Lamp April 2018 by NSW Nurses and Midwives' Association

AGED CARE

SAFE STAFFING

Victorian Bupa strike makes history

St Vincent’s budget woes lead to redundancies

Nurses blockade Adani

page 14

page 18

page 20

ENVIRONMENTAL HEALTH

REGULARS Your rights and entitlements at work Nurse Uncut – your stories What nurses and midwives said Nursing research online

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 75 NO. 3 APRIL 2018

NATIONAL PUSH FOR AGED CARE RATIOS Print Post Approved: PP100007890

p.33 p.35 p.37 p.39

COVER STORY

Winner. Outstanding value Superannuation. 2 | THE LAMP APRIL 2018

firststatesuper.com.au/feelfutureready | 1300 650 873 Winner of the Canstar award for the Personal Super product. Consider our product disclosure statement before making a decision about First State Super. Call us or visit our website for a copy. FSS Trustee Corporation ABN 11 118 202 672 ASFL 293340 is the trustee of the First State Superannuation Scheme ABN 53 226 460 365.

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

VOLUME 75 NO. 3 APRIL 2018

COVER STORY

National push for aged care ratios Aged care nurses around Australia will soon have an opportunity to help put an end to chronic understaffing of nursing homes.

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 2018 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30. Individuals $84, Institutions $140, Overseas $150.

66,436

Average Net Distribution per issue. The Lamp is independently under the AMAA's CAB Total Distribution Audit. Publisher's Statement for the period: 01/04/2016 - 30/09/2016

AGED CARE Victorian Bupa strike makes history

Bupa nurses in Victoria have won a better deal and highlighted staffing problems at nursing homes by going on strike for the first time ever.

PRIVATE HOSPITALS Safety first, nurses and midwives tell Ramsay

Nurses and midwives continue to press for safe staffing standards at NSW hospitals owned by Ramsay Health Care.

SAFE STAFFING St Vincent’s budget woes lead to redundancies

St Vincent’s Hospital is resorting to voluntary redundancies to try to overcome a budget shortfall.

20 22

DEFENCE RESERVE NURSES Nursing soldiers

General Secretary Brett Holmes joined an army training camp to find out what it takes to be a nurse in Australia’s Army Reserve.

ENVIRONMENTAL HEALTH Nurses blockade Adani

REGULARS

5 6 6 28 32 33 35 37 39 41 43 45 46

Editorial Your letters Competition News in brief NSWNMA Education Ask Judith Nurse Uncut Facebook Nursing Research Online Crossword Book Club At the Movies Diary Dates

AGED CARE

SAFE STAFFING

Victorian Bupa strike makes history

St Vincent’s budget woes lead to redundancies

Nurses blockade Adani

page 14

page 18

page 20

ENVIRONMENTAL HEALTH

REGULARS Your rights and entitlements at work Nurse Uncut – your stories What nurses and midwives said Nursing research online

p.33 p.35 p.37 p.39

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 75 NO. 3 APRIL 2018

Emergency nurse Angie Gittus and four colleagues were arrested for drawing attention to the public health threat posed by the controversial Adani mine.

CHANGE THE RULES Stagnant wages drag down the economy

It’s not only union officials who are worried about persistent low wage growth.

CHANGE THE RULES Unions push to fix broken work laws

The ACTU is campaigning to re-write the rules governing wage fixing and employment in Australia.

NATIONAL PUSH FOR AGED CARE RATIOS Print Post Approved: PP100007890

OUR COVER: Annie Butler, Suzanne Wilson and Ann McInnes Photographed by Gerrit Fokkema THE LAMP APRIL 2018 | 3

PROFESSIONAL EDUCATION 2018

CPD

Enrolled Nurses’ FORUM NEWCASTLE

WATERLOO

WOLLONGONG

11 May

25 May

9 November

Wests New Lambton, Bowling Club

NSWNMA

City Diggers

50 O’Dea Avenue

Corner Church and Burelli Streets

9am – 4pm

Greenhouse Function Room 1a Tauranga Road The enrolled nurse is a valued and pertinent member to the health workforce. This forum is an opportunity for enrolled nurses to gain some education on practice and professional issues related to their role. Hear from a range of speakers, network with colleagues and gain some valuable CPD hours.

All

PROGRAM:

$ Members $60 Non-members $120 Lunch and refreshments provided

• • • • • •

Wound Care; Measuring a Glasgow Coma Scale (GCS); Culturally Appropriate Healthcare; Professional Obligations and the NMBA Decision Making Framework; Mindfulness: Looking after yourself in times of stress; and more ...

There will also be time throughout the program for Q&A with each presenter.

CPD

Attendance at NSWNMA education sessions may count towards your Continuing Professional Development (CPD) hours. You will be provided with a certificate of completion at the end of each course. The number of hours noted beside each course is the maximum amount of claimable CPD hours assuming that as an attendee you remain for the entirety of the course and complete any extra activities as may be required.

4 | THE LAMP APRIL 2018

All

All nurses, midwives & assistants in nursing

Authorised by B.Holmes, General Secretary, NSWNMA

EDITORIAL

Brett

Holmes GENERAL SECRETARY

An aged care crisis that shames us The NSWNMA will throw all its weight behind the national campaign to improve staffing ratios in aged care.

Over the last 13 years, chronic understaffing has seen a 400 per cent increase in preventable deaths of elderly Australians in aged care with hundreds dying from falls, choking and suicide. There has been a plethora of reports and studies that, together, paint a grim picture of an escalating crisis in aged care (see p. 11). What all of these reports have in common is an analysis that says this crisis is underpinned by a substantive lack of nursing staff. A report by the Australian Law Reform Commission found that a lack of minimum staffing regulations and appropriate skill mix had resulted in the abuse of nursing home residents. In NSW, a survey of over 700 NSWNMA members working in aged care revealed that poor staffing ratios and skills mix impacted on nurses’ ability to follow safe medication practices. An alarming 83 per cent of nurses said they had witnessed a medication error. For all of us who care about the welfare of elderly Australians, alarmed is how we should feel. Yet governments, for far too long, have ignored the crisis in our aged care system and its steady deterioration.

TAXPAYERS’ MONEY SHOULD GO TO STAFFING NOT PROFITS While nurses and aged care staff struggle because there is simply not enough of them, last year owners of aged care facilities racked up hundreds of millions of dollars in profits while, at the same time, cutting staff.

‘ We want politicians to support legislation that makes staffing ratios mandatory in aged care.’ Over 70 per cent of the billions of dollars in revenue received by these aged care operators come from government subsidies. Despite this massive transfer of taxpayers’ money into the hands of private operators governments have not been vigilant enough in making these companies accountable for how that money is deployed. The ANMF and the NSWNMA believe that from both a public policy perspective and from a moral position that money should be used for more staff and better care, not to increase profits. Let us be clear. Our campaign is about insisting that public resources are spent to meet the urgent need for more nursing and care staff. Currently residents are receiving around two hours 50 minutes of care per day from nurses and carers, which is nowhere near enough time to shower, toilet, medicate, dress, feed, roll over, move, let alone talk to an aged care resident. The evidence shows that residents should be receiving a minimum of four hours 18 minutes per day – one and a half more hours than they are getting now. Currently the Aged Care Act of 1997 only stipulates that numbers of care staff should be adequate to meet the assessed care needs. The Act does not define what is “adequate”.

We want politicians to support legislation that makes staffing ratios mandatory in aged care.

NOW IS THE TIME FOR ACTION The ANMF has initiated a media campaign starting with TV ads and billboards targeted at politicians in Canberra (see p8). It has set up a website “More Staff for Aged Care” where you can register your support for the campaign. Within days of the site going live thousands had done so. I would urge you to add your support. The upcoming May budget and the next federal election are our chance to get the government to take action and make ratios law. To get the government to act we need your help. On page 13 of this Lamp there are some ideas about how you can help and how to join the campaign. In particular I would urge you to commit to supporting actions on 12 May – International Nurses Day – which will be a national day in support of aged care. We will soon contact you with more information about how you can participate along with your colleagues. ■

THE LAMP APRIL 2018 | 5

YOUR LETTERS

Cruise around Sydney Harbour taking in the spectacular

Have your

Say ENs make a difference

Vivid Sydney is a feast for the senses & Sydney’s most spectacular outdoor lighting, music and ideas festival. Experience the full canvas of the massive shore side projections along the foreshore from the water. Vivid Lights 2018 is held from 25 May to 16 June 2018.

Captain Cook Cruises exclusive offers for NSWNMA members for Vivid Sydney Vivid Sydney Lights Cruise $23 (normally $42pp). Departing Darling Harbour enjoy a 1 hour cruise nightly during Vivid Sydney (valid 25 May – 16 June 2018). Vivid Sydney 7.30pm Dinner & Drinks Cruise $99 (normally $155 pp). Departing from Darling Harbour, enjoy a 3-course dinner and drinks cruise disembarking at either Circular Quay or Darling Harbour where you can stroll along the Vivid Lights walk (valid 28–31 May, 4–7 June and 12–14 June 2018). To book go to www.captaincook.com.au/sydney-harbourcruises/whats-on-in-sydney/vivid-festival and enter promo code L6EBL8A For one lucky member we are giving away 2 complimentary tickets to the Gold Dinner cruise. Included in the prize is 6 course degustation menu, vintage Australian wines to complement each course, house spirits, beer & soft drinks and live music. Valued at $478* To enter the competition simply provide your name, address and membership number and email your entry with the subject: Vivid Sydney to lamp@nswnma.asn.au

*Conditions apply. Offer valid for the duration of Vivid Sydney 2018 and dates specified. Winning prize must be redeemed by 30 November 2018. Competition entries from NSWNMA members only and limited to one entry per member. Competition April 2018 and closes 6 | opens THE1LAMP APRIL 201830 April 2018. The prize is drawn on 1 May 2018. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/18/02955

I would like to congratulate Brett Sutherland (March The Lamp Letter, ‘More respect for ENs’) for standing up for us enrolled nurses! This gentleman has the makings of an excellent nurse because he cares but unfortunately he has already encountered the disrespect for enrolled nurses so early in his upcoming career. Brett, I have been an enrolled nurse for over 30 years. Throughout those years I believe I have gained the respect of the majority of my peers, from doctors to registered nurses and other ENs. However a few years ago during an education day in theatre, the educator (who was an RN) was talking about what to do in a cardiac arrest situation. She went on to say: “During this process don’t forget about the family... you can always send out an unskilled worker like the enrolled nurse”. You could have heard a pin drop! It was distasteful, demoralising and totally unprofessional. If we are so “unskilled”, then how can we deal with the family? But that’s just it. We can do it because we care; we are bedside nurses and we are the ones who hold the hand of the ones who need us. I have never been ashamed of this. I have been told many times over the years that I should become an RN. I have refused because I know I make a difference in my patients’ lives as a bedside nurse. It has never been about the money for me. As for “TAFE versus university,” let me say that as enrolled nurses we are expected to teach the new grads. We need to be recognised. So Brett, I am so proud of you for standing up. You will gain, like I have, so much knowledge from being an enrolled nurse. Believe in yourself to make a difference, if your life takes you onto being an RN then you will have the grounding of what counts in a patient’s journey. Good luck Brett. Enjoy your nursing journey. You will make a difference of that I am certain. Sharyon Boggs, EN

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 Forced to leave town I recently left my job working in Randwick to move to Newcastle. I couldn’t even afford a one-bedroom place near work anymore, and the long wait for a car park spot at the hospitals meant living further away where it was cheaper wasn’t much of an option. It’s still expensive up here but not unrealistically so; I can actually have a better work–life balance as all my income isn’t going on rent. It also means I have some money in savings for the first time and can work towards the dream of finally owning my own place! Sam Curry, RN EDITORIAL RESPONSE: Many nurses and midwives, like Sam, have told us that they have moved and changed jobs due to the high cost of housing. It is essential that nurses and midwives (and other workers in key service areas) are able to secure safe, appropriate and affordable housing close to their workplaces. We have been advocating for more affordable housing options. For example, Judith Kiejda will be discussing affordable housing for essential service workers at the 2018 Affordable Housing Conference in June.

