lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION
VOLUME 74 No.2 MARCH 2016
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2 | THE LAMP MARCH 2016
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
VOLUME 74 No.2 MARCH 2016
Hunter Office 8-14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962
COVER STORY
12 | Agreement to act on violence Health unions have achieved a breakthrough in the campaign to tackle violence in hospitals.
Relax and unwind at COVER STORY
5 Editorial 6 Your letters 8 News in brief 31 Ask Judith 33 Social media Lakeview Luxury Cabins 37 Crossword s a luxurious retreat for research online 39 Nursing couples only, 41 providing Books 43 for Movie a unique place thatof the month 46 Diary special occasion or to dates
15 | NSWNMA delegates urge action on security
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Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au
Annette Allrick and Jason Mullavey PHOTOGRAPH: SHARON HICKEY
REGULARS
For all editorial enquiries letters and diary dates T 8595 1234 E lamp@nswnma.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017
Editorial Committee • Brett Holmes, NSWNMA General Secretary • Judith Kiejda, NSWNMA Assistant General Secretary • Coral Levett, NSWNMA President • Peg Hibbert, Hornsby & Ku-Ring-Gai Hospital • Michelle Cashman, Long Jetty Continuing Care • Richard Noort, Justice Health Advertising Sarah Emms T 8595 2139 or 0429 269 750 F 9662 1414 E saemms@nswnma.asn.au Information and 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 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 2016 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30. Individuals $80, Institutions $135, Overseas $145.
THE LAMP MARCH 2016 | 3
Update your membership details online and go into the draw to
win a smart watch IT’S EASY! Log into the Association’s online portal at www.nswna.asn.au to check your membership details are correct. Do this at a time that suits you and your name will automatically go in the draw to WIN AN APPLE OR ANDROID SMART WATCH*! For a chance to win, simply register with your membership number, name and email address and create your own password. Then use your member number and password to log in directly to the Members login area on the website. You can now change your details at anytime – address, workplace, credit card number, mobile number, etc. You can pay fees online, print a tax statement or request a reprint of your membership card – IT’S SIMPLE. All those who use our online portal from 1 February – 30 June 2016 will be automatically entered into the draw. *The winner will be able to select one of these watches. Winner must be a financial member of the NSWNMA.
Membership online via www.nswnma.asn.au
EDITORIAL BY BRETT HOLMES GENERAL SECRETARY
No one should have to tolerate violence There is no silver bullet to the issue of violence in our hospitals but recognition by the government and NSW Health that there is a problem is a major step forward.
“Our campaigning has led to a constructive response from the government.”
For some time now the Association has been calling on the NSW government and NSW Health to recognize that there is a problem of violence in our public hospitals and has advocated for urgent measures which would improve the safety of public health system staff. Public hospitals are very open environments where people come and go freely. They do not lend themselves to the same sort of security measures such as scanners and x-rays that you might find at other government departments. Public hospitals routinely deal with people who are intoxicated with alcohol or drugs, that have mental health problems or who are just stressed or distressed. Some of these people are only a trigger point away from aggressive behavior. At our January Committee of Delegates there was a very animated and emotional discussion about this issue among our members. What became clear in that discussion was that violence is not confined to emergency departments – it occurs right throughout the health system. In rural and regional areas with multipurpose services there is little security. The police cover large areas and can be overwhelmed by their own responsibilities. This can lead to potentially violent patients being dumped on ill-equipped hospital staff. Often in these smaller facilities there is no security officer. That role can be thrust upon a wards person or a cleaner. The COD also heard how violence can erupt in other wards such as maternity. A ROUTINE ACCEPTANCE OF VIOLENCE Violence has become so rife in our public hospitals and health services that it is almost routinely accepted by health workers, the government and the health department. This is shocking. No one should have to work in an environment where violence is the norm and staff safety is at risk.
This acceptance and adaptation to violence means that aggressive events have been grossly unreported. Finally, however, our campaigning has led to a constructive response from the government. Last month health minister Jillian Skinner convened a roundtable of stakeholders including the NSWNMA and other health unions to discuss a way forward. This recognition of the magnitude of the problem is significant. At the roundtable NSW Health conceded that there is underreporting of the issue and that it is not confined to EDs. This is also significant. A 12-POINT PLAN The roundtable came up with a 12-point plan that was subsequently endorsed by the health minister (see pages 12-13). At the heart of the plan is an audit of 20 emergency departments with recommendations to follow on a range of issues. The plan also involves intensive training of ED nurses as well as security and medical staff. Managers will be trained to give effect to their workplace OH&S obligations and ensure their workplaces have a zero tolerance to violence. These and other measures are well overdue but are to be welcomed. The challenge that now lies before all stakeholders is to implement strategies that minimise the risk of violence. There is an important action that you as a nurse or midwife can do to help us. We need to know when violence occurs. The underreporting of violence has been a stumbling block that has delayed appropriate action. The NSWNMA has developed a phone app that allows you to notify us immediately when there is a violent incident in your facility. I urge you to use this resource.
THE LAMP MARCH 2016 | 5
YOUR COVERLETTERS STORY
YOUR LETTERS
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We work as midwives in a medium-sized regional maternity unit with about 1000 births a year. It has always been a busy unit but about two years ago we became aware we were becoming busier and busier, to the point where we felt unable to give safe care to the mothers and babies. Initially we took our concerns to the Reasonable Workloads Committee, but after several meetings, felt we weren’t getting anywhere. Eventually in desperation we contacted our organiser and said we now felt it was time to take our concerns further. She arranged a meeting between the midwives, Director of Nursing, Area Director of Midwifery, herself and Judith Kiejda. This was to be the first of several meetings over a two year period. At each meeting we expressed our deep concerns for the safety of our patients and ourselves. We told them we needed more midwives quickly as we were drowning. We were working a lot of overtime and extra shifts, regularly missing meal breaks, sick leave was increasing and we were becoming burnt out. We explained that we often had to choose between spending time on the ever-increasing documentation or caring for women in labour and on the ante/post natal ward; between dealing with phone enquiries or assessing women who attended labour ward with pregnancy concerns. We were told that according to our last Birthrate Plus review we were in fact overstaffed! Eventually we had our next Birthrateplus review brought forward. It finished in November 2015 and we were overjoyed to have our concerns validated – we were 5.65 FTE midwives short. We are so glad we didn’t give up fighting. There were times we felt helpless and that we weren’t being listened to but the overwhelming belief that our patients deserved better kept us going. We currently now have four agency midwives working with us, something else we fought hard for, and this is making things easier for us while we undergo the lengthy process to recruit new midwives. Our message to other nurses and midwives is: don’t give up. We are here as advocates for our patients – they deserve safe care and we deserve to know we can go to work and give it to them and not go home physically exhausted worrying about what we mightn’t have had time to do. Annette Alldrick and Jenny Greed Registered Midwives at Shoalhaven Hospital, Nowra
Conditions apply. Cabins subject to availability. Prize cannot be redeemed on long weekend or over festival weekends and must be taken midweek. Prize must be redeemed by 30 September 2016. Competition entries from NSWNMA members only and limited to one entry per person. Competition opens 1 March 2016 and closes on 31 March. Prize drawn on 1 April 2016.If a redraw is required for an 6 | THE LAMP D EACRECM B2E0R1 2 015 – JANUARY 2016 unclaimed prize it must be held up to 3Mmonths fromHthe original6draw date. NSW Permit no: LTPM/14/00042.
YOUR LETTERS
A great outcome for overseas nurses Thanks for the Association’s work to win recognition of service for overseas nurses. Such a great outcome for all overseas nurses registered in Australia. Thank you. Bibin Thekkel-Varghese RN, Gosford Thanks for embracing us This is such great news! I wouldn’t know what to do without all of you! I feel that you have provided us with what all of us really deserve. Working as nurses involves a lot of struggle and especially for us who came all the way from overseas to migrate here. I started working as an Emergency Nurse in NSW Health and they did not provide me with further training and supervision because they felt confident about my Emergency Department skills and experience gained back home; I personally felt frustrated knowing I wasn’t paid according to my years of experience and was being paid as a newbie. But now everything has been cleared and settled! Thank you everyone who made this possible and was always updating us with the turn of events. Thank you for hearing out the overseas sector and embracing us as a part of the Australian family. Ailsa RN, Wollongong Regret turns to satisfaction This is the best news I’ve had since I got to Australia, well, next to getting a permanent visa. Thank you so much for all your help. I regretted moving to NSW but now my regret has turned into satisfaction. You have given me a reason to stay in NSW. I am very thankful. Eliza Castro RN, Parramatta
NSWNMA responds: For many years there was a NSW Department of Health policy in relation to recognition of service of overseas qualified nurses and midwives in the public sector. The policy set out that where the overseas nurse was required by the Nurses Registration Board only to complete an assessment program in order to become registered in Australia, the prior overseas service would be recognised for salary purposes. Where the Board required any further formal education, the overseas service would not be recognised. The assessment program involves some classroom sessions, self-directed learning and a clinical placement and is normally completed within three months. That departmental policy was rescinded in 2008 and was not replaced. However, the practice amongst Local Health Districts and Specialty Networks remained the same and NSWNMA was able to enforce the long-standing and broadly-adopted practice towards recognition of overseas service. At some stage, the assessment program was re-titled “bridging program”, although the content and purpose of the program remained unchanged. Apparently in consequence, in December 2014 the NSW Ministry of Health issued advice of a changed approach to recognition of service of overseas qualified nurses and midwives across the state. The new approach was that where the Board required an overseas nurse or midwife to complete a bridging program (or any program) to become registered in Australia, the prior overseas service would not be recognised. This new directive disadvantaged our members from a number of countries but notably those from India and the Philippines who may have been practicing as a Registered Nurse in their respective country for many years. It also generated patently unfair inconsistencies and anomalies for nurses and midwives working side by side and rendered the NSW public health system an unattractive place to work for many. Over the past year NSWNMA persistently made representations to the Ministry opposing this change of approach to overseas nurses. This culminated in a meeting between the parties in October 2015. We are now pleased to advise that recent correspondence from the Ministry confirms that it has withdrawn the new approach to recognition of overseas service and NSWNMA understands that individual cases may now be reviewed by Local Health District and Specialty Networks with appropriate back-payments to be made.
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We need a robust defence of penalty rates If weekend penalties are under threat, then the Association (should) have a strong message for the Government and that is ‘If weekend penalties or any other penalty rates are at risk or are taken away then the Government can bet on rolling strikes across the board!’ This should not be a hollow threat. It should reverberate with truth to the letter. When politicians agree to lose all their entitlements, only then might we consider relinquishing some penalty rates. I know this will never happen so our loss of penalty rates will also never happen without a fight! John Stamatopoulos RN, Brunkerville
HAVE YOUR SAY
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.
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23/02/15 11:53 AM
NEWS COVERINSTORY BRIEF
World
World
2015 the hottest ever
62 billionaires own more wealth than 50% of world’s population
Independent studies by the UK Met Office, NASA and the Japanese Meteorological Agency show record global temperatures for the second year running. 2015 smashed the record for the hottest year since reporting began in 1850, according to figures from three of the world’s principal meteorological organisations. They show that the average global temperature in 2015 was 0.75C higher than the long-term average between 1961 and 1990, much higher than the 0.57C in 2014, which itself was a record, reported the Guardian.
A new Oxfam report shows that there has been a staggering concentration of wealth in fewer and fewer hands since 2010. Oxfam said that the wealth of the poorest 50% dropped by 41% between 2010 and 2015, despite an increase in the global population of 400m. In the same period, the wealth of the richest 62 people increased by $500bn (£350bn) to $1.76tn. The charity said that, in 2010, the 388 richest people owned the same wealth as the poorest 50%. This dropped to 80 people in 2014 before falling again in 2015. Oxfam said a three-pronged approach was needed to address this inequality: a crackdown on tax dodging; higher investment in public services; and higher wages for the low paid. It said a priority should be to close down tax havens, increasingly used by rich individuals and companies to avoid paying tax and which had deprived governments of the resources needed to tackle poverty and inequality. Oxfam estimates that rich individuals have placed a total of $7.6 trillion in offshore accounts, adding that if tax were paid on the income that this wealth generates, an extra $190 billion would be available to governments every year. The charity said as much as 30% of all African financial wealth was thought to be held offshore. The estimated loss of $14bn in tax revenues would be enough to pay for healthcare for mothers and children that could save 4 million children’s lives a year and employ enough teachers to get every African child into school.
