Lamp August 2018

AGED CARE

MIDWIFERY

NEW ZEALAND

REGULARS

Winning hearts and minds for aged care

Midwives reclaim their heritage

Historic national nurses’ strike

page 18

page 20

page 22

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

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 75 NO. 7 AUGUST 2018

PUBLIC BACK MIDWIVES Print Post Approved: PP100007890

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

COVER STORY

“I want a super fund that acts in my best interests.”

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Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. This information is of a general nature. It does not take into account your objectives, financial situation or specific needs so you should look at your own financial position and requirements before making a decision. You may wish to consult an adviser when doing this. Before making a decision about HESTA products you should read the relevant product disclosure statement (call 1800 813 327 or visit hesta.com.au/pds for a copy), and consider anyLAMP relevant risks (hesta.com.au/understandingrisk).

2 | THE AUGUST 2018

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 75 NO. 7 AUGUST 2018

Hunter Office 8–14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962 For all editorial enquiries letters and diary dates T 8595 1234 E lamp@nswnma.asn.au 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148

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Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au

COVER STORY

Editorial Committee Brett Holmes, NSWNMA General Secretary Judith Kiejda, NSWNMA Assistant General Secretary Coral Levett, NSWNMA President Peg Hibbert, Hornsby Ku-ring-gai Hospital Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health Advertising Danielle Nicholson T 8595 2139 or 0429 269 750 F 9662 1414 E dnicholson@nswnma.asn.au Information & Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, Coordinator.

T 8595 2175 E gensec@nswnma.asn.au The Lamp ISSN: 0047-3936 General Disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.

Public back midwives in staffing campaign Maternity staff at Wollongong Hospital have made gains in their campaign to raise staffing levels and service standards but say there is still a long way to go.

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COVER STORY Consumer power pushes for better births

An active group of Wollongong mums is showing how health care consumers can influence hospitals in ways that align with the campaign goals of midwives and nurses.

COVER STORY Midwife shortage: risks for mums and babies

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Understaffed maternity services are pressured to discharge mothers and newborns before they are ready.

PUBLIC HEALTH SYSTEM Why some branches voted ‘No’

172 NSWNMA public health system branches voted ‘Yes’ to accept a 2.5 per cent pay increase in a new award. 19 branches voted not to accept the pay increase. The Lamp spoke to members from two of these branches.

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.

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Subscriptions for 2018 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30.

Individuals $84, Institutions $140, Overseas $150.

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Avg Net Distribution per Issue

The Lamp is independently audited under the AMAA's CAB Total Distribution Audit.

Audit Period: 01/04/2017 - 31/03/2018

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AGED CARE Winning hearts and minds for aged care

Nursing home staff in northern NSW use shopping centres, community halls and the media to urge the public to support staff ratios in aged care.

MIDWIFERY Midwives reclaim their heritage

REGULARS

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

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

MIDWIFERY

NEW ZEALAND

REGULARS

Winning hearts and minds for aged care

Midwives reclaim their heritage

Historic national nurses’ strike

page 18

page 20

page 22

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

AGED CARE

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

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 75 NO. 7 AUGUST 2018

Midwives have protected women and their rights throughout history says Professor Hannah Dahlen.

NEW ZEALAND A decade of neglect leads

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to NZ nurses’ strike National stopwork is the culmination of a wage freeze and broken promises of improved staffing.

UNITED STATES Green light for workplace freeloaders

US Supreme Court loads the scales in favour of employers.

PUBLIC BACK MIDWIVES Print Post Approved: PP100007890

OUR COVER: Natalie McKune, Emma Gedge and Caitlin Blunden Photographed by Sharon Hickey THE LAMP AUGUST 2018 | 3

Dreaming of Fiji?

Recruit a new member and go into the draw to win a 5-night holiday at the Sofitel Fiji Resort & Spa, Denarau THE 2018 – 2019 NSWNMA MEMBER RECRUITMENT SCHEME PRIZE The winner will experience a luxurious holiday at the Sofitel Fiji Resort & Spa, with the following inclusions (for two adults): • 5 nights’ accommodation in a Luxury Oceanside King Room • VIP Meet & Greet welcome at Nadi Airport along with return airport transfers provided by Rosie Holidays • Full buffet breakfast daily • 1 x Salt Sensations Beach Bure Dinner for two inclusive of arrival cocktail • 1 x 60-minute full body massage for 2 guests at SO Spa, including a glass of bubbles at the end of the treatment The NSWNMA will arrange return flights for two to Nadi International Airport Escape to the South Pacific and retreat to a Fiji beach resort merging luxury hotel facilities with the destinations natural beauty, vibrant culture and an elegant French touch.

Experience a holiday in paradise. Relax and unwind.

Every member you sign up over the year gives you an entry in the draw!

Recruiters note: Join online at www.nswnma.asn.au If you refer a member to join online, make sure you ask them to put your name and workplace on the online application form. You will then be entered in to the NSWNMA Member Recruitment scheme draw.

PRIZE DRAWN 30 JUNE 2019

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THEPrize LAMP 2018by 30 June 2020 and is subject to room availability. Block out dates include all Australian and NZ school holidays and Christmas / New Year period. The prize will be drawn on 30 June 2019. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/17/01625

EDITORIAL

Brett

Holmes GENERAL SECRETARY

Working with the community for positive change Nurses, midwives and the community all have a common interest in improving the public health system.

For some time now pressure has been building in maternity services throughout NSW due to a significant shortage of midwives in our major hospitals.

Recently there were 28 midwife vacancies at Westmead, Wollongong had just under 10, Royal North Shore Hospital 16 and Blacktown Hospital 23.

Midwives working in these units are constantly stretched and this creates a situation that is a lot less than optimal for the mothers and babies who depend on their care.

Because there are shortages of midwives in post-natal areas mothers and babies are being discharged as soon as possible. This means there is a risk that mothers are not getting the assistance they need to establish breast feeding and to avoid complications that can lead to mothers returning to hospital if their baby is dehydrated and unwell.

NSW Health has been claiming publicly that there is no significant shortage of midwives, that there are merely “challenges” in some districts due to population growth.

This complacent analysis jars strongly with the real life experience of midwives on the ground. They are telling the Association that there are not enough midwives to deliver the care to be able to adequately support the mothers and babies they have responsibility for.

The intense workloads that midwives are working under often compound the problem. Working extra shifts – often double shifts – has led some midwives to reduce the number of hours they work in order to manage this pressure. Some seek alternative employment. In many cases vacancies are being filled by non-midwifery staff.

The Association is very concerned about how these vacancies and the subsequent stress they put on maternity services impact on the quality of care for mothers and babies.

In post-natal wards it is imperative that the mother can successfully breastfeed and their baby is well fed, that they can go home safely and won’t suffer from complications.

Our concerns about the state of maternity services are shared by many mothers who use these services and who can see for themselves that midwife numbers are frequently inadequate.

In this issue of The Lamp we talk to mothers from the NSW south coast who have formed their own group – Better Birthing Illawarra – to lobby the local health district for improved maternity services.

‘ In our campaign for better ratios we need to build and nourish our relationships with such like-minded people in the community.’

Through admirable persistence this group has established regular meetings with the chief executive and have also met with local MPs. The group supports our campaign to include babies when calculating Midwife to patient numbers and has raised the need for more staff at meetings with the hospital executive.

Like us, they want to “hold the executive to account and improve the service with more staff and models of care that work in line with what the community wants”.

Nurses and midwives should take heart that we have such strong and influential support from members of the community who, like us, have seen and understand what is happening in our maternity services.

In our campaign for better ratios we need to build and nourish our relationships with such like-minded people in the community. It will be critical to the success of our campaign.

Also in this issue of The Lamp we talk to an energetic group of aged care nurses on the NSW north coast who are taking our campaign for ratios in aged care to their community.

They have been holding stalls in shopping centres, engaging local MPs and spreading our message through local media.

I understand how many nurses in aged care find it difficult to put their head above the parapet in their workplace. The aged care nurses who have thrown themselves into this sort of community campaigning have found it a safe and rewarding way to improve conditions in aged care.

I would urge you to get involved in this engagement with the community and politicians so we can make aged care a safer and better environment for elder Australians. ■ THE LAMP AUGUST 2018 | 5

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I felt compelled to write after reading O’Brays letter – Baby hamper no help – in the July edition of The Lamp. I wholeheartedly agree with her and would like to add several other salient points.

What women really need is more midwives available to care for them and support the choices they make for themselves and their babies throughout the pregnancy, birth and postnatal periods. O’Bray has alluded to this; however, I would like to comment that many experienced nurse/midwives, particularly in rural areas, have been required to give up their hard-won qualification due to recency of practice requirements of the Australian Health Practitioner Regulation Agency (AHPRA), myself included.

A nurse/midwife who has had to give up their midwifery registration and then wishes to re-enter the profession would be hard pressed as a recent search on the AHPRA web site did not list any approved re-entry courses.

The second point I would like to raise is that there continues to be a dearth of publiclyfunded home births options available in Australia despite some women seeking that birthing choice. Home birth practice continues to be marginalised while the debate regarding safety rages on, despite copious amounts of contemporary evidence to the contrary.

Lastly, the Federal government is currently in consultation with the States, experts and stakeholders to develop an Enduring Australian Breastfeeding Strategy, in recognition of the breastfeeding health benefits conferred to babies, mothers and the wider community. How on earth will the NSW Ministry of Health achieve the stated goals of addressing the barriers to women establishing and maintaining breastfeeding if there are not safe, skilled midwife staffing levels so that women can be educated and supported to breastfeed confidently?

The NSW Premier’s decision to fund the socalled ‘baby bundles’ is, at best, misguided altruism and at worst a cynical ploy to garner desperate votes in the lead up to the NSW State election.

(Letter abridged) Liz McCall RN, Byron Central Hospital

If there’s something on your mind, send us a letter and have your say. The letter of the month will WIN a gift card

SEND YOUR LETTERS TO: Editorial Enquiries EMAIL lamp@nswnma.asn.au fax 9662 1414 MAIL 50 O’Dea Avenue, Waterloo NSW 2017.

Please include a high-resolution photo along with your name, address, phone and membership number. Letters may be edited for clarity and space. Anonymous letters will not be published.

LETTER OF THE MONTH A passion for ratios Although nursing is one of the most trusted professions, we are often so over worked, under staffed, burned out and tired that unintentionally things do go wrong and mistakes can happen.

I feel passionate about having nurse-to-patient ratios mandated as I know what that would mean for our patients, what it would mean for my colleagues within all departments of the hospital and what a positive impact it would have in the community.

Nurses who work in the hospital don’t need to hear on the news how more and more patients are presenting to ED because we are the ones looking after these patients in the hospital and are well aware of it. Many of these patients have complex health issues and require extra care. We are attending to all of this extra workload without adequate staffing or skill mix, which is dangerous and simply not good enough.

I miss having those one-to-one talks with my patients like I used to be able to do when I first started nursing 17 years ago. I’d find out more things about my patient – not only as a person but health wise – that may have been a contributing factor to their admission. Back

then we also had less paper work and it was more hands-on holistic care with our patients. That’s what inspired me to become a nurse and make a difference in people’s lives.

Through my nursing career I’ve often said, “I love being a nurse, it’s very rewarding; however, it’s the system/government that lets us down.”

I wish this government would value what nurses do on a daily basis and how we look after our patients with the little time that we have.

It’s not an easy job and it sure isn’t a job for everyone. I chose to be a nurse because I truly do love what I do. I just wish this government would give us the right tools to be able to provide a better and a safer service long term than what we are currently providing and I am not just referring to hospital environments.

I am also referring to aged care, mental health and having babies counted as patients for our hard working midwives.

I am a strong believer that a patient is a patient, your postcode shouldn’t discriminate as to how much funding you get. All patients deserve the same level of care. All patients deserve to be safe. All family members of these patients have the right to feel assured that their loved ones are well looked after the same way we would want our family members to be looked after. Nurses have the right to also provide the best care possible and feel safe in doing so.

Advertise in The Lamp and reach more than 66,000 nurses and midwives.

To advertise please contact Danielle Nicholson 02 8595 2139 / 0429 269 750 dnicholson@nswnma.asn.au

Everyone would benefit from having ratios mandated, it would mean we can adequately and safely look after our patients. Imagine 1:3 in ED and 1:4 on general wards with adequate skill mix, safe staffing levels, being able to spend more time with our patients that will deliver better outcomes and it would be a long term plan.

How is it that Queensland and Victoria have mandated ratios and its law!

What’s different from their patients to ours … nothing!

Why are we falling behind when we should be leading the way!

I am sick of seeing this government putting small band aids on public health. It’s very disheartening to see this government pouring so much money in to stadiums and leaving hospitals out to dry, hospitals that are open 24/7 that provide care for people in need.

Why isn’t this government putting patient safety first?

This is the time that we all need to come together in unity and fight for nurse-to-patient ratios, fight for our patients, fight for better working conditions.

It’s up to all of us to take a stand and make this change in all sectors, a change that would provide safe patient care.

Nadia Rodriguez, EN

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THE LAMP AUGUST 2018 | 7AM 23/02/15 11:53

COVER STORY

Public back midwives in staffing campaign Maternity staff at Wollongong Hospital have made gains in their campaign to raise staffing levels and service standards but say there is still a long way to go.

O

“Now, the public have heard our message about understaffing and have a better understanding of the issues.

The campaign included an open letter to the executive committee of the Illawarra Shoalhaven Local Heath District (ISLHD) signed by 112 Wollongong Hospital staff.

