Lamp October 2018 by NSW Nurses and Midwives' Association

RATIOS

NSWNMA PROFESSIONAL DAY

Ratios debated in parliament

Staffing for fairness

How 3D printing is changing health

page 16

page 22

page 26

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

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 75 NO. 9 OCTOBER 2018

ANGER GROWS OVER AGED CARE NEGLECT Print Post Approved: PP100007890

p.37 p.39 p.41 p.43

COVER STORY

The right support and advice to help you

feel future ready

1300 650 873

Consider our PDS before making a decision. FSS Trustee Corporation ABN 11 118 202 672, AFSL 293340, trustee of the First State Superannuation Scheme ABN 53 226 460 365.

2 | THE LAMP OCTOBER 2018

CONTENTS Contacts NSW Nurses and Midwives’ Association For all membership enquiries and assistance, including The 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. 9 OCTOBER 2018

Hunter Office 8–14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962

Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au Editorial Committee Brett Holmes, NSWNMA General Secretary Judith Kiejda, NSWNMA Assistant General Secretary Coral Levett, NSWNMA President Peg Hibbert, Hornsby Ku-ring-gai Hospital Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health Advertising Danielle Nicholson T 8595 2139 or 0429 269 750 F 9662 1414 E dnicholson@nswnma.asn.au Information & Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, Coordinator. T 8595 2175 E gensec@nswnma.asn.au The Lamp ISSN: 0047-3936 General Disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised. Privacy Statement The NSWNMA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information, please contact the NSWNMA office. If you are still not satisfied that your privacy is being maintained, you can contact the Privacy Commission. Subscriptions for 2019 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30. Individuals $84, Institutions $140, Overseas $150.

67,948

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

8 10 14

COVER STORY

Anger grows over aged care neglect Substandard aged care is in the media spotlight and the public is getting our message about the need for safe staffing laws. Now, a Royal Commission into the sector looms.

COVER STORY Aged care giants under fire

A Senate inquiry has shone a light on the murky financial and tax practices of Australia’s biggest for-profit aged care providers.

COVER STORY Veteran aged care campaigner bows out

For the past 16 years, the NSWNMA state council has benefited from Lucille McKenna’s strong advocacy for the aged care sector.

RATIOS Ratios debated in NSW parliament

FOUR CORNERS: PETA BORMANN

For all editorial enquiries letters and diary dates T 8595 1234 E lamp@nswnma.asn.au 50 O’Dea Avenue, Waterloo NSW 2017

The Berejiklian government and the NSW opposition have drastically different positions on nurse-to-patient ratios.

REGULARS

5 6 6 32 36 37 39 41 43 45 47 49 50

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

CHANGE THE RULES Staffing for fairness

Campaigns for safe staffing of hospitals and nursing homes are part of the union movement’s overall campaign for a fairer society, says Australian Council of Trade Unions secretary Sally McManus.

NSWNMA PROFESSIONAL DAY Don’t stay silent over unsafe staffing

Violating a professional standard could expose nurse and midwives to sanctions.

NSWNMA PROFESSIONAL DAY How 3D printing is changing health

RATIOS

Ratios debated in parliament page 16

NSWNMA ANNUAL CONFERENCE

Staffing for fairness page 22

PROFESSIONAL DAY

REGULARS

How 3D printing is changing health

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

page 26

p.37 p.39 p.41 p.43

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 75 NO. 9 OCTOBER 2018

3D printing has come a long way in recent years and offers the health sector exciting opportunities that are innovative and cost effective says Neil Sharwood.

WORKPLACE SAFETY #TheWorkplaceToo

Unions, labour lawyers, barristers and women’s rights activists are using the momentum of the #MeToo movement to fight against workplace sexual harassment.

ANGER GROWS OVER AGED CARE NEGLECT Print Post Approved: PP100007890

OUR COVER: Maree Wiseman, aged care RN Photographed by Sharon Hickey THE LAMP OCTOBER 2018 | 3

TRAVEL

Fabulous holiday offers Aitutaki Lagoon Private Island Resort – Cook Islands The ultimate in South Pacific indulgence, the only overwater bungalows in the Cook Islands! A twominute ride by private ferry from the main island of Aitutaki, this 4-star resort offers a restaurant, bar, day spa and beachfront pool.