Letter of the month The letter judged the best each month will win a $50 Coles Group & Myer gift card! Union Shopper offers members BIG savings on a wide range of products! unionshopper.com.au 1300 368 117

Advertise in The Lamp and 23/02/15 reach more than 66,000 nurses and midwives. To advertise please contact Danielle Nicholson 02 8595 2139 / 0429 269 750 dnicholson@nswnma.asn.au

Union Shopper Letter of the Month.indd 1

11:53 AM

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 Acuity and ratios I have been a registered nurse for 23 years and am currently looking for work outside of the career all together. I am a dedicated, hardworking nurse and like many other nurses I am BURNT OUT! I would like to know if there any nurses out there who work under staffing based on patient acuity? The overwhelming amount of physical/psychological expectations within the nursing role is becoming humanly impossible to fulfil. I am a big believer in accepting change and influence others to focus on the positive outcome of change; however, there is no listening from the other side. There is no comprehension of how long specific cares take to do. I have previously worked in a hospital in Queensland where acuity was taken into consideration for allocating staffing and it proved to be a very effective staffing tool. Does anyone use this tool currently, and if so do you think it is effective? How could we look into this in NSW? I understand it is extremely expensive to set up, but I believe it may be the answer to understanding why so many nurses are leaving the workforce. In the March 2018 The Lamp there was an article about the nursing crisis predicted in NSW – a shortage of 8000 nurses by 2030. I think drastic action is required and this just may be a possible solution to nurses getting heard. If I have a patient who requires a full colostomy change four times

in a shift, that takes a total of one hour in my eight-hour shift. OR if I have a patient who has just been told they have cancer, this requires an hour counselling. OR if I have a dressing that takes an hour to attend, then this is all recorded in acuity. However, in staff-to-patient ratio, none of this is considered. It is predicted for the next shift, and then actualised so a timeframe has been estimated for each patient. Has anyone got any suggestions as to how I can look further into this? Exhausted, frustrated and unheard. Skye Osborne, RN EDITORIAL RESPONSE: You are certainly not alone in feeling burnt out from excessive workloads, it is a widespread issue across our Public Health System. We have tried the NSW government’s preferred model of calculated ‘Nursing Hours Per Patient Day’, but it has let us down repeatedly. In fact, we are aware thousands of hours of nursing care have not been rostered over the last year in breach of the state Award. Enough is enough. The Queensland system you refer to has been augmented with legally enforceable ratios. Both Queensland and Victoria have now invested more money into ratios, it is time NSW caught up. In this year’s comprehensive Public Health System Ratios and Pay Claim we are seeking a better, more transparent ratios system for NSW to ensure adequate staffing to meet patients’ needs. We recognise nurse-to-patient ratios is a minimum and of course, where patient acuity demands more than the mandated minimum, extra staff can and should be rostered to deliver safe patient care. We are committed to better ratios and we must collectively maintain pressure on the government to act and deliver for NSW.

THE LAMP APRIL 2018 | 7

COVER STORY

National push for aged care ratios Aged care nurses around Australia will soon have an opportunity to help put an end to chronic understaffing of nursing homes.

urses’ unions in all states and territories are gearing up for a national More Staff for Aged Care campaign. They will invite their members to get involved in the campaign, which aims to make aged care understaffing a major issue at the next federal election. The campaign got underway last month with advertisements on Sky News television and Canberra billboards targeting federal politicians. The goal is to persuade politicians to support legislation that makes staffing ratios mandatory in aged care. The national nurses’ union, the Australian Nursing and Midwifery Federation (ANMF) will launch the campaign on 12 May – International Nurses’ Day. Acting federal secretary of the ANMF, Annie Butler outlined the campaign to a NSWNMA committee of delegates meeting last month. She said it would include social media advertising aimed at relatives of nursing home residents and general TV advertising closer to the next federal election, whenever it is held. “Our ads feature real people telling real stories,” she told the delegates. “They feature real aged care workers, residents and relatives – not actors. “We want the public to understand that aged care staffing is in crisis and to start feeling angry about it.” The ANMF has set up a national website ‘More Staff for Aged Care’, which invites people to pledge support. Almost 5000 people have already signed up and about 500 of them have indicated they want to do more to support the campaign. The NSWNMA will plan on-the-ground activities in NSW and advise members how they can get involved. Annie said the campaign was not seeking more government funding for aged care. “Aged care providers already make healthy profits.

8 | THE LAMP APRIL 2018

‘ We want the public to understand that aged care staffing is in crisis and to start feeling angry about it.’ — Annie Butler, Acting Secretary ANMF “In the first instance, we want politicians to make providers more accountable for the billions of dollars they already get from taxpayers. “Seventy per cent of providers’ revenue comes from the federal government. “No other industry gets so much public funding as a proportion of total revenue with such little accountability for the use of taxpayer funds. “Providers should be required to use public money to make sure elderly people get proper care. “The best way to do that is to mandate adequate and safe staffing ratios.” Annie said many elderly Australians miss out on the care and treatment they need due to understaffing and lack of accountability and transparency in the spending of public money. “Many nursing home residents are not properly fed, hydrated or safely given medication and they experience unnecessary pain, suffering and premature death. “Owners of aged care facilities pocketed over $1 billion in profits in 2017 while cutting staff and nursing and care hours. “Consequently, nurses and care staff struggle because there is simply not enough of them. “Australia has strict staff ratios for childcare, which is only fair and reasonable. But in aged care, it’s a very different story, where just one registered nurse may be responsible for managing the care of more than 100 residents. “Only mandatory ratios for aged care will ensure our elderly get the care they need.”■

COVER STORY

Residents get barely half the care they need Ratios campaign rests on ground-breaking study of hours and skill mix. Aged care residents should receive an average four hours and 18 minutes of care per day – almost double the 2.84 hours they currently get. The minimum skills mix needed to ensure safe care is registered nurses (RNs) 30 per cent, enrolled nurses (ENs) 20 per cent and assistants in nursing (AiNs) or personal care workers (PCWs) 50 per cent. These were some of the findings of the first Australian study to determine the hours of care and skill mix needed for safe care of the elderly. Called the National Aged Care Staffing and Skills Mix Project, the study was done by the Australian Nursing and Midwifery Federation (ANMF) and researchers from Flinders University and the University of South Australia. ANMF acting federal secretary, Annie Butler, says the study will be used to reinforce the ANMF’s national campaign for mandatory staffing ratios in aged care. She says Productivity Commission reports and Senate inquiries have recommended that a method of determining safe staffing levels and skills mix in aged care be established. “Nursing homes operate under the Aged Care Act of 1997, which says only that the numbers of care staff should be adequate to meet the assessed care needs. “However, the Act does not define ‘adequate’ and successive governments have failed older Australians by failing to legislate for staffing ratios. “This is an urgent and growing problem because the number of residential aged care places has grown to 200,689 operational places as at June 2017 – excluding flexible places. “Inadequate staffing is the main cause of incidents of missed care, which are common across all aspects of care.”

To read the full report go to: http://www.anmf.org.au/documents/reports/ National_Aged_Care_Staffing_Skills_Mix_Project_ Report_2016.pdf

‘ Successive governments have failed older Australians by failing to legislate for staffing ratios’. — Annie Butler

Mounting evidence for ratios Evidence of the need for staffing ratios in aged care continued to mount during 2017. A Senate inquiry into the future of Australia’s aged care workforce found that current nurse ratios were “too low and risked compromising the quality of care delivered”. It recommended that providers publish their workforce ratios “in order to facilitate informed decision making by aged care consumers.” A damning report by the Australian Law Reform Commission revealed that the lack of minimum staffing regulations and appropriate skills mix had resulted in the abuse of nursing home residents. It found that the proportion of registered and enrolled nurses had decreased and the proportion of assistants in nursing/personal care workers (AiNs/PCWs) had increased to 70 per cent of direct care workers in residential care. Another report by Monash University researchers found that the number of deaths in nursing homes from preventable causes had increased by 400 per cent in the 13 years between 2000 and 2013. Deaths by “external” and preventable causes quadrupled from 101 to 417, while the rate of such deaths rose from 1.2 per 1000 admissions to 5.3. In NSW, a survey of over 700 NSWNMA members working in residential aged care revealed that poor staffing ratios and skills mix impacted on nurses’ ability to follow safe medication practices. An alarming 83 per cent of nurses said they had witnessed a medication error. Members spoke of AiNs being given medication competency training by trainers who are not competent themselves and RNs being given the impossible task of overseeing medications for up to 200 residents in a facility where residents are housed on different sites. THE LAMP APRIL 2018 | 9

COVER STORY

‘ We need to explain to relatives and the general public that ratios are essential to providing proper care.’ — Pam McInnes

Staff cutbacks plague nursing homes “I do a morning shift in a hospital and I’m looking after five patients. I go to my aged care shift in the afternoon and I have 52 residents under my care,” says endorsed enrolled nurse Pam McInnes.

is a good move because the public need to know the true situation inside many nursing homes.

“Often I don’t have time to even lay eyes on every resident during a shift.

“Skin tears and bruises happen more often because everyone is rushing to get through their tasks. That creates more wounds for nurses to attend to.

“It’s not fair on them – they are paying good money and we should be providing better care.” Pam works on a casual basis at two nursing homes and a hospital on the NSW north coast. She has spent about nine years in aged care. After starting out as a hospitality employee she did an AiN course then trained as an EN. She supports the ‘More Staff for Aged Care’ campaign because staff cuts have “pushed aged care workers towards breaking point”. “One nursing home used to have three community nurses on in the morning and three community nurses in the afternoon and one RN in charge.

“Staff are rushing to shower people so they will get enough time to shower the next person.

“And when nurses don’t have time for pressure area care every two hours, residents end up with pressure ulcers as a result. “Some nursing homes are experiencing an increasing number of falls due to a lack of staff to assist residents. And more injuries mean more hospital presentations. “Staff also have to rush through meal times. That means residents who are slow eaters don’t get the nutrition they need and may start to lose weight.” Pam says relatives don’t always realise that problems are due to staff shortages.

“Now they have cut back to two community nurses in the morning and two community nurses in the afternoon, one of whom is also in charge.

“We need to explain to relatives and the general public that ratios are essential to providing proper care.

“We voiced our concerns at the time and pointed out that it was already impossible for three of us to get through the work, let alone just two nurses.

“I’m hoping that a lot of staff get involved in the campaign because everyone has had enough of the pressure we are working under.

“We were told that if we didn’t like it we could leave.”

“A few people will be worried about losing their jobs but we’ve all got to stick together and understand that if we don’t do anything the situation will only get worse.”

Pam says the planned ANMF advertising campaign

10 | THE LAMP APRIL 2018

COVER STORY

Residents need legal protection against understaffing Mandatory staffing ratios are needed to prevent nursing homes from cutting staff and lowering standards of care, says AiN Suzanne Wilson.

Suzanne says residents and staff need the protection of a law that sets out adequate staffing numbers.

Suzanne has six years’ experience as an AiN and works at a northern NSW facility.

She plans to attend the national campaign launch on International Nurses’ Day in May.

It employs just three AiNs to cover a 22-bed dementia ward during afternoon shift.

“I hope we get lots of aged care staff and community members to the launch because we need to educate the public about the extent of the problem.

An activities officer who was employed every weekend is now only on duty every second Sunday. “There are just not enough staff to give dementia residents the proper care they need,” Suzanne says. “Sometimes there is not enough time for staff to shower immobile residents or get them up for breakfast and we have to feed them in bed. “I don’t think that’s right. “Staffing has got worse over the last two years. Morale is really low and we are losing experienced staff to other facilities, which is a real shame.”

“When something goes wrong in hospital it gets a lot of media attention and a public outcry. Aged care doesn’t get anywhere near the same level of attention. “Most people don’t see understaffing as a problem until they or a family member go into a facility. “We need to convince politicians to change the law to bring in ratios. TV ads will play a part in that because the politicians don’t like bad publicity and nor do the aged care companies.”

‘ There are just not enough staff to give dementia residents the proper care they need.’ — Suzanne Wilson

THE LAMP APRIL 2018 | 11

COVER STORY

Ratios for aged care. Make them law. Now.

he Australian Nursing and Midwifery Federation (ANMF), and its state branches including the NSWNMA, are sending a message to all federal politicians with a new public awareness campaign calling for staff ratios in aged care to be legislated as a matter of urgency. The media campaign began with a series of TV commercials which aired in the ACT during March to coincide with federal senators returning to Canberra. Mobile billboards also circled Parliament House and were seen throughout the city. ANMF Acting Secretary Annie Butler said action was needed “to protect vulnerable, older nursing home residents who are the victims of Australia’s crisis in aged care”.

THERE’S A LAW TO PROTECT RUBY IN CHILDCARE

“It’s a national disgrace. It’s a crisis that shames us. Our aged care system has been ignored by governments for too long,” she said. The ANMF is also supporting the actions of Senator Derryn Hinch, who has introduced a private members’ bill the Aged Care Amendment (Ratio of Skilled Staff to Care Recipients Bill) 2017, and is calling on all parties to support ratios for aged care.

REAL PEOPLE TELLING THE REAL STORY The voices of the campaign are people who are all involved in the aged care system. They include a registered nurse, an assistant in nursing, a doctor working in the system, family members of a resident and even a resident who have come together to call on our politicians to fix aged care. ■

BUT NOT RUBY IN AGED CARE.

Chronic understaffing in Aged Care homes is leaving thousands of elderly Australians unfed, unwashed or even in soiled pads for hours because there’s simply not enough staff. The Federal Government must act now to make staff ratios law for Aged Care. Find out more at MoreStaffForAgedCare.com.au

Authorised by A Butler Australian Nursing and Midwifery Federation, 365 Queen St Melbourne.

12 | THE LAMP APRIL 2018

COVER STORY

Time for action The upcoming May budget and the next federal election is our chance to get the government to take action and Make Ratios Law. If you haven’t already joined the campaign, join the thousands of supporters across Australia. The NSWNMA will contact you to explain how you can help us make ratios for aged care law now.