“Lobby groups such as Better Births Illawarra have become good allies. They meet with hospital management and have achieved positive changes in the birth units.

n a recent count, Wollongong Hospital’s maternity unit was short by 9.5 FTE (full-time equivalent) staff – about half the number recorded almost a year ago.

The reduction in vacancies follows a public awareness campaign launched by Wollongong Hospital’s NSWNMA branch in September 2017.

They warned that a shortage of midwives, poor staff mix and other issues had led to an increase in re-admissions and clinical incidents in the maternity department.

“We’ve had so much more community support since we started working to get rid of the ‘us and them’ attitude between midwives and mums.

“The community realise if we can get better staffing they can access the maternity care that women deserve.”

WORKLOADS DISADVANTAGE PATIENTS

NSWNMA members also took industrial action to get after-hours cleaners employed.

Emma said maternity unit staffing is still “way below par. It’s still a rarity for a shift to be fully staffed.”

Members voted to refuse to clean maternity beds, which forced management to employ cleaners on afternoon shift. The unit also won the employment of a much-needed ward clerk on weekends.

“We go from being well staffed with six midwives on the ward – meaning a patient load of five women and babies each – to two midwives and a RN for 20 women on the next night shift.

Emma Gedge, a midwife on the postnatal ward, said community organisations and public opinion had swung behind midwifery staff in recent months.

“That means 10 women and babies for each midwife because the RN can’t provide all the care required.

“Before we started our campaign, the community tended to lump staff and hospital together and midwives were being publicly criticised for things like taking too long to answer the buzzer,” she said.

8 | THE LAMP AUGUST 2018

“The acting director of nursing will come around to the ward and say, ‘That’s good, you've got five on afternoon shift.’

“That’s a false picture if the staffing is three midwives and two RNs rather than five midwives.

COVER STORY

‘ The public have heard our message about understaffing and have a better understanding of the issues.’

— Emma Gedge

“If you have a ward with 28 women, it means two midwives have 10 women plus babies each and the third midwife has eight women plus babies.

“The midwives with 10 women are allocated a RN but a lot of tasks are outside the RN’s scope of practice.

“It’s a heavy workload for the midwives and frustrating for the RNs if they feel they are doing nothing of clinical importance.

“Most importantly, it disadvantages the woman.

For example, it’s impossible for one midwife to help 10 women breastfeed properly.

“Even though the hospital is still using RNs in the staffing numbers, there is a positive aspect in that most of them then apply for the Midstart program and become midwifery students with us.”

Emma says afternoon and night shifts seem to be the most poorly staffed. Afternoons are often “frantic” because the in-charge midwife also has a patient load.

HEALTH BUDGET IGNORES BABY BOOM Wollongong MP, Paul Scully, told The Illawarra Mercury more than 2,500 babies were born at Wollongong Hospital in 2017 and the state government health budget had failed to account for the baby boom in the Illawarra.

He said the ISLHD was continuing to look for midwives, a clinical midwifery educator and nurses with expertise in post-anaesthetic care for mothers who

had caesareans.

According to the ISLHD’s Acting Executive Director Nursing and Midwifery, Karen Tuqiri, the hospital is actively trying to recruit more midwives.

This was happening through a "centralised and fast-tracked recruitment process with ongoing rolling advertisements in place as well as advertisements for casual registered midwives,” Ms Tuqiri told The Mercury.

However, several experienced midwives have resigned over the past year.

“It seems as soon as we get a new staff member, someone else leaves,” Emma said. “It’s a revolving door and it’s so hard to find midwives.

“We are all really tired and for a lot of people it comes down to a choice between putting up with bad working conditions or getting another job out of the area, which usually means moving house and school.

“We still have an amazing group of midwives who have each other’s backs and continue to come to work because of the people they work with.” ■

Join our ratios campaign

Visit www.ratioslifeordeath.org.au THE LAMP AUGUST 2018 | 9

COVER STORY

Consumer power pushes for better births An active group of Wollongong mums is showing how health care consumers can influence hospitals in ways that align with the campaign goals of midwives and nurses.

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iselle Coromandel gave birth to her two children through Wollongong Hospital’s midwife-led Midwifery Group Practice (MGP) program.

Having Isabel, aged 2½, and Zac, 3 months, through MGP was “a really empowering birth experience”, Giselle says. Other MGP mothers also felt “overwhelmingly positive” about the program.

“However, we all had friends and family who could not get into MGP due to a lack of places.”

Giselle and other mums decided to form a pressure group, Better Births Illawarra (BBI) to try to get MGP expanded.

MGP supports women throughout their pregnancy, at birth and for about two weeks after. It encourages active labour and natural birth.

“Women who go through MGP report a greater sense of satisfaction due to the relationship and trust they build with their midwife,” says Giselle, an industrial designer who became BBI’s president.

“It’s an issue I've grown really passionate about.”

A 2014 Wollongong Hospital review showed the MGP program resulted in lower caesarean section rates, lower use of pain relief and higher rates of established breastfeeding.

However, only one third of women who apply for the program get accepted and BBI estimates about 800 women miss out every year.

10 | THE LAMP AUGUST 2018

BBI started about two years ago by using Survey Monkey – a free, online survey tool – to gather information from current and former maternity patients.

They also used freedom of information legislation to get hospital data on MGP outcomes and to determine that the hospital was well short of NSW Health’s Towards Normal Birth policy targets.

BETTER STAFFING MAKES ‘COMPLETE SENSE’ The 2010 Towards Normal Birth policy set a 35 per cent target for women accessing MGP services to be achieved by 2015.

However, Wollongong Hospital was managing only 13–15 per cent early last year though the number has since improved.

Within a few months of setting up, BBI established regular meetings with the hospital executive.

“We set up a Maternity Circle that meets with the chief executive and her staff. It came about because of our persistent contact,” Giselle says.

BBI has received considerable media coverage, met local MPs, written to Health Minister Brad Hazzard and met with his policy staff.

The group supports the NSWNMA campaign to include babies when determining staffing and has raised the need for more staff at meetings with the hospital executive.

“Heaps of women have come forward to us with

COVER STORY

‘ Heaps of women have come forward to us with their experiences of how they’ve been impacted by staff shortages.’

— Giselle Coromandel

their experiences of how they’ve been impacted by staff shortages, Giselle says.

“We are trying to hold the executive to account and improve the service with more staff and models of care that work better in line with what the community wants.

“It makes complete sense that if you have got a better ratio of midwives to mums and babies they are going to get more support.

“We absolutely love the midwives at the hospital whether they are with the MGP program or not. The public recognise that the staff do an amazing job under the circumstances.”

PRESSURE BRINGS IMPROVEMENTS Giselle says BBI also sought improvements to the “dirty, outdated and understaffed” birthing suites.

“We felt that with minimal investment the birthing suites could be drastically improved.”

BBI’s first achievement was the reintroduction of birth props that facilitate active labour such as stools, mats, balls and beanbags. They had been removed from the birthing suites years earlier.

BBI has joined a hospital project group looking at a redesign of the “old, sterile and medicalised” birth units and obtained a “verbal commitment” that MPG will be expanded, Giselle says.

Concerns raised by BBI recently prompted the hospital to review its ‘skin-to-skin’ policy and advertise for a caesarean section midwife.

A BBI survey found that 89 per cent of 200 women who underwent caesareans at Wollongong Hospital said they had been separated from their newborns during recovery – mostly without explanation.

Many said they had been separated for longer than two hours and 90 per cent said they were anxious and stressed as a result. One in five reported being diagnosed with postnatal depression.

Health experts recommend skin-to-skin contact due to its benefits for bonding and breastfeeding.

Giselle says that although skin-to-skin is part of the hospital's policy, one of the reasons it is not offered is because there is a “chronic" shortage of staff.

“This not only affects mothers and babies. It puts staff under immense pressure as well.” ■

Find out more about Better Births Illawarra Visit their Facebook page at: https://www. facebook.com/betterbirthsillawarra/ THE LAMP AUGUST 2018 | 11

COVER STORY

Recruitment woes for regional maternity unit Difficulty in recruiting experienced midwives and a dwindling casual pool are serious challenges for Shoalhaven Hospital on the NSW South Coast.

R

N/RM and NSWNMA delegate at Shoalhaven Hospital, Jennifer Greed, says it is especially hard to recruit midwives to regional areas like the South Coast.

Shoalhaven maternity unit is forced to rely on non-midwifery staff including registered nurses and enrolled nurses to fill its roster.

nights. Weekends are staffed by five on morning shift and four on afternoons and nights.

“A dwindling group of senior midwives is feeling the strain of excessive workloads, lack of support, high levels of stress and increasing sick leave, Jennifer says.

“There is no clerical support after 1530 hours, so midwives are required to answer all incoming calls, and there is no cleaning support after 1430 hours.

“Less experienced midwives feel stressed and frustrated when they are expected to ‘Step Up’ before they are ready without the support, education and experience they need.”

“A wardsman has to be called to clean bathrooms and floors in the birth units and they are unavailable for the postnatal area.

Birthing an average of 850 babies each year, the maternity service includes a 4-bed birthing unit, 13 postnatal/antenatal beds and an assessment bed; a freestanding antenatal care area with midwives’ clinics and a high-risk clinic.

The service also provides in-home postnatal care via a midwifery support program and the birthing unit provides 24/7 outpatient care to pregnant women.

With no registrar cover, the service has a resident on weekdays, one staff specialist and a number of locum obstetricians on call.

Normal staffing levels on the Monday to Friday morning shift is six staff plus the midwifery unit manager and midwifery educator.

This drops to four staff on weekday afternoons and 12 | THE LAMP AUGUST 2018

POOR SKILL MIX A PRESSING CONCERN Jennifer says workloads can be even higher on afternoons and nights when fewer support services are available.

“As a result of increasing pressures on other areas of the hospital, the maternity unit is regularly expected to accept ‘outliers’ who would normally be accommodated in medical or surgical areas.

“Maternity patients are shuffled to empty beds in the children’s ward to accommodate surgical or medical patients.

“The in-charge midwife who regularly has a full patient load and may well be the only senior on shift is expected to decide the most suitable patient to send to children’s ward, which is behind a locked security door.

“Children’s ward buzzers do not appear on our board so we rely on children’s ward staff to notify us of our patients’ needs.

“The increasing number of Bachelor of Midwifery midwives who do not have general registration puts more responsibility on those with general registration to

COVER STORY

care for general patients.”

Poor skill mix is one of the most pressing concerns raised by Shoalhaven members.

They say the problem is worst on afternoon and night shifts when the ratio of senior staff to junior/ inexperienced staff deteriorates and shifts can be a combination of RN/RM, RM, RN and EEN. Student midwives are counted in staffing numbers even though these shifts lack experienced staff to support them.

BROAD SUPPORT TO HAVE BABIES COUNTED Like for like replacement for staff on sick leave is not always available and the in-charge is usually carrying a full patient load and may be the only one able to work unsupervised on the shift.

“Birth unit staff can be responsible for four or more women in labour as well as outpatient presentations at any time – very much like an emergency department,” Jennifer says.

“Many outpatients can take at least an hour of care especially if they need monitoring, tests and review by an obstetrician and potentially transfer to a higher level of care.”

There is broad staff support for the NSWNMA campaign to change the maternity staffing system to ensure babies are counted in patient numbers in postnatal wards.

have had difficult births, complications or caesarean sections and are unable to care for their own babies. “We perform major abdominal surgery on these ladies, their movement is restricted, they are often on medication for pain and then we hand them a newborn baby and expect them to care for the baby independently.

“Of course, they can’t but the system pretends they do. This failure to acknowledge complicated postnatal care puts an additional workload on the midwife.”

Shoalhaven staff say it is hard to access education and training because the educator is often given a patient load to fill staffing shortfalls.

Staff report high rates of sick leave as midwives succumb to stress due to overwork. Meal breaks are seen as a luxury on many shifts and overtime is normal.

“Many are feeling overwhelmed and becoming despondent. People speak of moving on or already have,” Jennifer says.

“Despite low morale the maternity service has a strong team spirit.

“Everyone is trying their hardest including our manager and educator who have their own pressures.

“We are looking at structures we can put in place to lift morale and offer support and education.

“The bottom line is safe and excellent patient care – that is what our amazing team strive for always.” ■

“In the postnatal area there will often be patients who

‘ Failure to acknowledge complicated postnatal care puts an additional workload on the midwife.’

— Jennifer Greed

THE LAMP AUGUST 2018 | 13

COVER STORY

Midwife shortage: risks for mums and babies Understaffed maternity services are pressured to discharge mothers and newborns before they are ready.

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others and babies are at risk because maternity units are under increasing pressure to discharge patients early, the NSWNMA has warned.

NSWNMA General Secretary, Brett Holmes, said major hospitals were experiencing significant shortages of midwives which put “enormous pressure” on working midwives.

Recently, vacancies included 28 FTE (fulltime equivalent) positions at Westmead Hospital, 10 at Wollongong, 16 at Royal North Shore and 23 at Blacktown.

“The current practice is to discharge mothers and babies ASAP,” Brett told Nine TV’s Today Show.

“But where there is a shortage of midwives in the postnatal area there is a risk that mothers are not getting the assistance they need to establish breastfeeding properly.

“That can lead to complications and the need to return to hospital if babies are dehydrated or unwell.”

Brett was asked to respond to claims by NSW Health that, “There is not a significant shortage of midwives in NSW. However, there are workforce challenges in some districts associated with population growth.”

He replied: “What we go on is the real-life experience of midwives on the ground and they tell us loud and clear there is not enough midwifery time to deliver the care those mothers and babies need. And that they are constantly being asked to work additional shifts and double shifts.”