Overwater Bungalow – 5 nights $2756* (2 ADULTS) • Free return airport-resort transfers in Aitutaki • Free daily tropical breakfast • Free car rental for 1 full day • Bottle of fine wine (per stay) • One NZ$100 Spa Polynesia credit (per stay) • Free daily activities and use of nonmotorized water sport equipment

Ziva, A Boutique Villa – Seminyak, Bali Nestled in a Balinese tropical garden, this 4.5-star accomodation exudes peace and tranquility. Take a stroll on a pristine beach, soak up the lush surroundings while stretching out by the private pool or sample Seminyak's unique cuisine and nightlife.

One Bedroom Villa with private pool – 5 nights $1406* (2 ADULTS) • Daily breakfast • Daily afternoon tea or coffee • Return airport transfers • 1 x 2-hour massage • 1 x cooking class (lunch) • Butler service on arrival • 10% discount room service • Personalized check in and out • Seasonal tropical fresh fruit arrangement upon arrival • Complimentary coffee and tea in villa • Shuttle service within Seminyak square and Seminyak based on schedule^ • Unlimited WiFi in villa and lobby *Aitutaki Lagoon Private Island Resort: valid for low season 1 Nov – 19 Dec 18 and 11 Jan – 31 Mar 19. Crusoe’s Retreat: valid until 31 Mar 20 (from 1 Feb 19 the resort will be exclusively adults only, 16 years or older). Ziva: valid until 20 Dec 19. Carnival Legend: limited time sale valid until sold out . Other room categories available. #Choice of alternative dining at extra charge. ^Subject to availability. Full T&C at unionshopper.ubookdirect.com 4 | THE LAMP OCTOBER 2018

Crusoe’s Retreat – Coral Coast, Fiji Fiji’s best kept secret. A two hour drive from Nadi but a world away. Relax on Crusoe’s sandy beach, enjoy a full array of complimentary activities, visit a traditional Fijian village, indulge in a relaxing massage at Coco’s Spa, and enjoy a tropical cocktail while witnessing a breathtaking Fijian Sunset.

Sea view Bungalow – 5 nights $440* (2 ADULTS)

• Tropical buffet breakfast • Daily Fiji cultural activities • Complimentary resort activities including snorkel gear, sea kayaking, beach volleyball and village tour. Bonus for stays from 1 Oct 18 – 31 Mar 19: RECEIVE ONE FREE 30 MINUTE MASSAGE in Coco’s Spa per adult.

Carnival Legend: 12 Day New Caledonia, Fiji & Vanuatu DEPART SYDNEY 1 NOV 2018

Cruise the pristine blue seas of the South Pacific where sunshine and smiles meet.

FLASH SALE – Inside Twin Room 12 nights $899pp* (2 ADULTS) • All main meals on-board 24-hours • Sit-down or anytime dining# • Use of ship facilities: indoor and outdoor entertainment, live music and/or shows, movies, activities, kids to teen programs (2-17 yrs) • Ship-shore-ship transfers • Gratuities when on Australia-based ship.

Can’t find what you’re looking for? Contact the Member Concierge desk to discuss the world on sale. To book email bookings@ubookdirect.com.au or call 1300 959 550. For all other packages, head to unionshopper.ubookdirect.com

EDITORIAL

Brett

Holmes GENERAL SECRETARY

Persistance pays The state of the aged care sector is a national disgrace and our arguments for change are beginning to gain traction.

Aged care nurses have been campaigning for years to change the abysmal state of our aged care system and their persistence has finally been rewarded with a number of significant developments. Firstly, the media has finally listened to their concerns and cast a spotlight on the dangerously low staffing levels, the poor practices and the profiteering that is rife in the sector (see pp 8-9). Last month, Four Corners broadcast a very harrowing account that exposed a major crisis in our aged care homes. The Daily Telegraph also conducted a comprehensive investigation into aged care which revealed a shocking abuse of taxpayers’ money by some major aged care providers. This has had political consequences with Prime Minister Scott Morrison calling a Royal Commission into the state of aged care. The Four Corners report was very distressing. It was hard to watch these elderly, vulnerable members of our community suffer due to inadequate care, without proper food and without access to the most basic of needs like continence pads. The brave family members and staff that spoke out deserve our admiration and support. For many nurses these revelations were not news. Aged care nurses, the NSWNMA and the ANMF have worked tirelessly for many years to bring these conditions to light. We have commissioned research, lobbied politicians, held rallies, run advertising campaigns, taken to social media and talked to the community in a myriad different ways about the terrible state of aged care. It is a relief that finally these efforts are beginning to stir a response.

