN ALTERNATIVE WAY FORWARD? Neoliberalism was about getting governments out of the way. I’m a believer that there is a very important role for government. Let’s remember what governments are – it’s us, the people, who decide the type of society we want. We need a strong union movement that keeps politicians honest, but we also need political parties brave enough to make the changes needed to deal with inequality.
MALCOLM TURNBULL HAS BEEN OPENLY HOSTILE TOWARDS YOU. WHAT’S THAT ALL ABOUT? The Liberal party always resorts to bashing unions when things are bad for them. They’d like to have union leaders who are compliant and always agree with them, that aren’t going to challenge the status quo. So I suppose they find it confronting
‘ Employers have become harder edged and we absolutely need to become harder.’ — Sally McManus that I’m not doing that. For me the views of Malcolm Turnbull or The Australian newspaper don’t concern me because I don’t work for them. I work for union members. They are the people I represent. They are the people I am going to go out and fight for.
YOUR FACEBOOK PAGE HAS BEAUTIFUL PHOTOS OF BIRDS AND WILDLIFE. PLUS, A LOT OF YOU IN A SYDNEY WESTERN WANDERERS FOOTY SHIRT AND EVEN ONE OF YOU AT A THAI BOXING BOOT CAMP. IS THIS HOW YOU CHILL OUT?
out. I love the discipline of martial arts and I find it quite calming and I stand by the principle of it – the strong defending the weak. In terms of the Wanderers, I’m from Western Sydney and they are my football team. I love the Parramatta Eels as well and the Greater Western Giants in AFL. Bird watching and wildlife watching is something I’ve developed over time. I find the process of finding birds and capturing them with photography very enjoyable. It’s time in their world and not your world. ■
I’m not doing martial arts at the moment but I have done it all my life so that has been a part of how I chill
THE CHOICE FOR NURSING. If you’re looking to further your career in nursing then take a closer look at Western Sydney University. As one of Australia’s leading nursing institutions we’re world renowned for our teaching and research activities. In fact, our Nursing school is ranked No. 1 in Australia and Top 100 in the world. Our innovative professional programs ensure our graduates are highly sought after. We offer a wide range of Graduate Certificates in Nursing to help you take your career to the next level including Nursing, Primary Health Care, Child and Family Health (Karitane), Mental Health Nursing, and Acute and Critical Care Nursing. And because advancing your career shouldn’t mean putting it on hold to study, many of the courses are offered online so you can learn where and when it suits you.
Register to attend our October information evening and learn more about Graduate Certificates in Nursing westernsydney.edu.au/postgraduateTHE LAMP SEPTEMBER 2017 | 23
COVER STORY
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enough to have a defined benefit super scheme? Where the brandmark is positioned top left The right advice will help you make the most your retirement. in a of communication, the legacy”statement should be left aligned.
Defined benefit super schemes can help set you up for a comfortable retirement – but they’re complicated. It can be difficult to understand your benefits and easy to miss opportunities.
At StatePlus, we have over 26 years of experience in the public sector helping hard-working Australians just like you on their journey into retirement. Join us for a free pre-retirement seminar with our financial experts to see how we can help you plan ahead and get the right advice now, so you can live the kind of retirement you deserve.
Register today to find out how you can make the most of your benefit in retirement. Visit stateplus.com.au or call 1800 841 677.
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24 | THE LAMP SEPTEMBER 2017
COVER STORY
12,000 say ‘Don’t sell Shellharbour Hospital’
A
The Illawarra community has shown it is determined to keep Shellharbour Hospital in public ownership.
petition signed by more than 12,000 Illawarra residents opposing the privatisation of Shellharbour Hospital prompted vigorous debate in the NSW parliament last month. Labor MPs said the petition showed the depth of community feeling and demanded the government rule out any privatisation plan. Even the Liberal Party’s MP for Kiama, Gareth Ward, demanded the government make a quick decision on the issue. Shellharbour is one of five regional hospitals originally listed for privatisation under a “public–private partnership” (PPP) late last year. The government has since abandoned PPPs at Wyong, Bowral and Goulburn hospitals but Shellharbour and Maitland hospitals remain up for grabs. The parliamentary debate on the Shellharbour Hospital petition was watched by hospital staff and community supporters who travelled to Sydney by bus. They included emergency department nurse Silvana Dimovski, who finished a busy nightshift before boarding the bus after less than two hour’s sleep, the Illawarra Mercury newspaper reported. “The community is rallying behind us – I hear it at the shops, on the street, and on the wards,’’ she told the paper. ‘’I’m fighting for my patients to have quality care, for the community’s right to have equitable access to their hospital. And I’m fighting for my colleagues and I to have job security, to not lose our current salaries and entitlements.’’
CRACKS IN THE COALITION Inside parliament, MP Gareth Ward, the government’s Parliamentary Secretary for the Illawarra and South Coast, caused a stir when he demanded an answer from Health Minister Brad Hazzard on the hospital’s future. “Hurry up and get this thing done,” he told the minister. “Whatever decision you make, I want to see the facts,
‘ Over 12,000 people have made it very clear that this is a hospital that should remain in public hands.’ I want to see the evidence, and I think it’s high time that this debate was brought to a close. “We all want to know all of the information; it’s time to make a decision. I ask you to do that, Minister.” On the Labor side, Shellharbour MP Anna Watson said residents had “made their feelings undeniably clear”. “We have evidence from every corner of the community... we all stand together and collectively reject this government’s privatisation agenda.” Member for Wollongong Paul Scully said it was “time the government listened” to what the Illawarra had to say and “back-flipped” on their decision. Keira MP Ryan Park said the region was known for its “fighting spirit” and “over 12,000 people have made it very clear that this is a hospital that should remain in public hands.” Support for Shellharbour’s nurses and residents has also come from communities that earlier forced the government to back down on hospital privatisation. In Bowral, local shire councillor Graham McLaughlin said the government had backed down on issues when it faced a major community backlash. “I’m hoping the people of Shellharbour can get a win like we’ve had up here,” he said. Wyong MP David Harris said his community’s defeat of hospital privatisation had “resonated right through the whole community and that’s what we have to capture in Maitland, Shellharbour and Port Kembla – not because we’ve had a victory, but because it’s the right thing to do.” ■ THE LAMP SEPTEMBER 2017 | 25
ASSOCIATION MEMBER TRAINING
2017
Trade Union Training for NSWNMA Members BRANCH ESSENTIALS
WINNING AT WORK
DELEGATE SKILLS
(TWO-DAY COURSE)
(TWO-DAY COURSE)
(ONE-DAY COURSE)
6-7 September 22-23 November
13-14 September 8-9 November
19 September 21 November
8:30am registration for 9am start 5pm close
8:30am registration for 9am start 5pm close
NSWNMA Waterloo Office
NSWNMA Waterloo Office
10am – 4pm (Followed by Committee of Delegates) NSWNMA Waterloo Office
The most effective unions are those that have active workplace representatives. This 2-day course aims to provide you with the skills and knowledge you need to understand how the NSWNMA can win improvements in your workplace, across the industry, and how you can be an effective branch member. This is a MUST DO for newly elected branch officials, those wanting to brush up, or any members keen to become more involved in the Association.