14 | THE LAMP AUGUST 2018

‘ The more pressure that is put on midwives the more likely they are to seek alternatives to being under that enormous pressure.’ — Brett Holmes “Unfortunately, midwives are also choosing to reduce their hours as a result of the workload pressures they are under.

“The more pressure that is put on midwives the more likely they are to seek alternatives to being under that enormous pressure.

“We’re also concerned where those vacancies are occurring they are replaced by non-midwives.”

COVER STORY

MELANIE BARNES AND BABY SOPHIE, NATALIE MCKUNE, EMMA GEDGE, CAITLIN BLUNDEN, GISELLE COROMANDEL

He said postnatal staff had only a short time to establish that a mother could successfully breastfeed and be able to go home safely and ensure her baby was well cared for.

He was asked: “What is your advice to any new mum who feels she is being forced to leave hospital too early?”

He replied: “She should definitely speak up. Talk to the midwife about her concerns and if the midwife seems under too much pressure then talk to the Midwifery Unit Manager.”

Opposition health spokesman Walt Secord said a lack of resourcing was risking the safety of mothers, babies and staff.

“The Berejiklian government has a clear strategy here: don’t fill positions; push existing staff to breaking point and then claim to be great economic managers – but all the while jeopardising patient safety,” he said.

“Unfortunately, the government has the wrong priorities. They prefer to spend $2.2 billion on stadiums rather than improving patient safety and care for newborns and their mums.” ■

Breastfeeding rates down, re-admissions up In a letter to Health Minister Brad Hazzard, Brett Holmes highlighted the problems facing Wollongong Hospital’s maternity service.

“Staff are made to feel that patients must be discharged in 48 hours (the unwritten practice is two nights in hospital) with this early discharge often causing increased readmission rates ... requiring phototherapy,” he said.

“All midwives know that jaundice of the newborn takes two to three days to appear, hence the increase in readmissions.”

He said breastfeeding rates had “plummeted” for many reasons.

The main reason appeared to be a lack of time or skills needed to teach new mothers how to breastfeed.

“The best practice guidelines around breastfeeding are nowhere near being met.”

Brett told the minister that the union’s Assistant General Secretary, Judith Kiejda, visited Wollongong’s maternity unit to meet with members.

Judith reported that while “some things have changed for the better, most are only temporary.”

While midwives were being actively recruited, “those that have been ‘holding the fort’ are now leaving once ‘reinforcements’ arrive.”

Brett’s letter included suggestions for improvements at Wollongong’s postnatal ward, birthing unit, antenatal unit, maternity support program, midwifery group practice and early pregnancy assessment service.

For the postnatal ward, he recommended: • A pool of casual registered midwives be established to ensure that roster vacancies are filled with RMs. • Replace any absences with ‘like-for-like’ in line with the nurses and midwives award, Clause 53.

• If a baby is born early, anticipate the need for phototherapy and do not enforce the ‘out in 48 hours’ practice.

He said it was incredible that the antenatal unit had no clinical midwifery educator, vacancies due to midwives going on maternity leave were not backfilled and classes were inconsistent due to lack of staff.

THE LAMP AUGUST 2018 | 15

PUBLIC HEALTH SYSTEM

Why some branches voted ‘No’ 172 NSWNMA public health system branches voted ‘Yes’ to accept a 2.5 per cent pay increase in a new award.

19 branches voted not to accept the pay increase.

The Lamp spoke to members from two of these branches.

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n late June, an overwhelming majority of NSWNMA public health system branches voted to accept the state government’s offer of a 2.5 per cent pay increase in a new award.

These 172 branches also voted to continue to campaign for the union’s claim for better, more transparent staffing ratios, which the government rejected in negotiations for the new award.

However, 19 branches voted not to accept the pay increase and to fight on for a new award that also included staffing improvements.

Branches which voted against accept ing t he gover n ment ’s offer included 62-bed South East Regional Hospital (Bega) on the state's South Coast, and 796-bed John Hunter Hospital, the main tertiary referral hospital for Newcastle and northern NSW. Bega branch secretary Amanda Gillies said the branch voted unanimously not to accept the pay rise without ratios.

“We wanted to keep the pressure on for mandated ratios across the state,” Amanda said.

“We needed to say to the government, we care about being able to provide safe care for patients and nurses more than a pay rise.

“We didn’t want ratios to be put on the back burner. We wanted to show the government how passionately we feel and that we are prepared to give up our pay rise for ratios.

16 | THE LAMP AUGUST 2018

‘ I would like to see the union continue to campaign for the entire claim especially ratios, educators and ‘specials’ out of numbers.’ — Leearna Bennett, John Hunter Hospital

“It would have sent a powerful message to the public and politicians: nurses would rather have safe patient care than a pay rise.

“By accepting the offer, we lost a big opportunity to get that message out there in the run up to a state election.”

STRONG FEELINGS ABOUT RATIOS Amanda said feeling about the need for ratios was “pretty strong” in regional areas and the bush.

“As a peer group C hospital, Bega is supposed to get five NHPPPD on its two general wards – basically a one to five ratio.

“But on morning and afternoon shifts, one of the nurses is called a resource nurse who basically runs the ward and doesn't usually provide direct care.

“We often end up with a ratio of

one to seven or one to eight which is pretty tough.

“Many people are doing double shifts, everyone is burnt out and fed up which is why they voted the way they did.”

Amanda said that even a one to five ratio is substandard compared to more generous ratios at big city hospitals.

“What's the difference between a patient with say, pneumonia, in our hospital compared to the same patient in a big city hospital? Also, we don't have the same access to casuals and agency nurses as the big hospitals do.

“We need to change the award so that the NHPPD staffing level is truly regarded as a minimum which can be increased according to acuity. It is supposed to work like that in theory but in practice it is near-impossible to go over the NHPPD.”

PUBLIC HEALTH SYSTEM

‘ We wanted to show the government how passionately we feel and that we are prepared to give up our pay rise for ratios.’

— Amanda Gillies, Bega branch secretary

A VOTE TO KEEP FIGHTING Leearna Bennett, an alternate delegate for John Hunter Hospital branch, said she voted with the majority of her branch against accepting the resolution.

“I felt it was more important to achieve a package of measures that included increased staff and additional educators,” she said.

“Our claim wasn’t only about a pay rise and pay wasn't what most members were talking about.

“Some people agreed with the union’s view and voted to accept the 2.5 per cent offer while continuing to battle on for the other claims.

“Others said they wanted to keep fighting with the non-wage parts of claim as the main focus.

“We had a number of branch meetings where we discussed how nurses and patients would benefit from the claim. For example,

it would change the staffing from NHPPD numbers, give us more staff in ED, maternity and paediatrics, guarantee ‘specials’ above numbers and make the in-charge nurse a supernumerary.

“We struggled through a tough winter last year with poor staffing and I think that still resonates with a lot of branch members.”

Leearna said John Hunter is a level 6 tertiary hospital yet has only one clinical nurse educator for ED and two for the surgical department.

“The union’s claim will provide each area with access to more educators and the opportunity for in-depth and specialised education, which we rarely get now,” she said.

“I would like to see the union continue to campaign for the entire claim especially ratios, educators and ‘specials’ out of numbers.” ■

Our 2018 ratios claim The NSWNMA won some mandated nurse-to-patient ratios in the form of nursing hours per patient day (NHPPD) in 2011.

Since then, the government has failed to deliver a second phase of ratios to extend them to rural and regional hospitals and specialty areas, such as emergency departments, critical care units and paediatrics.

The 2018 NSWNMA ratios claim asked for: • One nurse to three patients in EDs, paediatric wards and critical care units • a minimum of one nurse to four patients in rural and regional hospital wards • better ratios in mental health and rehabilitation units • babies to be counted as patients in post-natal maternity staffing.

THE LAMP AUGUST 2018 | 17

AGED CARE

Winning hearts and minds for aged care Nursing home staff in northern NSW use shopping centres, community halls and the media to urge the public to support staff ratios in aged care.

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SWNMA members in the Northern Rivers region are working to get the public onside in the federal electorate of Richmond, which stretches from Tweed Heads on the Queensland border south to Ballina.

They are part of a national campaign to put an end to chronic understaffing of aged care facilities.

Their aim is to get community and political support for a law setting out staff-to-resident ratios. They say it is needed to protect the frail elderly and the overworked nurses and other workers who care for them.

Four NSWNMA members got a warm response when they set up an information table at the busy Sunnyside shopping centre in Murwillumbah.

“Hundreds of people came up to speak to us and most of them wanted to know how they could help,” said Jan Hadfield, an assistant in nursing.

“We didn’t get one negative comment and some people even wanted to give us a donation, which we couldn’t accept, of course.

“People who aren’t connected with aged care don’t realise we need ratios. But people with relatives or friends in care do understand it.

18 | THE LAMP AUGUST 2018

‘ Hundreds of people came up to speak to us and most of them wanted to know how they could help.’ — Jan Hadfield “A lot of them had stories about their own relatives in care. They blamed the companies that own the facilities for delivering substandard care. No one blamed the nurses.”

Jan and her colleagues wore red campaign t-shirts stamped “Ratios for aged care. Make them law now”, handed out leaflets and asked people to go online to sign up as campaign supporters.

“The local newspaper covered the shopping centre event and is keen to follow up the story.”

MORE ACTIVITIES PLANNED The members hope to organise another event in the town of Pottsville and take part in the Tweed Valley Banana Festival and parade later this month.

They will also seek meetings with local politicians. Page’s Labor candidate Patrick Degan has already signed the pledge. Richmond’s Labor MP Justine Elliot has indicated

support for the campaign, Jan says.

Jan has worked in aged care for 40 years including the last 15 years in the Tweed district.

“There is no doubt that we do not have enough staff to give residents the care they deserve,” she says.

“You can’t rush elderly people.

Some of them just want to talk to you and it’s awful when you don’t have the time to do that little bit extra for them, such as combing their hair a bit longer or moisturising their face or putting lipstick on.

“Nursing home owners claim you should be able to toilet and shower a frail, elderly resident in six to 12 minutes but some residents need two staff members and a mechanical lifter to shower them and put them on the toilet.”

Almost 100 people gathered in a Tweed Heads park for the launch of the aged care campaign in northern NSW. They included Tweed Shire

AGED CARE

SUZANNE WILSON, DEAR ANDREW AND JAN HADFIELD STAFF A STALL AT SUNNYVALE SHOPPING CENTRE.

‘ We are in the run-up to federal and state elections and that is when politicians are more likely to agree to step up and help people.’ — Suzanne Wilson mayor Katie Milne and Byron Shire councillor Michael Lyon – both members of the NSW Greens – and Craig Elliot, Labor candidate for the seat of Tweed at the 2019 state elections.

Speakers included assistant in nursing Suzanne Wilson who spoke of the struggle to provide quality care in understaffed facilities.

“I work in dementia and I find it really upsetting that the staff levels are no higher in dementia than other areas of aged care,” Suzanne said.

“We need more staff in general and especially for dementia patients, so we have time to support them and stop falls, fighting and other dangerous situations arising unnecessarily.

“Owners of facilities must be made to recognise that it takes a lot longer to do things with dementia patients. You have to give them time

to understand what is happening and what you would like them to do.

“They get upset and resist you when you try to rush them, which is understandable.”

PLENTY OF SUPPORT FOR CAMPAIGN Suzanne said some people at the meeting were surprised by what they heard and keen to help the campaign.

“I went around with the aged care petition getting people to sign up on the spot.

“We are in the run-up to federal and state elections and that is when politicians are more likely to agree to step up and help people.”

Federa l secretar y of the Australian Nursing and Midwifery Federation, Annie Butler, delivered a message to ma nagement representatives attending a national aged care workforce forum recently.

“Safe staffing has become the most critical issue for our members across the board,” Annie said.

“It’s more important than pay right now. While of course that’s also important, our members consistently report workload issues to us as the issue that matters most to them.”

She said aged care was an under va lued and underpaid occupation that was not adequately resourced or recognised.

“Our members are increasingly frustrated and distressed by what they regard as a lack of respect for the elderly by employers who in their view could and should be doing a better job.” n

Join our campaign Sign up to our Ratios for Aged Care – Make Them Law Now campaign at: https://www.facebook.com/ MoreStaffForAgedCare/

THE LAMP AUGUST 2018 | 19

MIDWIFERY

Midwives reclaim their heritage Midwives have protected women and their rights throughout history, says Professor Hannah Dahlen.

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couple of years ago Hannah Dahlen, a Professor of Midwifery at the University of Western Sydney, visited the red brick building in East London that was the inspiration for Nonnatus House, the fictional nursing convent home in Call the Midwife. Professor Dahlen’s mother lived and worked in the building, St Frideswide’s Mission House, during the 1950s with Jennifer Worth the author of Call the Midwife. “I grew up on stories of midwifery in the East End of London. It was probably one of the main reasons I became a midwife,” she says.

Professor Da hlen’s mot her had passed away before she could revisit St Frideswide’s, but she was accompanied instead by her mother’s best friend, Fiona Haines.

Born in India during colonial rule and the daughter of a British army officer, Professor Dahlen says Fiona’s resemblance “to the Call the Midwife character Chummy is uncanny”.