15 of the 16 warmest years on record have occurred since 2001 according to NASA data. The 2015 figures were exacerbated by a strong El Nino impact but scientists are in no doubt that the vast majority of the warming came from human activity. “Even without an El Niño, this would have been the warmest year on record,” said Prof Gavin Schmidt, director at NASA’s Goddard Institute for Space Studies. Bob Ward, at the Grantham Research Institute on Climate Change at the London School of Economics, told the Guardian: “This [record heat] should put pressure on governments to urgently implement their commitments to act against climate change, and to increase their planned cuts of greenhouse gases. “The warming is already affecting the climate around the world, including dangerous shifts in extreme weather events. Those who claim that climate change is either not happening, or is not dangerous, have been conclusively proven wrong by the meteorological evidence around the world.”
“15 OF THE 16 WARMEST YEARS ON RECORD HAVE OCCURRED SINCE 2001 ACCORDING TO NASA DATA.” 8 | THE LAMP MARCH 2016
“IN 2010, THE 388 RICHEST PEOPLE OWNED THE SAME WEALTH AS THE POOREST 50%. NOW IT IS THE 62 RICHEST.”
NEWS IN BRIEF
World
Women the biggest losers from automation A report commissioned for the World Economic Forum in Davos predicts 7 million jobs could be lost in the next five years in the world’s biggest economies with technological advances in robotics, 3-D printing and artificial intelligence. The report was compiled by UBS after interviews with human resources professionals in 15 of the world’s largest economies, including Australia. The richest stand to gain more from the introduction of new technology than those in poorer sections of society, according to a report which warns that policymakers may be required to intervene to tackle the widening inequality. “Many labour-intensive firms should be able to boost profit margins as they substitute costly workers for cheaper robots or intelligent software. Automation will continue to put downward pressure on the wages of the low skilled and is starting to impinge on the employment prospects of middle-skilled workers,” says the report. “The greatest disruption, however, could be experienced by workers who have so far felt immune to robotic competition, namely those in middle-skill professions,” it says. It points to clerical work, such as customer service, being replaced by artificial intelligence. Women will lose out in the workplace as they are less likely to be working in areas where the adoption of new technology will create jobs. Healthcare is expected to suffer the highest number of job losses in the next five years, followed jointly by energy and financial services.
“AUTOMATION WILL CONTINUE TO PUT DOWNWARD PRESSURE ON THE WAGES OF THE LOW SKILLED.”
RESEARCHERS SUGGEST IT MAY BE DUE TO MICROABRASIANS CAUSED BY SHAVING IN THE SKIN, WHICH MAY SUPPORT BACTERIAL COLONISATION AND PROLIFERATION.”
World
Beards may be more bacteria-resistant than shaven skin Researchers have found that clean-shaven men are more likely to harbour some infection-causing bacteria resistant to antibiotics than bearded men. The study was published in the Journal of Hospital Infection. The study tested swabs from the faces of 408 hospital staff with and without facial hair. According to the results, clean-shaven men are more than three times as likely to be carrying methicillin-resistant staph auerus (MRSA) on their cheeks as their bearded counterparts. Clean-shaven men were also more than 10 per cent more likely to have colonies of Staphylococcus aureus on their faces, a bacterium that causes skin and respiratory infections, and food poisoning. Researchers suggest this may be due to micro-abrasians caused by shaving in the skin, “which may support bacterial colonisation and proliferation”.
THE LAMP MARCH 2016 | 9
NEWS IN BRIEF
Australia
Teenage smoking at record low 6.7% of NSW teenagers in 2014 describe themselves as heavy, light or occasional smokers compared with 23.5% in 1996. Experts attribute the drop in teenage smoking rates to rising cigarette prices, a smoke-free environment and advertising policies, plain packaging and restrictions on adolescents’ access to tobacco. Research published in the journal Public Health Research & Practice, shows 3.4% of Australians aged 12 to 17 smoked daily. The study’s lead author, Anita Dessaix from the Cancer Institute NSW, told AAP that as traditional forms of tobacco advertising closed off, tobacco companies were seeking alternative ways to promote their products. “On average, for every extra hour that young people spend on the internet daily, their exposure to smoking in video games increases by 8%,” she said. “Significant progress has been made, but further action is required to achieve continued declines in smoking by Australian adolescents by preventing uptake and aiding quitting. “Constant vigilance is needed to address new and innovative tobacco marketing strategies.”
“CONSTANT VIGILANCE IS NEEDED TO ADDRESS NEW AND INNOVATIVE TOBACCO MARKETING STRATEGIES.”
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NEWS IN BRIEF
Australia
Britain
Memories of dogs and balaclavas
NHS Trust ignored safety warnings
In January, 30 Australian seafarers were taken from their bunks by up to 30 security guards and marched off their vessel in scenes that were reminiscent of the infamous Patrick dispute. The security guards were used in a secret midnight raid to remove the crew of the Alcoa ship MV Portland. The Maritime Union of Australia says the Australian seafarers “had been sacked and replaced by overseas workers on as little as $2 an hour, paying no tax and working for international companies operating out of tax havens.” Paddy Crumlin, Secretary of the MUA said it was “a move of questionable legality”. “This is an Australian workplace by any definition. The ship never leaves Australian territory,” he said. “I can vividly imagine the fear and surprise the crew would have felt when men dressed in black invaded their small rooms and threw them out. The crew at one stage thought they could be under terrorist attack.” ACTU Assistant Secretary Scott Connelly described the raid as “an attack on Australian workers and their families that has no place in an Australian workplace”. “An acceptance that people can be forcibly removed from their place of work in an orchestrated midnight action should send shivers down the spine of all Australian workers,” he said. Federal government support for Alcoa’s action was slammed by a number of crossbench senators. Jacquie Lambie described it as “disgusting”. “This is about Australian jobs,” she said.
“I CAN VIVIDLY IMAGINE THE FEAR AND SURPRISE THE CREW WOULD HAVE FELT WHEN MEN DRESSED IN BLACK INVADED THEIR SMALL ROOMS AND THREW THEM OUT.” — Paddy Crumlin, MUA Secretary. Australia
Super savings suffer from fossil fuel exposure Investment in fossil fuels is having a negative impact on super returns according to research. Balanced investment funds are estimated to have returned about 5.7% on average in the 2015 calendar year, according to preliminary analysis by Chant West, a superannuation research firm. But Future Super, which avoids any investment in fossil fuels, returned 7.04% in its balanced investment option. The Thomson Reuters/Future Super Australia Fossil Free Index, a tool created to compare fossil fuel-free investment strategies with the broader sharemarket, shows fossil-free investment strategies returned 4.96% in 2015 while the broader sharemarket returned only 2.12%. Tom Swann, a researcher at the Australia Institute, told the Guardian that anyone who had remained exposed to the fossil fuel energy sector had lost money in the past three years. “A lot of the large funds are doing next to nothing and that’s just not doing their job properly,” he said. “That’s putting people’s retirements at risk.” The managing director of Future Super, Simon Sheikh, said the results showed avoiding investment in fossil fuels was a responsible financial move, not just an ethical or environmental one. “While past performance is not always indicative of future returns, we see long-term risks for the fossil fuel industry,” he said.
“While past performance is not always indicative of future returns, we see long-term risks for the fossil fuel industry.” — Simon Sheikh, Future Super
An independent report has found that an NHS trust failed to investigate hundreds of deaths of patients with mental health problems and learning disabilities from health and safety failings. The report covered Southern Health, one of the country’s largest mental health trusts, which provides services to about 45,000 people. The inquiry arose after Connor Sparrowhawk, an 18-yearold with learning difficulties, drowned in a bath at a Southern Health building in Oxford in 2013. His mother Sara Ryan has described the trust’s leadership as “rotten” and called for resignations. The BBC revealed that Mike Holder who was employed as the interim head of health and safety at the trust informed Trust chiefs that “existing safety management systems are dysfunctional” when he left his position in 2012. He claimed some incidents were not reported, which was “a criminal offence which you are obliged to address” and safeguarding incidents that were reported were “often incorrectly graded, downgraded by administrators or closed down without the completion of action plans”. Mr Holder said: “When I looked at some incidents I found they hadn’t been reported. “Within a couple of months it was quite apparent they didn’t have robust systems.”
“WITHIN A COUPLE OF MONTHS IT WAS QUITE APPARENT THEY DIDN’T HAVE ROBUST SYSTEMS.” THE LAMP MARCH 2016 | 11
COVER STORY
Agreement to act on violence Health unions have achieved a breakthrough in the campaign to tackle violence in hospitals.
Health unions and the NSW government have agreed on action to combat rising levels of violence in public hospitals. Unions including the NSWNMA adopted a 12-point plan at a meeting with Ministry of Health senior officials. The plan was welcomed by Acting General Secretary of the NSWNMA, Judith Kiejda, and later endorsed by Health Minister Jillian Skinner. It includes a security audit of emergency departments, improved staff and management training, development of better ways of managing drug and alcohol-affected patients and examination of possible legal changes. Judith Kiejda described the plan as a breakthrough after persistent campaigning by health unions. She said the “Security Roundtable” meeting that drew up the plan achieved “general consensus from everyone” that the problem needed to be urgently addressed. “Given the escalating nature of these incidents and the fact they are occurring in both metropolitan and regional hospital settings, as well as beyond emergency departments, we are all of the view that appropriately trained security staff are paramount. “We discussed the need for improved training of all hospital staff, including nurses and midwives, who may be required to intervene when critical situations arise and for that training to be consistent across the state.” POSITIVE CHANGES NEEDED QUICKLY Judith said the Roundtable also focused on the need for consistent approaches to managing and caring for substance-fuelled patients.
The number of ice-related presentations to 59 public hospital EDs in NSW increased more than seven-fold between 2009 and 2014, according to a NSW Health background paper released last September. In the first six months of 2015, there were 1942 ice-related presentations – a 50 per cent increase on the same period in 2014. The Security Roundtable discussed the need for clinical assessments to ensure correct escalation plans can be enacted. The meeting also agreed on the need to find better ways for hospitals to interact with police. “We are optimistic that we have achieved a breakthrough after a long history of false starts,” Judith said. “Our job now is to maintain pressure to keep the process honest so we get positive changes happening as quickly as possible.” SHOCKING ATTACKS The need for change was dramatised again in January when an ice-affected patient in Nepean Hospital’s emergency department allegedly took a female doctor hostage by holding a pair of scissors to her throat. During a struggle with security guard Barry Jennings and police officer Luke Warburton, the patient allegedly grabbed Senior Constable Warburton’s gun from its holster and fired two shots, hitting both men in the legs. Nepean Hospital’s acting general manager, Brett Williams, praised staff, patients and visitors in the emergency department “who showed great bravery assisting those who were injured.” “I am proud of the professionalism of all our staff and how they have responded,” he said. He said staff, patients and visitors had been offered counselling.
“Our job now is to maintain pressure to keep the process honest so we get positive changes happening as quickly as possible.” — Judith Kiejda
12 | THE LAMP MARCH 2016
‘WE NEED TO BE MORE CONSCIOUS ABOUT REPORTING VIOLENCE’ Annette Allrick, RM, Shoalhaven District Memorial Hospital
Security Action Plan Twenty hospital emergency departments will be audited to examine, and make recommendations on, a range of issues. These include compliance with policy and training requirements, adequacy of ED design in managing aggressive patients, adequacy of security staff numbers, hospital liaison with local police when responding to physical aggression and handover by police of physically aggressive individuals requiring treatment. The audit is expected to start immediately and take about three months. In October the NSWNMA asked NSW Health to put security guards in every emergency department. The ministry declined, saying the current approach was “appropriate”. The plan will involve an “intensive program of multidisciplinary training” of ED nursing, security and medical staff. Training will focus on managing disturbed and aggressive behaviour “and ensure each member of the multidisciplinary team is clear about their respective roles.” A training program will be also delivered to “engender a stronger workplace health and safety culture and ensure all staff, including junior doctors, nurse graduates and other rotating staff are adequately inculcated into the safety culture.”