This course is aimed at members who are ready to take it up a notch. Perhaps there’s a long standing issue at work that needs a bigger campaign, perhaps your branch is involved in the state-wide issues or perhaps you want to develop skills to campaign in your community. This 2-day course explores how we achieve change and how we encourage decision makers to make the right choice for our communities.
For more information on any of the courses outlined:
The NSWNMA also offers the courses on assisting members during fact finding and disciplinary processes and a range of professional development subjects. For more information on any of these courses please give us a call on 1300 367 962 or email us at gensec@nswnma.asn.au
P 8595 1234 METRO
1300 367 962 NON-METRO E training@ nswnma.asn.au 26 | THE LAMP SEPTEMBER 2017
This course looks at the role of delegates and how your role fits within the NSWNMA. It will help you build confidence around participating as a delegate in your Branch, at Committee of Delegates and Annual Conference
Registration forms and copies of the course outlines are available on our website:
bit.ly/NSWNMAtraining
NEWS IN BRIEF
BRITAIN
Face-to-face bullying more common than cyberbullying A large survey of teenagers conducted by the University of Oxford found a third experienced regular “traditional” bullying while less than 1 per cent experienced online bullying only. The findings, published in the peer-reviewed journal The Lancet Child and Adolescent Health, were based on the responses of 110,000 adolescents who took part in the survey. The study found 30 per cent of the teenagers who replied experienced regular “traditional” physical, verbal or relationship bullying, while 3 per cent experienced both traditional and “cyberbullying” such as being on the receiving end of unpleasant text messages or social media posts. Less than 1 per cent experienced online bullying only. The researchers say any attempts to control the perceived rise in new forms of cyberbullying should also include efforts to crack down on traditional forms of victimisation. “Cyberbullying is unlikely to provide a source for new victims, but can best be understood as a new avenue for victimisation for those already suffering traditional forms of bullying,” they said. The researchers say their findings “are in stark contrast to media reports that young people are now more likely to be victims of cyberbullying than traditional forms”. Those putting in place strategies to curb cyberbullying should be aware that measures are only likely to be effective if they also consider “the dynamics of traditional forms of bullying”.
INDIA
Climate change claims 60,000 Indian farmers lives by suicide Climate change may have contributed to the suicides of nearly 60,000 Indian farmers and farm workers over the past three decades, according to new research. The study – from the University of California, Berkeley – found an increase of just 1°C on an average day during the growing season was associated with 67 more suicides. An increase of 5°C on any one day was associated with an additional 335 deaths, according to a study published in the journal PNAS (Proceedings of the National Academy of Sciences of the United States). In total, the study estimates that 59,300 agricultural sector suicides over the past 30 years could be attributed to global warming. It examined 47 years of suicide records and climate data, and showed “high temperatures increase suicide rates, but only during India’s growing season, when heat also reduces crop yields”. The results are consistent with widely cited theories of economic suicide in India. Temperature increases outside the growing season showed no significant impact on suicide rates, suggesting stress on the agriculture industry was the source of the increase in suicides.
‘ Cyberbullying can best be understood as a new avenue for victimisation for those already suffering traditional forms of bullying.’
Also backing the theory was that rainfall increases of as little as 1cm each year led to an average 7 per cent drop in the suicide rate. Suicide rates dropped for the two years that followed strong rainfall, researcher Tamma Carleton found.
‘ High temperatures increase suicide rates, but only during India’s growing season.’ THE LAMP SEPTEMBER 2017 | 27
EDUCATION@NSWNMA
what’s ON MENTAL HEALTH AND DRUG & ALCOHOL NURSES FORUM – 1 Day Medicinal Cannabis – Debunking the Myths n WATERLOO Friday 8 September Members: $30 | non-members: $60
ENVIRONMENTAL HEALTH FORUM – 1 Day Nurses & Midwives: Seizing Sustainable Healthcare Opportunities n RANDWICK Friday 15 September Members: $60 | non-members: $85 | associate members: $30
L L U F e cours
FINANCIAL WELLNESS SEMINAR
MEDICATION SAFETY FOR NURSES & MIDWIVES – ½ Day
This free half-day seminar is designed to assist people in their decision making regarding their financial future. Subjects covered on the day are detailed below and cater for all ages.
n NEWCASTLE Wednesday 27 September Members: $40 | non-members: $85
TOOLS IN MANAGING CONFLICT & DISAGREEMENT – 1 Day
n WATERLOO Monday 9 October Members: $85 | non-members: $170
PRACTICAL SKILLS MANAGING DIFFICULT AND AGGRESSIVE CLIENTS – 1 Day
n GYMEA Friday 20 October Members: $85 | non-members: $170
L L U F e cours
THE INFLUENTIAL THOUGHT LEADERS IN LEADING – 1 Day n PARRAMATTA Wednesday 1 November Target Group: new managers, senior managers, senior RNs/ RMs, DONs, DDONs Members: $125 | non-members: $225
ARE YOU MEETING YOUR CPD REQUIREMENTS? – ½ Day
n BALLINA Thursday 2 November An essential ½ day workshop for all nurses and midwives to learn about CPD requirements and what’s involved in the process. Members: $40 | non-members: $85
LEGAL & PROFESSIONAL ISSUES FOR NURSES & MIDWIVES – ½ Day n BALLINA Friday 3 November Learn about potential liability, disciplinary tribunals, NMC and HCCC complaints, Coroners Court and more. Members: $40 | non-members: $85
APPROPRIATE WORKPLACE BEHAVIOUR FOR NURSES AND MIDWIVES – 1 Day
This one-day seminar covers topics such as anti-discrimination law, identifying unlawful harassment and bullying, understand what can be done if subjected to harassment and bullying and also assists managers and supervisors to identify, prevent and resolve bullying and harassment. n NEWCASTLE Wednesday 8 November n GYMEA Friday 1 December Members: $85 | non-members: $170
Register online
www.nswnma.asn.au 28 | THE LAMP SEPTEMBER 2017
PROGRAM
• Superannuation Guarantee • Government CoContributions Scheme • Contribution Limits • Salary Sacrifice • Consolidation of Multiple Accounts (Rolling Over) • Insurance (Income Protection / Death Cover / Total and Permanent Disability / Binding Nominations / Nominated Beneficiary) • Investments (Asset Classes / Volatility etc) • Transition to Retirement • Help Links (e.g. MyGov Website / Money Smart Website) • ASFA Retirement Standard (the difference between a modest and comfortable retirement) • Centrelink (General Information e.g. income asset tests) • Q&A •
SHELLHARBOUR
Thursday 21 September The Shellharbour Club
BALLINA
Wednesday 1 November Ballina RSL
Time: 9am to 2pm Lunch and refreshments provided Nurses and midwives: this seminar will not attract CPD hours.
Numbers are limited in some locations. Pre-registration is essential.