Professor Dahlen is passionate about midwifery’s extraordinary history and she spoke last month at the NSWNMA’s professional day, about midwives reclaiming their heritage. “Midwifery is one of the oldest professions in the 20 | THE LAMP AUGUST 2018

‘ We’re reclaiming our heritage as the midwife in the village who caught the babies, gave advice and came in the middle of the night.’ world,” says Professor Dahlen, who is also a privately practising midwife. “Midwives have been h ig h ly rega rde d t h roug hout histor y a nd t here a re great examples of midwives protecting women’s rights.”

witch hunter books that says ‘No one does more harm to the Catholic Church than midwives’. They were the ones that carried out abortions, concealed babies and passed them off to other families and subverted the moral expectations of the day.

She cites the Old Testament story of the midwives Shifra and Puah. When the Pharaoh of Egypt asked them to kill boys born to Jewish mothers they came up with a clever plan. “When he called them back they told him ‘Jewish women aren’t like other women: they give birth very quickly, and so we don’t have a chance to get there before they are born’. Throughout history midwives have worked hard to protect women.”

“In the 1600s and 1700s the barber surgeons started to get into childbirth. The Chamberlen brothers, who developed the forceps, kept them under wraps, and women would be blindfolded and they’d use them, often with terrible results.

HARD-WON RECOGNITION Midwives were burnt at the stake during the years of the witch hunts. “There is a line in one of the

“Slowly, as modern medicine started to arrive, the doctors realised the only way to have a monopoly on childbirth was to get women into hospital. They started to very aggressively campaign to get women into hospital, offering them money, scaring them about ‘illiterate’ and ‘dirty midwives’. What happened then was that medicine grew and nursing grew and the midwife got

IMAGE: HOLLY PRIDDIS

MIDWIFERY

FIONA HAINES OUTSIDE ST FRIDESWIDE’S MISSION HOUSE

absorbed into nursing.

“The fully autonomous midwife was wiped out. For years we’ve had the nursing and midwifery professions entwined, even though they’re very different professions.”

When she entered the profession in the late 1980s, she first trained as a nurse at Hornsby Hospital.

“I was one of the last groups to go through the hospital system.”

After a short post-graduate stint in the paediatric and maternity unit, she went to UK to do her midwifery training, returning to Australia in 1991.

Now with the introduction of a standalone Bachelor of Midwifery, Professor Dahlen sees a return to a recognition of midwifery’s specific traditions and skills. “It is fantastic that we have many pathways to midwifery. Midwives now are very much about reclaiming their autonomy and heritage; midwives are not better than nurses, they are just different.”

AUSTRALIA’S HIGH RATE OF CAESEREANS This shift has huge benefits for mothers and babies, she notes.

Recently the Cochrane review of

HANNAH DAHLEN’S MOTHER ON THE ROOF OF MISSION HOUSE

research on continuity of midwifery care found that midwife-led care resulted in lower intervention rates during birth, higher maternal satisfaction, lower costs and lower baby morbidity and mortality rates.

Australia has one of the highest caesarean section rates in the world at 33 per cent. “We are one of the worst in the world now for caesareans. We’ve got countries in the world with half our caesarean rate and they lose fewer babies.”

Professor Dahlen’s research on the 25 per cent of women giving birth through private obstetric care shows poorer outcomes.

“Those women have double the intervention rate – far too much medical intrusion. Hospitals are starting to respond by offering continuity of midwife care.”

Aside from her academic work, Professor Dahlen is a practising midwife with Midwives @ Sydney and Beyond. One of the few midwives in New South Wales with admitting rights, she has the same rights as a VMO to admit and discharge her clients to hospital and prescribe medicine. “We provide all the antenatal care so you know a lot about the woman by the time you

HANNAH DAHLEN AT WORK

catch the baby, and then we provide six weeks of postnatal care.”

Last year midwives at her private practice obtained visiting rights to Westmead Hospital, the only NSW hospital to offer this option.

Fighting for practising rights for midwives hasn’t been a completely smooth transition though, she said.

“Other health providers will report you to AHPRA,” she says, citing a case where a doctor ignored a labouring woman’s request that he not intervene. When he went ahead and the private midwife told him ‘She said no,’ he reported her to AHPRA for “obstructing a medical procedure”.

It is for these reasons, as well as the tendency to replace midwives with nurses on maternity and postnatal wards, that we must “recognise midwifery as a n autonomous profession,” says Professor Dahlen. “We’re reclaiming our heritage as the midwife in the village who caught the babies, gave advice and came in the middle of the night.” n

THE LAMP AUGUST 2018 | 21

NEW ZEALAND

A decade of neglect leads to NZ nurses’ strike National stopwork is the culmination of a wage freeze and broken promises of improved staffing.

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ver 30,000 nurses and midwives conducted a 24-hour national strike in New Zealand public hospitals on 12 July after rejecting a fourth pay offer from their employers.

It was the first strike by New Zealand nurses in 30 years.

Cee Payne from the New Zealand Nurses Organisation (NZNO) said the combined District Health Boards (DHB), negotiating together for a multi-employer collective agreement, had not offered enough to compensate for “10 years of broken promises”.

“The issues faced and reported by our members have arisen from a decade of severe underfunding of our public hospitals which have failed to keep pace with growing community need, the ageing population and workforce, and increased costs,” she said.

Pay talks have been dragging on for over a year.

The District Health Boards’ offer was three pay rises of three per cent staggered over 18 months plus a lump sum of NZ$2000 with some limited funds made available to the DHBs to hire extra staff.

T he NZNO wa s cla im ing pay increases of 12.5 per cent to 15.9 per cent.

22 | THE LAMP AUGUST 2018

‘ Nurses are burnt out, anxious and morally distressed. If DHBs and government are serious about addressing nurses’ concerns then they must address both pay and conditions.’ — Dr Helen Rook T he Labou r M in ister for Health David Clark said he was sympathetic to nurses’ feelings which he said had been building over the nine years of the previous National government.

“Their frustration is understandable. I think everyone agrees nurses should be paid more than they are now, but it takes more than one pay round to address nine years of neglect.”

STRONG SUPPORT FROM HEALTH PROFESSIONALS AND PUBLIC Nurses received widespread support for their action from doctors, nursing exper ts and the public.

Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS), said senior doctors were concerned that their nursing colleagues had been put in a position where last-resort strike action was considered necessary.

“Nurses are a skilled, dedicated workforce and the fact things have

deteriorated to this point reflects a crisis of leadership in our public health system.”

He said years of “deliberate g ove r n m e n t u n d e r -f u n d i n g ” had taken its toll, resulting in the devaluing of nursing both by the government and the District Health Boards.

Nurses were a vital part of the public health system and “don’t deserve to be treated as a balance sheet liability”, he said.

Nursing experts also recognised the dire state of health after nine years of National government when health spending and wage growth were virtually frozen.

“Nurses are burnt out, anxious and morally distressed. If DHBs and government are serious about addressing nurses’ concerns then they must address both pay and conditions, which includes the wider culture of healthcare,” said Dr Helen Rook from Wellington’s Graduate School of Nursing, Midwifery and Health. ■

NEW ZEALAND

Empty promises on staffing bred distrust In 2004, NZ nurses withdrew a claim for mandated nurse-to-patient ratios after they were promised a committee of inquiry to develop a national safe staffing model. Implementation of the model was to start “no later than 2006”.

“More than a decade later most public hospital nurses are still waiting for that safe staffing model to make a difference to the number of nurses on their ward,” reported the NZ Nursing Review.

Safe staffing has been on the table of every collective agreement negotiation since 2004 “but progress has been painfully slow”, it says.

Only one District Health Board (out of 20) has fully implemented the tools that calculate how many nurses are needed on each ward.

The broken promises around staffing have been a key reason for the erosion of trust by nurses in their employers says NZNO organiser, Cee Payne. “(Nurses’) experience over the last 10 years is DHBs haven’t delivered on what they’re saying around safe staffing,” she says.

Professor Jenny Carryer, Massey University School of Nursing, says the dire state of health has come about because the DHBs and the previous government had seen nursing as “a cost to be pruned” rather than as a resource.

“There is a constant drive to reduce nurse staffing to levels which mean nurses are under constant stress and making critical decisions in a sea of distraction, whilst trying to prioritise those actions which will ensure people are safe,” she said.

What NZ nurses said about the strike “ It is nice to know nurses are out there nationally today standing together in solidarity to make sure our healthcare system is safe for our patients and nurses.”

— Cheryl Hanham, NZNO Christchurch “ We didn’t want to strike. We still want to be there caring for our patients but it’s necessary.”

— Sarah Overall, Wellington Regional Hospital “ Care is rationed in the work environment when you don’t have enough staff. That puts us in a moral dilemma.”

— Jacqui Bennetts, Christchurch Hospital “ We’re not striking for us.

We’re striking for the public.”

— Erin Law, Wellington Regional Hospital Source: stuff.co.nz

THE LAMP AUGUST 2018 | 23

UNITED STATES

Green light for workplace freeloaders US Supreme Court loads the scales in favour of employers.

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he United States Supreme Court has dealt a huge blow to public sector unions by abolishing their legal right to collect bargaining fees from non-members.

In a 5–4 decision the court overturned a 1977 judgement that had allowed public sector unions to collect fees from non-members when bargaining for higher wages and improved working conditions.

No state requires a worker to involuntarily join a union, as opposed to merely paying bargaining fees which are set as a percentage of membership fees.

To be eligible to collect bargaining fees, unions must be endorsed by a majority of workers in an enterprise.

US Supreme Court judges are appointed by the president with Senate approval. The election of Donald Trump with a Republican Senate majority has placed antiunion judges in the majority.

They ruled that requiring nonmembers to pay their “fair share” was inconsistent with the US Constitution’s First Amendment right to free speech.

In a dissenting opinion, Justice Elena Kagan warned the decision “will have large-scale consequences.

Public employee unions will lose a secure source of financial support”.

She said the decision was the culmination of a six-year campaign to overturn legal precedent.

The closely watched case – Janus v. American Federation of State, County, and Municipal Employees – will impact public sector employees 24 | THE LAMP AUGUST 2018

‘ Selfish workers will now be able to free ride on their colleagues’ efforts to bargain for improved working conditions and higher pay.’ — Joseph Stiglitz in 22 states and could permanently weaken public unions.

The case was brought by Mark Janus, an Illinois state government employee who is represented by the AFSCME union.

Although he is not a union member, 78 per cent of full union dues are deducted from his wages to pay for the Union’s work in bargaining on his behalf.

Janus argued the arrangement violated his right to free speech as unions enter into collective bargaining agreements with the government and all of their activity should be seen as political.

A “PERVERSE RULING” Joseph Stiglitz, a Nobel prizewinning economist and Columbia University professor, described the ruling as “perverse”.

“In a country already suffering from a massive imbalance between employers and workers, the court has loaded the scale even further in favor of the former,” he said.

“Selfish workers will now be able to free ride on their colleagues’ efforts to bargain for improved working conditions and higher pay; and if there are enough of such workers, unions will be further weakened for lack of funds.”

Stiglitz pointed out that the court earlier decided that the First Amendment permits corporations to make unlimited contributions to political campaigns.

“So, in the eyes of the court’s conservatives, corporations may support views that run contrary to a majority of their shareholders and workers – who had no say in the matter – but unions may not express views that are opposed by even a single dues-payer,” he said.

The court had become “merely another instrument for advancing an extreme right-wing agenda.”

Cornell Law School’s Stewart Schwab, a leading scholar in employment law, described the court judgement as “simply amazing”.

Professor Schwab said while some workers may disagree with the union’s goals, many others support the union’s aims of higher wages and better benefits but still hope to “freeride” by having someone else pay the union fees.

“All taxpayers can sympathise that the government often uses our money for causes we don’t believe in, but that doesn’t give us a First Amendment right not to pay taxes,” he said. ■

OBITUARY

VA L E

Jacqueline Gai Scott, RN, nee Hayward 16 J U LY 1 9 6 6 – 3 0 MAY 2 01 8

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acqui, who died of a brain aneurism, grew up at Shoalhaven Heads, where she was a competitive hockey player and surf lifesaver. At Bomaderry High, where she displayed a wicked sense of humour, lifelong friendships were formed with others aiming to be part of the initial university nursing intake in 1985.

The class of 1985 reprogrammed the male dominated NSWIT with much socialising, including the Sport & Recreation Dinner, where she met the love of her life, Craig Scott. Jacqui completed her diploma in 1987 and her Bachelor’s in 1990. She joined the Association in January 1988 when she commenced at RNSH. Jacqui and Craig were married in 1995. In 1996 Jacqui switched from intensive care to community nursing at St George Hospital. In 2002, Mitchell was born in dramatic circumstances (HELLP syndrome) in northern Scotland. The couple were on a working

holiday in the UK, with Jacqui working in ICU at Bupa Cambridge. In 2006, Lachlan was born and Jacqui devoted herself to the boys full-time. In early 2018, she changed to a non-practising registration.

A fantastic and trusted listener, Jacqui was a confidante who gave great advice.

She could come across as tough but was a marshmallow on the inside. That Teflon exterior and inner strength allowed her to excel as family matriarch, mother, and staunch advocate for her children. Our no-nonsense, straight-talking Jacqui was also compassionate and caring, which is why nursing was such a good career choice for her.

Selfless to the end, in losing her life so young and leaving us to grieve, Jacqui gave the gift of life to five other people through organ donation. This was also a selfless act by her family, which had to make this decision at a time of intense shock and grief. ■ Sarah Jane Adams, RN

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CNS NUM

RN

Join the health fund that’s all about you.

At Nurses & Midwives Health, we’re dedicated to caring for the carers. And the great news is, as a member of NSWNMA, you’re eligible to join us. When you join, you become part of the family. And that’s why your family members are also eligible to join*.