ZERO TOLERANCE TO VIOLENCE In a significant concession by the ministry, clinical unit and hospital managers will be “trained to understand and give effect to their workplace health and safety obligations and ensure their local workplaces have a zero tolerance to violence.” Recruitment and training of security officers will be improved. Ways of better integrating security officers “in a multidisciplinary response to patient aggression” will be examined. A group of expert clinicians will be established to look at ways of improving the management and treatment of patients presenting to EDs under the influence of psycho-stimulants such as ice. There will also be an immediate examination of the availability of mental health and drug and alcohol resources “including the use of telehealth options for rural and regional areas” for patients presenting to EDs under the influence of psycho-stimulants. Health officials will work with NSW Police “to ensure arrangements adequately and consistently cover liaison, firearms safety, handover and incident response involving aggressive individuals presenting at public hospitals including pursuing prosecution of offenders.” Authorities will examine whether laws need changing to strengthen legal protection of hospital security staff. They will also identify the circumstances in which security staff can remove disruptive non-patients from public hospitals. Incident management reporting systems are to be improved “to ensure they are user friendly, well utilised and provide transparent management and feedback loops to staff making the reports.” THE LAMP MARCH 2016 | 13
COVER STORY
Going to work shouldn’t mean stepping into this.
ARE YOU A VICTIM OF WORKPLACE VIOLENCE? Have you or a colleague been assaulted at work? Have you reported your incident?
Download the NSWNMA App and report your workplace violence incident. The NSWNMA has a new tool as part of our NSWNMA Toolkit App that allows you to quickly report an incident to the Association as soon as it happens. It’s an easy fillable form that you can submit from your mobile device and an officer of the Association will be in touch with you. Nursing is considered one of the most dangerous professions. HELP STOP VIOLENCE AT WORK!
14 | THE LAMP MARCH 2016
NSWNMA Toolkit App is FREE and available to download from iTunes and Google Play store
COVER STORY
NSWNMA delegates urge action on security NSWNMA delegates across the state have called for urgent action against hospital violence.
Police delivery of patients to emergency departments and inadequate powers of security staff were among violence-related issues discussed at the NSWNMA Committee of Delegates meeting in January. About 140 delegates unanimously approved four resolutions moved by the union’s Nepean Hospital Penrith Branch. Nepean Hospital’s emergency department was the scene of a widely publicised shooting incident in January (see story page 12). The delegates’ meeting also heard of recent violent incidents at Lockhart in the Riverina district, Shoalhaven on the NSW South Coast, RPA in Sydney, Scone in the Upper Hunter region, and the north coast towns of Coffs Harbour, Byron Bay and Tweed Heads. Delegates called on Health Minister Jillian Skinner to seek an urgent meeting with Police Minister Troy Grant “in order to address how NSW police officers manage individuals in Emergency Departments who have been arrested/awaiting bail or scheduled under the NSW Mental Health Act, and who are considered dangerous.”
They called for a review of the practice of police leaving aggressive and violent patients in Emergency Departments. The delegates urged Mrs Skinner to reinstate the special constable status for security staff in health facilities. They also called on NSW Health to ensure all staff in Emergency Departments are trained in self-defense techniques and de-escalation processes and that all EDs urgently review duress alarms and responses. UNDER-REPORTING IS COMMON NSW Health officials have conceded that there has been a significant degree of under-reporting of violence in hospitals. Officials made the concession during the Security Roundtable meeting with health unions last month (February). Inadequacy of official assault data has led the NSWNMA Association to launch its own smart phone app for members to log workplace assaults. Acting General Secretary of the NSWNMA, Judith Kiejda, said data provided by NSW Health
showed that about 20 per cent of recorded violence occurred in emergency departments. About half the remaining 80 per cent of incidents happened in mental health facilities. She said these figures roughly tallied with early results recorded via the union app. Ministry data on health service occupations subject to violence in emergency departments showed that nurses and security officers were equally on the frontline. Violent incidents resulting in workers’ compensation injury claims in emergency departments in the last three years were split 50/50 between nurses and security officers. There were none recorded for doctors. In January, the Sydney Morning Herald reported that NSW Health had refused to give it any data on assaults in hospitals, saying violent incidents were not categorised clearly so it would be too time-consuming to collate them. Using freedom of information laws, the Northern Star newspaper found in December that assaults on staff at Ballina Hospital had tripled in five years.
NSW Health officials have conceded that there has been a significant degree of under-reporting of violence in hospitals. THE LAMP MARCH 2016 | 15
COVER STORY
“ “ON NIGHT SHIFT THERE ARE ONLY TWO STAFF” — Michelle Sharp, EEN NSWNMA delegate, Lockhart District Hospital Multi Purpose Service
Lockhart in Murumbidgee Local health District is a small rural hospital in an area of high unemployment, increasing drug use and a growing number of mental health presentations. On night shift there are only two staff – one RN and one EN. If we have a mental health admission who is violent or otherwise difficult to manage, staff have to leave the rest of the hospital unattended. It’s not a common occurrence but when it happens staff and other patients are very vulnerable. The 24-hour Accident and Emergency is down one end of the hospital and our aged care facility with acute beds is about 200 metres away. The only doctors we have are on call and even then, they are not on call all the time. When no doctor is available we notify other A&Es via
“ “NURSES HAVE BECOME DESENSITISED TO AGGRESSION”
— Gil Wilson, NSWNMA branch secretary and councillor, Lismore Base Hospital
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I know from personal experience the value of using the union’s smart phone app to report incidents of workplace violence. On a Saturday night last October I suffered a broken nose after being head-butted twice by a patient who was very confused and in danger of hurting himself. I reported the incident that night via the health service’s statewide IIMS (Incident Information Management System) and also through the union app. The union got back to me on Monday morning – the next working day – to ask how I was and what assistance I needed. They were really good. I didn’t hear from hospital management until three days later. Nurses have become desensitised to aggression and accustomed to a level of violence, which is wrong. I urge all nurses who are exposed to aggression and violence to report it via the union app. We often don’t report incidents because we think they are too minor, or because they happen all the time and we think no one will do anything about them. If we reported more incidents maybe we would have more
COSOPS. However the ambulance service can still bring people to us regardless. Police recently delivered a man at midnight who had been violent towards his mother. He was verbally aggressive towards the two nurses and the doctor. However the police and ambulance officers just dropped him and left. We had to wait four hours before he could be teleconferenced for mental health assessment by Wagga Base Hospital. These are isolated incidents but we need to find a safer way of managing them. When I heard about the union app for reporting dangerous incidents I was absolutely thrilled. It’s like a mapping tool which will allow the union to identify “hot spots” and help to get action from the ministry.
”
security in the workplace and more resources to prevent violence. Only last month a patient at Lismore Base threatened staff with weapons carried into the hospital in a bag by someone else. The incident was scary as hell for all the staff involved – they were in shock. Apparently the police had picked the man up for something and taken him to hospital after he complained of chest pains. Why then wasn’t he in custody and under guard? It took six cops to restrain the alleged offender who was later charged with intimidation, custody of a knife in a public place, and breach of bail. I’m also concerned about the use of private security agencies employed in hospitals. They try but what training do they get and what do they understand about the health care environment? Some turn up to do a shift with us after doing a 12-hour gig somewhere else. Who controls how long these individuals work without adequate breaks? We should have our own security staff trained in techniques of de-escalation and familiar with hospital layout and procedures.
”
“
Discussion at the recent Committee of Delegates meeting showed that violence in hospitals is a serious statewide problem. The problem is not confined to emergency departments, as a recent incident at Shoalhaven hospital’s maternity ward shows. The partner of a maternity patient threw a rock through a hospital window on Christmas Eve. In theory there is a zero tolerance policy towards violence but no one took the step of banning him after that incident. He was allowed in the next night when his partner went to theatre. He lost control in the theatre and threatened to trash the theatre and harm staff. The police were called and they removed him but it was frightening and distressing for all staff involved. We got threatening phone calls from him the next day – I took one myself. Our manager called the police and we never heard from him again.
“
At Nepean ED we sometimes have 14 or 15 nurses looking after 70 or 80 patients. We see about 200 presentations a day and aggressive behaviour towards staff or patients is a daily occurrence. The tendency for police to just drop potentially dangerous patients at emergency is a huge issue. We all recognise that the job of police isn’t just to sit in emergency with troublesome patients. But at least once a day we see someone present who is aggressive or has been involved in aggressive behaviour before they’ve come to hospital. If they have not been charged with an offence the police are always very keen to leave them as soon as possible. Given the limited powers of security personnel we often find it very difficult to manage such patients once police have left.
In another incident a midwife was assaulted late last year by a patient’s relatives who had been locked out and inadvertently let back in when someone else entered the unit. In situations like these, senior management should take the initiative to ban people who pose a danger. Midwives on duty are not in a position to ring around to ask who is going to take responsibility when these incidents occur. In addition, security guards need greater powers to do more than just watch and report on incidents We also need a review of the effectiveness of the lockdown system. It doesn’t always work as recent incidents at Shoalhaven have shown. I recently downloaded the union “app” for logging workplace assaults and I’ll be encouraging everyone to use it. We need to be more conscientious about reporting violence so the union has the evidence to measure the extent of the problem, and get something done about it.
”
The problem is not exclusive to ED – it applies to the health service across the board, and across the state. There is a lot of frustration among nurses about the limited powers of security officers. In many instances there is really not much they can do other than observe. There is a grassroots feeling among nurses that we need to get the special constable status of hospital security staff restored. Before those powers were taken away security personnel had wider powers to detain people, for example. Nurses like me who worked in the system in those days felt better protected by the system. Reinstating the special constable powers would allow security staff to work in conjunction with us nurses to better protect the people we are looking after, and ourselves.
”
“THE PROBLEM IS NOT CONFINED TO EMERGENCY DEPARTMENTS” — Annette Alldrick Branch secretary and NSWNMA councillor, RM, Shoalhaven District Memorial Hospital
“AGGRESSIVE BEHAVIOUR IS A DAILY OCCURRENCE” — Jason Mullavey RN and NSWNMA branch president, ED Nepean Hospital
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AGED CARE
Survey finds violence is endemic in NSW aged care homes NSWNMA research has found that violence has become ‘normal’ in long term care and there is a danger that ‘fear becomes an acceptable part of daily life’ in our aged care facilities.
“IF WE VALUE OUR ELDERLY WE MUST PROTECT NOT ONLY THOSE WHO RECEIVE CARE, BUT ALSO THOSE WHO DELIVER IT.” Judith Kiejda
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A NSWNMA survey of NSW residential aged care facilities (RACFs) has found high levels of resident-to-resident and resident-tostaff violence. 92 per cent of staff have been witness to resident-to-resident abuse in their facility. 90 per cent of staff have been subject to some form of aggression from residents. Almost 76% of respondents cited inadequate staffing as a precursor for elder abuse. The report acknowledges that ‘managing challenging behavior is a complex care issue’ and ‘aged care providers are not solely responsible for the prevalence of abuse but points out that the law requires aged care providers to provide adequate staffing to manage people’s behaviours effectively. “Therefore, some collective responsibility must lie with aged care providers and the aged care regulator, whose remit is to ensure adequate staffing arrangements are in place,” it says. POOR STAFFING A BIG FACTOR The report emphasises how low staff-patient ratios and high staff turnover increase the risk of aggressive behaviours. “Typically RACFs have lower staffing levels and less registered nurses than in public hospitals. This means staff often lack the time to engage with residents and to properly assess behaviour which means triggers to resisting care can be missed,” it said. A lack of supervising staff for those with dementia-type illnesses can lead to residents wandering, and left vulnerable to an act of aggression, the report says. Staffing and skill mix levels are crucial for effective strategies to manage challenging behaviours, it says, as they rely on close supervision of a person and an individualised assessment and care management. The report warns that insufficient staffing
“may lead to over-prescribing of antipsychotics to control behaviours.” “Use of medication in this way could be considered an abusive practice,” it says. STAFF AND CARE BOTH SUFFER The report says that for some staff violence has become an acceptable part of the job – with dire consequences personally and in the provision of care. “Staff who are constantly at risk of abuse from residents can become emotionally distressed and, more concerning, detached from residents, reducing their ability to provide person-centred care which is essential in the management of challenging behaviour. “It is therefore unsurprising that settings with a high number of abusive episodes produces a lower quality of care environment,” it says. 61% of survey respondents admitted they feared repercussions if they reported an incident of assault. It also found that where staff had reported concerns they often considered management to be unresponsive. A NEED FOR A REGULATORY FRAMEWORK NSWNMA Acting General Secretary Judith Kiejda says the study shows there is a need for urgent change in dealing with elder abuse. “This can only be brought about through better staff training and the establishment of a Federal regulatory framework. This would give aged care providers clarity in what constitutes elder abuse and spell out requirements for staff training and reporting systems,’ she said. “If we value our elderly we must protect not only those who receive care, but also those who deliver it.”