RECORD PROFITS INE. AGED CAR

AGED CARE OWNERS CLEAN UP

WHILE RESIDENTS SIT IN SOILED PADS

Authorised by A Butler Australian Nursing and Midwifery Federation, 365 Queen St Melbourne.

Like us on Facebook: https://www.facebook.com/ agedcarenurses

THERE’S A LAW TO PROTECT RUBY IN CHILDCARE Julie, Assistant in Nursing

Authorised by A Butler Australian Nursing and Midwifery Federation, 365 Queen St Melbourne.

Share your story Spread the word about the campaign www.nswnma.asn. au/aged-care-nurses/

Make a date Put 12 May into your diary – this will be a national day of action in support of aged care. Parramatta Park, 11am–1pm RSVP here: http://www.nswnma. asn.au/aged-care-nurses/ Authorised by A Butler Australian Nursing and Midwifery Federation, 365 Queen St Melbourne.

AGED CARE UNDERSTAFFING SHOULD BE A CRIME

MAKE RATIOS LAW.NOW. Authorised by Annie Butler, Australian Nursing and Midwifery Federation, 1/365 Queen Street, Melbourne

THE LAMP APRIL 2018 | 13

AGED CARE

Victorian Bupa strike makes history Bupa nurses in Victoria have won a better deal and highlighted staffing problems at nursing homes by going on strike for the first time ever.

nprecedented strike action by Bupa Aged Care nurses and carers in Victoria has delivered a wage increase of 11.25 per cent over three years under a new enterprise agreement (EA). The first wage rise is back-paid from 1 August 2017 and the EA includes significant improvements to entitlements and workload management processes. The EA comes with a signed agreement that the first wage increase in the next EA will be from 1 July 2021. Bupa’s original offer was 2.1 per cent in a one-year agreement with no other changes. Staff negotiated with Bupa for more than 14 months after rejecting the original offer. More than 1000 nurses and carers took part in the protected industrial action across Bupa’s 26 Victorian nursing homes. The union gave Bupa management the required five days’ notice to make arrangements for the care of residents. Lisa Fitzpatrick, secretary of the Victorian branch of the Australian Nursing and Midwifery Federation (ANMF) called it the most serious industrial action ever to occur in the private aged care sector in Victoria. Staff took 37 days of action, including three days of strike action for an entire morning or afternoon shift. They held stop work and community rallies across the state with a 400-strong rally outside Bupa’s Melbourne corporate headquarters. ANMF members wore the union’s red ‘Value Recognise Reward’ campaign T-shirts, handed out campaign materials to residents, relatives and the public and spoke to the media.

STILL SEEKING BETTER STAFFING LEVELS Lisa Fitzpatrick said Bupa’s initial offer would have kept its nurses’ and carers’ wages in the bottom 10 per cent of aged care facilities. She said that while the union was pleased with the outcome for wages and entitlements, it would continue to 14 | THE LAMP APRIL 2018

‘ Aged care nurses and carers striking for the very first time is evidence something is deeply wrong with the aged care system.’ — Lisa Fitzpatrick seek better staffing levels of registered nurses, enrolled nurses and personal care workers every shift to improve resident care. “Aged care nurses and carers striking for the very first time is evidence something is deeply wrong with the aged care system and the way employers choose to roster staff,’ she said. “Residents have increasingly complex nursing needs, but there are fewer nurses. Safe staffing is not supported by the aged care law, the aged care assessment audits, the Aged Care Complaints Commissioner or workplace laws. “Members are telling us what they have told their managers. They are seriously concerned for their residents because they are understaffed, working short and going home worried about the care that was missed.” The ANMF advocates enforced minimum nursing levels in the federal Aged Care Act 1997. The Act only requires nursing homes to “maintain an adequate number of appropriately skilled staff to ensure that the care needs of care recipients are met”. ‘Adequate’ is not defined in the legislation and is not enforceable. ANMF Victorian Assistant Secretary Paul Gilbert said Bupa nurses and carers had shone a spotlight on aged care staffing numbers and had prompted people to ask “what is a safe number of nurses and carers to look after our elderly loved ones?” “Their action has set a new precedent for engagement in the aged care sector and sent a strong message to private aged care employers still to negotiate agreements,” he said. ■

AGED CARE

Jubilant Victorian nurses from Bupa celebrate their historic win.

NSW Bupa EA campaign continues Nurses working for Bupa in NSW have told the NSWNMA that the situation in their workplaces is serious. Nurses say they are working harder and harder to provide the level of care residents and families pay for and expect. During visits to Bupa facilities across NSW over the past month, nurses have told the NSWNMA that: • Absences are not replaced • There is an exodus of nurses from many facilities • Shifts are too short without the opportunity to increase hours • Level of responsibility and workloads are unrealistic

BUPA DOES NOT PAY AS MUCH AS OTHER AGED CARE EMPLOYERS Nurses say Bupa can’t attract new staff in many of its facilities in NSW. This, on top of nurses leaving, has compounded the understaffing. NSWNMA MEMBERS SAY: BUPA MUST TAKE ACTION NOW TO ADDRESS STAFFING AND WORKLOADS! Members identify plenty of solutions to the situation at Bupa, including: • a pay increase to bring Bupa in line with its competitors; • an effective process to fix staffing; • improved medication processes and an AIN medication allowance; • rostered time to complete e-learning.

JOIN YOUR CAMPAIGN NSWNMA members are getting involved to make life better at Bupa. Nurses are pressuring Bupa to do the right thing and to start to take steps for a positive change. Bupa can’t afford to let things get worse! ■

What YOU can do to help: • Encourage your colleagues to join the NSWNMA. • Like our Bupa Aged Care Nurses Facebook page. • Want to get involved? Contact Alfredo at the Association.

THE LAMP APRIL 2018 | 15

PRIVATE HOSPITALS

Safety first, nurses and midwives tell Ramsay Nurses and midwives continue to press for safe staffing standards at NSW hospitals owned by Ramsay Health Care.

amsay, one of the world’s biggest private hospital operators, owns 30 hospitals across NSW. Its NSW nurses and midwives work under an enterprise agreement (EA) which expired on March 31. NSWNMA members have asked the union’s bargaining team to make staffing improvements the top priority in current negotiations for a new EA. “The biggest sticking point in negotiations is ratios or safe staffing,” said Lyn Whitlam, a NSWNMA delegate at Ramsayowned North Shore Private Hospital in Sydney. Lyn is one of eight Ramsay nurses and midwives who have joined NSWNMA officers in the NSWNMA bargaining team negotiating the EA with senior management. “By far the biggest issue for our members is safe staffing to ensure that patients get the right care by the right person at the right time,” she said. “That is the message we are getting from members across the state, from the smallest hospital to the biggest.” In a NSWNMA survey of 1397 Ramsay members, 90 per cent of them nominated improved staffing as the top priority. More t ha n 10 0 0 Ra m say members said staffing numbers in their ward/unit/theatre were 16 | THE LAMP APRIL 2018

‘ Private patients expect to get the same sort of care as public patients who benefit from a ratio system already in place.’ — Lyn Whitlam inadequate to deliver the quality care their patients need.

nursing, which means the RN has to take on a bigger workload.

Ramsay nurses’ EA claim seeks a safe staffing framework with a skill mix of a minimum 85 per cent RNs for each shift.

“In addition, patient acuity is greater and management expects us to move patients through the hospital faster in order to increase turnover and revenue.

The claim seeks ‘like-for-like’ replacement for a ll absences including sick leave and with the designated in-charge nurse of a ward, unit or hospital to be supernumerar y without a patient load.

SPEEDY TURNOVER OF PATIENTS TO INCREASE REVENUE The NSWNMA statewide Committee of Delegates unanimously called on Ramsay management to agree to the safe staffing claims last month. “In particular we need our NUMs, and in charge of ward, unit or hospital without a patient load,” the resolution said. Lyn said staff have told the union bargaining team that management routinely replaces absent nurses with lesser qualified staff. “When a registered nurse goes off work for whatever reason they may be replaced with a less qualified staff member such as an assistant in

“However, private patients expect to get the same sort of care as public patients who benefit from a ratio system already in place.” Lyn said the union had kept members informed through phone hook-ups with branch delegates and other active members, hospital branch meetings, regular updates on social media and emails. The NSWNMA Ramsay Facebook page has more than 1300 members. “Members have had plenty of opportunities to keep abreast of developments in the campaign and put forward concerns and suggestions,” Lyn said. NSWNMA General Secretary Brett Holmes said Ramsay members had made it clear the nurse in charge of a ward, unit or hospital should not also have a patient load. He said the in-charge nurse was required to manage the ward, with responsibilities such as attending daily meetings, dealing

PRIVATE HOSPITALS

Global health giant digs in over $32 allowance

Ramsay members on the enterprise agreement negotiating team.

‘ It’s pretty disgusting to see a highly profitable company ripping off staff for $32 a week.’ — Brett Holmes with doctors and relatives, arranging staff replacements and serving as a back-up in exceptionally busy periods and emergencies. However, members had reported cases of the in-charge nurse being assigned a patient load of 10 or more patients at night and up to seven in the afternoon. “It is farcical to expect them to carry out those tasks and also safely care for up to 10 patients,” he said. Brett said the NSWNMA bargaining team had presented Ramsay with numerous examples of the need for safe staffing at its hospitals. However, as this edition of The Lamp goes to press, the company had repeatedly rejected members’ safe staffing claims. Ramsay had also failed to respond in writing to other impor tant conditions claims. Ramsay owns 235 hospitals and other facilities in Australia, France, the United Kingdom, Italy, Indonesia and Malaysia. It made a net profit after tax of $288 million for the six months ended December 31, 2017, with the Australian division performing strongly. Brett said members are frustrated

with Ramsay’s approach and will be left with no choice but to escalate to member actions if negotiations fail to make progress. ■

Ramsay staff win back ADOs Nurses and midwives at North Shore Private and St George Private hospitals have successfully fought to reclaim allocated days off (ADOs) for all full timers. Since mid-2017, Ramsay have employed many full time nurses and midwives – including new graduates – without ADOs, in contrast to existing full timers who have ADOs in their contracts. Ramsay has now agreed to a process under which full timers without ADOs can apply for them through their NUM. Contracts will then be reissued and members should get legal advice from the NSWNMA before signing.

Ramsay Health Care says its staff are its most important asset and the “key to the organisation’s ongoing success.” Midwives at Ramsay-owned Westmead Private Hospital could be forgiven for thinking otherwise. They have been battling to get the hospital to pay midwives a qualification allowance of $32.28 per week, in accordance with the entitlements in their enterprise agreement. Hospital management maintain the allowance should only be paid to staff who work in the delivery suite and not those working in the post-natal unit. “Management claim that staff in post-natal are not eligible because they are not using all their qualifications,” said NSWNMA General Secretary Brett Holmes. “This is contrary to the industry norm and the standard practice in other private and public hospitals. “Midwives are employed on the basis of their qualifications regardless of where they are assigned and the allowance should be paid from the start of their employment. “It’s pretty disgusting to see a highly profitable company ripping off staff for $32 a week.”

THE LAMP APRIL 2018 | 17

SAFE STAFFING

St Vincent’s budget woes lead to redundancies St Vincent’s Hospital is resorting to voluntary redundancies to try to overcome a budget shortfall.

t Vincent’s Hospital in Darlinghurst has initiated a surprise voluntary redundancy program and closed a bed on every ward. This follows the widespread temporary closure of beds and services in December and January, in order to cut costs. Assistant General Secretary of the NSWNMA, Judith Kiejda, said the union wanted to ensure that any offers of redundancy did not put additional strain on nurses who remain. “We acknowledge St Vincent’s Hospital is facing some serious budgetary issues,” Judith said. “However, any plan to resolve these problems must not impede the clinical needs of the health service being provided to the local community. “Losing our most experienced nurses is not an option when searching for solutions to budget shortfalls. “Experienced nurses are needed to keep our public health system together and retention of this experience is essential as new graduates build their experience in a clinical setting.” Expressions of interest in the redundancy program closed last month. T he ho spit a l’s NS W NM A branch called on management to convene a forum to explain the redundancy program. The branch resolution outlined questions it wanted the forum to answer. Among other questions, the branch wanted to know how much 18 | THE LAMP APRIL 2018

‘ This has caused a lot of anxiety and morale is even lower than during the December/ January period of bed closures.’ — Kristel Alken money would be saved through voluntary redundancy, which nursing positions had been identified for voluntary redundancy and what nursing model of care was being proposed for each affected department. It asked how voluntary redundancy could be justified in light of the large number of positions already vacant and whether contract workers would be hired to fill vacant nursing positions. The forum took place just two days before redundancy applications closed.