For your free, side-by-side comparison, and our latest offers, visit nmhealth.com.au or call 1300 344 000 *Eligibility criteria and conditions apply. Nurses & Midwives Health Pty Ltd ABN 70 611 479 237.

A Registered Private Health Insurer. NMH-NSWNMA-07/18

THE LAMP AUGUST 2018 | 25

TRAVEL TBA

Dreaming of your next holiday? Take a look at these fabulous offers The NSWNMA is working together with Union Shopper and ubookdirect to bring NSWNMA members special packages and rates for all your holiday dreams. Each issue will feature new packages so be sure to keep an eye out

The Pearl South Pacific Resort, Spa & Championship Golf Course – Coral Coast, Fiji

L

ocated on Fiji's Coral Coast, this 4-star elegant beachfront resort sits on a private beach overlooking Beqa Lagoon.

Come and leave the frenzied world far behind.

Set by the beach and surrounded by lush tropical landscapes, The Pearl Resort is an idyllic escape where chic accommodation, exquisite cuisine and as much – or as little – adventure and relaxation required await you.

26 | THE LAMP AUGUST 2018

Can’t find what you’re looking for?

Contact the Member Concierge desk to discuss the world on sale. They will find you the best value accommodation deals in your preferred locations and dates, ensuring the rate is better than you can find elsewhere online.

To book one of these fantastic packages email bookings@ ubookdirect.com.au or call 1300 959 550 For all other packages, head to unionshopper. ubookdirect.com

Premium Room – 7 nights $999* (2 ADULTS)

• Daily Full Buffet Breakfast • One Free Round of 18 Holes Golf for 2 on The Pearl Championship golf course • One Free (60 min) Tropical massage for two guests at The Pearl Spa • 1 pm Free Late Check-out *Further $200 off for Union Shopper members. Valid for stays until 28 January 2019 for a 7 night consecutive stay. Full T&C at unionshopper.ubookdirect.com

TBA

ADULTS ONLY RESORT!

Mangosteen Ayurveda & Wellness Resort – Phuket, Thailand A romantic boutique resort in southern Phuket, it offers a luxury hillside escape with villa style rooms designed exclusively for adults only. Set over 2.5 hectares of lush tropical gardens and positioned high for ultimate seclusion, the resort commands spectacular views over Chalong Bay and its surrounding islands. Align your mind and body with a morning yoga session, plus a complimentary Ayurveda health consultation.

Superior Jacuzzi Villa – 7 nights $599* (2 ADULTS) • 30-minute massage each • Thursday night "Five Gems of Asia" buffet dinner • Romantic candlelit dinner • ThaiFood Lovers buffet dinner • Welcome fruit basket and drink • Complimentary Ayurveda health consultation • Complimentary intro diving course in the resort pool with Sea Bees Diving • Monday morning yoga session • Explore with a shuttle bus to Nai-Harn Beach and local markets

Hotel Nikko – Benoa Beach, Bali A five-star hotel resort set amid expansive tropical greenery in the enclave of Tanjung Benoa with direct beach access and just 5 minutes drive from Nusa Dua. Hotel Nikko Bali Benoa Beach is an ideal retreat to escape, unwind and enjoy peace of mind.

Deluxe Room – 6 nights $799 (2 ADULTS) • Daily international buffet breakfast at Grand Benoa Resto • Free use of gym in Biwana Spa • Free village tour • Free usage of Cening Kids Club for kids under 12 years old • Free wifi in room and public areas • A lunch • Daily 2 bottles of still water • Complimentary use of iMac at the internet point • Late check out until 3pm • 20% discount for treatments at Biwana SPA# • 20% discount for food and beverage at restaurants# • 60 minutes Balinese massage for 2 • Free daily shuttle bus to Kuta • Finns Bali Day Pass.

Valid for stays until 31 March 2019 and for booking until 31 August 2018. Full T&C at unionshopper.ubookdirect.com #exclude promotional sale items

*Further $100 off for Union Shopper members. Valid until 31 March 2019 for a 7 night consecutive stay. Full T&C at unionshopper.ubookdirect.com

Tropicana Lagoon Resort – Efate, Vanuatu Couran Cove Island Resort – South Stradbroke Island, Queensland

This luxury boutique apartment resort is situated in a picturesque location on a private white sandy beach and only minutes from Port Vila. Its peaceful location offers guests a friendly tropical escape in the most romantic location of Efate, yet only 5 minutes away from downtown.

Deluxe Beachfront Studio – 5 nights $799* (2 ADULTS)

Indulge yourself in a perfect island escape to Couran Cove Island Resort on South Stradbroke Island. A sanctuary of natural beauty with a secluded 22km beach and heritage-listed bushlands filled with native animals, Couran Cove Island Resort offers guests all they need for a blissful, back-to-nature getaway.

• Exotic Welcome Drink on arrival • Complimentary use of non-motorised water sports equipment • Complimentary WiFi in public areas and in applicable accommodations

One Bedroom Marina Apartment – 2 night $266* (2 ADULTS)

EARLY BIRD OFFER: Book 60 days prior and receive a bonus airport pick-up and transfer, fruit platter and exotic drink on arrival, a free bottle of wine and a Sunset cocktail.

*Further $20 off for Union Shopper members. Valid for stays until 31 March 2019. Full T&C at unionshopper.ubookdirect.com

*Further $100 off for Union Shopper members. Valid for stays until 31 March 2019. Full T&C at unionshopper.ubookdirect.com THE LAMP AUGUST 2018 | 27

NEWS IN BRIEF

WORLD

Wage growth still ‘missing in action’ The Organisation for Economic Cooperation and Development (OECD) says wage increases remain rare among its 35 member ‘countries’ including Australia.

The OECD says unemployment rates are now even lower than what they were before the Global Financial Crisis. This, it says, should create the right environment for workers to demand higher pay and better conditions.

However, it said significant pay rises remain rare and the trend growth rate for average hourly wage increases had more than halved from 4.8 per cent before the crash to 2.1 per cent.

Stefano Scarpetta, the OECD’s Director of Employment, Labour and Social Affairs, said the most worrying finding was that “this unprecedented wage stagnation is not evenly distributed across workers”.

“While jobs are finally back, only some fortunate few at the top are also enjoying improvements in earnings and job quality,” he said.

Many economists attribute the sluggish wage growth to a fall in the power of unions, the rise of the gig economy and the proliferation of part-time jobs and other precarious forms of work.

The OECD found that in countries where working people are able to bargain together across industries or sectors, wages, overall employment, economic equality, productivity and even the quality of working environments, are better than in countries like Australia where bargaining is limited to a single business.

‘ While jobs are finally back, only some fortunate few at the top are also enjoying improvements in earnings and job quality.’

Slowdown in wage growth in many countries Average annual percentage growth in real wages, Q4 2017 and Q4 2007

NOTE: OECD refers to the unweighted average of 29 countries (excluding Chile, Iceland, Korea, Mexico, New Zealand and Turkey. SOURCE: OECD calculations based on quarterly national accounts.

Read more: OECD Employment Outlook 2018 – http://www.oecd.org/els/oecd-employmentoutlook-19991266.htm 28 | THE LAMP AUGUST 2018

AUSTRALIA

New report demolishes Turnbull’s argument for corporate tax cuts Multinationals move $16 billion from Australia to tax havens each year.

A groundbreaking report has found that corporate tax rates have been driven lower by multinational corporations shifting profits to tax havens rather than by competition for capital among different countries.

The Turnbull government has argued that lower company taxes will encourage companies to invest in Australia, boost productivity and lift wages.

The study, written by economists from the University of California, Berkeley, and the University of Copenhagen, and published by the National Bureau of Economic Research, debunks this idea.

“Machines don’t move to low-tax places: paper profits do,” it says.

“By our estimates, close to 40 per cent of multinational profits were artificially shifted to tax havens in 2015. This tax avoidance and the failure to curb it are the main reason why corporate tax rates are falling globally, not tax competition for productive capital.”

Australia’s corporate tax revenue was reduced by about seven per cent by profits moved to offshore tax havens – roughly $5.4 billion in lost revenue in 2017.

The paper outlines how multinational corporations such as Google, Apple and Facebook have changed the global tax system.

“In 2016, Google Alphabet made $19.2 billion in revenue in Bermuda, a small island in the Atlantic where it barely employs any workers nor owns any tangible assets, and where the corporate tax rate is 0 per cent.”

‘ Machines don’t move to low-tax places: paper profits do.’

NEWS IN BRIEF

WORLD

WTO rejects challenge to tobacco plain packaging Australia’s Department of Foreign Affairs and Trade claim ‘resounding victory’ in global test case.

The World Trade Organisation has rejected a complaint brought by Indonesia, Honduras, the Dominican Republic and Cuba against Australia’s historic tobacco plain packaging law.

The WTO panel said Australia’s law improved public health by reducing the use of tobacco products, and rejected claims that alternative measures would be equally effective.

It also rejected the argument that Australia had unjustifiably infringed tobacco trademarks and violated intellectual property rights.

Experts say the challenge was a test case for public health legislation globally. The Rudd government introduced the plain packaging laws in 2010. It was the first country in the world to do so.

According to the WTO six other countries – Hungary, Ireland, France, New Zealand, Norway and Britain – have since introduced plain packaging laws, while another six – Burkina Faso, Canada, Georgia, Romania, Slovenia and Thailand – have passed laws yet to be implemented.

Vera Luiza da Costa e Silva, from the World Health Organisation said there was already a “domino effect”, with countries moving towards Australian-style rules.

The federal government said it was prepared to fight any appeals against the decision.

“We will not shy away from fighting for the right to protect the health of Australians,” the trade minister, Steve Ciobo, and rural health minister, Bridget McKenzie, said in a joint statement.

“Australia has achieved a resounding victory.”

‘ Experts say the challenge was a test case for public health legislation globally’

AUSTRALIA

Sacklers sued for fuelling opioid epidemic The family that owns Purdue Pharma are accused of fuelling addiction in order to boost profits.

The state of Massachusetts is suing the pharmaceutical company Purdue Pharma, the makers of the painkiller OxyContin which is at the centre of the US opioid crisis.

The lawsuit also ensnares 16 past and present executives of the company including members of the billionaire Sackler family which owns the company.

The lawsuit alleges Purdue deceived patients and doctors about the risks of opioids, pushed prescribers to keep patients on the drugs longer and aggressively targeted vulnerable populations, such as the elderly and veterans reports The Guardian.

“Their strategy was simple: the more drugs they sold, the more money they made, and the more people died,” the Massachusetts Attorney General, Maura Healey, said.

The sale of more than 70 million doses of prescription opioids in the state over the last decade brought in more than $500 million for the company, Healey said.

“It was Purdue’s executives who led and directed this illegal business model, leading to addiction and deception to enrich a few while leaving a path of devastation and destruction in its wake,” she said.

The company is also being sued separately by 15 other states.

Nicotine Addiction & Smoking Cessation Training Course 23-25 Oct 2018

MORE INFO & REGISTRATION info@woolcock.org.au

The Sackler family fortune is collectively valued at an estimated $13 billion according to Forbes Magazine, with the vast bulk of the fortune generated from sales of OxyContin.

‘ Their strategy was simple: the more drugs they sold, the more money they made, and the more people died.’

— Massachusetts attorney general, Maura Healey THE LAMP AUGUST 2018 | 29

NEWS IN BRIEF

UNITED STATES

Trump administration bullies over breastfeeding The United States delegation to a World Health Assembly used threats to try and scupper a resolution that promoted breastfeeding.

The resolution called for countries to encourage their citizens to breastfeed based on research that overwhelmingly showed its health benefits. The resolution also warned parents to be alert to inaccurate marketing by formula milk companies.

According to The New York Times the resolution was supported by all assembly members except the United States, which pushed to remove a section that asked governments to “protect, promote and support breast-feeding”.

The Times says Ecuador, which introduced the resolution, came in for heavy-handed pressure from the American delegation.

“The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced,” it reported.

An observer, Patti Randall, from the British-based organisation Baby Milk Action, told The Times: “What happened was tantamount to blackmail, with the US holding the world hostage and trying to overturn nearly 40 years of consensus on the best way to protect infant and young child health.”

A 2016 Lancet study found that universal breastfeeding would prevent 800,000 child deaths a year across the globe, and yield $US300 billion in savings from reduced healthcare costs and improved economic outcomes for those reared on breast milk.

The formula milk industry has been hit by stagnant sales in recent years although it is still worth $70 billion annually. The small number of corporations that dominate it are concentrated in the United States and Europe.

30 | THE LAMP AUGUST 2018

‘ What happened was tantamount to blackmail, with the US holding the world hostage and trying to overturn nearly 40 years of consensus on the best way to protect infant and young child health.’ — Patti Randall, Baby Milk Action

NEWS IN BRIEF

AUSTRALIA

Cancer costs BRICS billions Premature – and potentially avoidable – death from cancer is costing tens of billions of dollars in lost productivity in a group of key developing economies.

A study published in the Journal of Cancer Epidemiology

by Australian researchers from UTS, shows that the total cost of lost productivity because of premature cancer mortality for Brazil, Russia, India, China and South Africa – key developing countries known as BRICS – was US$46.3 billion in 2012. (The most recent year for which cancer data was available for all these countries.)

BRICS countries account for 40 per cent of the world’s population and 25 per cent of global gross domestic product.

South Africa has the highest cost per cancer death (US$101,000) compared with the other BRICS countries. Its cost is five times that of India, which had the lowest cost per death. China experienced the largest overall loss (US$28 billion) due to its large population.