THE KEY NUMBERS
92%
have been witness to resident-to-resident abuse in their facility.
90%
of staff have been subject to some form of aggression from residents.
76%
of respondents cited inadequate staffing as a precursor for elder abuse.
More skilled nursing staff the key to reducing violence Nurse educator Cheryl Firth says aged care facilities try hard to address the problem of violence and elderly abuse but it is difficult with the large turnover of staff in aged care, the staffing levels and the skill set. “There is a lack of staff, especially registered staff, in aged care and the pressure on existing staff trying to manage residents with behavioral issues and dealing with violent outbursts remains an ongoing problem despite mandatory training in the areas of elder abuse and aggressive behaviour,” she says. “Staffing, skill mix and ongoing training are extremely important in reducing violence and outbursts of elder abuse. For me it’s about getting more skilled staff – more RNs and ENs,” she said. “RNs and ENs understand their professional accountability. They are ultimately responsible for unskilled or unregistered staff working with them on a shift. You need more skilled staff who understand the whole concept.”
VIOLENCE CAN BE CAPPED IF STAFF HAVE MORE TIME Cheryl says aggressive situations can be reduced if staff have the time and resources to act appropriately. “If a person is displaying triggers leading up to an outburst of aggression staff need to have not only the training to be able to identify these triggers but the time and understanding of how to de-escalate the situation before it reaches the critical level. “You have staff pushed to the limit from the moment they get on duty and, often, there is a reliance on agency staff who can be unfamiliar with the facility. The environment can then become more stressful and issues can escalate when they could have been resolved earlier before they had a chance to result in a violent outburst.” Cheryl says there needs to be more awareness among nursing staff that the behavior they may display can, in fact, constitute one of the forms of elder abuse. “The big issue for me is the more subtle type of abuse where staff appear unaware that what they are doing or saying is a form of elderly abuse. It’s unconscious. There is often an overlap between what is seen as keeping a resident safe and elder abuse.”
Who will keep me safe?
Elder Abuse in Residential Aged Care
Read the report You can read or download the NSWNMA report “Who will keep me safe? Elder Abuse in Residential Aged Care” at: http://www.nswnma.asn.au/ wp-content/uploads/2016/02/ Elder-Abuse-in-Residential-AgedCare-FINAL.pdf
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PENALTY COVER STORY RATES
Health is not safe from penalty rate cuts A new report highlights the importance of penalty rates to the health of patients, the incomes of health care workers and local economies.
Any cut to penalty rates threatens to significantly reduce the take home pay of nurses, midwives and aged care workers, a new report reveals. Reduced penalty rates would negatively impact on the local economies where health care employees work and live, says the report by the independent, not-forprofit McKell Institute. The Australian Nursing and Midwifery Federation commissioned the report after the Productivity Commission recommended Sunday penalty rates be cut to the level of Saturday rates for workers in the hospitality and retail industries. Prime Minister Turnbull quickly declared that changes to penalty rates were “inevitable.” His government has sent the Productivity Commission recommendation to the Fair Work Commission which will hear arguments for and against the cutting of penalty rates. On average 20 per cent of gross nurse, midwife and aged care worker income comes from penalty rates, reflecting the high demands on the profession to work unsociable and irregular hours. Reducing Sunday penalty rates to Saturday levels, would represent an average pay cut of 2 per cent or $1,921 a year for registered nurses in Australian public hospitals, the report says. In total, permanent nursing and midwifery employees within acute and psychiatric hospitals and direct care nursing staff (including AINs and PCWs) in residential aged care would be $359 million a year worse off. HEALTH EXEMPTION IS “UNRELIABLE” While the Productivity Commission report currently excludes health workers from recommended penalty rate cuts, the proposed exemption is “unreliable”, the report warns. “There is a real prospect that changes in one industry will have a ripple effect to other industries, as is the experience internationally,” it says. “This is a particular threat to the health sector which 20 | THE LAMP MARCH 2016
is under constant scrutiny due to rising costs and the need to find long term savings. “Furthermore, industry bodies such as the Australian Chamber of Commerce and Industry are continuing to call for cuts to penalty rates in other industries and on public holidays.” “One of the strongest arguments put forward by the Productivity Commission is that because retail and hospitality services are now expected to be provided 24 hours a day, 7 days a week the need for penalty rates has reduced. “Paradoxically, this is one of the strongest rationales why penalty rates are needed in essential services, to ensure the provision of services 24 hours a day, 7 days a week. “If the argument holds for the retail and hospitality sectors, it is clearly only a matter of time before it is extended to essential services by governments keen to reduce costs in the health sector.” PENALTY RATES HAVE BEEN CUT IN NHS The report points out that the British government is now pushing for cuts to overtime and shift work pay loadings in the National Health Service. “There is a real concern that any erosion of the principals underpinning the application of penalty rates across the economy will in time reach the health sector with significant impacts on the take home pay of nurses, midwives and aged care workers, local economies where nurses reside and reduced access to patients and residents to high quality health care.” The report says rural and regional economies would be hardest hit by cuts to penalty rates of health care workers. It estimates that nurses earn at least $3.6 billion a year in penalty payments. “Importantly for regional economies around $1 billion of this penalty rate income flows to regional and remote areas each year,” it points out.
The British government is now pushing for cuts to overtime and shift work pay loadings in the National Health Service.
“Reducing Sunday penalty rates to Saturday levels, would represent an average pay cut of 2 per cent or $1,921 a year for registered nurses in Australian public hospitals.”— McKell Institute Health workers will leave
How cuts would affect you
Any reduction in penalty rates risks worsening forecast shortages in the nursing profession, the McKell Institute warns. “Australia’s future health care needs will quite literally require all hands on deck, as the population ages and the ratio of working aged to non-working aged drops by almost a half,” it says. “Meeting the challenge of an ageing population as well as advancing health technology requires a growing and highly skilled health workforce. “Policies that erode the compensation paid to our nurses and midwives for working the unsociable hours required to provide 24 hour/7 day a week health care undermine our ability to meet these challenges. “Most employees would choose not to work long or unsociable hours if they were not adequately compensated.”
What would happen to nurses’ income if Sunday penalty rates were cut to Saturday levels, as the Productivity Commission is recommending for retail and hospitality workers? The McKell Institute looked at a representative 152 hour, 4 week rotating roster, which included two early Sunday, one late Sunday and one early Saturday shift per month. It calculates that: • a registered nurse in a NSW public hospital would lose $1,767 per year or 1.9 per cent of gross pay. • an enrolled nurse in a NSW public hospital working “average hours” would lose $1,573 per year or 2.59 per cent of gross pay. • the loss for a personal care worker in an aged care facility working a full time equivalent of 38 hours per week, would total $1,399 per year or 2.59 per cent of gross wages.
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PENALTY RATES
“IT WILL BE HARDER TO GET NEW NURSES TO WORK WEEKENDS” Julie Goss, Registered nurse/midwife and NSWNMA branch delegate, Nepean Private Hospital
“
Nurses might be safe from penalty rate cuts for a little while. But if employers are allowed to cut rates in other industries it will only be only a matter of time before the cuts spread to the health sector. Cutting weekend rates for hospitality and retail staff is really unfair because they are often lowpaid and many of them are students who can only work on weekends. How are they supposed to support themselves if they don’t get paid reasonable rates? And how can it be fair to leave nurses’ rates untouched while reducing rates for the rest of the weekend workforce? It is still a Monday to Friday working week for most people. Most people don’t mind paying a little bit extra to have dinner or a coffee on a weekend when they are off work and others are working. I’ve worked Sundays for the last 26 years, which has boosted my wage. If you took away current penalty rates I would lose a big chunk of my income. Student nurses don’t have to do weekends in their training. They will be more likely to look for careers that pay more and don’t involve weekend work.
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“One of the strongest rationales why penalty rates are needed in essential services, to ensure the provision of services 24 hours a day, 7 days a week.”— McKell Institute
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“IT’S INEVITABLE THEY WILL TARGET HEALTH” David Pfanner, Operating theatre nurse and NSWNMA branch delegate, John Hunter Hospital
“
Cutting penalty rates will force people to work longer hours to maintain their income and they will miss out on more family life. We will end up like the USA where hospitality wages are so low that patrons are expected to prop up workers’ declining incomes by giving tips. I think most employers will use lower penalty rates purely as a cost-cutting exercise. I don’t believe many will use the savings to hire extra staff. Employers and the government will see if they can get away with these cuts (in retail and hospitality) and then try it on in other areas such as health care. The health sector is always in the spotlight with governments looking to make cost savings. With 1500 nurses the penalty rates bill at John Hunter must be astronomical. It will be very tempting to try to make cuts in this area. I think it is inevitable that they will target penalty rates in health sooner or later. It will be a sad day for nursing if they succeed because once penalty rates go they will never come back. Senior management in hospitals should be fighting very hard to maintain penalty rates because without them they will have a lot of trouble staffing the hospitals. If penalty rates were to go a lot of our staff say they would look for jobs elsewhere. Nursing as a profession would be in trouble. Young people won’t spend three years doing a nursing degree to get $50,000 a year. They might go for a business degree so they can earn $100,000 and work Monday to Friday. If the Liberals are able to reduce penalty rates now I can’t see a Labor government reintroducing them down the track. It would be seen as just too expensive.
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“NURSES IN RURAL AREAS RELY ON PENALTY RATES TO COVER EXTRA COSTS SUCH AS FUEL” Maree Wiseman RN, NSWNMA branch secretary and delegate, Fairview Retirement Village, Moree
“
I am quite concerned about the attack on penalty rates and I think a lot of people are. Retail and hospitality workers are mostly low paid and they rely on penalty rates to make ends meet. A lot of nurses would be immediately affected because they have family members working in those industries. If penalty rates can be cut on the grounds that the community expects shops and cafes to be open seven days a week, the same argument can be applied to health care. Some nurses think it will never happen in health care. But if employers get away with it in one area there is no reason why they won’t try it in another area. Nurses in rural areas rely on penalty rates to cover extra costs such as fuel. A lot of us travel long distances to get to work and there is often no public transport. A lot of nurses won’t want to work on weekends if penalty rates are cut. I’m concerned we could lose staff over it. To hold and attract staff, nursing needs all the incentives it can get, especially in the bush. We are currently short staffed and rely on overseas nurses to fill the gaps.
”
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PRIVATE COVERHOSPITALS STORY
Workloads win at Calvary Riverina New rostering guidelines a step towards safer staffing.
“It took a number of long and at times difficult negotiation sessions for there to be positive movement. However we are reasonably happy with the outcome.” — Helen Teakel, NSWNMA branch secretary
24 | THE LAMP MARCH 2016
Nurses at Calvary Riverina Hospital in Wagga Wagga hope new rostering guidelines in their latest enterprise agreement will help to deliver improved workloads. The agreement was negotiated between the NSWNMA and Little Company of Mary Health Care, which operates the 104-bed hospital. “The new rostering principles are a tool we can use to try to improve workloads in the interests of safe patient care and safe staffing,” said NSWNMA branch president Janet Hume. She said a union survey of nurses showed that workloads were “overwhelmingly” their main concern. “We hope to survey the workforce again in March to see if there has been any improvement in workloads following the introduction of the new enterprise agreement.” Management refused to discuss mandatory nurse to patient ratios, as apply in the public health system and some private hospitals. However getting the rostering principles included in the agreement was a step forward, Janet said. Janet, along with branch secretary Helen Teakel and a third Calvary nurse were on the NSWNMA committee that negotiated the agreement. “It took a number of long and at times difficult negotiation sessions for there to be positive movement. However we are reasonably happy with the outcome,” Helen said.