Click on the education tab. Scroll down to the education session you would like to register into and click Register Online. For enquiries contact NSWNMA • Metro: 8595 1234 • Rural: 1300 367 962
NEWS IN BRIEF
WORLD
Sperm counts drop by 52 per cent among Western men New research reveals that between 1973 and 2011, the concentration of sperm in the ejaculate of men in Western countries has fallen by an average of 1.4 per cent a year, leading to an overall drop of just over 52 per cent. “The results are quite shocking,” Hagai Levine, an epidemiologist and lead author of the study from the Hebrew University of Jerusalem told The Guardian. Levine said little had been done to address the cause of the issue, and that low sperm counts might also be an indicator of poorer health among men more generally, which has also seen increases in rates of testicular cancer.
‘ This is a classic under the radar, huge public health problem that is really neglected.’ Hagai Levine, epidemiologist Experts say it is still unclear what is behind the drop, citing the under-investment in male reproductive research. Numerous possibilities have been suggested for the lower sperm count, with links to body weight, a lack of physical activity and smoking. It is not the first time researchers have highlighted concerns about sperm counts, but previous studies have been criticised. The authors of the latest study say they have addressed such criticisms towards research methodology. The study, published in the journal Human Reproduction Update by an international team of researchers, drew on 185 studies conducted between 1973 and 2011, involving almost 43,000 men.
WORLD
Fatal fat More than two billion adults and children are suffering from health problems in the world because of their weight. Being overweight – even without being obese – is killing millions of people around the world, according to the most extensive and authoritative study of the global impact ever carried out, reports The Guardian. More than two billion adults and children in the world are suffering from health problems because of their weight, says a team of 2,300 experts led by the Institute for Health Metrics and Evaluation (IMHE), based at the University of Washington in Seattle. In 2015, nearly four million people died from disease related to their weight, most commonly from heart disease. But only 60 per cent were technically obese, which is defined as a body mass index (BMI) over 30. The other 40 per cent, or 1.6 million people, were overweight but not obese. One of the study’s authors, Prof Azeem Majeed from Imperial College London, said you don’t have to be obese to be at risk of mortality and other diseases. “People often assume you need to be really fat to be at risk,” he said. “But once you hit a BMI of 25, your risk of diabetes, heart disease and cancer all begin to increase.” The authors of the paper, published in the New England Journal of Medicine describe “a growing and disturbing global public health crisis”. The study looked at 195 countries, using data from 1980 to 2015.
‘ In 2015, nearly four million people died from disease related to their weight.’
THE LAMP SEPTEMBER 2017 | 29
NEWS IN BRIEF
AUSTRALIA
Australian households are hurting Australian workers are being hurt by stagnant wages and the soaring cost of living according to the latest household survey. The University of Melbourne’s Household, Income and Labour Dynamics in Australia (HILDA) survey found household incomes have been going backwards since the Global Financial Crisis. In 2009, the median household disposable income in Australia was $77,411 (in 2015 dollars), but in the six years from 2009 to 2015, median household incomes actually fell 1.5 per cent to $76,225. Home ownership is now also out of reach for most Australians under 40, with the percentage of people who owned a home in 2014 lower than it was in 2002. In Sydney the numbers were particularly grim, with home ownership for under-40s down to 20 per cent from 31 per cent since 2012. The cost of childcare was also found to be having a profound impact on the lives of working people, with costs up 104 per cent for single income families and 75 per cent for couples since 2002. “Inequality is a live issue in Australia and the HILDA survey confirms it on almost every measure. People are struggling. Children are falling into poverty, the cost of living has skyrocketed, inequality is rife and ordinary household incomes are falling,” said ACTU President Ged Kearney.
‘ Children are falling into poverty, the cost of living has skyrocketed, inequality is rife and ordinary household incomes are falling.’ — ACTU President Ged Kearney
‘ We will campaign, rally and do what is necessary to achieve paid family and domestic violence leave for all.’ — ACTU President Ged Kearney AUSTRALIA
Family violence leave would cost five cents a day New analysis from the Centre for Future Work at the Australia Institute has found the average cost of extending access to 10 days’ paid Family and Domestic Violence (FDV) leave across the workforce would average less than five cents per worker, per working day. The Centre estimated that the cost to employers of extending access to 10 days paid leave to all paid employees in Australia would equal between 0.015 per cent and 0.02 per cent of existing compensation costs – and likely less. Average earnings in Australia are approximately $60,000 per annum across the workforce so FDV would have an average extra cost of $9 to $12 per worker, per year – or just four to five cents per working day. Based on the experience of major employers (both private sector and public sector) who have already implemented paid FDV leave, the actual cost will likely be much lower, says the ACTU.
While you look after those who need it most, we’re looking out for you. Contact us to register today.
02 9965 9456
nurses@pulsestaffing.com.au pulsestaffing.com.au 30 | THE LAMP SEPTEMBER 2017
The ACTU has committed to continue campaigning until every Australian worker has access to a minimum of 10 days paid FDV leave in the future. “It’s critical for survivors and people experiencing family and domestic violence to stay in work and have financial security,” said ACTU President Ged Kearney. “Evidence has shown this is crucial in helping them escape. We will campaign, rally and do what is necessary to achieve paid family and domestic violence leave for all.” Federal Labor promised in 2005 it would legislate for five days’ family violence leave. The NSW ALP State Conference held in July passed a resolution for 10 days’ paid family violence leave.
NEWS IN BRIEF
AUSTRALIA
Power prices soar under privatisation A new report from the Australia Institute confirms that privatising energy assets significantly drives up power prices. According to the report – Electricity Costs (www.tai.org.au) – instead of delivering on promises of cheaper and better electricity supply, privatisation has delivered the exact opposite – higher prices and lower services. The report found that privatisation had led to skyrocketing managerial salaries, sprawling sales departments and record corporate profits for energy companies. It also found that reforms encouraged profit gouging on the part of companies. “All in all, we find that the additional direct and indirect charges are likely to be of the order of $404 to $502 per household per annum,” said the author of the report, David Richardson. Richardson says the promise that privatising, corporatising and marketisation of the electricity sector would deliver cheaper and better electricity supply “never happened”. “Between December 1996 and December 2016, Australian electricity prices increased by 183 per cent—almost three times the overall increase in prices. In those figures the carbon price was barely noticeable,” he said. The government’s own regulators back up the report’s findings. The 2017 Australian Energy Market Commission Retail Energy Competition Review, shows 1 July 2017 power price increases were significantly higher in states that had privatised their energy.
‘ Between December 1996 and December 2016 Australian electricity prices increased by 183 per cent—almost three times the overall increase in prices.’
4-9%
QLD (Public)
6-21% SA (Private)
15-21% NSW (Private)
11-43%
VIC (Private) (excluding Alinta)
BRITAIN
Dementia and Alzheimer’s main cause of death for women A new report by Public Health England suggests that while life expectancy has been steadily increasing – now 79.5 years for men and 83.1 years for women – more of those extra years are spent in poor health. Women can expect to live nearly a quarter of their lives in ill health and men a fifth. The causes of death have shifted since the turn of the century, the report found, with the rise in deaths from dementia and Alzheimer’s the most significant features alongside declines in other diseases. “Since 2001, death rates from heart disease and stroke have halved for both males and females,” it said. “Over the same time deaths from dementia and Alzheimer’s have increased by 60 per cent in males and have doubled in females.” In 2015, heart disease was the most common cause of death among men, but Alzheimer’s and dementia are now the most likely among women. Lifestyle, poverty and education all make a difference to health. Among the medical risks are being overweight or obese and having high cholesterol. “Behavioural risks include smoking, alcohol and unsafe sex, while environmental and occupational risks include air pollution, unclean water and other risks due to the working or living environment,” said the report.