Liver and lung cancers had the largest impact on total lost productivity across the BRICS countries due to their high incidence. In South Africa, there are high productivity losses per death due to a form of cancer – Kaposi sarcoma – that people with AIDS are particularly vulnerable to.

Tobacco and infection-related cancers – such as liver, cervical, stomach cancers and Kaposi sarcoma – were major contributors to productivity losses across all five countries.

Many of these are amenable to prevention, early detection or treatment. But most developing countries don’t have such programs, the researchers say.

They also said policies encouraging lifestyle changes that reduce the risk of cancer could have positive effects on the BRICS countries’ economies.

‘ Tobacco and infectionrelated cancers were major contributors to productivity losses across all five countries.’

BRITAIN

Night shift plays havoc with gut New research finds that night shift knocks the digestive system out of sync with the body’s central biological clock.

The study revealed that just three days of being on a night shift schedule will disrupt the body’s metabolism. This disruption appears to be driven by separate biological clocks in the liver, gut and pancreas, rather than the brain's master clock.

The new research, from the Sleep and Performance Research centre at Washington State University and published in the online edition of the Proceedings of the National Academy of Sciences, dispels the belief that the metabolic disruption in shift workers is driven primarily by the brain’s master clock, reports Science Daily.

Instead, the study revealed that separate biological clocks – called peripheral oscillators – in the liver, gut and pancreas, have a mind of their own.

“Some biological signals in shift workers’ bodies are saying it’s day while other signals are saying it’s night, which causes disruption of metabolism,” said the head researcher Hans Van Dongen.

The results showed that three night shifts in a row moved the brain’s master clock by about two hours on average. But the impact on the digestive system’s clock was massive, with the brace of night shifts knocking it out by 12 hours.

The night shifts also disrupted the rhythms of two metabolites that are linked to chronic liver disease.

‘ Some biological signals in shift workers’ bodies are saying it’s day while other signals are saying it’s night.’

THE LAMP AUGUST 2018 | 31

PROFESSIONAL EDUCATION Wound Care Series: Northern NSW

CPD

6

All

$

Friday 10 August, Tweed Heads: Venous Insufficiency Friday 21 September, Ballina: Arterial Insufficiency Friday 5 October, Byron Bay: Pressure Injuries Members $95 / non-members $190 (each session)

Wound Care: Understanding Wound Care Products All

CPD Friday 10 August, Waterloo 6 $ Members $95 / non-members $190 This workshop will focus on wound products in relation to wound aetiology, wound shape and the overall objectives of wound care.

Legal, Ethical and Professional Issues for Nurses and Midwives

All

5

Thurs 9 August, Waterloo Wed 15 August, Albury Thurs 23 August, Ulladulla Wed 5 September, Broken Hill $ Members $95 / non-members $190 Learn about potential liability, disciplinary tribunals, NMC and HCCC complaints, Coroner’s Court and identify the fundamental ethical standards and values to which the nursing and midwifery profession is committed.

Policy and Guideline Writing for Nurses and Midwives All

CPD

Monday 3 September, Wollongong 6 $ Members $95 / non-members $190 This interactive workshop gives beginning skills to develop a document, either a policy or clinical guideline, for the workplace.

Medication Safety, Professional Obligations, Professional Comprehensive Documentation and the NMBA Decision-Making Framework

Thurs 16 August, Albury Fri 24 August, Ulladulla Fri 7 September, Broken Hill $ Members $50 / non-members $100 Assist nurses and midwives to better understand the key concepts and relevant information to ensure effective recording and completion of CPD to meet NMBA standards.

CPD

6 Friday 17 August, Waterloo $ Members $60 / non-members $120 This seminar focuses on reflection, relaxation and continued rejuvenation as well as the principles and importance of practising self-care to combat stress and promote healthy practices.

All

In-Charge Team Leader Skills ‘Lead by Example’ All

Tues 21 August, Waterloo Thurs 6 September, Broken Hill $ Members $30 / non-members $60 Evening Frontline nurse and midwife leaders are essential in Series assessing, planning and implementing quality patient CPD care. Effective leadership is fundamental to staff 3 retention, satisfaction and improved patient outcomes.

$

Dementia Management Training All $

32 | THE LAMP AUGUST 2018

All nurses, midwives & assistants in nursing

CPD

6

Thursday 20 September, Springwood Members $95 / non-members $190

The Influential Thought Leader at Work All

CPD

6

Monday 24 September, Waterloo Members $95 / non-members $190 This program will provide you with the skills and tools to build your confidence in becoming an inspiring and motivational thought leader. $

Clinical Handover Evening Series

All

Tuesday 9 October, Waterloo CPD Members $30 / non-members $60 3 This session covers: points of clinical handover; overview of bedside handover; patient involvement; information exchange. $

Increasing Resilience in Stressful and Changing Times All

Friday 12 October, Central Coast Members $95 / non-members $190 The goal of this workshop is to provide you with tools and strategies to help get your mojo back and put you in the best position to deal with stress, strain and change. $

Attendance at NSWNMA education sessions may count towards your Continuing Professional Development (CPD) hours.

The number of hours noted beside each course is the maximum amount of claimable CPD hours assuming that as an attendee you remain for the entirety of the course and complete any extra activities as may be required.

All

6

Thursday 6 September, Broken Hill Wednesday 17 October, Lismore Members $95 / non-members $190

REGISTER ONLINE bit.ly/educationNSWNMA CPD

CPD

All

4

Self-Care Forum

6

Wednesday 29 August, Batemans Bay $ Members $60 / non-members $120 For RNs, ENs and AINs in residential, community and hospital agedcare settings across private and public sectors and any nurse who has an interest in aged care or the subject of elder abuse issues in NSW.

CPD

RN EN MW

CPD

CPD

All

CPD Made Easy

Aged Care Focus Day: Elder Abuse

RN

RN

EN

EN

AiN

AiN

MW

Midwives

YOUR RIGHTS

Ask

Judith Breaking News Inquiry into the rollout of the NDIS The NSW Legislative Council has established an inquiry into the implementation of the NDIS and the provision of disability services in NSW. Its terms of reference are designed to specifically look at its implementation and the choice it has provided for people with disabilities, along with several other factors regarding the support available, the adequacy of regulatory controls and oversight, and what strain may be evident in the provision of such services.

This is most timely.

Our nursing members in FACS have since last year progressively had their employment transferred to NGO providers without their consent as part of the NDIS rollout. As the NSW Government vacates the disability field altogether as a provider, it has treated FACS nurses similar to other assets or properties transferred. It was and remains an outrageous use of legislative power.

And what are the results to date? Whilst the Association and its members will be providing a submission to the Inquiry, it would surprise no one that the process of transfer and the treatment of many longstanding FACS nurses has fallen well short of reasonable, let alone the ramifications for residents, for example, in group homes.

Using the NDIS rollout to privatise a significant chunk of residential disability services in this state, often caring for the most profoundly disabled with complex clinical care needs, is a misstep. NDIS was predicated on choice but the reality is that those receiving care and support in group homes had little to no choice regarding their care needs – least of all a capacity to remain in receipt of care from the public sector.

Replacement of absences I am a registered nurse working in a public hospital. When someone calls in sick, how is that absence managed if staffing levels need to be maintained?

Under Clause 53 of the Public Health System Nurses’ and Midwives’ (State) Award, the “default position is to fill the absence with a nurse of the same classification as the absent nurse” (ie. like for like). It is only after all avenues to backfill at the same classification are exhausted that the use of a nurse with a lower classification can be considered. In

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

that scenario, “the NUM (or delegate) must consider how the functions in the ward/unit can be safely and appropriately performed by a nurse of another classification”.

Where a decision is made to backfill with a nurse of a lower classification, the Award stipulates that a record of this, together with the reasons, must be made.

12-hour shifts

I work in a hospital operated by Healthe Care. My ward has been approached to introduce 12-hour shifts. How do we respond?

Clause 12(xix) of the Healthe Care Pty Ltd (New South Wales Hospitals) and the NSWNMA/ANMF Enterprise Agreement 2014 sets out that 12-hour shifts will only be introduced when there has been full consultation and a majority of staff agree to its introduction. Staff can nominate a union representative to be notified by the employer, with relevant information provided. The clause further sets out how any 12-hour shift system is rostered and how any staff member who does not wish to participate is accommodated.

Overtime for part-timer

I work part-time at an aged care facility run by RSL LifeCare. How is overtime calculated?

Clause 17.2 of the RSL LifeCare, NSWNMA and HSU NSW Enterprise Agreement 2017–2020 sets out that overtime is paid as follows, using your base rate of pay: Monday to Saturday, time and one half up to two hours each day and thereafter double time; on a Sunday any overtime will be paid at double time; on a public holiday overtime is paid at double time and one-half. Remember, the payment for overtime hours worked will not include shift and weekend penalties in its calculation.

Multiple assignments

I have multiple assignments across two LHDs. I am planning to leave one of these. What happens to my accrued leave in that assignment?

In this situation, Clause 4A of the Public Health System Nurses’ and

Midwives’ (State) Award sets out that “… where an employee terminates an assignment, any leave credits that are held against that assignment will be transferred to the remaining assignment/s”.

In charge allowance at Anglicare I work as a registered nurse in a facility operated by Anglicare.

When is the in-charge allowance payable?

Clause 18.1 in the Anglican Community Services Enterprise Agreement 2017 sets out that a registered nurse who is designated by the employer to be in charge of a residential service will be paid the allowance set out in Schedule B of the Agreement (currently $23.12 per shift in a facility of less than 100 beds and $37.26 per shift for 100 beds or more).

Note that this provision does not apply to nurses employed in a classification higher than a Registered Nurse Level 1.

Days in a row at Catholic Healthcare I work part-time at an aged care facility run by Catholic Healthcare. How many days in a row can I be rostered to work?

Under Clause F2(b) of the Catholic Healthcare Residential Aged Care Enterprise Agreement (New South Wales) 2015–2018, full-time and parttime employees must not work more than seven consecutive days.

Healthscope time in lieu I work as a registered nurse in a hospital run by Healthscope. Is there a time limit to taking time off instead of being paid overtime?

Under Clause 19(xiii) of the Healthscope Group – NSWNMA/ANMF – NSW Nurses and Midwives’ – Enterprise Agreement 2015–2019, time off in lieu of overtime needs to be taken within six months. Where this proves impossible, it is to be paid out at the appropriate overtime rate based on the rates of pay applying at the time payment is made.

THE LAMP AUGUST 2018 | 33

Recently changed your email?

Classification changed? online. nswnma. asn.au

Log on Update details Go into the draw

WIN AN APPLE WATCH online. nswnma. asn.au

Log on and make sure all your details are up to date.

You can easily update your address, workplace or credit card details as well as pay fees online, print a tax statement or request a reprint of your membership card – it’s simple!

Everyone who uses our online portal from 1 July – 30 November 2018 to update their details will automatically be entered in the draw to win.

* The winner must be a financial member of the NSWNMA. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/18/02955.

SOCIAL MEDIA

Do you have a story to tell? An opinion to share?

Nurse Uncut is a blog written by everyday nurses and midwives.

We welcome your ideas at nurseuncut@nswnma.asn.au

New on our Support Nurses YouTube channel Nurse Libby’s four tips for starting a green hospital program NSW LABOR CONFERENCE SUPPORTS AGED CARE Nurses Thomas and Linda speak to NSW Labor Party members and seek their support for ratios in Aged Care. bit.ly/NSWLaborAgedCare

VIOLENCE IN NURSING AND MIDWIFERY Brett Holmes delivers a message on workplace violence. bit.ly/NSWNMAviolence8 Connect with us on Facebook Nurse Uncut www.facebook. com/NurseUncutAustralia New South Wales Nurses and Midwives’ Association www.facebook.com/nswnma Ratios put patient safety first www.facebook.com/ safepatientcare Aged Care Nurses www.facebook.com/ agedcarenurses Look for your local branch on our Facebook page www.facebook.com/nswnma

Nurse Libby Barnes from the NSW Nurses and Midwives’ Association Lismore Branch gives her four tips for starting a greening program at your hospital. https://www. nurseuncut.com.au/libbys-tips-forstarting-a-green-hospital-program/

Four hours travel a day to be a nurse – housing affordability is pushing us to the limit I am a nurse who is currently experiencing the crunch of housing affordability. A story in the March issue of The Lamp on Housing Affordability, really struck a chord with me and I wanted to share my story. https://www.nurseuncut.com.au/ four-hours-travel-a-day-to-bea-nurse-housing-affordability-ispushing-us-to-the-limit/

Twists and turns to become a Nurse Life never quite takes the trajectory that we expect it to. Nurse Rachel shares her story about going from budding film-maker to newly qualified Registered Nurse in Outback Australia. https://www.nurseuncut.com.au/ twists-and-turns-to-become-a-nurse/

Ratios needed in aged care to help prevent elder abuse World Elder Abuse Awareness Day (June 15) is a reminder that not enough is being done to stamp out elder abuse in all its forms. It can be financial, social, physical, psychological and includes mistreatment and neglect. This not only occurs in homes but in aged care facilities too. https:// www.nurseuncut.com.au/ratiosneeded-in-aged-care-to-help-preventelder-abuse/

Nurses and midwives stand up for refugees

Follow us on Twitter @nswnma / @nurseuncut

More Indigenous nurses and midwives build trust in health

Share on Instagram by tagging @nswnma and don’t forget to use the hashtag #nswnma!