VAGUE REPLIES TO IMPORTANT QUESTIONS Branch secretary Kristel Alken said hospital executive members gave vague replies to important questions and nurses remained unhappy with the lack of information. “You could feel the tension in the room,” she said. “This has caused a lot of anxiety and morale is even lower than during the December/ January period of bed closures.” She said management did not

satisfactorily explain why it was planning redundancies when the hospital said it was seeking to recruit staff for 77 full-time-equivalent vacancies. “On my ward, for example, three nurses have gone on maternity leave and only one vacant position has been recruited for. “They have closed a bed on every ward and, on some wards, the equivalent of one staff member per shift has been reduced according to the nursing hours per patient day calculated by senior management. “Affected nurses are being redeployed.” At the forum, nurses quizzed management about winter staffing plans. “The answers did not seem to reflect the fact that last winter’s extremely busy period was badly handled,” Kristel said. She said downtime was scheduled for Easter with only two theatres open for emergency and long-waitlist patients. ■

SAFE STAFFING

Concern mounts for St Vincent’s care capacity Nurses are worried about the community impact of financial problems afflicting St Vincent’s Hospital.

he NSWNMA branch at the publicly-funded, privately-operated St Vincent’s Hospital in Darlinghurst plans to raise concerns about the impact on patient care with local members of parliament. Already, budget-driven bed closures have resulted in delays to treatment of drug and alcohol patients seeking urgent care. The hospital is funded by the state government but is operated by St Vincent’s Health Australia group, which describes itself as Australia’s largest not-for-profit health and aged care provider. St Vincent’s Health Australia has reportedly told the hospital to find $18 million in savings to overcome a budget blowout – despite being allocated more than $362 million in government funding in the 2016– 2017 financial year, under its service agreement with NSW Health. Management blamed the budget blowout on several factors, including “activity-based changes to heart/ lung funding arrangements, the rising cost of major goods and services like electricity, and tightening of the revenue from privately insured patients,” The Sydney Morning Herald reported. The Herald also reported that at least two executives at St Vincent’s “were rewarded with $25,000 bonuses for making budget at the end of the 2016–17 year, despite the hospital being over budget less than one month later”. “The bonuses have become a source of resentment among some staff members, who told Fairfax

‘ Losing our most experienced nurses is not an option when searching for solutions to budget shortfalls.’ — Judith Kiejda Media they were pushed to make unrealistic cuts to services that were back in the red in August.”

BURDEN FALLS ON STAFF Assistant General Secretary of the NSWNMA, Judith Kiejda, said that whenever any private or so-called “not for profit” involvement in health care failed, the burden would inevitably fall on staff and the community. At St Vincent’s, staff were forced to take leave and nurses were redeployed into areas where they had little or no expertise. Redeployed nurses did not receive adequate orientation and support, partly because educators and NUMs were on leave over the December/January period. In February The Lamp reported that the hospital’s acute drug and alcohol unit, Gorman House, had its bed numbers cut from 20 to 12 in November, with nurses redeployed to other wards. This forced nurses to delay elective admissions – including from people wanting urgently to detox. “There have been multiple days when we’ve had to call people who

are in a really bad way and need to come in to detox, and tell them we have had to postpone their treatment, even though there are beds sitting there empty,” NSWNMA branch member and registered nurse Leana Payne said. When the hospital announced an extended “low activity period” in December the NSWNMA General Secretary, Brett Holmes, called on the NSW Health Minister to “step in and ensure the community is provided access to the public health services it deserves.” He warned that the hospital’s budget problems would impact surrounding hospitals that would be forced to cope with patients unable to be seen at St Vincent’s. ■

FIND OUT MORE For more information and updates visit the NSWNMA St Vincent’s Hospital Facebook page at: https://www. facebook.com/ StVincentsPublic DarlinghurstNSWNMA/

THE LAMP APRIL 2018 | 19

DEFENCE RESERVE NURSES

Nursing soldiers General Secretary Brett Holmes joined an army training camp to find out what it takes to be a nurse in Australia’s Army Reserve.

t the end of January Brett Holmes, General Secretary of the NSWNMA, flew on a Hercules military aircraft from Darwin to Kuala Lumpur. From there he travelled with a group of 18 Australian employers by bus to spend three days visiting an Australian military base in Malaysia called Camp Burma. Representing the Australian Council of Trade Unions (ACTU), Brett was there to observe Australian Army Reserve members undergoing training. His group took part in some of the exercises too. “We saw live fire exercises and observed simulated urban warfare,” Brett told The Lamp. “We were taken to a jungle survival camp and instructed in dealing with survival situations how to set up shelters and how to safely work out what to eat.” Brett was travelling as part of ‘Exercise Boss Lift’, a program created by the Australian Defence Force to show employers the training, skills and experience their employees develop while undertaking Army Reserve training. There were 18 employers in Brett’s group from South Australia, Tasmania and Victoria. All had employees undertaking training at the camp. “The ACTU sits on the Defence Reserve Support national board. I represented the ACTU after it advised me that the Army has a shortage of nurses and is keen to recruit more nurses to the Reserve Force,” Brett said.

20 | THE LAMP APRIL 2018

‘ There is no doubt that there is training and skills development that is certainly beyond what the regular nurse would experience, and that can certainly benefit you in career development.’ — Brett Holmes NURSES NEEDED IN DISASTER SITUATIONS Brett says he was interested in taking the trip because while “nurses are generally pacifists, and they don’t want to see people injured, the reality is that we do need a Defence service”. “It is also the Defence service that is most likely to respond to major natural disasters, either here or in our neighbourhood. “There is a need for nursing services in the Reserve Army, but nurses are also needed in community situations where disasters occur. This is what interested me and awakened me to the need to have some more discussions about this.” There were over 100 Australian Army Reserve members training at the three-month course. Back home, their occupations are as diverse as real estate agent, car mechanic and public servant. Brett also met two reservists who were on a break from their nursing studies. “I came across a couple of guys who were finishing their nursing degree but had taken up reserve training as another interest.” Some of the skills reservists

learn included battle planning and how to give concise and accurate instructions on what would happen on an exercise. “We also watched them carry out some field exercises, including ones where they were training in urban warfare and hostage recovery.” Brett said the training they observed really helped reservists to “develop problem solving, to think on their feet, and to continue to work in what would be stressful situations by learning the skills to look after your colleagues and yourself, to work as teams and rely on your colleagues”.

AN OPPORTUNITY TO EXPAND SKILLS AND EXPERIENCE Rear Admiral Bruce Kafer, head of the Reserve and Youth Division, said the Boss Lift exercise gave employers a valuable first-hand insight into the benefits their employees can provide civilian workplaces. “Reservists’ training builds confidence, and develops problemsolving skills, leadership ability and other attributes highly valuable in the workplace,” he said. Reservists at Camp Burma live in multi-bunk communal living with “fairly primitive but reasonable

IMAGE: SGT JANINE FABRE

DEFENCE RESERVE NURSES

NSWNMA General Secretary Brett Holmes on an Australian Army Hercules military transport aircraft. ablutions block” according to Brett. “They learn to make do, and the site’s engineers were very proud of what they had achieved.” Army Reservists are paid tax-free incomes while training, and employers can also be paid a weekly payment of approximately $1,500 to compensate for the absence of their worker. Higher rates can be paid to health worker employers. “Commonwealth laws make it illegal for employers to disadvantage a reservist who undertakes required training throughout the year,” Brett says. “In the public health system there are clauses within the award recognising the right to leave for defence service duties. Quite a number of a private sector agreements include these too.” “Defence Reserve training is a good opportunity for beginning nurses to expand their scope of skills and experience. There is no doubt that there is training and skills development that is certainly beyond what the regular nurse would experience, and that can certainly benefit you in career development.” ■

Nursing roles in the Army Reserve While there are approximately 15,000 full-time members of the Australian army, those numbers are boosted by almost 50 per cent by active members of the Army Reserve. Specialist medical services are almost exclusively provided by Reserves because regular doctors in the Defence Force don’t get the specialist training doctors in the health system get. Nurses can join the Defence Reserves and use their skills in a central pool of medically-trained reservists, or they can also choose to join the Army Reserves as regular platoon members. Platoons have a medic within their group. Brett says that all reservists receive basic first aid training. “Everyone gets taught the basics of first aid, such as applying a tourniquet to yourself if you are shot, before you can be taken back to where the level of care steps up with medical support.” Nurses in the Army Reserves train with and deploy alongside Regular Army colleagues on exercises and operations fulfilling the same range of roles. As with regular Army nurses, the Reserve welcomes applications from a wide range of specialist nurses with post-graduate clinical qualifications and experience. THE LAMP APRIL 2018 | 21

ENVIRONMENTAL HEALTH

Nurses blockade Adani Emergency nurse Angie Gittus and four colleagues were arrested for drawing attention to the public health threat posed by the controversial Adani mine.

n the middle of December last year, emergency nurse Angie Gittus together with some 15 other health workers from the Queensland coastal town of Bowen drove for four hours until they were close to the worksite of the rail line being built to carry the coal from the proposed Adani mine. They camped overnight, woke in the early hours of the following morning and drove another 45 minutes to get the work site before dawn. There, they blockaded the entrance, holding up placards while two of the doctors in the group locked themselves to the gates. “We had to get up before dawn so we could be there before the workers arrived,” says Angie. “Our group consisted of nurses, doctors, allied health professionals and some supporters. We went out to the site in our work clothes or scrubs with a message that focussed on the health effects of coal mining.” “An Adani worker saw us and must have alerted the police. After about two hours the police arrived. They told us we were obstructing the workers’ driveway, and that if we didn’t leave we would be arrested. Some people chose to leave at this point to avoid arrest, as we’d planned beforehand. That left five of us – two public health physicians and three nurses.” Five members of the group, including Angie, had decided they were prepared to be arrested to draw attention to the public health threat posed by Adani. The police arrested the nurses and held them in the back 22 | THE LAMP APRIL 2018

‘ I feel I have a duty of care to not only provide care when it’s needed, but to prevent harm.’ — Angie Gittus of the van while they worked out what to do with the doctors. “We were in the back of the van for about an hour, then they drove the three of us nurses to Clermont police station, another three and a half hours west. They held us in cells, fingerprinted us, took our mugshots and processed charges.” The two doctors were brought in about two hours later.

CLIMATE CHANGE IS THE GREATEST PUBLIC HEALTH THREAT WE FACE Angie says she was there because “climate change is the greatest public health threat we’ve ever faced”. Coal mining is the dominant single cause of air pollution in Australia. According to the Australian Institute of Health and Welfare some 3000 Australians die prematurely each year because of air pollution. Angie cites Principle 7.2 of the nurses’ Code of Conduct, which outlines nurses’ responsibility to advocate for community and population health. “The principle directs nurses use their expertise and influence to protect and advance the health and wellbeing of individuals as well as communities,” Angie says. “I feel I have a duty of care to not only provide care when it’s needed, but to prevent harm. The Adani coal

mine will be a major contributor to climate change. Its carbon emission footprint will be equivalent to a small country.” The proposed mine will also see “billions of litres of water drained from the Great Artesian Basin, which means that the water levels in the aquifers that farmers rely on will be at risk,” Angie adds. Local rivers and streams risk being polluted and damaged. Angie also cites the 30,000 tourism jobs at risk if the Great Barrier Reef is destroyed as a result of the global warming Adani will contribute to. Angie has firsthand experience of the devastating effects of extreme weather events that have been linked to global warming. In the aftermath of Typhoon Haiyan in 2013, she flew to the Philippines as a volunteer with an Emergency Medical Response Team. Working in a small clinic, she provided primary health care to communities whose health services were destroyed. “But what was more distressing was the psychological harm to people of losing everything they owned, including members of their family.”

PROTECTING OUR NEIGHBOURS More recently she has worked as a volunteer teaching emergency nursing in Kiribati, a Pacific nation

ENVIRONMENTAL HEALTH

Health workers Sue Cook, Sarah Ellyard, Linda Selvey, Angie Gittus and John Sheridan who were all arrested on the Adani blockade with supporters outside the Clermont police station. of coral atolls threatened with disappearance within a generation due the effects of climate change on sea levels, tides and weather events. “I saw their fresh water source contaminated with salt water after king tides, and I witnessed the fear, frustration and grief of a culture staring down the barrel of human-driven climate change. I cannot be part of the complacency that allows Australia to disregard our neighbours’ wellbeing and future.” Recently Angie volunteered with her local Red Cross branch after Cyclone Debbie. “I saw the devastating effect of an unprecedented weather event on my own community, including some of my work colleagues who lost their homes to the flood waters. We cannot keep picking up the pieces of damaged communities without taking action to prevent them from occurring in the first place. “I think it’s important for people in health, who have such a privileged place in the community where we are really trusted and respected, to very loudly advocate for preventing the harms of coal and gas. “I think that is something we can do in our private life and in our professional life. We can do it by being activists and by writing to our local members. It is protecting our neighbours and protecting the future for the health of our children and grandchildren.” ■

FIND OUT MORE Angie will be speaking more about why health professionals are protesting Adani on 6 April at a seminar organised by the Association’s Climate Change Action Reference Group (CCARG). Location: NSWNMA, 50 O’Dea Ave Waterloo Time: 9.00am – 3.30pm

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THE LAMP APRIL 2018 | 23

CHANGE THE RULES

Stagnant wages drag down the economy It’s not only union officials who are worried about persistent low wage growth.

ust ra lia ha s a new economic problem: profits are surging but wages are stagnant or barely keeping pace with living costs. Last year, company profits grew by 22 per cent – the second fastest annual growth in the past 30 years. However, total wages and salaries grew by just 1.4 per cent – the slowest growth outside of a recession or the Global Financial Crisis. The ave r a g e Au s t r a l i a n household now has less disposable income in real terms than when the Liberal/National Coalition took power in 2013, The Guardian newspaper reports. The major reason, it says, is persistent low wages growth. “In a period where the cost of living for essential items such as energy and health have skyrocketed, workers’ wages have grown at record low levels,” The Guardian said. “It is an issue that sees households, despite living in a country in its 26th year without a recession, with a living standard no better than seven years ago.” Wages in Australia traditionally grew in line with the strength of the overall economy. That relationship saw wages rise from 1998 through to the end of 2012 at an average of around 3.5 per cent each year. That amounted to a 1 per cent annual increase in real wages, after taking inflation into account.