‘ In 2015, heart disease was the most common cause of death among men, but Alzheimer’s and dementia are now the most likely among women.’ THE LAMP SEPTEMBER 2017 | 31
YOUR RIGHTS
Ask
Judith Breaking News More needs to be done for injured workers! Assisting injured members to return to work – either in full or in some modified form – remains a constant battle for these members and the Association. Those injured at work are often treated poorly and disrespectfully, with their future contribution to the workplace often ignored. This has only been made worse by the NSW government changes to workers compensation laws in 2012, despite some subsequent tinkering. New research from Macquarie University* echoes such thoughts and experiences. The current laws are failing workers, and is not providing a robust enough framework to provide for a timely and durable return to work. This research also found that, for many injured workers, their subsequent interactions with employers and insurers are resulting in exacerbated and secondary injuries, along with negative social and vocational consequences. We agree with this finding. Policy makers in general, and certainly the NSW government, must break this corrosive cycle: “by addressing the culture of suspicion and stigmatisation of injured workers and increasing the accountability of employers and insurers for sustainable RTW outcomes”.* Injured workers deserve so much better… and we must speak up at every available opportunity or forum to ensure their rights and dignity are restored and better respected. * Thornthwaite L, Markey R. Return to work after workplace injury: Injured workers, insurers and employers. Aust J Soc Issues. 2017;52:98–115, doi: 10.1002/ajs4.11.
Part time hours at RSL LifeCare
I have been successful in getting a part-time job at a nursing home run by RSL LifeCare. What should I ask for before starting? You should receive, before
When it comes to your rights and entitlements at work, NSWNMA Assistant General Secretary Judith Kiejda has the answers.
commencing employment, an agreement in writing setting out the guaranteed minimum number of hours to be worked and the rostering arrangements that will apply to those hours. Under Clause 12.3 of the RSL LifeCare, NSWNMA and HSU NSW Enterprise Agreement 2015–2017, this should be discussed between you and RSL Lifecare and an agreement reached.
Grandparents leave
I have worked as a registered nurse for some time at a nursing home operated by Hardi Aged Care. Recently one of my colleagues mentioned that our agreement includes Grandparents Leave. How does that work? Under Clause 26 of the Hardi Aged Care Nursing Staff Enterprise Agreement 2016 a permanent staff member can, after 12-months employment, request to take up to one month’s unpaid grandparents leave once per 12-month period to help with caring for a grandchild/ grandchildren. This may include helping out at the time of the birth of a grandchild or in order to help care for a grandchild during school holidays. Approval of grandparents leave is discretionary, and an application can be refused on business grounds e.g. staffing requirements, the amount of notice provided, and operational requirements. When requesting grandparents leave, a statutory declaration outlining the reason is required. Wherever possible, three months’ notice should be provided.
Pay increase at Lifehouse
Following negotiation of our new agreement, when does the next pay increase kick in at Lifehouse Australia? A 2.5 per cent wage increase came into effect from the first full pay period on or from 1 July 2017. A further 2.5 per cent wage increase becomes available on 1 July 2018.
Redeployment of an injured worker
I am an enrolled nurse at a public hospital but injured myself last year at work. It looks like I will not be able to return to my previous position but I am still able to undertake a range of duties. What are my rights to maintain employment? Workers compensation legislation in NSW requires that as far as is practicable, every effort should be made to place an injured staff member into a position that is the same as, or equivalent to, their existing position to which they cannot return. A vacancy, for example, can be filled by the redeployment of an injured worker if they meet the selection criteria for the position or can within an agreed period, with training provided. LHDs must have a process in place to identify injured workers and suitable positions for redeployment. This should occur prior to advertising. These obligations are also set out in Recruitment and Selection of Staff to the NSW Health Service (PD2015_026, Clause 2.3).
Casual conversion to permanent employment
I work in a public hospital as a casual RN. I and other casuals are being told that we cannot become permanent despite working full-time hours for over 12 months, and despite vacant positions being available. Is that right? No. Clause 29, Part II(B) of the Public Health System Nurses’ and Midwives’ (State) Award 2017 permits a casual to request conversion to permanent employment reflecting the hours regularly worked. This request should be in writing, and the employer should not unreasonably refuse. If refused, the reasons must be discussed and a genuine attempt made to reach agreement. THE LAMP SEPTEMBER 2017 | 33
JOURNEY ACCIDENT INSURANCE
REGULARS
Your journey injury safety net
DID YOU KNOW THAT
your membership fees cover you for travel to and from work? If you are involved in an accident while travelling to or from work, NSWNMA’s Journey Accident Insurance provides you with peace of mind. As a financial member of the NSWNMA you are automatically covered by this policy. Make sure your membership remains financial at all times, so you’re covered.
Unsure if you are financial?
It’s easy! Ring and check today on 8595 1234 (metro) or 1300 367 962 (rural). Change your payment information online at
“
It was nice to know that the Association was there to provide that assistance. I am so impressed and indebted to them for it. RN Alexis Devine
”
bit.ly/NSWNMA-alexis Watch Alexis talk about Journey Accident Insurance
“
The Association has been absolutely marvellous, helping me step by step throughout the whole process. They also organised and helped me go back to work on restricted duties. RN Shari Bugden
”
bit.ly/NSWNMA-shari Watch Shari talk about Journey Accident Insurance
www.nswnma.asn.au
34 | THE LAMP MARCH 2017
SOCIAL MEDIA
Do you have a story to tell? An opinion to share? Nurse Uncut is a blog written by everyday nurses and midwives. We welcome your ideas at nurseuncut@nswnma.asn.au
New on our Support Nurses YouTube channel
Nurses and assisted dying
NICU nurse, thriller writer CONFERENCE HIGHLIGHTS Diversity in health http://bit.ly/nswnmaconf17
Even palliative care can’t prevent some people dying awful deaths, Tara tells us from experience. http:// www.nurseuncut.com.au/ nurses-and-assisted-dying-part-1/
In her spare time between NICU shifts and mothering a toddler, Audrey writes thrillers. nurses. http://www.nurseuncut.com. au/this-nicu-nurse-is-also-a-thrillerwriter/
Advice for ‘baby nurses’ WYONG & BOWRAL Celebrations! http://bit.ly/wyongbowral Connect with us on Facebook Nurse Uncut www.facebook. com/NurseUncutAustralia New South Wales Nurses and Midwives’ Association www.facebook.com/nswnma Ratios put patient safety first www.facebook.com/ safepatientcare Aged Care Nurses www.facebook.com/ agedcarenurses Look for your local branch on our Facebook page www.facebook.com/nswnma Follow us on twitter @nswnma / @nurseuncut Share on Instagram by tagging @nswnma and don’t forget to use the hashtag #nswnma!