A BETTER WORK/LIFE BALANCE Rostering principles include “an appropriate mix of experience and competence to meet clinical requirements of the ward” and “avoidance of rostering principles that contribute to unfair workload.” Rostering should aim for “work life balance that minimises the fatigue of staff” the principles say. Rosters will “take into account fluctuations in the demand of clinical requirements to meet the appropriate supply of nurses and midwives.” They should be based on “ensuring provision of best care for patient/client that actively enhances or improves patient outcomes.” Helen said the inclusion of skill mix in the rostering principles was very important. “Most wards need a mix of skills and experience. We need to make sure every shift includes sufficient staff with adequate experience. The two-year agreement includes a 2.5% increase to wages and allowances in January 2016 followed by a 2.2% increase in January 2017. This put Calvary Riverina pay rates 3.8% above public sector rates in January 2016. Helen said earlier notification of rosters was “a very welcome improvement” to the EBA. The agreement requires roster notification to be improved so that “where practicable” rosters are to be put out three weeks in advance and no later than two weeks in advance. The previous requirement was two weeks and one week.
Janet Hume and Helen Teakel
BENEFITS FOR THEATRE STAFF The agreement also contains a new clause stating that all mandatory training including e-learning, is to be done in rostered time and paid. There is also an improvement to the calculation of leave for theatre staff. Theatre staff who work on call, can accrue up to one week extra annual leave every year. Helen said a new requirement that the additional leave to be applied on a prorata basis rather than in six-week blocks will benefit all theatre staff including part timers. “Theatre staff have always maintained that the previous method of calculating the extra leave was confusing and unfair. Part timers for example would never have met the hours required in a six week block.” Janet said union activity increased as a result of the negotiations. “The response from members was positive and they were pleased that the union was having a go at getting improved staffing levels as part of the enterprise agreement process,” she said. “The negotiators from union head office were very visible and generated a very positive response from nurses. “The union’s communication processes meant that is was easier for us to keep members informed on the progress of the negotiations.” Nurse to patient ratios will again be on the agenda for the next round of negotiations in late 2017.
“The new rostering principles are a tool we can use to try to improve workloads in the interests of safe patient care and safe staffing.” — Janet Hume, NSWNMA branch president
What was won at Calvary PAY
2.5%
Increase to wages and allowances in January 2016
2.2% increase in January 2017
3.8%
Calvary Riverina pay rates are now 3.8% above public sector rates
ROSTERS
OTHER GAINS
> an appropriate mix
> mandatory training
> avoidance of
> an improvement to
> rosters that aim for
> theatre staff who
of experience and competence to meet clinical requirements of the ward rostering that contribute to unfair workload a work life balance that minimises the fatigue of staff
including e-learning, is to be done in rostered time and paid the calculation of leave for theatre staff
work on call, can accrue up to one week extra annual leave every year
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TRANS PACIFIC COVER STORYPARTNERSHIP
Selling our sovereignty for no economic benefit The World Bank says the Trans-Pacific Partnership will give Australia next to nothing, the Productivity Commission is strongly critical and Nobel Prizewinning economist Joseph Stiglitz says “we should hope for the TPP’s defeat”.
Despite these stinging critiques the Trans-Pacific Partnership (TPP), negotiated in total secrecy, has been given the thumbs up by both Trade Minister Andrew Robb and Prime Minister Malcolm Turnbull. Malcolm Turnbull described the deal, signed off in October last year, as a “gigantic foundation stone” and said it would deliver “more jobs, absolutely”. Robb said the agreement would deliver enormous benefits by driving integration in the Asia-Pacific region. According to a report by the World Bank those benefits and jobs will not be going to Australia. In a comprehensive economic analysis it says the benefits to Australia will be next to nothing. The World Bank says TPP would boost Australia’s economy by 0.7% by the year 2030. That would give an annual boost to Australia’s growth of less than one half of one 10th of one per cent. The Productivity Commission has also been critical of aspects of the TPP saying that it is more of a preferential agreement than a free trade agreement. It offered to carry out an economic analysis of the agreement from an Australian perspective but was turned down by the Turnbull government.
“THE WORST TRADE AGREEMENT IN DECADES” Joseph Stiglitz, a Nobel prize-winning economist is highly critical of the TPP. He says it “may turn out to be the worst trade agreement in decades”. “The problem is not so much with the agreement’s trade provisions, but with the investment chapter which severely constrains environmental, health, and safety regulation, and even financial regulations,” he wrote on the Project Syndicate website. The agreement, he says, invites “costly lawsuits pitting powerful corporations against poorly financed governments – even regulations protecting the planet from greenhouse gas emissions are vulnerable.” Stiglitz says the United States government has championed the agreement in order that “the rules governing global trade and investment are written by US corporations for US corporations. This should be unacceptable to anyone committed to democratic principles.” “In 2016, we should hope for the TPP’s defeat and the beginning of a new era of trade agreements that don’t reward the powerful and punish the weak.”
“In 2016, we should hope for the TPP’s defeat and the beginning of a new era of trade agreements that don’t reward the powerful and punish the weak.” — Joseph Stiglitz, Nobel Laureate for Economics. 26 | THE LAMP MARCH 2016
Parliament hears community opposition Fifty-nine community organisations representing more than two million Australians have endorsed a letter to parliamentarians asking for an independent review of the Trans-Pacific Partnership and its impact on Australians before Parliament votes on the TPP implementing legislation. Representatives from the ACTU, the Public Health Association, GetUp and AFTINET spoke to ALP, Greens and independent parliamentarians at a forum in February. ACTU President Ged Kearney said Australia had negotiated the worst deal for local jobs of the 12 TPP signatories. “Despite promises, the TPP has no effective enforceable labour rights and will expand the use of frequently exploited temporary migrant workers without first testing for available local workers,” she said. Michael Moore, CEO of the Public Health Association of Australia said that the cost of the deal to public health
could outweigh any economic benefits. “The TPP could end up costing our Pharmaceutical Benefits Scheme millions of dollars if monopoly rights on biologic medicines are extended. There must be an independent assessment of all public health impacts,” he said. AFTINET Convener Dr Patricia Ranald said the Senate must critically examine “the dangerous details” of the treaty. “We could be selling our sovereignty for little or no economic benefit, as shown by the recent World Bank study. In the absence of independent assessments, the implementing legislation should not be passed,” she said. Daney Faddoul, Senior Campaigner from GetUp, said “over three hundred thousand Australians have signed petitions saying ‘no’ to the TPP because they feel sold out by the terrifying deal made without their consent and without their knowledge.”
THE LAMP MARCH 2016 | 27
TRANS PACIFIC PARTNERSHIP
The TPP is bad for health Jessica Houston, a community nurse told our recent Committee of Delegates that the TPP will be detrimental for all Australians – “unless you own a multinational company”.
“
One of the potential impacts of the TPP includes trading off our consumer rights to access affordable medicines. Agreeing to the TPP in its current form would mean increasing the rights of pharmaceutical corporations to extend their patents and therefore delay access to cheaper generics for our patients. This would have the knock on effect of reducing competition and increasing the costs of all our medications. The TPP would also give power to foreign pharmaceutical companies to have a say over the running of our PBS; they would be able to influence what drugs are included and/ or excluded from our PBS in the interests of themselves and their profitability and not what’s required from the community. It will weaken the government’s negotiating capacity with these pharmaceutical companies by giving them more rights and thereby increasing the costs of our medicines. I probably don’t need to elaborate further on the impacts this would have on our patients and our healthcare system. From a community care standpoint, I come across patients who already are often non-compliant with their medication for many reasons one of which is cost. The TPP would in this case make matters worse and result in a poorer outcome for our patients. The end result would be more home visits, longer recovery times and higher health service costs.
As a front line community nurse I also care for oncology and palliative patients. Under the TPP this would mean many affordable cancer treatments would not be available to them as pharmaceutical companies would be allowed to extend their patents by three years. This will result in a decline of our patient’s quality of life by denying them access to medication they require and could deny them treatments that may extend or save their lives. The Australian government has also agreed to a process in the TPP known as Investor State Dispute Settlement or ISDS. ISDS allows multinational companies to sue us, the Australian people, if our government makes laws in the best interest of the community that may hinder the profitability of the company under the TPP. A good example of this is the recent Big Tobacco case where Phillip Morris took the Australian government to court on the basis that our pro-health plain packaging laws were hurting their profits. Philip Morris sneakily did this by invoking an ISDS clause in an old bilateral free trade agreement struck between Australia and Hong Kong in 1993. The government recently won this case, but at the outrageous cost to the Australian taxpayer of $50 million – why would any government sign up to this?
”
“The TPP would also give power to foreign pharmaceutical companies to have a say over the running of our PBS” 28 | THE LAMP MARCH 2016
Jessica Houston addresses our Committee of Delegates
The dangerous detail in the TPP
Find out more
Multinationals have the right to sue governments over domestic laws
NURSE UNCUT: Our blog site explains how the TPP will impact on our healthcare system and the consequences for nurses.
The TPP allows corporations to sue governments in international tribunals if they can argue that a change in law or policy at national, state or local level “harms” their investment. There have been an increasing number of these cases against health, environment and even minimum wage laws including a case brought by big tobacco company Philip Morris against the Australian government over our plain packaging laws. Stronger monopoly rights for pharmaceutical corporations Pharmaceutical companies already have 20 years of patent monopoly and higher prices on new medicines before cheaper versions become available. The TPP will strengthen patent rights and provide additional monopoly rights for the costly biologic medicines used to treat cancer and other serious diseases. Doctors Without Borders says the TPP will restrict and delay access to lower-priced medicines for millions of people, especially in developing countries. Weak workers’ rights and environmental standards
www.nurseuncut.com.au/ trans-pacific-partnership-tpp
AFTINET: The Australian Free Trade and investment Network has a wealth of information and news about TPP and other free trade agreements. http://aftinet.org.au/
GET UP: has an excellent video that explains what is at stake with the TPP. There is also an online petition that has been signed by more than 200,000 people opposed to the agreement.
The TPP removes labour market testing for temporary migrant workers from five TPP countries, meaning there is no requirement to test if Australian workers are available. Global corporations could use the TPP to sue governments for taking action against climate change.
https://www.getup.org.au/ campaigns/tpp/
What happens next
NSWNMA: The NSWNMA strongly recommends members and our community supporters contact NSW federal senators and ask them to vote no to the implementing legislation. To email your senator go to:
The text of the TPP trade agreement between the US, Australia, and 10 other countries was released in November 2015. For the TPP to go ahead in Australia, Cabinet needs to approve it. Once Cabinet approves it there will be two Senate processes – a joint standing committee on treaties and a Senate review. The implementing legislation will then go to the Senate. If the Senate does not pass the implementing legislation, the TPP cannot progress. This Senate review provides a small window of opportunity for the Australian public to engage and have their say on a treaty that could have serious consequences for our healthcare system and our workplaces.
Take action now
http://action.nswnma.asn.au/page/ speakout/email-senators-about-thetpp
THE LAMP MARCH 2016 | 29
Calling all runners, joggers & walkers – join us on 8 May for the
MOTHER’S DAY CLASSIC
The Mother’s Day Classic held on 8 May is a national fun run raising money for the National Breast Cancer Foundation. The NSWNMA have created a team to participate in the 2016 event. 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 both running and walking events to cater for all levels of fitness.
TO REGISTER: 1 www.mothersdayclassic.com.au/ register your details and select the 2 Enter event and race
Register and nominate the Association as your team, all participating members will receive a NSWNMA team running shirt for the day*.
*To be eligible for the team running shirt, please register by Wednesday 6 April.