24 | THE LAMP APRIL 2018

‘ Larger wage rises would be a good thing.’ — Reserve Bank governor Philip Lowe

However, as The Guardian noted, Australia has not seen average wages growth of 3.5 per cent since September 2012 – “and worse, no one thinks we will see it for a very long time yet”.

LOW WAGE GROWTH LEADS TO OTHER ECONOMIC PROBLEMS

A Sydney Morning Herald editorial last month described a lack of wage growth at a time when businesses are doing well as “the main problem currently exercising the minds of economists and central bankers”. Even Reserve Bank governor Philip Lowe has said higher wages would benefit the whole economy. He talked of low wage growth as a “crisis” and said he hoped relatively low unemployment would re-energise workers to demand higher wages. “At some point, one imagines that’s going to lead to workers being prepared to ask for larger wage rises,” he said. “If that were to happen it would be a good thing.” Mr Lowe said low wages growth was now a “distinguishing feature” of the Australian economy and at the heart of many of the problems

the Reserve Bank was currently grappling with, including a boom in house prices and dangerous, record debt levels. “Low growth in wages means low inflation, which means low interest rates, which means high asset valuations.” He said low wages were also hur ting many businesses by depressing consumer confidence. Companies had shown a “laserlike focus on containing costs” by holding down wages and cutting allowances. ■

Low wages a budget risk – IMF The International Monetary Fund warned recently that weak wages growth threatens to undermine the federal budget. The IMF said the Turnbull government’s ability to pay for its promised company tax cuts and major infrastructure projects were at risk from stagnant wages and low tax receipts. “Lower wage growth and lower household income growth is one of the risks we are concerned about,” said Thomas Helbling, the head of the IMF’s Asian division. ■

CHANGE THE RULES

Wages system is broken Thirty years of “reform” and “modernisation” have entrenched income inequality

hree decades of changes to Australia’s wage-fixing systems, laws and rules have blocked workers from getting decent wage increases, according to Professor John Buchanan, the chair of business analytics at Sydney University. “Within the political class there is low-level moral panic about low wages growth,” he wrote. “The irony is that those lamenting this situation are simply witnessing the ultimate outcomes of policies they have long advocated.” P rof Bucha na n says Au st ra l ia’s wa ge -f i x i ng system reduced income inequality in the 20th century but, after 30 years of “modernisation”, the industrial relations framework is now entrenching it. Consequently, the enterprise bargaining system is on “life support” according to federal Labor leader, Bill Shorten. He recently promised a Labor government would shake up workplace laws to boost wages. Productivity had risen 20 per cent in the past decade while real wages had risen by just six per cent, he said. “If we don’t push big companies to pay a fair day’s wage for a fair day’s work, if we don’t demand a better deal and greater security for working Australians, then it just won’t happen.”

LABOR PROMISES TO RESTORE PENALTY RATES

‘ If we don’t demand a better deal and greater security for working Australians, then it just won’t happen.’

A future Labor government would “restore Sunday penalty rates. We will crack down on the exploitation of labour hire, we will put the bargaining back into enterprise bargaining and lead a new national push to close the gender pay gap”. The Opposition Leader was particularly critical of employers having the ability to terminate enterprise bargaining agreements that have passed their nominal expiry date. Workers covered by terminated agreements a re forced back on to usually-lower award pay and conditions. The number of terminations by employers in 2017 was more than double the long-term average. “We don’t think that should be allowed. I think existing agreements should stay in place until they’re renegotiated by mutual agreement,” Mr Shorten said. Earlier, Labor’s deputy leader, Tanya Plibersek, said there was a clear link between declining union membership, the lowering of workers’ bargaining power, and low wage growth. She said workers’ wages growth could be revitalised if the bargaining power of workers and their unions could be strengthened. ■

— Bill Shorten THE LAMP APRIL 2018 | 25

CALLING ALL RUNNERS, JOGGERS & WALKERS JOIN US ON SUNDAY 13 MAY FOR THE

The Mother’s Day Classic held on 13 May is a national fun run raising money for the National Breast Cancer Foundation. Come along and join in the fun on Mother’s Day as we make our way around the Domain in Sydney, or around any one of the events held across NSW. There are running and walking events to cater for all levels of fitness. Register and nominate the Association as your team. All participating members will receive a NSWNMA team running shirt for the day*.

VOLUNTEERS NEEDED Mothers Day Classic 2018.indd 1

26 | THE LAMP APRIL 2018

TO REGISTER

Early bird rates until 17 April Save up to $10 per registration

1 www.mothersdayclassic.com.au/register 2 Enter your details and select the event and race 3 When prompted with the page asking if “you would like to

join a team” select YES

4 Search and select our team name – NSW Nurses & Midwives’

Association using team password NSWNMA if prompted.

* To be eligible for the team running shirt, please register by 12 April.

We are also looking for volunteers to hand out water and refreshments on the day at the Domain and Parramatta events. Please contact Miriam Galea at events@nswnma.asn.au 7/2/18 12:52 pm

CHANGE THE RULES

Unions push to fix broken work laws

The ACTU is campaigning to re-write the rules governing wage fixing and employment in Australia.

t is now widely accepted that Australia’s industrial laws are broken and have given too much power to employers, ACTU Secretary Sally McManus said last month. Outlining the ACTU’s Change the Rules campaign, Sally said wages barely keep pace with inflation while company profits and productivity continue to rise. Wage rises will only come when workers have enough power to negotiate for better pay, she said. The ACTU wants to reform the enterprise bargaining system which prohibits unions from taking industrial action to establish uniform conditions across a whole industry. Instead, unions are required to bargain workplace by workplace for pay deals. Sally said the system of industry-wide awards used to be fair and transparent and set a level playing field for employers. “Awards allowed improvements in terms and conditions of employment to flow through the economy in a measured and sustainable way,” she said. She cited examples such as the 38-hour week, skillsbased classifications structures, redundancy entitlements and, most importantly, wage movements. However, rates of pay in industry awards have failed to keep pace with rising costs in housing, electricity, health insurance and other aspects of living standards.

ENTERPRISE BARGAINING IS SMOTHERING WAGE GROWTH The enterprise bargaining system has become so restrictive and regulated that it is “smothering wage growth”, Sally argued. She said that in some industries, such as childcare, it was not practical to bargain for separate pay deals. “The only way for those workers to have the power they need is to band together beyond a small childcare centre.” She listed other ways in which the rules are stacked against workers. “Employers are organising their entire workforces to avoid bargaining altogether by using labour hire, subsidiaries, franchises and outsourcing. “Even when workers can bargain, the rules limit their power and protect employer’s interests above all else. “The ‘nuclear option’ of employers simply terminating agreements has become commonplace and means that all bargaining is conducted under the threat of loss of all

previously negotiated wages and conditions. “As a result, wages are in crisis. We need to give power back to working people to organise and win improvements to their pay and conditions in fair negotiations with their employers. “We need to end restrictions on what can be included in a collective agreement and allow free negotiations between employers and employees. “Workers need to be able to negotiate where the power is, whether that’s at the enterprise, industry, supply chain, site, or project level.” ■

Give casuals a choice – ACTU A major goal of the “Change the Rules” campaign is to limit the spread of insecure work. ACTU Secretary Sally McManus says a Fair Work Commission decision last year confirmed that under current laws, workers are not even allowed to negotiate to stop their permanent jobs being casualised. “Casual work has increased, sham contracting continues unchecked, labour hire is growing, contracting out continues and the so-called gig economy is expanding,” she said. The ACTU wants casual work to be properly defined to stop companies keeping their staff on “casual” rates despite effectively employing them in a permanent capacity. The ACTU wants to allow people to be able to convert to permanency if they have been working in a regular capacity for six months. “Other countries limit the duration of temporary, non-standard employment and the circumstances in which it can be used,” Sally said. “Yet in Australia casual and labour hire work with inferior rights and protections can continue forever. “Our current laws do not properly define casual work. As a result, workers can remain casual for years – the average tenure of a casual is around three years – not because all those people want casual work, but because they are given no other option.” Get involved: http://changetherules.org.au THE LAMP APRIL 2018 | 27

NEWS IN BRIEF

BRITAIN

UNITED STATES

The NHS’s unaffordable affordable housing

Billionaires’ legal push to destroy US unions

NHS staff have been given first refusal to buy thousands of homes to be built on unused or surplus NHS land across England, but critics say they won’t be able to afford them.

For the third time in four years the US Supreme Court is to hear arguments mounted and funded by right wing billionaires that would strip public sector unions of a major source of their income.

The British government’s Public Land for Housing program policy is touted to create 3000 homes, with the funds created channelled back into NHS services. Minister of state at the Department of Health and Social Care, Stephen Barclay said: “Where surplus land is developed for housing, NHS staff will be given the right of first refusal on any affordable homes built.” The proceeds from the sale of surplus NHS land will generate up to £3.3 billion. But a report by the New Economics Foundation (NEF) think tank claims that four out of five homes being built on NHS land will be unaffordable on a nurse’s salary, assuming nurses should spend 45 per cent of their income or less on housing. It says public land held by NHS hospitals and organisations is being ”flogged off” to provide luxury homes and “massive profits for developers”. The average cost of the houses for sale on NHS sites was £315,279. This is 10 times the salary of midwives and nurses, 12 times a paramedic salary and 17 times that of clinical support staff, according to the report. In London the average cost will be £561,589, which the NEF said would require a nurse to save for 117 years just to afford a 20 per cent deposit.

‘ Public land held by NHS hospitals and organisations is being “flogged off” to provide luxury homes and ‘massive profits for developers’.’

US unions are able to charge all public employees a portion of the costs of collective bargaining as every worker, not just union members, benefit from the negotiated higher wages. The Supreme Court case, funded by right wing billionaire donors including the notorious Koch brothers and the Bradley Foundation, challenges this right. If successful, the case would deprive unions of a major source of their income. The Bradley Foundation, set up in the 1980s by two billionaire industrialists, Lynde and Harry Bradley, has given more than $US30 million to 24 conservative groups that have attacked public sector unions through the courts. Minutes from a Bradley committee meeting, stolen by hackers in 2016, showed the foundation calculated that restricting union rights in four of the country’s most unionised states – New York, California, Oregon and Washington – would impact 2.8 million public sector employees and threaten more than $2 billion of union income. Lee Saunders, president of the AFSCME, the largest public sector union in the United States, said the intention behind the legal action was to gut the power of progressive forces. “The billionaires and corporate special interests behind this case don’t believe we should have a seat at the table,” he said.

‘ The billionaires and corporate special interests behind this case don’t believe we should have a seat at the table.’ — Lee Saunders, president of AFSCME

28 | THE LAMP APRIL 2018

NEWS IN BRIEF

AUSTRALIA

Early last drinks reducing Sydney ED violence A study published in the Medical Journal of Australia (MJA) indicates that alcohol restrictions in inner Sydney have effectively reduced the number of violent alcohol-related injuries.

INDIA

Indian nurses’ strike passes 200 days Over 100 nurses have been on strike in the southern Indian state of Kerala since August last year. The United Nurses Association (UNA) says the nurses have been unfairly dismissed and haven’t been paid by the private hospital operator, KVM, for more than six months. Working hours at the hospital – 250 hours per month – are well above the legal standard of 190-208 hours. Nurses’ wages in Kerala were set in 2013 at 11,500 Indian rupees a month. At KVM wages range between 6000 and 9000 rupees. According to Public Services International: “This is too low for the nurses to sustain their families as well as repay the loans that many of them take to pay for their education.”