7 tips for combining study with work
Our readers had a lot of golden advice for new grad nurses, starting with ‘guard your pen’. http://www.nurseuncut.com.au/ your-advice-for-baby-nurses/
Mariel guarantees you can work, study and actually graduate! http://www.nurseuncut.com.au/ 7-tips-for-combining-nursing-studywith-work/
Rheumatic heart disease in pregnancy Rheumatic heart disease in pregnancy http://www.nurseuncut.com. au/rheumatic-heart-disease-inpregnancy-in-australia/
Tax deductions for nurses and midwives What can you claim as a work deduction now that tax time is here? http://www. nurseuncut.com.au/what-can-iclaim-tax-deductions-for-nursesand-midwives/
Listen to our podcast PROFESSIONAL DAY 2017 http://bit.ly/ profession17 THE LAMP SEPTEMBER 2017 | 35
Going to work shouldn’t be like this
Download the NSWNMA App and report your workplace violence incident. The NSWNMA has a tool as part of our NSWNMA Tool Kit App that allows you to quickly report an incident to the Association as soon as it happens. It’s an easy fillable form you can submit from your mobile device and an officer of the Association will be in touch with you. Nursing is considered one of the most dangerous professions. HELP STOP VIOLENCE AT WORK! NSWNMA Toolkit App is FREE and available to download from iTunes and Google Play store 36 | THE LAMP MARCH 2017
SOCIAL MEDIA
your
Say New frontiers to explore
What nurses and midwives said and liked on Facebook www.facebook.com/nswnma
procedure on me rather than have to wait for a lengthy period just to have a doctor do it. It is a brilliant idea and I hope NSW considers this too. I would certainly love to be trained to perform this procedure.
A South Australian proposal to allow nurses to perform colonoscopies on patients deemed to be at low-risk of bowel cancer has been met with mixed responses. I worked in an Endoscopy Unit in a NHS hospital in the U.K. 20 years ago. We had an nurse endoscopist who did gastroscopies and sigmoidoscopies. She was every bit as proficient and capable as the consultants who encouraged and worked alongside her. I would have preferred her than a number of medical staff I have witnessed over the years. I am an RN and I think it should be left to the doctors. They have the medical understanding and clinical expertise in the area. Nurses would be fine doing the procedure. However, if biopsies are required then definitely a doctor needs input. However, it would have to be at least nurse practitioner level. I am confident I could perform the procedure! I would be willing to undertake any necessary training to perform the procedure! However, I am not willing to perform the procedure for a nurse’s wage! If a nurse is trained for it I don’t see a problem. I’d certainly allow a nurse who was trained in that expertise to perform that
the gallery
Let’s get it done, I’m sick of the politics and time and money wasting, it should have already happened. This is Australia. This is 2017. /1
/2
Unmasking aged care Priorities, priorities Magda Szubanski said that we should spend money on aged care, rather than on a marriage equality plebiscite. Here’s what you said. Good on you, Magda. What a waste of money to have to fight for the right to marriage equality. What does this matter to us, it is their right to marry whomever they want. Let’s concentrate on our elderly. Remember, they are ones who have given us the Australia that we have grown up with. Yep, let’s just get on with it. We need to stop wasting time and money and start helping our elderly! Alternatively, we could rehouse homeless people! 100 million would build a few boarding houses! Just get on with it: everyone in this country has a right to equality. Love is love, whether it’s a man and woman, woman and woman or man and man. Just enact marriage equality now. Do not say that everyone is against a plebiscite! That is not true! Well said, Magda. The sooner the better.
In the English series ‘Undercover Boss’, the manager of an aged care facility went undercover. We asked you what you thought.
/3
All care managers need to do this. They may learn something. Why go undercover? How about just spending a day on a ward. With no notification to the ward so that management see things as they actually are – not a “tidied up” version. This would be nice, but do they want to know what is going on? I don’t think so. They already know. As the comments go, it’s a business! This would be great, assuming that the bosses don’t already know what’s wrong – many of them do, they just don’t try to fix the issues. It’s also assuming that they might actually care about what’s wrong – and a lot of them really don’t care that much. This is an awesome idea because sometimes we don’t have a clue how our dearest family members are treated, good or bad. I know I’d like to know and have peace of mind that my mum would be treated as I would treat her. I totally agree, except so long as there’s money to be made in aged care, the standards will drop. So sad.
/4
/5
1/ Wyong NSWNMA Branch celebrate their massive win in keeping their hospital in public hands 2/ Bowral nurses and midwives join with their community to celebrate the decision to keep Bowral Hospital public 3/ Shellharbour and Port Kembla nurses and midwives send a strong message to MPs as they visit NSW Parliament 4/ Huge support at the Labor Party State Conference for our “Keep NSW in a Healthy State” campaign 5/ Nurses and nursing students rally to end sexual violence on our campuses
THE LAMP SEPTEMBER 2017 | 37
LIONS NURSES’ SCHOLARSHIP Looking for funding to further your studies in 2018? THE LIONS NURSES’ SCHOLARSHIPS OPEN ON 1 AUGUST AND CLOSE ON 31 OCTOBER EACH YEAR The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships. Nurses eligible for these scholarships must be resident and employed within the State of NSW or ACT. You must currently be registered with the Nursing and Midwifery Board of Australia
and working within the nursing profession in NSW or the ACT, and must have a minimum of three years’ experience in the nursing profession – the last twelve months of which must have been spent in NSW or the ACT. Details of eligibility and the scholarships available (which include study projects either within Australia or overseas), and
application forms are available from: www.nswnma.asn.au/education Administration Liaison Lions Nurses’ Scholarship Foundation 50 O’Dea Avenue Waterloo NSW 2017 or contact Matt West on 1300 367 962 or education@nswnma.asn.au
COMPLETED APPLICATIONS MUST BE IN THE HANDS OF THE SECRETARY NO LATER THAN 31 OCTOBER Lion Nurses Scholarship.indd 1
38 | THE LAMP SEPTEMBER 2017
10/07/2017 10:37 AM
NURSING RESEARCH ONLINE The Australian Journal of Advanced Nursing aims to provide a vehicle for nurses to publish original research and scholarly papers about all areas of nursing. Papers will develop, enhance, or critique nursing knowledge and provide practitioners, scholars and administrators with well-tested debate. The journal is available at ajan.com.au
Elements to promote a successful relationship between stakeholders interested in mental health promotion in schools
A paediatric nurses’ journal club: developing the critical appraisal skills to turn research into practice
Christine Handley, Professor Margaret McAllister
Margaret Purnell, Gina Majid, Dr Virginia Skinner
Research and systematic improvements in a multidisciplinary issue such as mental health promotion require ongoing collaboration. This paper explains the successful processes identified in a collaborative research project involving teachers, child and youth mental health practitioners and academic researchers. Elaborating on the active elements may be useful in working out how to sustain engagement and enhance the sustainability of the working relationship between these three groups. Because these three groups have varied skill sets, training, and perspectives on youth learning and wellbeing, ongoing collaboration may also herald the development of new models to approach challenges and implement programs for youth mental health.