VOLUNTEERS NEEDED
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 and Midwives Association
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
30 | THE LAMP MARCH 2016
ASK JUDITH WHEN IT COMES TO YOUR RIGHTS AND ENTITLEMENTS AT WORK, NSWNMA ASSISTANT GENERAL SECRETARY JUDITH KIEJDA HAS THE ANSWERS. Can I convert to permanent employment? I am an EN and work casually at a regional public hospital. I have worked regular shifts at the hospital for about 18 months. Someone mentioned to me recently that I should convert to permanent employment. Can I do this? Under clause 29 (Part II) of the Public Health System Nurses’ and Midwives’ (State) Award 2015, a casual employee who works on a regular and systematic basis during a calendar period of at least six months has the right to elect to have their employment converted to permanent full time or part-time. Such a conversion should be done on roughly the hours and days regularly worked, unless the employer and employee agree to other arrangements. In fact, the LHD/network should be providing every casual who falls within the scope of this award provision notice in writing of such a right to elect within four weeks of having completed six months of such regular work. Where an employer refuses an election from an employee to convert from casual to permanent, the reasons for doing so must be fully stated and discussed with them. The employer shall not unreasonably refuse such an election to convert. Make sure you keep a good record of the days and hours you have worked, making special note of any regular pattern of work undertaken. This will assist you in pursuing such an election and contributing towards any discussion as to the basis of any conversion ie full time or part-time, and if the latter, what hours.
Rights at Healthshare I am a RN working in non emergency patient transport services at a public hospital. We have just been told we are going to be transferred to HealthShare. Although I would like to keep working in the service, I am worried about my award entitlements and accrued leave. What are my rights? When the initial announcement in October 2015 was made regarding the consolidation of NEPT Services to HealthShare, nurses’ employment arrangements with LHDs was to remain untouched. This has now changed, and consultation has commenced with the Association to effect the transition of nurses to HealthShare. This consultation continues but it can be confirmed that nurses will: • transfer on their current classification and rate of pay; • remain on the same public health award for nurses; • have all leave entitlements transferred over; and
•h ave their employment deemed as being continuous. Furthermore, HealthShare will introduce a professional reporting line to the proposed operational structure, along with clinical educators, for nurses working in the NEPT Service. Consultation continues and a statewide USCC has now been established.
BREAKING NEWS Members may recall that in late 2014, the Ministry of Health adopted the position that overseas qualified Nurses and Midwives required by AHPRA to undertake a bridging course to obtain registration would not have their overseas service recognised for salary purposes under the award. This was despite the fact that the bridging course introduced in 2014 by AHPRA was the same as the previous assessment program undertaken (which was not considered by the Ministry as a barrier to having such service recognised). At first instance, the Association was successful in ensuring that attempts by LHDs/networks to apply this new approach retrospectively were resisted. After a long and dogged battle by the Association, the Ministry has now conceded that where an overseas trained nurse or midwife is only required by AHPRA to complete a bridging or assessment program in order to become registered in Australia and successfully completes that program, the overseas service will be recognised for salary purposes. However, where AHPRA requires the completion of any program additional to a bridging or assessment program in order to become registered, then the overseas service will not be recognised for salary purposes. This ‘return’ to the previous approach and interpretation is a great outcome for our many colleagues who initially began their profession overseas, and it could not have been achieved without the persistence and determination of such members – well done!
Obligations with workplace change I am an EN working in an aged care facility. The Manager has informed us that we will need to cut back on hours and change start/finish times of shifts. Can these changes just be rolled out?
Most enterprise agreements covering aged care facilities contain provisions relating to workplace change. Obligations on the employer include providing proper notification and clearly setting out the proposed change in writing; the effect the changes will have; and what can be done to mitigate or avert any adverse impact. Most contain the ability for employees to ‘appoint’ a representative for the purposes of participating on their behalf in such procedures, which can be the Association. You should seek assistance and advice from the Association at the first available opportunity if your employer tries to reduce your hours or vary your usual employment arrangements. In some cases, we may be able to approach the issue as a collective one on behalf of many/ all nursing staff. You should, if at all possible, seek such advice before signing any new contract. This highlights the importance of having high union density and if possible developing or establishing an Association Branch in your workplace. This helps in dealing with such issues as a collective, rather than approaching them (at least to begin with) on an individual basis.
Reviewing a job outcome I work full time as a RN at a public hospital. Recently I applied for a position but was unsuccessful. Can I challenge the outcome? The relevant policy directive (Recruitment and Selection of Staff to the NSW Health Service – PD2015_026) sets out the obligations of the employer and your rights. In short, you must be advised in writing that you were not successful, with contact details provided if you wish to seek feedback (Section 2.19). You are entitled to be informed of the identity of the successful applicant – once they have accepted the offer of employment (Section 2.19). We would always encourage members to obtain such feedback, which should be provided to you in a constructive and useful way (Section 2.20). If after receiving such feedback you believe that some anomaly or concern arises, you can seek an internal review of the process undertaken (Section 2.22). This must be lodged generally within 14 days of being notified of the successful applicant. It should also set out in clear terms what your concerns are with the process and where you believe it departed from the standards outlined in the policy directive. Someone independent to the selection process will assess the complaint. Further action will be dependent on whether credible evidence is identified during that initial assessment that may warrant a more detailed review.
THE LAMP MARCH 2016 | 31
Cavell Edith
TRUST BEQUESTS
T
he Edith Cavel 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 and midwives through further studies and research, made available through scholarship. The knowledge and expertise gained by nurses and midwives, supported by the Edith Cavell Scholarships, is an asset to the care of their patients and clients. Bequests to the trust would 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
PHONE EMAIL
Preferred method of payment ELECTRONIC FUND TRANSFER Account name: New South Wales Nurses and Midwives’ Association Bank: Commonwealth Bank BSB: 062-017 Account no: 10017908 CREDIT CARD I authorise the NSWNMA to debit my credit card for the amount of Visa
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SOCIAL MEDIA | NURSE UNCUT
WHAT’S
A BLOG FOR AUSTRALIAN NURSES AND MIDWIVES www.nurseuncut.com.au
Do you have a story to tell? An opinion to share? NURSE UNCUT IS WRITTEN BY EVERYDAY NURSES AND MIDWIVES.
We welcome your ideas at nurseuncut@nswnma.asn.au
THIS MONTH
Nurse Uncut is also on Facebook: www.facebook.com/NurseUncutAustralia and on Twitter @nurseuncut
Retired members activist group Many nurses and midwives who’ve retired don’t want to drop their involvement in healthcare issues. www.nurseuncut.com.au/retired-nswnma-members-activist-group
Morning wake-up times for aged care residents What can aged care nurses do if they’re expected to wake and shower residents before 6am? Is this elder abuse? www.nurseuncut.com.au/morning-wake-up-time-for-aged-care-residents
Communication – so you think you got it right? ‘Removed your false eye?’ Amusing – or potentially deadly – tales of miscommunication between nurse and patients. www.nurseuncut.com.au/communication-so-you-think-you-got-it-right
Medical support for asylum seekers Two large Catholic healthcare organisations offer medical support to the asylum seekers facing deportation to Nauru. www.nurseuncut.com.au/healthcare-groups-of fer-medical-asylum
Trans-Pacific-Partnership – on the brink Once you’ve read about the TPP process and its potential outcomes, you’ll be as concerned as we are. www.nurseuncut.com.au/trans-pacific-partnership-tpp
We’re on Instagram!
Share your photos by tagging @nswnma and don’t forget to use the hashtag #nswnma!
New on SupportNurses YouTube channel New on SupportNurses YouTube channel RYDALMERE CENTRE WORK BANS Facing an uncertain future, ADHC nurses have placed work bans across their facility.
THESE CUTS ARE KILLING US It’s time to end healthcare austerity and save our Medicare. bit.ly/pathologycuts
bit.ly/rydalmere
Follow us on Twitter NSWNurses & Midwives @nswnma Watch us on YouTube SupportNurses Connect with us on Facebook
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 page on our website.
THE LAMP MARCH 2016 | 33
EDUCATION@NSWNMA
Another great reason to make TUH your number one choice. When it comes to the best cover for you and your family, there’s really only one choice. Which is perhaps why CHOICE has recommended TUH for our Total Care Hospital cover. With no restrictions or exclusions for medically necessary procedures, TUH’s Total Care Hospital gives you peace of mind for life’s unexpected events. What’s more, you can also have Total Care Hospital with or without an excess – it’s your choice! To learn more, visit tuh.com.au/lamp or call 1300 360 701 today.
what’s ON March 2016
PRACTICAL, POSITIVE WAYS IN MANAGING STRESS AND BURNOUT – 1 Day n Monday 14 March, Waterloo Members $85 | Non-members $170
MANAGING OVERTHINKING – 1 Day n Monday 4 April, Waterloo Members $85 | Non-members $170
ENVIRONMENTAL HEALTH FORUM – 1 Day n Friday 15 April, Camperdown Members $60 | Non-members $85
PRACTICAL, POSITIVE LEADERSHIP – 4 Days n Monday 18 April, Monday 9 May, Wednesday 8 June & Monday 11 July, Waterloo Members $340 | Non-members $600
ARE YOU MEETING YOUR CPD REQUIREMENTS? – ½ Day n Thursday 28 April, Waterloo Members $40 | Non-members $85
POLICY AND GUIDELINE WRITING FOR NURSES AND MIDWIVES – 1 Day n Friday 29 April, Waterloo Members $85 | Non-members $170
TOOLS IN MANAGING CONFLICT AND DISAGREEMENT – 1 Day n Monday 2 May, Waterloo Members $85 | Non-members $170
THE INFLUENTIAL THOUGHT LEADERS IN LEADING – 2 Days LAMP032016
n Friday 13 May & Friday 24 June, Waterloo Members $250 | Non-members $450
FOOT CARE FOR NURSES – 2 Days n Wednesday 25 & Thursday 26 May, Port Macquarie Members $203 | Non-members $350
Register online 34 | THE
Queensland Teachers’ Union Health Fund Limited ABN 38 085 150 376 LAMP MARCH 2016 438 St Pauls Terrace, Fortitude Valley QLD 4006.
WWW.NSWNMA.ASN.AU/ EDUCATION/EDUCATION-CALENDAR For enquiries contact NSWNMA Metro: 8595 1234 Rural: 1300 367 962
SOCIAL MEDIA | facebook
WHAT NURSES & MIDWIVES
SAID & LIKED on facebook www.facebook.com/nswnma User pays in pathology A petition to the Government not to cut bulk-billing for pathology services such as pap smears and ultrasounds attracted immediate support.
Please sign! It will help save lives if we can get this outrageous decision overturned. Basic health care saves money, then you don’t have to pay for expensive interventions for very sick people. This is ridiculous, we will end up with so many people with cervical cancer from not having a Pap smear. Complete lack of vision and any sort of understanding that people will just present with more complications and therefore cost more in the long run! We are going backwards on so many things it’s so hard to comprehend where we will end up. Headed for a system like America.
Violence in our hospitals
This issue can no longer be swept under the carpet. The level of protection for nurses particularly must be escalated immediately. The consequences for failing to act now could be devastating. An audit into security? That’s political double speak for ‘we’ll just leave it till after the next election and we will try and drag it out even further then!’ Minister Skinner, duress alarms are no good if there are no security staff with appropriate power to act. Wake up Minister. Roll up your sleeves and learn the dangers your staff face every day. Staff are your most valuable asset.
The violent episode at Nepean unleashed strong concerns about violence and assaults in our public hospitals.
The language of aged care
Does the term ‘facility’ dehumanise aged care, as one newspaper article suggested?
PHOTO GALLERY
Their jobs are being privatised but Marsden disability nurses remain defiant.
I can’t get my head around why people think it’s okay to abuse health personnel. Think about your own workplace and someone yelling abuse at or punching you. Being ill is not an excuse! I think some people do it because they know they can get away with it. It’s not just emergency departments either, it’s all clinical areas. It’s an industry! If you’re looking for a word. Couldn’t agree more. Hate that aged care homes are called facilities. Reminds me of shopping centres and army bases. Doesn’t really matter what we call them when the people that own them are really only in it for the profits. Sadly. Who cares what they are called...it’s the level of care that matters and right now there are no staff to resident ratios! The words don’t matter, the care does. And that means more staff, so that each resident is treated as an individual and given the respectful care they need. This problem of what to call it - are you serious! Wake up - there is not enough staff. I have been in aged care for 22 years. I will not flower up a situation that is getting worse. It is overseen by a Government that does not look at the policy of quality caring time spent with the person and that moves the goal posts to cut funding at every turn.