The emergency room at Sydney’s St Vincent’s Hospital has seen a 10 per cent reduction in the incidence of fractures which are often caused by a punch to the face, over the two years since the so-called “lockout laws” were introduced, reported online news site The Conversation. The MJA study looked at the rates of alcohol-related orbital (eye socket) fractures before and after the changes to alcohol access. There were 27 fewer fractures that required surgical management during the period of the laws. Some orbital fractures can be considered minor injuries. But in 2016, some of the study’s authors found a 25 per cent reduction in major alcohol-related injuries in the 12 months after the laws were introduced. This latest research adds to compelling evidence from Australia and internationally that demonstrates restricting access to alcohol by closing drinking venues early reduces serious assaults and injuries. An international study on alcohol-related presentations to EDs, which include intoxication and other emergencies besides injuries, found almost one in 10 of all attendances were alcohol-related. A survey of more than 2000 ED staff in 2014 found nine out of ten had experienced violence from a drunk person in the emergency department.

In June and July 2017, UNA took out statewide industrial action that led to an Indian Supreme Court order to bring the salary of nurses working in private facilities level with that of nurses working in government facilities. KVM management refused to honour this decision. Instead it sacked union activists at the hospital, locked out the other nurses and then closed the hospital. It was later reopened using new nurses. The striking nurses have received solid support from their union and other colleagues in Kerala. On 8 February, UNA State Secretary Sujanapal Achuthan started an indefinite hunger strike in front of KVM Hospital. In an impressive show of strength 50,000 nurses from across Kerala gathered on the National Highway 66, stopping traffic for eight hours, demanding to meet government representatives.

‘ (Their wages) are too low for the nurses to sustain their families as well as repay the loans that many of them take to pay for their education.’

‘ An international study found almost one in ten of all attendances (to EDs) were alcohol-related.’ THE LAMP APRIL 2018 | 29

NEWS IN BRIEF

CHINA

Chinese prefecture mandates aged care ratios Taiyuan, with a population of 4.2 million, has introduced a ratio of one carer for every five residents in aged care facilities.

AUSTRALIA

Industry super funds run rings around banks Not-for-profit industry super funds continue on average to outpace their bank-owned competitors, according to the latest independent ratings agency data. According to the monthly SuperRatings SR50 Balanced Index data, industry super funds have on average outperformed bank-owned retail funds by 3.29 per cent over one year, and 3.49 per cent over three. Across the five, seven and 10 year periods the performance gap is well above 2 per cent. Industry Super Australia public affairs director, Matt Linden, said the results highlighted the strong link between business model and member returns. “Industry super funds send all profits back to their members, and this is reflected in better retirement savings returns,” said Linden. “Bank-owned retail funds serve two masters, splitting returns between shareholders and members”. “Two per cent doesn’t seem like much, but over a lifetime it may add up to tens of thousands of dollars more – or, sadly, less – at retirement,” he said.

As the ANMF sets out on a campaign to introduce ratios into Australian aged care facilities, a Chinese city has shown that it can be done. Taiyuan, one of China’s largest industrial complexes, located in the north of the country, and with a population of more than 4.2 million has introduced compulsory standards for aged care facilities. If a facility has 20 beds, the minimum for a “community pension centre” in the area, then it would need at least four aged care workers. That’s a ratio of one carer for every five residents reports online magazine HelloCare. In May 2017, the Taiyuan municipal civil affairs bureau submitted a draft of what standards were required by the relevant quality supervision departments. After four revisions and approval by the local provincial expert group, a conclusive set of standards was established that must be met. These standards were put into place on 1 March this year. According to Austrade, the Chinese Government has started an ambitious program to transform the country’s aged care. “The government aims to provide 35 to 40 care beds per thousand elderly citizens and a workforce of 10 million aged care workers by 2020,” it says.

Average Annual Rates of return (%), Industry Super Funds & Bank Owned Super Funds, 1, 3, 5, 10 Years to 31 January 2018 1 Year %

3 Year %

5 Year %

7 Year %

10 Year %

Industry Super Funds

12.7

8.3

10.0

8.8

6.2

Bank-Owned Super Funds

9.4

4.8

7.1

6.2

4.0

Outperformance

3.29

3.49

2.94

2.66

2.21

Source: ISA analysis of SuperRatings Fund Crediting Rate Survey, SR50 Balanced (60-76) Index, January 2018

30 | THE LAMP APRIL 2018

‘ If a facility has 20 beds, the minimum for a “community pension centre” in the area, then it would need at least four aged care workers.’

NEWS IN BRIEF

WORLD

What doesn’t kill you makes you weaker Children who grow up in poverty may be at risk of poor health in later life, even if they escape poverty when they are older according to research from the University of Geneva.

WORLD

A surge in antibiotic use worldwide International research from 76 countries found a 65 per cent increase in the consumption of antibiotics from 2000 to 2015. The bulk of the increase has come from a rise in use in poorer nations, the study found. “We saw a dramatic increase in antibiotic use globally and this is mostly from gains in low and middle income countries where economic growth means they have greater access to the drugs,” said Eili Klein, an author on the study at the Center for Disease Dynamics, Economics and Policy in Washington DC. “While it’s generally a positive that there’s better access to effective antibiotics in these countries, there’s the potential for serious problems down the road from overuse.” The study, published in Proceedings of the National Academy of Sciences, found that on average poorer nations still use antibiotics far less than richer ones. In low and middle-income nations, the number of “defined daily doses” handed out per 1,000 people rose 77 per cent from 7.6 to 13.5 over the 16 years studied. But richer nations consume antibiotics at nearly twice that rate. According to the study, consumption rates in highincome countries fell on average by a modest 4 per cent, to 25.7 doses per 1,000 people. The researchers called for a “radical rethinking” of policies to reduce antibiotic consumption, and advocated major investments to boost hygiene, sanitation, and vaccinations in countries where antibiotic use is rocketing.

In the new study of over 24,000 people across 14 countries, researchers found that individuals, particularly women, of lower socioeconomic status in childhood had lower hand grip strength in older adulthood. This is a reliable health indicator, predicting the risk of frailty, disability and death from cardiovascular disease and cancer in older age. “This suggests that childhood adversity doesn’t just affect our choices, but also directly compromises the biological ability of our bodies to stay healthy,” Noortje Uphoff, a researcher in social epidemiology, wrote on the online news site, The Conversation. “Our childhood affects our health across the course of our lives. Stress, it seems, is a major contributor.” This may come from social tensions, domestic abuse, neglect, food and fuel poverty, unsafe or poor quality housing, and separation from caregivers, she says. “Now, we have evidence that growing up in poverty has a cumulative wear-and-tear effect on the physiological systems that govern how our bodies respond to our environment, permanently disrupting the ability of affected individuals to maintain good health in old age. “While more work is still needed to understand how early adversity affects our immune system and other physiological systems in later life, one thing is already clear. To make our society less stressed, happier and healthier, we need to recognise just how crucial a role hardship in childhood plays in determining an individual’s long-term health.”

‘ We need to recognise just ‘ We saw a dramatic increase in how crucial a role hardship antibiotic use globally and this in childhood plays in is mostly from gains in low and determining an individual’s middle income countries.’ long-term health.’ THE LAMP APRIL 2018 | 31

PROFESSIONAL EDUCATION

The Influential Thought Leader at Work

Professional Comprehensive Documentation All

All

Tuesday 10 April, Waterloo $ Members $30 / non-members $60 This workshop is designed to revisit the principles of documentation within the healthcare setting. Wound Care: Pathophysiology, Skin Tears and Pressure Injury Prevention

Evening Series CPD

CPD

All

6 Friday 20 April, Gymea $ Members $95 / non-members $190 This program will provide you with the skills and tools to build your confidence in becoming an inspiring and motivational thought leader. Prepping for Interviews All

Bullying: Let’s put an end to it All

Friday 13 April, Waterloo Wednesday 2 May, Newcastle Friday 27 April, Hornsby Wednesday 23 May, Taree $ Members $95 / non-members $190 Learn about potential liability, disciplinary tribunals, NMC and HCCC complaints, Coroners Court and identify the fundamental ethical standards and values to which the nursing and midwifery profession is committed. CPD

RN EN MW

Wednesday 18 April, Gymea Friday 18 May, Waterloo Thursday 3 May, Newcastle Thursday 24 May, Taree $ Members $50 / non-members $100 This seminar is designed to assist nurses and midwives to better understand the key concepts and relevant information to ensure effective recording and completion of CPD that meets NMBA standards. Medication Safety, Professional Obligations, Professional Comprehensive Documentation and the NMBA Decision-Making Framework

CPD

Thursday 19 April, Kempsey Members $95 / non-members $190

Cultural Competence in Healthcare All

CPD

Thursday 19 April, Wagga Wagga $ Members $50 / non-members $100 Attending this interactive workshop will equip you with Better Practice Strategies to embrace the diversity in care.

Policy and Guideline Writing for nurses & midwives All

CPD

Friday 4 May, Waterloo 6 $ Members $95 / non-members $190 This interactive workshop is designed to give nurses and midwives the beginning skills to develop a document, either a policy or clinical guideline for their workplace. Practical, Positive Leadership Series – 4-DAY PROGRAM

CPD

All

Wound Care: Leg Ulcers and Compression Dressing – 2-DAY COURSE All

Tuesdays, 8 May and 29 May, Wollongong $ Members $190 / non-members $380

8595 1234 (METRO) • 1300 367 962 (RURAL)

Attendance at NSWNMA education sessions may count towards your Continuing Professional Development (CPD) hours. The number of hours noted beside each course is the maximum amount of claimable CPD hours assuming that as an attendee you remain for the entirety of the course and complete any extra activities as may be required. All

Tuesday 1 May, Newcastle Tuesday 22 May, Taree $ Members $95 / non-members $190 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.

CPD

Mondays, 7 May, 4 June, 2 July, 6 August, Waterloo $ Members $340 / non-members $600 The aim of this program is to equip and empower managers and senior staff in their leadership role.

All $

CPD

All

CPD Made Easy

CPD

Thursday 26 April, Newcastle Thursday 24 May, Waterloo $ Members $20 / non-members $40 To prepare nurses, midwives and undergraduates for interviews.

Wednesday 11 April, Waterloo $ Members $95 / non-members $190 Legal, Ethical and Professional Issues for nurses and midwives

CPD

All nurses, midwives & assistants in nursing

AiN

Midwives

CPD

YOUR RIGHTS

Ask

Judith Breaking News Privatisations still unfolding In last month’s The Lamp we rightly celebrated the final privatisation reversal at Maitland Hospital, but for members working at Manly and Mona Vale Hospitals it was a bittersweet moment. The public health services they currently deliver will become the responsibility of a private provider (Healthscope) who will run the new Northern Beaches Hospital. Healthscope will also be the employer of staff working there. Manly Hospital will retain no public health services. Mona Vale will become a small rump – largely rehabilitation services and a walk-in Urgent Care Centre. The LHD’s role in the Northern Beaches will largely be reduced to the purchaser of services and activity from Healthscope rather than as the provider. Members at both of these hospitals are currently navigating an Expression Of Interest and job matching process that should have started last year. They now confront a compressed timetable of decision making about their very employment and professional futures. Our members working in FACS are in an even worse situation. They are being forcibly transferred to NGO providers under the NDIS agreement struck between the NSW and Federal governments, which sees the NSW government vacating the disability space altogether. This industrial conscription, via legislation passed by the NSW Parliament, expressly states that the consent of an employee is not required in such a transfer. This approach is draconian. Early feedback from members transferred in the disability space, and more generally with the NDIS rollout, is worrying. Governments at all levels and all persuasions must accept that the provision of care and support to the sick, injured, the disabled and elderly is in many instances a core public service that governments cannot and should not easily deflect or delegate or sell off.

Influenza vaccinations I am a registered nurse working in a public hospital. I was recently told that I now must have an influenza vaccination. Is that right? The revamped Occupational Assessment, Screening and

When it comes to your rights and entitlements at work, NSWNMA Assistant General Secretary Judith Kiejda has the answers.

Vaccination Against Specified Infectious Diseases policy directive (PD2018_009) has introduced Category A High Risk (defined in Attachment 1 of the PD). Workers in this category must obtain an influenza vaccination. It is provided free and NSW Health agencies must make arrangements to conduct vaccination clinics and for them to be available to workers on a rotating roster and administered during work hours, for example, during a range of shifts of the week.

Changing rosters at Ramsay I work at a hospital operated by Ramsay. There is some talk of changes to rosters and hours of work. How should this be managed? Under Clause 2.3 of the Ramsay Health Care Australia Pty Limited, and NSW Nurses & Midwives’ Association/ANMF Enterprise Agreement 2015-2018, local managers have an obligation to consult with staff on major change, which includes changed rosters and working times. If a decision is made, they are required to provide staff with all relevant information and genuine consideration must be given on staff feedback. Of course, staff can nominate the Association to be their representative in such discussions. It is especially important to note that when a change to a regular roster or ordinary hours of work is contemplated, hospital management must invite affected staff to give their views about the impact of the change (including any impact in relation to their family and caring responsibilities).