Health professionals are required to continually assess their clinical practice to provide the best patient care. Evidence-based practice provides a structure for finding and evaluating the latest current research evidence and integrating it into daily clinical care. This is fundamental to optimising patient outcomes (Profetto McGrath et al 2010). Keeping clinically current in the nursing profession has become more important in recent years, especially with increasing research being published to support changes in practice. Honey and Baker (2011) identified a clear need for healthcare professionals to be more research aware in order to meet the requirements of professional registration and to deliver patient care that is informed by evidence. There are a number of strategies that can be used to achieve these standards. One of these strategies is to initiate and integrate a regular journal club into the professional development time of the workplace environment. This paper outlines a study that was conducted to explore the impact of one such hospital-based journal club. The project aimed to assess whether implementation of a regular journal club improves critical appraisal confidence and facilitates integrating research literature into nursing practice. http://www.ajan.com.au/Vol34/Issue4/4Purnell.pdf
http://www.ajan.com.au/Vol34/Issue4/2McAllister.pdf
Accessibility and outcomes from a rural diabetes nurse-educator led self-management program Diane Roberts, Bernadette Ward, Deborah Russell, Belinda O’Sullivan Diabetes is a significant global problem. Prevalence among adults is estimated to be 9 per cent and in 2013 it was the seventh leading cause of death (Vos et al 2015; World Health Organisation 2014). In Australia, 5.4 per cent of adults have diabetes, and of these 85–90 per cent have type 2 diabetes mellitus (T2DM) (Australian Institute of Health and Welfare 2012; Australian Bureau of Statistics Microdata 2011–2012). The prevalence of T2DM and its associated complications is significantly higher in rural and remote areas and the complications of poor control of T2DM are well known and frequently life-threatening (Australian Institute of Health and Welfare 2008). Nurses working in rural areas play a key role supporting the management of T2DM, particularly where local staff and healthcare resources are limited. This paper addresses the research gaps and investigating factors associated with participation in a diabetes nurseeducator led self-management program that aims to increase access to local diabetes support, education and management for rural Australian clients with T2DM. Further, this study investigates the significance of changes in health outcomes (glycosylated haemoglobin (HbA1c), total cholesterol, BMI, quality of life and psychological distress) for individual clients and factors associated with whether or not HbA1c management goals were achieved. http://www.ajan.com.au/Vol34/Issue4/3Russell.pdf
Managing medical service delivery gaps in a socially disadvantaged rural community: a nurse practitioner led clinic Jo Kelly, Deb Garvey, Mary Anne Biro, Susan Lee Nurse practitioners (NPs) have been authorised and licensed to practise in Australia since December 2000 (Dunn et al 2010). Since 2010, they have had provider and prescriber rights under the Medicare Benefit Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS). By December 2013, 1,000 NPs were endorsed in Australia. In a survey of Australian adults, Parker et al (2014) found that 87 per cent were willing to see an NP regarding their primary care needs. In addition, it is widely accepted that a shortage of doctors in rural areas requires innovative solutions, beyond recruiting overseas-trained doctors and training more local doctors. One such solution is the development of the NP service (Kamalakanthan and Jackson 2009). There is, however, a lack of research regarding the provision of NP services, particularly to rural communities within Australia. http://www.ajan.com.au/Vol34/Issue4/5Lee.pdf
THE LAMP SEPTEMBER 2017 | 39
REGULARS
Recently changed your email? Classification changed?
online. nswnma. asn.au
Log on Update details Go into the draw*
WIN A
32GB
CELLULAR
iPad *The winner must be a financial member of the NSWNMA
online. nswnma. asn.au
40 | THE LAMP MARCH 2017
Log on and make sure all your details are up to date. You can easily update your address, workplace or credit card details as well as pay fees online, print a tax statement or request a reprint of your membership card – it’s simple! Everyone who uses our online portal from 1 July – 30 September 2017 to update their details will automatically be entered in the draw to win.
CROSSWORD
test your
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ACROSS 1. Vomiting associated with pregnancy (6.10) 9. A nonsterile member of a surgical team, who assesses the patient’s condition before, during, and after the surgical operation (10) 10. The evacuation of injured persons from the scene of an emergency by air ambulance (7) 11. Stubborn or viletempered (6)
12. Fatal, deadly, or disastrous (7) 13. Left eye (1.1) 14. A generator, especially one for producing direct current (6) 15. Tax office (1.1.1) 16. Oil-Emulsion Vaccine (1.1.1) 18. Read the Online Help (1.1.1.1) 21. Immunotoxin (1.1) 22. A capacity to perceive that something exists even when it is not seen (6.10)
26. Affected by albinism (7) 27. The lowest point, such as the blood count after chemotherapy (5) 28. Right ear (1.1) 29. Symbol for titanium (2) 30. Vision of objects situated 25-50 cm from either the eye, or more commonly the spectacle plane (4.6) 32. A value that defines a specified measure of a population or dataset
(9) 33. Symbol for molybdenum (2) 34. A lesion closely associated with a primary abscess (9.7) DOWN 1. Ollier’s disease (16) 2. Any of three subtypes of a protease located in cell membranes of the brain (9) 3. Flatfoot (9) 4. Having the capacity to remember (9) 5. Wormlike in shape or appearance (9) 6. A perennial herb containing inulin (9) 7. Pass through a hole or opening (5) 8. Relating to both muscular and tendinous tissues (16) 13. Auricular (4) 17. Eyefolds (9) 19. Having symptoms that develop slowly or appear long after inception (7) 20. Encouraging or promoting investigation (9) 23. Exultingly joyful (8) 24. Related to an asexually produced fungal spore (8) 25. A small, round shield (8) 28. The smallest particle of an element with all the properties of the element (4) 31. Endotracheal intubation (1.1)
THE LAMP SEPTEMBER 2017 | 41
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ESSENTIALS
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5 NSWNMA Royal Blue Cap $10. Quantity: 100% cotton; one size fits all; crossover velcro at back for adjustability & fit 6 ‘Trust me’ Mug $10. Quantity: Postage and Handling $5 per item. Total cost of order $
Phone H MOB METHOD OF PAYMENT Cheque MasterCard
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TO ORDER www.nswnma.asn.au 42 | THE LAMP MARCH 2017 FAX (02) 9662 1414
POST NSWNMA, 50 O’Dea Avenue, Waterloo NSW 2017
REVIEWS DISCOUNT BOOKS FOR MEMBERS The Library is pleased to announce that McGraw-Hill Publishers are now offering members a 25% discount off the RRP! The offer currently covers medical as well as a range of other professional series books. Please see the online Book Me reviews for a link to the promotion code and further instructions, or contact the Library directly for further information.
T ES
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Naoki Higashida, introduced by David Mitchell and translated by KA Yoshida & David Mitchell: Sceptre http://www.fishpond.com.au/ RRP $25.40 ISBN 1444776770
INTE IAL
ST RE
The Reason I Jump
SPE C
book club
All the latest Book Club reviews from The Lamp can be read online at www.nswnma.asn.au/libraryservices/book-reviews.
R
The No. 1 Sunday Times and New York Times bestseller. Written by CI Naoki Higashida when he was only thirteen, this remarkable book AL IN T E provides a rare insight into the often baffling behaviour of autistic children. Naoki explains things like why he talks loudly or repeats the same questions, what causes him to have panic attacks, and why he likes to jump.