Aboriginal nursing and midwifery cadetships have transformed the lives of Indigenous nurses and patients alike. https://www. nurseuncut.com.au/more-indigenousnurses-builds-trust-in-health/

This International Refugee Week, NSW Nurses and Midwives’ Association General Secretary Brett Holmes, writes about why nurses and midwives are standing up for the rights of those seeking asylum on our shores. https://www.nurseuncut.com. au/nurses-and-midwivesstand-up-for-refugees-2/

Listen to our podcast

Jane Currie: 'Mass Casualty Education' bit.ly/JaneCurrie THE LAMP AUGUST 2018 | 35

PROFESSIONAL EDUCATION 2018

Mental Health Drug & Alcohol Nurses Forum THE TIME FOR CHANGE

Friday 7 September

CPD

6

9am – 4pm • NSWNMA

All $

50 O’Dea Avenue, Waterloo

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

HEAR FROM: • Dr Karin Lines, Executive Director, Mental Health Branch, Strategy and Resources Division, NSW Health.

• Bethne Hart, Associate Professor, School of Nursing, University of Notre Dame.

ALSO ON THE PROGRAM: • Using the NMBA Decision Making Framework (DMF) • Work Health and Safety in the workplace • Legal Issues for mental health and drug & alcohol nurses.

CPD

6

Skill-Set for New Managers and Senior Nurses and Midwives

Friday 14 September 9am – 4pm • NSWNMA 50 O’Dea Avenue, Waterloo

All $

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

This 1-day seminar is aimed at Managers and Senior Nurses and Midwives to assist in reaffirming and developing management qualities, skills and attributes.

PROGRAM: • Clinical Supervision (The Reflective Model) • Rostering and Award Requirements • Bullying and Conflict Resolution • Leadership Skills • Staffing: What you need to know.

REGISTER ONLINE bit.ly/educationNSWNMA Attendance at NSWNMA education sessions may count towards your Continuing Professional Development (CPD) hours.

You will be provided with a certificate of completion at the end of each course. The number of hours noted beside each course is the maximum amount of CPD claimable CPD hours assuming that as an attendee you remain for the entirety of the course and complete any extra activities as may be required.

36 | THE LAMP AUGUST 2018 All All nurses, midwives & assistants in nursing Authorised by B.Holmes, General Secretary, NSWNMA

SOCIAL MEDIA

your

Say

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

As a child and family health nurse (and lapsed midwife) I agreed completely. Let’s hope the voters of NSW don’t fall for all this pork barrelling.

Gladys and her team treat us all with utter contempt.

Great article O’Bray.

The horror stories of near misses and midwives/ student midwives struggling to provide care under great duress is very disturbing. Mothers and babies sent home before breastfeeding is established, not enough midwifery at home staff to follow them up, the list of failures of this Government is endless. They must go!

As an expectant mother myself, I don't want this so-called ‘goody bag’.

This isn't even a ‘band aid solution’; it's a “sweep it under the rug and hope it goes away” solution – which isn’t solution at all. I sincerely hope they reconsider the ridiculous insult that these bags are, recall them all and put the funding where it belongs – back to support those whose support we rely on when a new life enters this world.

New mums are already given Bounty Bags for free. We don’t need the government to give them one when that money could be spent on providing more midwives to support new mothers!

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Ridiculous ratios are Russian roulette

There’s a pork barrel in my baby hamper!

Midwife, nurse and new mum O’Bray Smith, reckoned the Berejiklian government’s baby hamper is too little, too late for mums and bubs. You shared her outrage:

the gallery

We shared the story of an Aged Care AiN who worked on a ratio of 2:90. The disgust against this practice was palpable.

Libby’s recycling initiative a hit We posted about ICU nurse Libby Barnes’ initiative to make her hospital more environmentally friendly.

Members were excited to get their own facilities involved: This is so great! As a nursing student who’s gradually adopting a zerowaste policy in my personal life, I’ve already struggled with the idea of having to throw so much stuff in landfill so it’s good to know that there are ways to minimise this.

With so much single use in hospitals, why has this taken so long to initiate?

I’d like to see industry design more products that can be composted not just recycled! Well done for making a difference!

I have constantly wondered at the difference my little bit of recycling makes when hospitals create piles of landfill every day.

We do this at my hospital too. Many wards allocating cardboard bins for the glove boxes and packaging of items. I think it’s great.

What have they lost their brain cells? That’s just playing Russian roulette with elderly health and safety. I get that residents are aged and heading to the end of life stage, but instead of making their experiences positive and increasing their quality of life, Aged Care operators are doing their best to send their elderly residents to the other side more quickly.

This is a totally disgusting attitude towards residents and staff. We need drastic changes to staff-to-resident ratios and wages.

I did my placement in a well-known Aged Care facility. Most days there were two carers to 40 residents. I have never stepped back into a facility since that experience.

We must all fight and express our outrage! This is so wrong in so many ways This is so wrong. I’ve been the one RN for 140.

I’ve also been the one CSE on a sleepover shift for 80 hostel and 50 selfcare residents. What if something went wrong?

At my age I am trying to keep healthy. I dread the thought of being in an Aged Care facility.

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/5 1/ S hellharbour Hospital Branch show their colours by voting to put patient safety first 2/ S t George Hospital Branch Executives get ready to meet with branch members over coffee and lollies 3/ N SWNMA Linda Kelly advocates for safer patient and resident care at this year’s NSW Labor Annual Conference 4/ Aged Care nurses and retired members rally the support of MPs Susan Templeman and Ged Kearney in the Blue Mountains 5/ Nurses and midwives of the Narromine Branch show their support for our ratios campaign

THE LAMP AUGUST 2018 | 37

TBA

LIONS NURSES’ SCHOLARSHIP

Looking for funding to further your studies in 2019?

THE LIONS NURSES’ SCHOLARSHIPS OPEN ON 1 AUGUST AND CLOSE ON 31 OCTOBER EACH YEAR The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships.

Nurses eligible for these scholarships must be resident and employed within the State of NSW or ACT. You must currently be registered with the Nursing and Midwifery Board of Australia

and working within the nursing profession in NSW or the ACT, and must have a minimum of three years’ experience in the nursing profession – the last twelve months of which must have been spent in NSW or the ACT. Details of eligibility and the scholarships available (which include study projects either within Australia or overseas), and

application forms are available from: www.nswnma.asn.au/education Administration Liaison Lions Nurses’ Scholarship Foundation 50 O’Dea Avenue Waterloo NSW 2017 or contact Matt West on 1300 367 962 or education@nswnma.asn.au

COMPLETED APPLICATIONS MUST BE IN THE HANDS OF THE SECRETARY NO LATER THAN 31 OCTOBER Lion Nurses Scholarship.indd 1

19/6/18 11:09 am

Great deals for members at

The Good Guys As a valued Union Shopper member you can now get exclusive access to a new online shopping site with The Good Guys Commercial.

You will be able to see ‘live’ discounted pricing on the entire The Good Guys range – that’s great deals on over 4,000 products!

And you will be able to make your purchases online – saving you time and money.

To register for online access to The Good Guys Commercial website, visit www.unionshopper.com.au/the-good-guys/ or phone 1300 368 117

1300 368 117 unionshopper.com.au 38 | THE LAMP AUGUST 2018

NURSING RESEARCH ONLINE The Clinical Communiqué (http://vifmcommuniques.org/) is an electronic publication containing narrative case reports about lessons learned from coroners’ investigations into preventable deaths in acute hospital and community settings.

The goal is to improve the awareness of health care professionals, clinicians and managers about the nature and circumstances of the systems failures that contributed to patient adverse events.

The Clinical Communiqué is written, edited, published and distributed by the Department of Forensic Medicine, Monash University and the Victorian Institute of Forensic Medicine.

Clinical Communique vol. 5 issue 2, June 2018 This edition looks at three cases of patients who died shortly after being assessed and discharged from an emergency department. In each case, an evolving abdominal problem was missed, and the symptoms were attributed to other, less critical causes.

Fluctuating signs were misinterpreted, investigative abnormalities were not fully appreciated, and ultimately, diagnoses of life-threatening conditions were missed.

A common mantra in medicine is: Beware the diagnosis of constipation in the elderly patient with abdominal pain. To that could be added: Beware the diagnosis of viral gastroenteritis in patients with severe abdominal pain and high fevers. http://vifmcommuniques.org/wp-content/ uploads/2018/06/CC-June-2018.pdf

Residential Aged Care Communique vol 13, issue 2, May 2018 This edition draws on PhD research on suicide among older people living in residential aged care services (RACS) in Australia. It takes readers on the journey from what we knew about this issue in 2014, to what we know now.

The following is an extract from a reflective piece written for the Medical Journal of Australia on the experience of reviewing 141 coroners’ files on RACS residents who had died by suicide between 2000 and 2013 in Australia: “I sat alone in a windowless room for a week at a time... There were times when I had to clock off early for the day because I was emotionally drained and I wanted to preserve my own sanity. There were times when a seemingly minor feature of someone’s story made me stop and shake my head in disbelief, and even brought me to tears. Some of the stories were tragic. Some were relatable, even understandable.

Some were political statements, others a statement of the deficiencies of our aged care and mental health systems.”

The PhD research aimed to examine the epidemiology and prevention of intentional deaths from suicide

and resident-to-resident aggression among RACS residents in Australia through the use of existing medico-legal death investigation information.

This is the first time in Australia that these types of deaths have been collated and analysed for their implications for public health and injury prevention at a national level, as opposed to being considered on a case-by-case basis by individual coroners. This is also the largest study of its kind in the world. http://vifmcommuniques.org/wp-content/ uploads/2018/05/RACC-May-2018.pdf

Future Leaders Communique vol 3, issue 2, April 2018 This issue reviews the coronial inquest into the death of a woman shortly after her attendance at a small rural hospital. The doctor presiding over this patient’s care was a junior doctor who was operating in an under-resourced and under-supported environment.

This is not an uncommon experience for junior doctors.

As junior doctors working within a hectic public health care system, it is important to be aware of our limits and operate within our current scope of safe practice. This can be difficult when we are asked to work above our capacity, or are placed in situations where we are not as supported as we should be.

Extending ourselves professionally is necessary but it is imperative that this development occurs under appropriate supervision.

The challenge of maintaining the fine balance of staffing and supervision is faced daily by our medical workforce units, mostly made up of nonmedically trained staff who do not always have a full understanding of the specific skills required for each job description. It is therefore essential as junior doctors that we realise our limits and ensure we are placed in jobs that meet our level of experience. It is also essential, as we progress through our careers, that we are cognisant of providing adequate support and open lines of communication to our junior colleagues. http://vifmcommuniques.org/wp-content/ uploads/2018/04/FLC-Apr-2018.pdf

THE LAMP AUGUST 2018 | 39

Going to work shouldn’t be like this

Download the NSWNMA App and report your workplace violence incident.

The NSWNMA has a tool as part of our NSWNMA Tool Kit App that allows you to quickly report an incident to the Association as soon as it happens.

It’s an easy fillable form you can submit from your mobile device and an officer of the Association will be in touch with you.

Nursing is considered one of the most dangerous professions.

HELP STOP VIOLENCE AT WORK! NSWNMA Toolkit App is FREE and available to download from iTunes and Google Play store 40 | THE LAMP AUGUST 2018

CROSSWORD

test your

Knowledge 1

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ACROSS 1. Skin condition in which hair follicles are irreversibly destroyed by scarring processes (8.8) 9. Arthrodial joint or plane joint (7.5) 11. Highly significant or important 12. A series of diagnostic tests before an organ transplant to determine compatibility (6.6) 13. Obscure or hidden

from view 14. To examine or map the body 17. Any burning sensation of the face 19. Unsweet 20. Seed of this plant is used for food 21. A part or portion 22. Relating to a vocation or job 24. From inside (3.2) 26. Insect that in the adult state has four wings more or less

covered with tiny scales, like butterfly and moth 29. Tetracycline-induced steatosis (1.1.1) 30. Relating to vulva and uterus 32. A heart condition characterised by interstitial myocardial fibrosis and thickening of the small blood vessels in progressive systemic sclerosis

DOWN 1. Inflammatory induration of the ovary 2. An instrument for inspecting the ear 3. The largest part of the liver (5.4.2.5) 4. The outer layers of the skin and are composed of keratin 5. A slender, needle-like part or structure 6. Should 7. An asexual spore developed externally by budding 8. A test for antibodies (12.4) 10. Latex Agglutination Inhibition Test (1.1.1.1) 14. Stored a large supply for future use 15. Computed tomography (1.1) 16. RNA found in nuclei (1.1.1.1) 17. To raise, elevate 18. Gain, make 23. Physiotherapy Evidence Database (1.1.1.1.1) 25. Relating to ankle bone 27. To tap gently 28. An Indian side dish 31. Units of measurement (1.1.1)

THE LAMP AUGUST 2018 | 41

COVER STORY

Winter warmers

2

3

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

1 Long Sleeve Quick

Dry Polo Shirt $25 Australian made and owned.

Sizes: XS-3XL. Poly/cotton, breathable light fabric with 2-button placket.

4

5

2 Navy Hoodies $45. Sizes:10-16 and S-3XL. 80% cotton/20%

poly brushed fleece, kangaroo pocket with full lining hood.

3 Red Hoodies $45. Sizes:10-16 and S-3XL. 80% cotton/20%

poly brushed fleece, kangaroo pocket with full lining hood.

4 Bonded Polar Fleece Zip Front Jacket $30. Sizes: S-3XL. 100%

polyester, high quality anti-pill polar fleece, extra deep pockets.

5 Active Soft Shell Navy Jacket $50. Sizes:10-18 and S-3XL.

Poly/spandex, micro polar fleece lining, breathable fabric.