Multiple assignments and voluntary redundancy I work in two different classifications in public health. One of these positions looks set for deletion. A redundancy has been mentioned but I have been told that I would have to resign from my other position to get it. Is that right? It is the default position that, on receipt of a voluntary redundancy,

a worker is normally precluded from working in the government sector for the time period covered by the redundancy pay (unless repaying the relevant portion). The exception to this rule is if you work in multiple assignments. Section 4 of PD2012_021 (Managing Excess Staff of the NSW Health Service) sets out that in such a situation the staff member is only declared excess from the assignment that is deleted.

Workloads in Uniting I work in an aged care facility run by Uniting. How do we discuss concerns regarding workloads? Under Clause 47 of the UnitingCare Aged Care Residential & Community Services Agreement (NSW) 2014– 2017, the accepted starting point for such discussions should be with your immediate supervisor, and if the matter is not resolved it should be escalated to more senior management. Records should be kept and feedback provided by managers. In addition, clause 47 requires workload management to be an agenda item at staff meetings on at least a quarterly basis. Items in relation to workloads must be recorded in the minutes of the staff meeting, as well as actions to be taken to resolve the workloads issue/s.

Nurses and domestic work I work in a public hospital and shortages of non-nursing staff is leading to an expectation that nurses will fill in and help out with cleaning duties. Can I be required to do such work? This issue arises from time to time and is well worth reiterating. Clause 44 of the Public Health System Nurses’ and Midwives’ (State) Award makes clear that “nurses shall not be required to perform, as a matter of routine, the following duties: viz.; washing, sweeping, polishing and/or dusting of floors, walls or windows of wards, corridors, annexes, bathrooms or verandahs or any duties which are generally performed by classifications other than nursing staff …” THE LAMP APRIL 2018 | 33

The Edith Cavell Trust is now able to receive non-tax deductable donations/bequests. The Trust – named in honour of Edith Cavell – assists in the advancement of NSW nurses, midwives and assistants in nursing/midwifery through further studies and research, made available through scholarship. The knowledge and expertise gained by nurses, midwives and assistants in nursing/midwifery, supported by the Edith Cavell Scholarships, is an asset to the care of their patients and clients. Bequests to the Trust continue to support this important work. Edith, a British nurse serving in Belgium in WW1, is a hero to most nurses and midwives. She helped some 200 Allied soldiers escape from German-occupied Belgium. Her actions saw her arrested, accused of treason, found guilty by a court-martial and sentenced to death. Despite international pressure for mercy, she was shot by a German firing squad. NAME ADDRESS

Cavell Edith

TRUST BEQUESTS

EMAIL PHONE

BEQUEST/ DONATION AMOUNT

PREFERRED METHOD OF PAYMENT Electronic Fund Transfer Bank: Commonwealth Bank

Account name: Edith Cavell Trust BSB: 062-017 Account no: 10017908

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Lippincott Procedures

Australia

ALWAYS CURRENT. ALWAYS EVIDENCE-BASED.

Wolters Kluwer is honoured to partner with the Australian College of Nursing to localise the Lippincott Procedures content specifically for the Australian health care market. “We decided to partner with the ACN on this project because we share similar missions in seeking to provide health care professionals with the best available evidence to inform their practice. By using Lippincott Procedures Australia at point of care for clinical decision support, nurses and other health care professionals can provide the highest quality, evidence-based care to their patients, which means improving patient outcomes.” Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN Chief Nurse of Wolters Kluwer, Health Learning, Research and Practice

Wolters Kluwer, a global leader in professional information services has partnered with The Australian College of Nursing (ACN), Australia’s preeminent and national leader of the nursing profession, to adapt Lippincott Procedures for Australia, fully reflecting local protocols and regulations, terminology, and drug names.

Visit our site and request a free trial http://lippincottsolutions.com/landing/procedures-aus Scan the QR code with your smartphone camera or APP for instant 34 | THE LAMP APRILaccess 2018 to our website.

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 “You’ve got to get off the ward or your body will fall apart” NSWNMA AT MARDI GRAS 2018 Nurses and midwives joined the parade at the 2018 Sydney Gay & Lesbian Mardi Gras, celebrating 40 years of pride and protest. bit.ly/nswnmamardigras

MAITLAND CELEBRATE THEIR PUBLIC HOSPITAL Nurses and midwives joined with community and other hospital staff to celebrate their recent win in keeping Maitland hospital public. bit.ly/maitlandwin 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!

Tess was not your typical new grad RN when she started at age 55. But her energy and drive is to be admired and here she highlights all the positives and great experiences she’s had so far. https:// www.nurseuncut.com.au/youve-gotto-get-off-the-ward-or-your-bodywill-fall-apart-a-new-grad-rn-at-55/ was-beautiful/

Night shift made simple The Nourished Shift Worker is an RN with a wealth of experience to share about what new grads can expect, how to prep your lunch for a week and other nurse and midwife specific tips and tricks! https://www.nurseuncut.com.au/ night-shift-made-simple-for-nursesand-midwives/

RNs are vital in aged care New codes of conduct for Australian nurses and midwives The Nursing and Midwifery Board of Australia’s (NMBA) new Code of Conduct for nurses and Code of conduct for midwives came into effect from March 1, 2018. https://www.nurseuncut.com.au/ new-codes-of-conduct-for-australiannurses-and-midwives/

Residential Aged Care Facilities (RACF) are homes for the sickest, frailest people in our society and yet the responsibility of their care can fall on unregistered carers with limited skills and knowledge. https://www.nurseuncut.com.au/ rns-are-vital-in-aged-care/

Strange advice from a NUM to new grads “I get hit at work and no one cares” Nurses and midwives care so much about their patients and residents that they inevitably sacrifice a lot to do their job. This is a story detailing everything one aged care nurse gives up for her residents. https://www.nurseuncut.com.au/iget-hit-at-work-and-no-one-caressacrifices-made-by-aged-care-nurses/

With a lot of nurses and midwives graduating recently, there’s all sorts of encouragement and motivational speeches that help these students on their way. https://www. nurseuncut.com.au/strange-advicefrom-a-num-to-new-grads/

Listen to our podcast Midwifery Forum – Diversity in Midwifery: Fiona McArthur bit.ly/ GreenLineProgram THE LAMP APRIL 2018 | 35

COVER STORY

JOURNEY ACCIDENT INSURANCE 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

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36 | THE LAMP APRIL 2018

SOCIAL MEDIA

your

Say

A cry for help in aged care Aged care nurses were joined by residents and their families to demand safe patient ratios at a rally in South Australia. Please remember that not all carers are awful, evil people. We feel awful whenever we discover a wet or soiled pad; we try our hardest to keep your loved ones clean, presentable and safe. But when there’s two of us and 30 of them, it gets hard. Please don’t think nursing homes are full of nasty, neglectful staff. That’s simply not true. Anyone out there who has a care in the world for our precious and muchloved elderly folk, please help fight to get the ratios changed. Working in Aged Care is a passion of mine, but it is so hard mentally and physically – having buzzers going off constantly with residents requiring assistance and only limited staff due to staff meal breaks etc. sure does make way for stress levels to peak for both residents and their carers. Please, Mr PM, come and have a week’s holiday at our facility and see firsthand what it is really like. It ain’t no holiday in the Bahamas I can assure you! Up our neck of the woods, an RN was dismissed for not coping with nightshift where the ratio was 1:100 residents. SURELY these places should be shut down? Their glamorous, shiny and clearly expensive ad campaigns on TV make me cringe.

What nurses and midwives said and liked on Facebook www.facebook.com/nswnma

Still plenty to do on hospital violence Violence against nurses, midwives and hospital staff is happening across the country – and it’s completely unacceptable. These are your comments regarding a violent incident at Royal Perth Hospital. I was attacked at work and I did an IIMS like we are told to; security called the police and I also emailed the DON, the general manager and my NUM. Not one of them bothered to reply and it’s been ignored! I have suffered PTSD from it and they just ignore me. Why bother getting upset. Nobody cares about us. Zero tolerance is a joke, assaults are met with “that’s just how it is, nothing we can do about it”. There is nobody on our side and the violence will continue because, like in this case, there are no repercussions for perpetrators.

Recognition at last! After a hospital stay in February, former NSW Deputy Premier John Watkins wrote about his appreciation for the work nurses do. Yes, John Watkins, all you said is true...AND... nurses are highly intelligent, highly educated to degree, Masters and PHD levels, knowledgeable about the workings of the human body and what is needed

to provide healing. All this along with caring, kindness and compassion, as you said. About time something was done in the NSW health system to relieve the pressure on ALL nurses. We are understaffed nearly every shift, nursing admin do not allocate like for like (RN for an RN, EEN for an EEN), and there is so much overtime because there just aren’t enough nurses to fill those shifts. This pressure keg is going to blow if something is not done about it, and sooner rather than later. I appreciate his words. With his experience and connections, perhaps he can help bring change e.g. nursepatient ratios for improved staffing?

the gallery /1

Show us the love with ratios! On Valentine’s Day, we didn’t want chocolate or roses (although they would be nice). Instead, we said we’d love it if we got RATIOS in all hospitals and facilities! Lying in my local hospital’s ICU for the fourth night – I watched the nurses assigned to me put up with stuff most wouldn’t tolerate. I am alive thanks to these nurses. Fixed, mandated nurse to patient ratios is the only way we can get the LHDs to comply and provide adequate nurses so we can provide safe patient care. As we have seen, management manipulate NHPPD to the detriment of patients and nurses. Yes I agree, roses and chocolates would be nice but better ratios would be a heck of a lot better.

/6 1/ N SWNMA staff support the campaign for domestic violence leave on International Women’s Day 2/ N urses and midwives decked out in rainbow in the Mardi Gras Parade 3/ U ni students joining the Association during O-Weeks across NSW 4/ Lynne Rydge is awarded the Union’s NSW Scroll of Honour for her commitment to unions and years of service to the NSWNMA 5/ Aged care nurses in Tamworth attended a forum to discuss elder abuse 6/ Maitland nurses and midwives celebrate their hospital remaining public THE LAMP APRIL 2018 | 37

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38 | THE LAMP APRIL 2018

PROFESSIONAL, KIND & GENEROUS

NURSING RESEARCH ONLINE The Australian Healthcare and Hospitals Association (AHHA) is the only independent national peak body advocating for universal and equitable access to high quality healthcare in Australia. With 70 years of engagement and experience with the acute, primary and community health sector, the AHHA is an authoritative voice providing strong political advocacy on the Australian healthcare system.

On 18 December 2017 the AHHA released Healthy people, healthy systems, a solid blueprint for a post-2020 national health agreement with a range of short, medium and long-term recommendations on how to reorientate our healthcare system to focus on patient outcomes and value rather than throughput and vested interests. Healthy people, healthy systems Strategies for outcomes-focused and valuebased healthcare: A blueprint for a post 2020 National Health Agreement Australian Healthcare and Hospitals Association December 2017 Healthy people, healthy systems was developed by Australia’s health leaders for Australia’s health leaders. Health systems in advanced economies around the world are on the cusp of change, and now is Australia’s chance to transform our healthcare system into a fit-for-purpose 21st-century system that will meet 21st-century needs and expectations. Maintaining the status quo and tinkering around the edges of system reform will not provide the future-proofed health system that Australians expect and deserve. Negotiations between the Commonwealth Government, and the state and territory governments for a post-2020 national health agreement provides the opportunity to define a shared vision and ensure that everyone is doing what they can to work towards outcomes-focused, value-based healthcare. This will require a nationally unified and regionally controlled health system that: • puts patients at the centre; • ensures performance information and reporting is fit for purpose; • develops a health workforce that exists to serve and meet population health needs; and • is supported by long-term, sustainable funding that drives high-quality health outcomes. Current roles and responsibilities for different aspects of our health system are divided among the Commonwealth, the states and territories, and public and private entities, with government roles set out in the Constitution, and influenced by factors beyond the health sector. As such, coordination and integration of health services to meet the outcomes that matter to patients and communities needs a shared vision and coordinated effort, not just between governments but with all those who contribute to and influence the provision of healthcare.

Integrating local services commissioned and coordinated by Primary Health Networks and Local Hospital Networks (or equivalent) in addition to the wide range of services provided by the notfor-profit and private sectors, will go a long way towards achieving this aim and providing a cohesive and more integrated health system to deliver improved outcomes. TRANSFORMING DATA INTO HEALTH INTELLIGENCE If there is a genuine commitment to delivering patient-centred care that improves health outcomes, consumers must be genuinely engaged in codesigning services and how the entire health system functions across hospitals, primary healthcare and prevention activities. There is a need to move away from siloed care delivered within four walls to an integrated model delivered by a healthcare neighbourhood. There is also a requirement to move away from an episodic view of healthcare to a model that meets people’s health needs over the long term. This will require progressing from simple data collection to embracing the information and communication technology revolution, and transforming the vast amounts of data generated by our health system into intelligence that will facilitate continued improved system integration and a focus on outcomes. This will require a health workforce that is flexible, competent, working to the top of their scope of practice, and actively participating in the design and delivery of health services. This will require appropriate funding that is sustainable and durable, which provides certainty for longer-term planning. This will also require sustained, non-partisan cooperation across all governments, and existing professional and financial incentives not being allowed to frustrate healthcare system reform. We know we need to provide value-based healthcare. We know integrated care fits the value agenda. We know we need intelligent data and a modern workforce to drive these changes. It’s time to step out of our comfort zones and transform fragmented healthcare in Australia. The recommendations found in this blueprint are a good place to start. http://ahha.asn.au/sites/default/files/docs/ policy-issue/ahha_blueprint_2017.pdf THE LAMP APRIL 2018 | 39

REGULARS

e m S i l n a y a t i k R w O y ha F a st aw RECENTLY I!

r! fe oo

Be A TRI sw P ep t

AL B O OT

WI N

CHANGED YOUR EMAIL? CLASSIFICATION CHANGED?