He also shows the way he thinks and feels about his world – other people, nature, time and beauty, and himself. Abundantly proving that people with autism do possess imagination, humour and empathy, he also makes clear how badly they need our compassion, patience and understanding. The Reason I Jump gives us an exceptional chance to enter the mind of another and see the world from a strange and fascinating perspective. The book also features eleven original illustrations, inspired by Naoki’s words, by the artistic duo Kai and Sunny.
Caring for people with dementia: a shared approach Christine Wilson
Sage Publications: http://www.footprint.com.au/ RRP $66.00 ISBN 9781412962001
Skills in caring for people with dementia are increasingly demanded of all health care practitioners as the numbers of diagnosed increase. Caring for People with Dementia presents Christine Brown Wilson’s latest research into improving dementia care for both non-expert students and junior staff as well as more senior managers. This book will be indispensable reading for all nursing and healthcare students and practitioners who want to improve the quality of life for people with dementia.
Supporting Children’s Health and Wellbeing Jackie Musgrave
Sage Publications: http:// www.booktopia.com.au/ RRP $59.00. ISBN 9781473930322
In the recent years ‘safeguarding’ measures to ensure the health and wellbeing of all children has become an increasing focus in the early years. Supporting Children’s Health and
Wellbeing helps early years students and practitioners working with children and young people gain an understanding of the key issues relating to children’s health in particular, examining the possible ways in which health can impact upon young children’s early childhood education and care. A timely, topical text that will be invaluable to early years professionals.
Public mental health – global perspectives Edited by Lee Knifton and Neil Quinn,
McGraw-Hill Education: http://www.footprint.com.au/ RRP $35.78. ISBN 9781446268186
Mental health is a fundamental public health priority, and this stimulating and comprehensive book brings together all of the key issues to offer an overview for students and practitioners alike. Written by a team of leading international experts, the book summarises the evidence base and asks the key questions at the heart of a range of topics from community development to public mental health in schools and recovery and wellbeing. All books can be ordered through the publisher or your local bookshop. NSWNMA members can borrow the books featured here via the Library’s Online Catalogue: visit http:// www.nswnma.asn.au/library-services. Call 8595 1234 or 1300 367 962, or email gensec@nswnma.asn.au for assistance with loans or research. Some books are reviewed using information supplied and have not been independently reviewed.
Harrison’s hematology and oncology Dan L Longo, McGraw Hill Education: https://www. booktopia.com.au/ RRP $163.95. ISBN 9781259835834 Featuring a compilation of chapters related to haematology and oncology derived from Harrison’s Principles of Internal Medicine, Nineteenth Edition (including content from the acclaimed Harrison’s DVD, now available here in print), this concise, full-colour clinical companion delivers the latest knowledge in the field backed by the scientific rigour and authority that have defined Harrison’s. You will find 57 chapters from more than 75 renowned editors and contributors in a carry-anywhere presentation that is ideal for the classroom, clinic, ward, or exam/certification preparation.
To purchase a copy of Nurses at Work: A history of industrial and occupational health nurses in New South Wales, Nancy Bundle AM and Jim Kitay go to www.nswnma.asn.au/ nswnmamembers/merchandise/ $20 – NSWNMA Members $39.95 – non members THE LAMP SEPTEMBER 2017 | 43
Bali?
COVER STORY
Do you want to escape to
Re
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i! l w a r a r e n d b d g o e i h n a t t o m e m B u, ew g n g n a a C n i t to win a 5 night holiday rui
The 2017–2018 NSWNMA Member Recruitment scheme prize The winner will experience their very own private oasis in two luxurious villas, with the following inclusions (for two): g Five nights’ accommodation at two super luxe properties located in Canggu, Bali (three nights at Sandhya Villa and two nights at Lalasa Villas) g Return airport transfers and transfers from Sandhya Villa to Lalasa Villas g Breakfast daily g One dinner for two guests at Lalasa Villas g One 60-minute massage for two guests at Unagi Spa g The NSWNMA will arrange return flights for two to Denpasar. You will experience a serene and peaceful holiday away from the hustle and bustle, with Seminyak’s fabulous restaurants and shopping just a stone’s throw away. Relax by your private pool, take a free shuttle service to Berawa Beach or explore the village of Canggu. Recruiters note: Join online at www.nswnma.asn.au. If you refer a member to join online, make sure you ask them to put your name and workplace on the online application form. You will then be entered in to the NSWNMA Member Recruitment scheme draw.
Every member you sign up over the year gives you an entry in the draw! Conditions apply. Prize must be redeemed by 30 June 2019 and is subject to room availability. Block out dates 1–30 August 2018 and 24 December 2018–5 January 2019. Competition opens on 1 August 2017 and closes 30 June 2018. The prize will be drawn on 30 June 2018. If a redraw is required for an unclaimed 44it |must THE SEPTEMBER prize be LAMP held up to 3 months from2017 the original draw date. NSW Permit no: LTPM/17/01625
Prize drawn 30 June 2018
REVIEWS
GIV E
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MOV
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DVD
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at the movies
Dr Jacqui Pich, Lecturer – Faculty of Health University of Technology Sydney is this month’s reviewer. If you would like to be a movie reviewer, email lamp@nswnma.asn.au
GIV E A W
The Final Portrait The Final Portrait is a character driven film that provides an insight into the mind of an artistic genius, Alberto Giacometti, played by Academy Award winner Geoffrey Rush. The eccentricity, self-doubt and unpredictability that characterise his life are mirrored in daily portrait sittings with American writer and art-lover James Lord (Armie Hammer). The process of the portrait sitting for painter and subject is central to the film, and it becomes part of the daily routine for these two men who develop a unique bond. The process is at times torturous as Alberto struggles with the painter’s equivalent of “writer’s block” and regularly stops and starts his painting, often with the catch cry “Oh F__k”). During their time together James becomes privy to intimate details of Alberto’s life, as he becomes almost invisible, like one of the many art works in the studio. Rush’s character is not always likeable but is always engaging. The relationship with his wife
Delicious
and former muse Annette (Sylvie Testud) is often strained as he carries on a very public affair with a young prostitute Caroline, played by Clemence Poesy. She has replaced Annette as Alberto’s muse, and has become a constant companion whose presence is integral to Alberto’s happiness. The end point for the portrait sitting is tenuous as Alberto declares that a portrait is never truly finished, and restarts it a number of times as he strives for perfection. Despite the promise that the portrait would only require a few hours of James’ time, the hours turn into days then weeks. In the end James becomes wise to this ploy and almost tricks Alberto into finishing the portrait, which will become the artist’s final portrait.
Delicious is an honest and compelling story of love, sex, lies and betrayal, where things are never as they seem. Passionate cook Gina (Dawn French) was once married to Leo Vincent (Iain Glen), a successful entrepreneur, chef and hotel owner in Cornwall. Leo owes much of his success to Gina’s exceptional cooking, but since leaving her for the glamorous Sam (Emilia Fox), his business has continued to thrive. When Sam has suspicions that Leo is having an affair she confides in Gina, confident that she’ll recognise the signs. But the secrets and scandals that spill out are proof that sleeping with another woman’s husband is never a good idea – even if he was your husband first. As Sam and Gina try to fix their broken families, will a friendship rise from the ashes of betrayal or will they tear each other apart? Starring: Dawn French (Vicar of Dibley), Emilia Fox (Silent Witness) and Iain Glen (Game of Thrones).