ORDER FORM 1 Long Sleeve Quick Dry Polo Shirt $25. Quantity:

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Postage and Handling $5 per item. Total cost of order $ 42 | THE LAMP AUGUST 2018

Email Method of Payment Cheque MasterCard

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

Size:

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FAX (02) 9662 1414 POST NSWNMA, 50 O’Dea Ave. Waterloo NSW 2017

REVIEWS

book club

All the latest Book Club reviews from The Lamp can be read online at www.nswnma.asn.au/libraryservices/book-reviews.

DISCOUNT BOOKS FOR MEMBERS The Library is pleased to announce that McGraw-Hill Publishers are now offering members a 25% discount off the RRP! The offer currently covers medical as well as a range of other professional series books. Please see the online Book Me reviews for a link to the promotion code and further instructions, or contact the Library directly for further information.

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Christine Hallett Oxford University Press: bookdepository.com RRP $45.50. ISBN 9780198703693

ST RE

IN AL TE

Veiled Warriors: Allied Nurses Of The First World WarI

The APRN’s Complete Guide To Prescribing Pediatric Drug Therapy 2018 Mari Wirfs

Springer Publishing Company: springerpub.com RRP $ 49.95 ISBN 9780826166685

This prescribing guide, organised uniquely by diagnosis, facilitates speedy drug information retrieval for advanced healthcare providers in all settings involved in the primary care management of newborns through to adolescence. The guide encompasses pharmacotherapy regimens for more than 450 clinical diagnoses and includes cross-referenced generic and trade names for ease of use.

Academic Leadership In Nursing Leslie NealBoylan, Sharon Chappy and Sharron Guillett Springer Publishing Company: springerpub.com RRP $70.00 ISBN 9780826134523

This is the first resource

to compare the experiences of nursing academic leaders among public, private, and for-profit institutions for nurse educators of all experience levels and ambitions.

The information and advice in this text addresses misconceptions and myths about all three types of organisations to enable readers to thrive in their chosen institution.

Foundations For Health Promotion Jennie Naidoo and Jane Wills Elsevier – Health Sciences Division www.amazon.com RRP $38.25 ISBN 9780702054426

The new edition of the highly successful Foundations for Health Promotion continues to offer a wealth of information in a unique, userfriendly format. Containing over 300 artworks, tables and ‘pull out’ boxes, this helpful text covers the theory, strategies and methods, settings and implementation of health promotion. Applicable to a wide range of health and social care professionals and anyone engaged with education about health and wellbeing.

R

IA Caring for the wounded of the First World War was tough and L IN T E challenging work demanding extensive knowledge, technical skill and high levels of commitment. Although allied nurses were admired in their own time for their altruism and courage, their image was distorted by the lens of popular mythology. Veiled Warriors offers a compelling account of nurses’ wartime experiences and a clear appraisal of their work and its contribution to the allied cause between 1914 and 1918, on both the Western and the Eastern Fronts.

Living With Chronic Illness And Disability Ester Chang and Amanda Johnson Elsevier – Health Sciences Division www.amazon.com RRP $67.95 ISBN 9780826155818

To help families manage an intense medical-related event, Power and Dell Orto propose that a familyoriented life and living perspective should be combined with a family intervention philosophy.

Stressing acknowledgment of the adverse effects of the illness and an affirmation approach to family struggle and opportunities, the authors explore issues relevant to treatment, family adaptation, quality of life, and family survival.

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 AUGUST 2018 | 43

JOURNEY ACCIDENT INSURANCE

For NSWNMA Members

DID YOU KNOW

your membership fees cover you if you are injured travelling to or from work?

If you are injured in an accident while travelling to or from work, NSWNMA’s Journey Accident Insurance provides you with peace of mind with a Weekly Bodily Injury Benefit of up to 85% of your average gross weekly salary for a period of up to 104 weeks (after 7 day waiting period).

As a financial member of the NSWNMA you are automatically covered by this policy.

Make sure your membership remains financial at all times, so you’re covered.

Unsure if you are financial?

It’s easy!

Ring and check today on 8595 1234 (metro) or 1300 367 962 (rural) Change your payment information online at www.nswnma.asn.au

www.nswnma.asn.au 44 | THE LAMP AUGUST 2018

REVIEWS If you would like to be a movie reviewer, email lamp@nswnma.asn.au

In the tradition of Amblin classics where fantastical events occur in the most unexpected places, Jack Black and two-time Academy Award® winner Cate Blanchett star in The House with a Clock in its Walls.

This magical adventure tells the spine-tingling tale of 10-year-old Lewis (Owen Vaccaro) who goes to live with his uncle in a creaky old house with a mysterious tick-tocking heart. But his new town’s sleepy façade jolts to life with a secret world of warlocks and witches when Lewis accidentally awakens the dead.

Based on the beloved children’s classic written by John Bellairs and illustrated by Edward Gorey, The House with a Clock in its Walls, is directed by master frightener Eli Roth and written

by Eric Kripke (creator of TV’s Supernatural). Co-starring Kyle MacLachlan, Colleen Camp, Renée Elise Goldsberry, Vanessa Anne Williams, Lorenza Izzo and Sunny Suljic, it is produced by Brad Fischer (Shutter Island) and James Vanderbilt (Zodiac), as well as Kripke.

In cinemas 20 September 2018.

Email The Lamp by 16 September to be in the draw to win one of five family passes (2 adults, 2 children) to The House with a Clock in its Walls thanks to Entertainment One. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

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The house with a clock in its walls

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at the movies

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Save me From the multi-award-winning producers of Line of Duty comes the brand new gritty, gripping British drama Save me.

Written by and starring the multi-talented Lennie James (The Walking Dead, Line of Duty), alongside renowned, must-watch star Suranne Jones (Doctor Foster, Scott & Bailey).

Nelson “Nelly” Rowe (James) is a ducker and a diver, a charmer, a chancer, a fighter and a liar. He ‘likes a drink’, spending most of his time in the local pub, and he loves whoever he’s sleeping with. He’s also a man who should know better at his age but couldn’t care less…that is until his whole world comes crashing down around him.

When Nelly’s 13-year-old daughter, who he barely knows, goes missing, her mother Claire (Jones), is convinced of his guilt. Before he knows it he’s been arrested and charged with kidnapping. Desperate to clear his name Nelly, looks to his community for help. Hell-bent on finding the perpetrator and saving his daughter, he will stop at nothing in his life-changing quest for truth.

Email The Lamp by the end of September to be in the draw to win a DVD of Save me thanks to Acorn Media. Email your name, membership number, address and telephone number | to lamp@nswnma.asn.au for a chance to win!

THE LAMP AUGUST 2018 | 45

DIARY DATES

make a date

Diary Dates for conferences, seminars, meetings and reunions is a free service for members. lamp@nswnma.asn.au

EVENTS: NSW Australian Grief and Bereavement Conference 2018 6–10 August, Novotel Manly Pacific, Manly, Sydney https://eventsbeyond.eventsair.com/ QuickEventWebsitePortal/acgb2018/acgb2018 Spring with the Kids Paediatric Perioperative Seminar 2018 15 September 2018 Rydges Parramatta, Rosehill NSW claudia.watson@health.nsw.gov.au sally.phoebus@health.nsw.gov.au Pain. A Balancing Act. Pain Interest Group Nursing Issues 21 September 2018 Sydney NSW Masonic Centre www.dcconferences.com.au/pigni2018 Transplant Nurses’ Association National Conference 24–26 October 2018 Rydges World Square, Sydney www.tnaconference.com.au./ Audiometry Nurse Association of Australia Conference 36th Annual Conference and AGM 24–26 October 2018 Orange Ex-Services Club 231-243 Anson St, Orange NSW 2800 www.anaa.asn.au Palliative Care NSW 2018 Biennial State Conference – Riding the Waves of Change 8–10 November 2018 The Pavilion, Kiama NSW http://pcnsw2018.com.au Critical Care Nursing Conference 9 November 2018 Westmead Hospital Jennifer.Yanga@health.nsw.gov.au 42nd Australian Association of Stomal Therapy Nurses Conference: Power of connections – coming together 17–19 March 2019, SMC Conference and Function Centre Sydney. http://www.stomaltherapyconference.com/

EVENTS: INTERSTATE A5M Anti-Ageing and Aesthetics Conference: Connecting inner and outer health 4–7 August 2018, Sofitel Hotel Melbourne www.a5m.net/conference-information/ a5m-annual-conference Australasian Diabetes Congress 22–24 August 2018 Adelaide Convention Centre, SA http://www.diabetescongress.com.au/ 19th Asia-Pacific Prostate Cancer Conference 2018 22–25 August 2018 Brisbane Convention and Exhibition Centre www.prostatecancerconference.org.au Australasian Neuroscience Nurses Association Conference 30–31 August 2018 Sheraton Grand Mirage, Gold Coast Leigh McCarthy conferenceconvenor@asn.com.au larrows@hotmail.com DECLARED 2018 Delirium Clinical and Research Days 4th Biennial Conference 6–7 September 2018

46 | THE LAMP AUGUST 2018

Please send event details in the format used here: event name, date and location, contact details – by the 5th of each preceding month.

Send your event details to: lamp@nswnma.asn.au Fax 02 9662 1414 Post 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space.

Priority is given to non-profit professional events.

Melbourne Convention Exhibition Centre Victoria www.delirium.org.au/2018-Conference Australian College of Nurse Practitioners (ACNP) National Conference 2018 10–13 September 2018 Hellenic Club Canberra, Canberra ACT https://acnpconference.com.au/ CATSINaM Professional Development Conference 17–19 September 2018 Hilton, Adelaide www.catsinam.org.au/events-folder/ catsinam-conference-2018 Australian College of Children & Young People’s Nurses Conference: Heading west: focus on children and young people’s health 25–26 October 2018 Perth Children’s Hospital, WA https://www.accypn.org.au/Conference/ 22nd International Conference on Global Nursing Education and Research: Innovation and advancements in nursing education and research 12–13 November 2018 Melbourne, Australia https://nursingeducation.conferenceseries.com/ 8th Biennial Australian and New Zealand Falls Prevention Conference 18–20 November 2018 Hotel Grand Chancellor, Hobart, TAS https://anzfpconference.com.au/ 2018 STOP Domestic Violence Conference 3–5 December 2018 QT Gold Coast, Surfers Paradise https://stopdomesticviolence.com.au/ 15th National Rural Health Conference 24–27 March 2019 Hobart Tasmania www.ruralhealth.org.au/15nrhc/ Lowitja Institute Indigenous Health and Wellbeing Conference 17–20 June 2019, Darwin, NT http://www.nirakn.edu.au/event/2019-lowitja-instituteinternational-indigenous-health-and-wellbeingconference/

INTERNATIONAL Annual Association of Stoma Care Nurses UK Conference 9–11 September 2018 ICC Birmingham, UK http://ascnuk.com/ascn-uk-annual-conference-2018/ 33rd Euro Nursing and Medicare Summit 8–10 October 2018, Edinburgh, Scotland europe.nursingconference.com/ Euro Midwifery Congress 2018 15–16 October 2018 Athens, Greece midwiferycongress.nursingconference.com/ World Congress of Cardiology and Cardiovascular Health 5–8 December 2018 Dubai, United Arab Emirates www.world-heart-federation.org/wcc-2018/ EuroSciCon Conference on Clinical Pathology and Bacterial Diseases 2019 27–28 February 2019 Prague, Czech Republic https://clinicalpathology.euroscicon.com/ International Council of Nurses 2019 Congress 27 June–1 July 2019 Marina Bay Sands Expo and Convention Centre, Singapore http://www.icn.ch/events/

ICN-Congress-Singapore-June-2019/ International Council of Nurses (ICN) 21st International Conference on Nursing 25–26 September 2019 London United Kingdom www.icn.ch/

EVENTS: REUNIONS Pambula Hospital Reunion Saturday 15 August 2018 Oaklands Barn, Pambula pambuladistricthospitalreunion@gmail.com SVH Annual Nurses’ Reunion 25 August 2018 St Vincent’s Hospital Lismore Monica Spinaze Email: mspinaze@gmail.com Mobile: 0410443832 Milton Ulladulla Hospital Reunion 2018 14–16 September 2018 Milton Ulladulla Hospital Mollymook Beach Bowling Club NSW https://www.facebook.com/ groups/187341808667284/events/ Contact: Robyn Bean robynjoybean1@gmail.com Sydney Hospital Graduate Nurses’ Reunion Lunch 3 October 2018 Parliament House, Macquarie Street.

Jeanette Fox: 02 4751 4829 bekysa@tpg.com.au Port Kembla District Hospital Reunion 6 October 2018 The Sinclair Room, Dapto Leagues Club https://www.facebook.com/ events/2043091062684227/ Jocelyn Rentoul 0438 695 076 Helen Smith 0410 763 800 End of an Era Party – Manly Maternity 27 October, 2018 Balgowlah RSL Memorial Club https://www.eventbrite.com.au/e/end-of-an-eraparty-manly-maternity-tickets-47802651016 WWBH PTS 1979 40-year Nursing Reunion 2 February 2019 Contact: Alison Meek (Giese) 0402612240 Sharyn Wellham (Noonan) 0432416419 Steph Taggart (Heenan) 0457414503

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No GP referral required No downtime from work No hospital admission or general anaesthetic The Vein Institute is a leading Australian medical clinic specialising in the non-surgical treatment of varicose veins.

Saturday, 17 November 2018 The Hilton Hotel Ballroom 488 George Street, Sydney 9:00am to 4:00pm

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48 | THE LAMP MARCH 2017