Log on to ONLINE.NSWNMA.ASN.AU and update your details to be automatically entered in the draw to win

5 nights in your very own one-bedroom pool villa at the luxurious Villa Kayu Raja. YOU AND A FRIEND WILL ENJOY:

• 5 nights’ accommodation in a 1-bedroom pool villa for two • Return airport transfers for two • Return flights for two to Denpasar • Breakfast daily for two • 2 x dinners for two • 2 x 60-minute massages. Spend your time relaxing and recharging at the resort, a tropical oasis surrounded by palms, or take the complimentary shuttle into Seminyak and experience all the region has to offer – boutique shopping, cafes and chic bars.

lt er

40 | THE LAMP MARCH 2017

Log on and update your details from 1 October 2017 – 30 June 2018 and you will automatically be entered in the draw to win.

m sa nd co nd it

ion s

are

avai lable

at www .nswnma.asn.au/nswnm

st s nte o c / bers amem

ns /

online.nswnma.asn.au

ot m ro p d- an

CROSSWORD

test your

Knowledge 1

11 13 14

23 25

24 26

ACROSS 1. Convulsion with intermittent contractions; the muscles alternately contract and relax (6.10) 9. Purplish red (7) 10. Removes or clears an obstruction from (8) 11. A specialist in biological study of the nervous system (14) 13. Intestinal

spirochetosis (1.1) 14. Softening of the brain (16) 16. A genus of poisonous mushrooms (9) 17. Adequate (6) 19. The first letter of the Greek alphabet (5) 20. Red algae (10) 23. User Interface (1.1) 24. Eosinophil (1.1) 25. To press close together (9) 28. Twelfth letter of the

Greek alphabet (2) 30. The posterior horn of the lateral ventricle (9) 31. Strain fracture (8.8) DOWN 1. Glaucoma with angle-closure and open-angle mechanisms in the same eye (8.8) 2. Derived from living organisms (7) 3. A protein capable

of pumping ions actively across a membrane against a concentration gradient (3.4) 4. The blue-green bacteria which are photosynthetic and also fix nitrogen (13) 5. A tumour of the nerve sheath (9) 6. Resembling an umbel (9) 7. The cellular endoskeleton of which is a source of commercial sponges (7) 8. A catheter inserted through the nasal cavity into the trachea (12.4) 12. A retention or suppression of urine (7) 15. Heat-generating chemical reaction (10) 18. The back of the neck (4) 21. An isolated occurrence; something that happens just once (3.3) 22. The genus of primates that includes humans (4) 23. Wombs (5) 26. Temporoparietal (1.1) 27. Erythromelalgia (1.1.1.1) 29. Pakistani language (4)

THE LAMP APRIL 2018 | 41

WINTER

WARMERS 1 3

ORDER FORM

Winter is here. Keep warm in NSWNMA winter favourites which are not only stylish & comfortable, but also affordable & sold at cost to members. Name

1 Bonded Polar Fleece Zip Front Jacket $30. Quantity: Size: S M L XL XXL XXXL

Address Postcode

2 Active Soft Shell Navy Jacket $50. Quantity: Size:

10 S

12 M

14 L

16 XL

18 XXL

Phone H

3XL

3 Long Sleeve Quick Dry Polo Shirt $25. Quantity: Size:

2XL

XXL

XXXL

4 Navy Hoodies $45. Quantity: Size:

10 S

12 M

14 L

16 XL

5 Red Hoodies $45. Quantity: Size:

10 S

12 M

14 L

3XL

MOB Email METHOD OF PAYMENT Cheque MasterCard

Money Order

Name of card holder 16 XL

XXL

XXXL

Postage and Handling $5 per item. Total cost of order $

Card number Expiry date

TO ORDER » WWW.NSWNMA.ASN.AU 42 | THE LAMP MARCH 2017

Visa

Signature

FAX (02) 9662 1414 POST NSWNMA, 50 O’Dea Ave. 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.

How To Win Campaigns: Communciations For Change Chris Rose

Earthscan, Book Depository https://www.bookdepository.com RRP $49.88 ISBN 9781849711142

How to Win Campaigns is a practical guide for creating and running successful campaigns. Written for the new campaigner and the experienced communicator alike, it explores what works (and what doesn’t) and shows how to use principles and strategy in campaigning as a new form of public politics. Applicable to any issue and from any point of view, the book’s key steps and tools provides models of motivation, analysis and communication structure.

Assessing Dangerousness: Domestic Violence Offenders And Child Abusers Jacquelyn Campbell, Jill Messing

Springer Publishing https://www.springerpub.com RRP $65.00. ISBN 9780826133267

Practitioners in the social, behavioural and health fields

often work with perpetrators and survivors of interpersonal violence. Many are asked to make predictions about the likelihood of future violence. Assessing Dangerousness reviews the intricacies of predicting intimate partner violence and homicide, as well as child abuse and homicide, to better prepare readers to make such assessments. The contributors’ experience in research and practice makes this the go-to resource for anyone interested in learning about making predictions with regard to violent behaviour in family settings.

Skills For Midwifery Practice (4th Edition) Ruth Johnson, Wendy Taylor

Elsevier https://www.elsevierhealth. com.au RRP $51.30 ISBN 9780702063875

The new edition of this highly acclaimed stepby-step guide continues to offer readers with the relevant physiology, evidence-based and rationale for the key midwifery skills. Authored by experienced practitioners and educationalists, Skills for Midwifery Practice will be ideal for al midwifery students, both within the UK and worldwide.

T ES

With amusing anecdotes, sad recollections and frank comments, As It Was is a candid account of a nurse’s career in the mid-20th century.

S PE

Claire Ravele https://www.amazon.com.au RRP $3.99 ISBN 9780646978635

INTE IAL

ST RE

As It Was

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.

IN T E

Comparative Health Systems (2nd Edition) James Johnson, Carleen Stoskopf, Leiyu Shi, Jones & Bartlett Learning

Book Depository http://www.bookdepository. com RRP $119.20 ISBN 9781284111736

Global health policy, administration, and practice continue to evolve while countries throughout the world seek to balance their economic and health goals through health system reform, improvement, and modification. The Second Edition of Comparative Health Systems: A Global Perspective addresses emerging events, advances, reforms, and challenges in the delivery of health care around the world. Ideal for courses in health administration, public health, nursing and other allied health professions, this innovative text challenges readers to reflect deeply about how health care is organised and delivered. 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. THE LAMP APRIL 2018 | 43

Bali?

Do you want to escape to

i! l w a r a r e n d b d g a o e i h n t t o m e B m 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 LAMP 2018from the original draw date. NSW Permit no: LTPM/18/02955 prize be held up toAPRIL 3 months

Prize drawn 30 June 2018

REVIEWS

MEMBE AW

The year is 1953 in Moscow, Russia. The Soviet Union’s leading politician is the ever-spinning arrow on a moral compass. As the stark reality of his dictatorship is brought to light, the gulf between him and the common people is glaringly obvious. Stalin dies. Surely a man so strong has many strong hands holding him up. Right? The audience shares the rather rocky journey taken by the men in the committee that surrounds Stalin. How ever will the great leader be replaced? Their sorrow is shortlived and quickly overshadowed by deception and hunger for power. His right-hand men become righthanded henchmen. How many squabbles, and misplaced footsteps, need to be undertaken to reach the heights of domination? A barrel of laughs is guiltily enjoyed from this point onwards. You find yourself chuckling at anecdotal nonsense and witty one-liners. At one point a squeaky-toy is used to provoke a yapping dog in order to run interference while a consequential conversation is taking place in the back of a stationary vehicle.

The clever writing and brilliant characters will have you guffawing and shaking your head. Nikita ‘Nikki’ Krushchev (Steve Buscemi, Reservoir Dogs) is amusing as a master of political manipulation. It takes something exceptional for actors to give presence and depth to their historical character while simultaneously flexing their comedic muscles. A special mention for Jeffrey Tambor (Arrested Development) who plays Georgy Malenkov, the Soviet politician who succeeded Stalin and Jason Isaacs (The Patriot), who is memorable as Field Marshal Zhukov. He sweeps in like a good, hard punch to the face. You might just recognise him by his chest of medals. The Death of Stalin shows political power gone haywire. At a certain point beyond the laughs you’re left with the realisation that these people are monsters. Email The Lamp by the 12th of the month to be in the draw to win a double pass to The Death of Stalin thanks to Madman Entertainment. Email your name, membership number, address and telephone number to lamp@nswnma. asn.au for a chance to win!

DVD IE

MEM AL

R BE

RUR

I E GIV

The Death of Stalin

METR

at the movies

Lyndall Frost RN, Department of Radiology, Royal Prince Alfred Hospital is this month’s reviewer. If you would like to be a movie reviewer, email lamp@nswnma.asn.au

GIV E

The Guernsey Literary & Potato Peel Pie Society London, 1946. Juliet (Lily James, CINDERELLA), a charismatic and freespirited writer receives a letter from a member of a mysterious literary club started in Nazi-occupied Guernsey. Her curiosity piqued, Juliet decides to visit the island. There she meets the delightfully eccentric members of The Guernsey Literary & Potato Peel Pie Society, including Dawsey (Michiel Huisman, ‘Game of Thrones’), the rugged and intriguing famer who wrote her the letter. As the secrets from their wartime past unfold, Juliet’s growing attachment to the island, the book club and her affection for Dawsey will change the course of her life forever. Email The Lamp by the 15th of the month to be in the draw to win a DVD of The Guernsey Literary & Potato Peel Pie Society thanks to StudioCanal. Email your name, membership number, address and telephone number |to lamp@nswnma. asn.au for a chance to win! THE LAMP APRIL 2018 | 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 Workshop – Living with Anxiety 28 April 2018, 9–11am Macquarie Park, Sydney followed by

NCFA AGM 11.30am–1pm

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.

EVENTS: INTERSTATE 17th National Nurse Education Conference 1–4 May 2018 Crown Promenade, Melbourne

www.dcconferences.com.au/nnec2018

www.ncfansw.org Mobile: 0412 862 776

NCFA Professional Meeting 5 May 2018, 9am Melbourne, Victoria

Australian Orthopaedic Nurses’ Association NSW (AONA) Annual Conference 4 May 2018 8.30am–4.00pm Dooleys’ Catholic Club, Lidcombe

DECLARED 2018 – Delirium Clinical and Research Days 4th Biennial Conference 6–7 September 2018 Melbourne Convention Exhibition Centre Melbourne, Victoria, Australia

Mirjana Armstrong: armstrong@optusnet.com.au or mirjana.armstrong@health.nsw.gov.au

Custodial Health Conference 31 May–3 June 2018 International Convention Centre, Sydney https://www.ivvy.com.au/event/CHC18/ registrations.html

The Wellness Show 25–26 June 2018 International Convention Centre Sydney www.wellnessshow.com.au

‘Spring with the Kids’ Paediatric Perioperative Seminar 2018 15 September 2018 Rydges Parramatta, Rosehill Claudia Watson claudia.watson@health.nsw.gov.au Sally Phoebus sally.phoebus@health.nsw.gov.au

46 | THE LAMP APRIL 2018

www.ncfansw.org, Mobile: 0412 862 776

www.delirium.org.au/2018-Conference

INTERNATIONAL 3rd Asian Conference in Nursing Education 18–20 April 2018 Yogyakarta, Indonesia.

http://acine2018.fk.ugm.ac.id/

7th World Congress on Midwifery and Women’s Health 11–12 May 2018 Osaka, Japan

https://midwifery.nursingconference.com/ scientific-program

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 Hornsby and Ku-ring-gai Hospital (HKH) May 1978 PTS ‘Pink Group’ 40th Year Reunion Lunch. 19 May 2018 Deborah Noakes 0401 838927 Deborah.noakes@hnehelath.nsw.gov.au

Cowra District Hospital Reunion – Diamond Anniversary 26 May 2018, bit.ly/cowrareunion Crown Street Women’s Hospital Graduates March 1968 50-year Reunion Lunch 1 June 2018, The Royal Sydney Yacht Club Wendy Wooller: kwooller@tpg.com.au

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Find out how at hesta.com.au Before making a decision about HESTA products you should read the relevant Product Disclosure Statement (call 1800 813 327 or visit hesta.com.au for a copy), and consider any relevant risks (hesta.com.au/understandingrisk). Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321.

REGULARS

48 | THE LAMP MARCH 2017