Email The Lamp by the 12th of the month to be in the draw to win a double pass to The Final Portrait thanks to Transmission Films. Email your name, membership number, address and telephone number to lamp@nswnma. asn.au for a chance to win!
Email The Lamp by the 15th of the month to be in the draw to win a DVD of Delicious thanks to Acorn Media. Email your name, membership number, address and telephone number to lamp@nswnma. asn.au for a chance to win! THE LAMP SEPTEMBER 2017 | 45
DIARY DATES
make a date
Diary Dates for conferences, seminars, meetings, and reunions is a free service for members. lamp@nswnma.asn.au
EVENTS: NSW Enrolled Nurse Professional Association (ENPA) NSW Conference 21-22 September, Mercure Hotel, Sydney 1300 554 249 Waves of Change: PANDDA Conference 10-11 October 2017, Novotel Parramatta www.pandda.net Audiometry Nurses Association of Australia Annual Conference. 25-27 October 2017. Novotel North Beach, Wollongong. www.anaa.asn.au Lee Lewis: Lee.Lewis@sswahs.nsw.gov.au 4th International Collaboration of Perianaesthesia Nurses (ICPAN) Conference 1-4 November 2017, Luna Park, Sydney www.icpan2017.com.au Westmead Hospital Critical Care Nursing Conference 3 November 2017 Jennifer Yanga: Jennifer.Yanga@health.nsw. gov.au Where is God in Mental Health? Professional Breakfast 4 Nov 2017, 9 am, Coorong West Ryde http://ncfansw.org - mobile: 0412 862 776 Australian College of Critical Care Nurses NSW Branch Seminar 17 November 2017 Colombo House Theatres, UNSW, Randwick https://www.acccn.com.au/events/event/ nsw-critical-care-seminar-17-november-2017 The Jo Kent-Biggs NETS Neonatal Retrieval Seminar 10 November 2017, Pier One, Sydney Harbour NETS.health.nsw.gov.au Jane Roxburgh: jane.roxburgh@nets.health. nsw.gov.au 5th National Elder Abuse Conference 19-20 February 2018, Sofitel Sydney Wentworth togethermakingchange.org.au
EVENTS: INTERSTATE Australian Palliative Care Conference 6-8 September 2017, Adelaide, pca2017.org.au The Art and Science of Spiritual Care October 2017, Adelaidewww.ncfansw.org 20th ACM National Conference 2017 30 October – 2 November, Adelaide http://www.acm2017.org/conference2017/ The National Enrolled Nurse Association of Australia (ANMF SIG) 11 October 2017, Wrest Point, Hobart nena.org.au/2017NENAConference.html
EVENTS: INTERNATIONAL 6th World Congress of Clinical Safety 6-8 September 2017, Rome, Italy www.iarmm.org/6WCCS 8th International Nursing and Midwifery Student Conference in Spiritual Care: Spiritual Care – A Resource in Nursing 46 | THE LAMP SEPTEMBER 2017
Please send event details in the format used here: event name, date and location, contact details – by the 5th of each preceding month. Send your event details to: lamp@nswnma.asn.au Fax 02 9662 1414 Post 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space. Priority is given to non-profit professional events.
21-22 September 2017 Copenhagen, Denmark http://diakonissestiftelsen.dk 3rd Shanghai International Nursing Conference 28-30 September 2017 Shanghai, China http://nursing.knwpartners.com Heart Rhythm Congress 1-4 October 2017, Birmingham, UK www.heartrhythmcongress.org IHF 41st World Hospital Congress 7 October – 9 November Taipei International Convention Centre, Taiwan https://ihfnews.files.wordpress.com/2017/01/ihftapei-call-for-abstracts-11jan17.pdf Disability Matters: Making the Convention Real 26-27 November 2017, Dunedin, New Zealand disability.matters@otago.ac.nz 10th European Congress on Violence in Clinical Psychiatry 26-28 October 2017 Crown Plaza, Dublin, Ireland http://www.oudconsultancy.nl/dublin_10_ ECVCP/index.html 3rd World Congress on Midwifery and Women’s Health November 13-17 2017, London, UK http://midwifery.conferenceseries.com/europe/ 4th Commonwealth Nurses and Midwives Conference 12 March 2018, London, UK http://www.commonwealthnurses.org/ conference2018 3rd Asian Conference in Nursing Education April 18-20 2018, Yogyakarta, Indonesia. http://acine2018.fk.ugm.ac.id/ 12th PACEA CONFERENCE: Pre-conference Training Courses 4-6 June 2018, Taipei, Taiwan http://ncfi.org/conference/ ncfi-pacea-regional-conference/ NCFI PACEA Conference ‘Christian Nursing in a Troubled World’ 7-11 June 2018 Chientan Youth Activity Center, Taipei, Taiwan ncfi.org/conference/ ncfi-pacea-regional-conference
EVENTS: REUNIONS Hunter Healthcare Workers Prayer Meeting 16 September, 8am-10:30am, Newcastle http://ncfansw.org Nurses’ High Tea 16 September, St John’s Ministry Centre, Ashfield http://ncfansw.org Sydney Hospital Graduate Nurses’ Reunion Lunch 4 October 2017 Parliament House, Macquarie Street Jeanette Fox: (02) 4751 4829 or bekysa@tpg.com.au Ku-Ring-Gai Hospital 1984 Intake Orange Group 30th Reunion
Saturday October 14 2017, Sydney Contact Sue Cushway (Coleman-Davis) susan.cushway@health.nsw.gov.au St George Hospital Graduate Nurses Association 70th Anniversary and Reunion 22 October 2017, 12 pm The Gardens on Forest, 764 Forest Rd, Peakhurst Joan Wagstaff: 02 9771 2508 Prince of Wales, Prince Henry Hospitals and Eastern Suburbs NSW of UNSW 1973 PTS class 17 February 2018, 6 pm Malabar (Randwick) Golf Club Roslyn Kerr: gert@optusnet.com.au Patricia Marshall (Purdy): tapric135@bigpond.com Tamworth Base Hospital February 1984 Intake 30-year Reunion 25 November 2017 Rachel.Peake@hnehealth.nsw.gov.au Vickie.Croker@hnehealth.nsw.gov.au Wendy.Colley@hnehealth.nsw.gov.au Nurses Christian Fellowship, Christmas BBQ 4 December 2017, 6pm Balls Head Reserve, Sydney http://ncfansw.org Crown Street Women’s Hospital Graduates March 1968 50-year Reunion Lunch 1 June 2018 Wendy Wooler kwooler@tpg.com.au RNSH Hospital July 1977 Intake 40-year Reunion Ann Fincher (Wyllie-Olson) afincher0@gmail.com Linda Tebbutt lyndagtebbutt@gmail.com Tamworth Base Hospital February 1976 intake 40-year reunion Sandra Cox: sandra.cox@hnehealth.nsw Sean O’Connor: 0408 349 126 Gerard Jeffery: 0417 664 993 Camden District Hospital PTS February 1978 Reunion Gay Woodhouse 0438 422 069 Gay.woodhouse@health.nsw.gov.au
CROSSWORD SOLUTION
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