Two Union Summer students and other nurses flew the flag at the #LetThemStay rally.
Happy new grad members at Westmead Kids orientation with their free stethoscopes.
The Government may have signed the TPP but delegates urge the Senate to vote against it.
THE LAMP MARCH 2016 | 35
Are you a Registered Nurse, who is a passionate educator and who would like to help improve the lives of many Australians living with epilepsy?
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TEST YOUR KNOWLEDGE
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Across 1. One of the four muscles of mastication (10.6) 9. Lying down (9) 10. Capable of participating in a chemical reaction (8) 12. Coverings of fine hairs or scales (9) 13. Anorexia Nervosa (1.1) 14. A lipophosphoprotein combined with lecithin in the yolk of egg (8) 16. To settle or decide (a dispute) (9) 20. Existing at or before birth usually through heredity, as a disorder (10) 21. Causing alcohol intoxication (9)
22. A radiating structure; a collection of nerve fibers connecting different portions of the brain (8) 25. Thyroxine-binding index (1.1.1) 26. To cling fondly to (7) 27. Minute planktonic or parasitic crustaceans (8) 28. Observation care unit (1.1.1) 29. Concludes, reasons (7) 30. Bands or bundles of fibers in the central nervous system (8) 32. Nonmedical term for an emotional or mental illness (7.9)
Down 1. Trinucleotide sequence that specifies the end of translation or transcription (11.5) 2. Mouldy, musty, or slimy (5) 3. An instrument for measuring osmotic concentration or pressure (9) 4. The period that has elapsed since birth (3) 5. Within a ventricle of the brain or heart (16) 6. An organism that has undergone genetic mutation (6) 7. Relating to a wall or partition dividing a body space or cavity (6)
8. Movement of a joint, around its long axis, away from the midline of the body (8.8) 11. A means or route of entrance (5) 15. Boredom (5) 17. Borage (3.5) 18. An increase in the thickness of the stratum spinosum of the epidermis (10) 19. A measure of weight or mass (3) 23. Put into practice or a particular use (7) 24. A mineral found in meat, nuts, seeds, eggs, whole grains, and brewerâ&#x20AC;&#x2122;s yeast (4) 31. Macroaggregated albumin (1.1.1) THE LAMP MARCH 2016 | 37
NURSES & MIDWIVES: There are many benefits of being a financial member of the NSWNMA — did you know that
Authorised by B.Holmes, General Secretary, NSWNMA
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. In recent years this insurance has been a financial safety net for many members who have met unfortunate circumstances travelling to or from work. As a financial member of the NSWNMA you are automatically covered by this policy. It’s important to remember however, that it can only be accessed if you are a financial member at the time of the accident. So make sure your membership remains financial at all times by paying your fees by Direct Debit or Credit. Watch Alexis talk about Journey Accident Insurance
JOURNEY ACCIDENT INSURANCE
Your journey injury safety net
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
38 | THE LAMP MARCH 2016
www.nswnma.asn.au
NURSING RESEARCH ONLINE
Australian Policy Online (apo.org.au) represents an excellent resource for research and discussion of current health topics from a wide range of sources. 25 years of health expenditure in Australia: 1989-90 to 2013-14
Report on government services 2016 volume E: Health
Australian Institute of Health and Welfare, Feb 2016
Productivity Commission Feb 2016
This paper presents data for the 25 years from 1989-90 to 2013-14 and describes some of the key trends and explores the relationships between health expenditure and its drivers. Over the 25-year period, health expenditure grew much faster than: • inflation – growing from $50.3 billion in 1989-90 to $154.6 billion in 2013-14 in real dollars (that is, taking inflation into account) • the population – with per person expenditure increasing by 123.5% • population ageing – with the ratio of total spending to the size of the population aged 65 and over increasing by 69.0%. Health expenditure growth occurred in a context of relatively rapid growth in the broader economy – but at a faster pace. Health expenditure increased from 6.5% of gross domestic product (GDP) in 1989-90 to 9.7% of GDP in 2013-14. Despite this growth in health expenditure relative to the economy, health expenditure did not grow faster than government revenues and the wealth of individuals at all stages in the entire 25-year period. It is likely that population factors such as population growth and population ageing have had an important influence on the demand for health goods and services. The development of new technologies and community expectations regarding their availability and use also appear to have a large impact on this demand. Increased demand for health goods and services does not automatically translate into increased health expenditure though. The information presented in this report suggests that a combination of factors, including increased wealth and government policies, have determined if, how and when demand for services are met and, ultimately, how much is spent. http ://www.aihw. gov.au/publicationdetail/?id=60129554398 & tab=2
This sector overview provides an introduction to the health section of this report, comprising primary and community health (chapter 10), public hospitals (chapter 11) and mental health management (chapter 12). It provides an overview of the health sector, presenting both contextual information and highlevel performance information. Health services are concerned with promoting, restoring and maintaining a healthy society. They involve illness prevention, health promotion, the detection and treatment of illness and injury, and the rehabilitation and palliative care of individuals who experience illness and injury. The health system also includes a range of activities that raise awareness of health issues, thereby reducing the risk and onset of illness and injury http ://www.pc.gov.au/research/ ongoing/report-on-governmentservices/2016/health
Intersex: stories and statistics from Australia Tiffany Jones, Bonnie Hart, Morgan Carpenter, Gavi Ansara, William Leonard, Jayne Lucke Sex is complex. Humans are simultaneously more similar in their sex development, and more diverse, than is commonly appreciated or understood. Females and males are not made of wildly different ingredients. The potential to have intersex variations – to be born with atypical sex characteristics – exists for all humans in the first few weeks of their prenatal development. 1.7% of people actually go on to be born intersex. However, most of us know little about intersex variations. This is only partly due to their occasional invisibility. Intersex people have historically faced deep social stigma – the assumption that they were simply bizarre aberrations from the human norm. Furthermore, intersex infants have been widely subjected to systematic institutional mistreatment, particularly within medical settings. Finally, some people with intersex variations have simply tried to integrate themselves unnoticed into
the socially accepted categories of male and female. Drawing on stories and statistics from the first national study of intersex the book argues for a distinct ‘Intersex Studies’ framework to address intersex issues and identity—foregrounding people with intersex variations’ own goals, perspectives and experiences. Collected in 2015 and arranged in thematic chapters, the data presented here on 272 individuals gives a penetrating account of historically and socially obscured experience. This book is an important and long-overdue contribution to our understanding of human sexuality and a must-read for people with intersex variations, health practitioners, psychologists, advocacy groups, students, and anybody interested in knowing more about our diverse human make-up. http ://www.openbookpublishers. com/product/431/-intersex--storiesand-statistics-from-australia
Co-parenting: it’s all a bit of a juggling act, but all in the name of love Australian Seniors Insurance Agency Feb 2016 Grandparents in Australia are being increasingly called upon to help take care of their grandchildren, according to this report. It’s said the world over that being a parent is one of the best things you’ll ever do. But being a grandparent is on a whole other level, one that has all the good bits and the luxury of time to enjoy them. But just how much time is going towards helping to raise the next generation and how much do Australians as a whole rely on this ongoing labour of love? Putting such theories to the test, we surveyed 1,000 Australians over 50 about the impact of modern life in order to gain some valuable insights into trends among our aging population. And the results were surprising to say the least. For example, how are Aussies over 50 using technology and coping with their expanded new role as go-to care-givers for the grandkids? Just fine, thank you very much. In fact, the two may well be inextricably linked! http ://www.seniors.com.au/newsinsights/co-parenting THE LAMP MARCH 2016 | 39
NSWNMA EDUCATION COVER STORY
FRIDAY 15 APRIL 2016
Nurses, Midwives and interested health personnel:
Working Towards a Sustainable Health Care Future Environmentally Sustainable Practice in Hospitals and Community Setting
5 1/2 hours of CPD!
In partnership with the Royal Prince Alfred Hospital and Sydney LHD and following last year’s successful seminar, the focus is on the importance of nurses, midwives and interested health personnel being involved in sustainable health care … from nursing students learning about sustainable health care in their course through to hospitals, using the Global Green & Healthy Hospitals (GGHH) network at their workplaces and becoming a member.
GUEST SPEAKERS INCLUDE: Patricia Schwerdtle | Lecturer & Keynote Speaker, Monash University, Victoria
Chris Hill | Director Environmental Sustainability, Mater Hospital Queensland and CAHA’s Sustainable Healthcare Project Officer The Green Team: Mahmoud Chatila & Anne Newman | Southern Cross Care (NSW & ACT), Cardinal Gilroy Village, Merrylands NSW
Michelle Skrivanic | Concord Hospital – “The Sydney Based Nurses Environmentally Sustainable Approach”
REGISTER EARLY & SAVE THE DATE! Friday 15 April 2016! Royal Prince Alfred Hospital Kerry Packer Auditorium, Missenden Road, Camperdown
9am to 3.30pm
Matt Power | Group Manager Energy and Environment, St Vincent’s Health, Sydney.
Members $60 | Non-members $85 | Students $30 Associate Members no cost* Lunch and refreshments provided
Susan Wilburn | Sustainability Director, Global Green & Health
*Associate member please contact the Association to register
Hospitals – “Quality and Safety on Medicines and Chemicals”
REGISTER ONLINE www.nswnma.asn.au/education/education-calendar ENQUIRIES: 8595 4 0 | T H E L A M P(02) MAR C H 2 01234 1 6 (metro) or 1300 367 962 (regional)
Authorised by B.Holmes, General Secretary, NSWNMA
BOOK ME All the latest Book Me reviews from The Lamp can be read online at www.nswnma.asn.au/library-services/book-reviews. Substance abuse treatment: options, challenges and effectiveness Sylvia Mignon
Verso (through Allen & Unwin), www.allenandunwin.com. RRP $21.99. ISBN 9781781682999 This comprehensive, practical guide synthesizes treatment approaches from medicine, psychology, sociology and social work, and investigates regimens that range from brief interventions to the most intensive and expensive types of inpatient treatment programs. It examines controversies over best practices for treating substance abuse and closely analyses current research findings and their applicability for improving treatment in the future. Written for both academics and clinicians, the book makes complex research findings easily understandable.
Stories in midwifery: reflection, inquiry, action
Christine Catling, Allison Cummins & Rosemarie Hogan Elsevier (through JR Medical Books): www.medicalbooks.com.au. RRP $79.95. ISBN 9780729542234
Stories in Midwifery presents an insightful collection of personal stories as told by a range of women, midwives, students, health professionals and family members. This unique resource offers midwifery students and practicing midwives an extraordinary perspective on a range of topics related to birthing and midwifery, including continuing of care, perinatal mental health, complex pregnancies, homebirth and assisted reproductive techniques, among others. Presented in workbook online multimedia format, this Australian work builds empathy and understanding, and provides examples of innovative approaches to woman-centred care with a focus on reflection, inquiry and action.
25% off 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.
SPECIAL INTEREST OUT OF TIME: THE PLEASURES & PERILS OF AGING Lynne Segal (Allen & Unwin), www.allenandunwin.com. RRP $21.99. ISBN 9781781682999
As millions of baby boomers approach their sixth or seventh decade, many are re-examining the myths and stereotypes, stigmas and truisms surrounding the place of older women in the world. In Out of Time leading Australian feminist thinker Lynne Segal examines her life and surveys the work and lives of other writers and artists to explore the pleasures and perils of growing old. Following in the footsteps of Simone de Beauvoir – who in her mid fifties mourned ‘never again!’ - Segal mixes memoir, literature and polemic to explore the trials and challenges of ageing. This life-affirming work explores questions of generational warfare, passion, loss, memory and activisim with a critical eye and ample compassion.
High performance healthcare: using the power of relationships to achieve quality, efficiency and resilience
Ward-based critical care: a guide for health professionals, 2nd edition
McGraw Hill: www.mheducation.com.au. RRP $64.96 (Member discount available). ISBN 9780071621762
M&K Publishing: www.mkupdate. co.uk. RRP £49. ISBN 9781905539925
Jody Hoffer Gittel
High Performance Healthcare explores how healthcare organisations can harness the power of relationships to achieve and sustain high performance over time, building on ideas that first emerged from a study of the flight departure process. From the airline study the author established a reliable system for evaluating ‘relational coordination’ as a driver of quality and efficiency, which was then reassessed for the healthcare industry. This book, as the outcome of the healthcare study, carefully describes the process of identifying weak areas of relational coordination, transforming work practices that are creating barriers, and building a high performance work system to foster consistent relational coordination across all disciplines.
Ann Price, Sally Smith & Alistair Challiner
Ward-based Critical Care aims to guide practitioners in the initial management of critically ill adult patients within the ward setting. This informative book contains many useful features such as clinical scenarios, hot tips and practical skills, and the text is richly illustrated and cross-referenced throughout. The book is structured around the ABCDE approach, plus each section starts with a chapter on assessing and managing those aspects of patient care. New chapters cover anaphylactic shock, patient safety, massive blood transfusions and pregnant women in the ward setting.
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 MARCH 2016 | 41
TO ORDER FAX: Myrtle Finlayson, (02) 9662 1414 POST: NSWNMA, 50 O’Dea Avenue, Waterloo NSW 2017 EMAIL: gensec@nswnma.asn.au
www.nswnma.asn.au
WEB
ORDER FORM NSWNMA Navy Polo Shirt with embroidered logo $20 Quantity: Size: Ladies Size 14 (to fit sizes 8-10) Ladies Size 16 (to fit sizes 12-14) Unisex S Unisex M Unisex L Unisex XL Unisex XXL Unisex XXXL
NSWNMA Navy Polo Shirt with embroidered logo $20
NSWNMA Navy Canvas Duffle Bag $25 Quantity: NSWNMA Bone China Mug $10 Quantity:
Available in Ladies size 14 (to fit sizes 8-10) and 16 (to fit sizes 12-14); and Unisex sizes S, M, L, XL, XXL, XXXL
Total cost of order $ Please include postage & handling of $3/order for NSWNMA mug and $5/order for other merchandise. Bulk orders will be charged accordingly.
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A NSWNMA Navy Canvas Duffle Bag $25
Large main zippered compartment; cotton webbing heavy duty double carry handles, removable adjustable shoulder strap, 1 side end slip pocket.
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2016 Seminars
for Health Professionals Perth March 2nd • Adelaide March 4th • Sydney March 5th • Brisbane March 17th • Melbourne March 18th • Hobart March 19th and also broadcast online… FeAturing: Professor Paula Meier (USA) Dr Shoo Lee (Canada) Nancy Williams (USA) Dr Kelly Dombroski (NZ) Dr Susan Tawia (Australia)
Breastfeeding: Making Connections
For more information and to register go to: www.breastfeedingconferences.com.au Australian Breastfeeding Association in partnership with Breastfeeding Conferences
www.breastfeeding.asn.au
The Australian Breastfeeding Association is a not-for-profit organisation. All income from these seminars is used to support the free mother-to-mother services that ABA provides in the community.
42 | THE LAMP MARCH 2016 BRE1355 ABA LAMP Advert.indd 1
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METROMEMBER GIVEAWAY
EMAIL The Lamp BY THE 12TH OF THE MONTH TO BE IN THE DRAW TO WIN A DOUBLE PASS TO A BIGGER SPLASH THANKS TO SONY PICTURES RELEASING. EMAIL YOUR NAME, MEMBERSHIP NUMBER, ADDRESS AND TELEPHONE NUMBER TO lamp@nswnma.asn.au FOR A CHANCE TO WIN!
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NURSING & MIDWIFERY SCHOLARSHIPS Open 9 February – Close 14 March 2016 Scholarships are available for: > Continuing Professional Development
> Emergency Department
> Nursing and Midwifery Re-entry
> Remote Regions
> Midwifery Prescribing
> Clinical Placements
Apply online www.acn.edu.au scholarships@acn.edu.au 1800 117 262 An Australian Government Department of Health initiative supporting nurses and midwives. Australian College of Nursing is proud to be the fund administrator for this program.
THE LAMP MARCH 2016 | 43
EDUCATION
? 16 0 2 in s ie d u t s g n ci n e m Com g Professional Education?
Updating your Continuin
The NSWNMA can help members and associate members achieve their career aims with our ...
SCHOLARSHIPS Edith Cavell Scholarship Your membership allows you to apply for an Edith Cavell education or research scholarship at www.nswnma.asn.au/ the-edith-cavell-trust-scholarship-information
CONTINUING PROFESSIONAL DEVELOPMENT
LIONS NURSES’ SCHOLARSHIP The Lions Nurses’ Scholarship is available for nurses and enrolled nurses. For more information go to www.nswnma.asn.au/ the-lions-nurses-scholarship-information NSWNMA members are able to attend current, relevant workshops and study days both at the Association and in regional areas. These workshops are subsidised for members. See the 2016 NSWNMA education calendar at www.nswnma.asn.au/ education/education-calendar
The Australian Nursing & Midwifery Federation runs a suite of online education programs. Check them out at http://anmf.org/pages/online-education-programs. As a member of the NSWNMA, you are able to access the ANMF courses at a subsidised rate.
LIBRARY SERVICES 44 | THE LAMP MARCH 2016
The Association’s Library Services can support you while you are studying. The library has access to a large range of databases as well as a comprehensive textbook collection. Check out our library services at www.nswnma.asn.au/ about-library-services-information
AGED CARE TRAINING ROOM AGED CARE NURSES:
Get your annual subscription for the ANMF Aged Care Training Room in before June 2016 as the subscription rate is about to go up! The ANMF Aged Care Training Room’s (ACTR) one-stop-shop has over 60 learning activities addressing mandatory education; residential and home care standards; and older peoples’ physical and mental health; special needs and disability. Currently the annual conscription rate is just $110 for members and $132 for non-members. As a NSWNMA member you are also a member of the ANMF so you can access this education at the member rate. A recent review of the costs to conduct the ANMF online learning showed that an increase in fees for this course was warranted, which means that from June this year the annual subscription rate will increase. So make sure you get your 2016 subscription in before June!
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Union Member Benefits • Banking • Insurance • Gift Cards • Travel
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COVER STORY DIARY DATES — CONFERENCES, SEMINARS, MEETINGS DIARY DATES IS A FREE SERVICE FOR MEMBERS Please send event details in the format used here: event name, date and location, contact details – by the 5th of each 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.
DIARY DATES IS A FREE SERVICE FOR MEMBERS lamp @ nswnma.asn.au NSW
Australian Breastfeeding Association Seminar Series for Health Professionals 2016 5 March 2016 Novotel Sydney Central, Sydney www.abas.breastfeedingconferences. com.au Nepean Midwifery Conference 11 March 2016 Hawkesbury Race Club, Clarendon Juanita Taylor: (02) 4734 2525 or Juanita.Taylor@health.nsw.gov.au Lizz Giambuzzi: (02) 4734 4116 or Lizz. Giambuzzi@health.nsw.gov.au Australian Healthcare Week 2016 15-17 March 2016 Australian Technology Park, Sydney www.iqpc.com Digital Health Show 1-3 April 2016 Hordern Pavilion and Royal Hall of Industries, Sydney www.digitalhealthshow.com.au/expo. html Professional Development Day 30 April 2016 Harbourview Function Centre, Newcastle www.empowernurseeducation.com.au Neuroscience conference ‘Navigating Neuro’ 7 May 2016 Sage Hotel, Wollongong Joanne.mcloughlin@sesiahs.health. nsw.gov.au Dimensions of Cardiology Conference 8-9 July 2016 Harbourview Function Centre, Newcastle www.empowernurseeducation.com.au The Children’s Hospital at Westmead Paediatric Perioperative Seminar 10 September 2016 Novotel Parramatta, Sydney claudia.watson@health.nsw.gov.au 4th Annual Anaesthetics & PARU Conference 16-17 September 2016 Harbourview Function Centre, Newcastle www.empowernurseeducation.com.au Australasia-Pacific Post-Polio Conference 20-22 September 2016 Four Seasons Hotel, Sydney www.polioaustralia.org.au/
INTERSTATE
Australian Breastfeeding Association Seminar Series for Health Professionals 2016 17 March 2016 Brisbane Convention and Exhibition Centre, Brisbane www.abas.breastfeedingconferences. com.au Australian Breastfeeding Association Seminar Series for Health Professionals 2016 18 March 2016 Pullman on the Park, Melbourne www.abas.breastfeedingconferences. com.au Australian Breastfeeding Association Seminar Series for Health Professionals 2016 19 March 2016 The Old Woolstore Apartment Hotel, Hobart www.abas.breastfeedingconferences. com.au
46 | THE LAMP MARCH 2016
Civil Society Australia National Conference: Co-Designing Our Mental Health Services 22 March 2016 Angliss Conference Centre, Melbourne www.civilsociety.org.au/March2016 RegistrationForm.htm Cancer Nurses Society of Australia 12-14 May 2016 Cairns Convention Centre, Cairns www.cnsacongress.com.au 3rd Eating Disorders and Obesity Conference 16-17 May 2016 Mantra on View, Gold Coast www.eatingdisordersaustralia.org.au The Australian & New Zealand Addiction Conference 18-20 May 2016 Mantra on View, Gold Coast www.addictionaustralia.org.au 17th International Mental Health Conference 10-12 August 2016 Sea World Resort, Gold Coast www.http://anzmh.asn.au/conference ASPAAN Twilight Seminar Thursday 17th December Sir Charles Gairdner Hospital, Perth www.aspaan.org.au
INTERNATIONAL
12th World Congress of Nurse Anaesthetists 13-16 May 2016 Scottish Exhibition and Conference Centre (SECC), Clyde Auditorium, Glasgow, UK www.wcna2016.com NCFI Quadrennial International Conference Healthy Lives in a Broken World – a Christian response to nursing 6-10 June 2016 Tagaytay City, Philippines www.ncfi.org 5th International Conference on Violence in the Health Sector 26-28 October 2016 Dublin, Ireland www.oudconsultancy.nl/dublin_5_ ICWV/index.html
REUNIONS
Australian Nursing and Midwifery Federation NSW Branch
FINANCIAL STATEMENTS The Australian Nursing and Midwifery Federation NSW Branch Audited Financial Statements for the Year Ended 30 June 2015 are available on the Members Only page at https://online.nswnurses.asn.au Members without internet access may obtain a hard copy of the statements by applying in writing to: Brett Holmes Branch Secretary Australian Nursing and Midwifery Federation NSW Branch 50 O’Dea Avenue, Waterloo NSW 2017
NSWNMA Financial Report notice.indd 1
St Vincent’s Darlinghurst PTS Class January 1976 40-year reunion 19 March 2016 fnethery@gmail.com.au or jacquie. scott@btopenworld.com Wollongong Hospital Nurse Intake of 1976 Reunion 16th April 2016 Jacqueline Hurley: jacqui0322@hotmail.com 0423286080 Auburn Hospital October 1976-1979 40th Reunion Sharon Byers: 0419 144 965 or sbyers01@bigpond.net.au Margaret Borg (nee Mueller): 0431 159 964 or margaret_borg@bigpond.com Tamworth Base Hospital February 1976 intake 40-year reunion Contacts: Sandra Cox: sandra.cox@ hnehealth.nsw Sean O’Connor: 0408349126 Gerard Jeffery: 0417664993 RAHC Royal Alexandra Hospital for Children PTS 1977 – 40 Yr Reunion 4-5 February 2016 Coleen Holland (Argall): bobandcolh@yahoo.com.au
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We do everything as if you are here You work hard caring for others; we work hard to care for you. Your needs, your goals, your future. You wouldnâ&#x20AC;&#x2122;t have it any other way. Neither would we.
Winner. Best Growth Super Fund.
firststatesuper.com.au | 1300 650 873 This document contains general information only and does not take into account your specific objectives, financial situation or needs. Before making a decision about First State Super, consider the Product Disclosure Statement (PDS) for the product you currently hold or are considering. The PDS is available from firststatesuper.com.au or by calling 1300 650 873. FSS Trustee Corporation ABN 11 118 202 672 AFSL 293340 is the trustee of the First State Superannuation Scheme ABN 53 226 460 365.