THE PUBLIC RESPONDS WITH FURY And the response by the community to the Four Corners report was telling. The Four Corners Facebook page was awash with caustic comments about aged care providers and their weak explanations for the poor state of care in their homes. More than 36,000 people voted in an online poll in the first three days after the program went to air. Ninety

‘ Society has a moral obligation to stop this neglect and abuse of the elderly. ’ seven per cent said minimum staff to resident ratios should be enforced in aged care facilities. This is highly encouraging. The public instinctively understands that the lack of staff is central to the problem and minimum staff-to-resident ratios are an important part of the solution. The response of the federal government was also telling. Even before Four Corners had gone to air the government preempted the fall out by calling a Royal Commission. The crisis in aged care certainly warrants a Royal Commission. Society has a moral obligation to stop this neglect and abuse of the elderly. But there have been decades of reports and inquiries outlining the problems and issues in aged care and any findings of a Commission and the federal government response must go beyond more talk to action. Addressing the glaring staffing problems remains the overriding challenge. Aged care providers receive billions of dollars in taxpayer-funded subsidies yet there is no law to guarantee that public funding goes directly to the provision of care. The NSWNMA and the ANMF have championed a safe staffing law that guarantees safe nurse-to-resident ratios in our aged care facilities. We will remain resolute pursuing that goal. There is still some way to go to achieve our goals so we must keep up our campaign. The tenacity shown by our aged care members has gotten us this far and we must keep it up. It is a lesson for us all, in all of our campaigns. Making substantive change in health and aged care always seems impossible until it is done. But if we show tenacity, resolve and courage we know there is a public out there that supports us and governments that fear that public support. ■ THE LAMP OCTOBER 2018 | 5

COMPETITION

YOUR LETTERS

Have your

REL A X A N D UNW I ND IN THE LU X UR I O US

Say

LETTER OF THE MONTH A message to Liberal/National Coalition politicians

You will be surrounded by elegance from the moment you walk through the doors of the Rydges Sydney Central. Conveniently located in Surry Hills, just minutes from Sydney’s Darling Harbour, China Town, Australian Museum and the Royal Botanic Gardens, you will be in the perfect location to explore the city of Sydney. Or, should you choose to do nothing at all, you can enjoy lounging poolside or relaxing in the sauna. The hotel bar, Sydney Brewery Surry Hills, is now open. With its focus on craft beer and good food, all in a relaxed atmosphere, it’s the perfect location to enjoy your day, night or both!

WIN!

The Lamp is offering NSWNMA members the chance to win two night’s accommodation in an Executive King Room with breakfast daily and complimentary parking. Package valued at over $700. To enter the competition, simply provide your name, address and membership number and email your entry with the subject: Rydges Sydney Central to lamp@nswnma.asn.au *Conditions apply. Rooms subject to availability. Prize must be redeemed by 30 June 2019 (not valid during long weekends). The voucher is non-exchangeable, non-transferable and not redeemable for cash. Voucher must be presented on arrival. Competition entries from NSWNMA members only and limited to one entry per member. Competition opens 1 October 2018 and closes 31 October 2018.LAMP The prize is drawn on 1 November 2018. If a redraw is required for an unclaimed 6 | THE OCTOBER 2018 prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/18/0295

Bear witness to the heartless policy you have created – the insidious Aged Care Act 1997 where you made the care of our vulnerable older Australians into a commodity sold on the sharemarket. Your party’s favorite buzzwords of “deregulation”, “cut red tape”, “ increase business flexibility” have catastrophic consequences to human lives! You have upended our decent society. Nurses and personal care workers are struggling as well and it is getting worst! All you talk about is “the economy!” ... and jobs! Well, the jobs of nurses are just about gone in most nursing homes. We have been replaced by unregistered care workers in most places. Some do not even have RNs at night! Also, even the name “Nursing Homes” is gone. They are now called residential aged care facilities! We call on our community – please see your Members of Parliament and ask them to sign the pledge to mandate ratios in Aged Care. If not, why not? Don’t they have mothers and fathers, too? Jocelyn Hofman

Babies need to be counted Whilst NSW Labor’s proposal for shift-by-shift ratios is great news – I am interested to find out exactly what is being promised to those of us who work in the state’s maternity wards where babies are yet to be configured in the numbers ratio. When a patient’s call buzzer is activated, it needs to be answered as quickly as possible. Because choking, sepsis, acute pain, haemorrhage and other life-threatening situations can and do occur at any given moment – and the midwife, regardless of her allocated patient load, must also manage this. If ratios are recognised as being important in ED and on surgical, medical, renal and paediatric wards, then babies need to be counted as individual patients, wherever they are within the hospital setting. The workload expected of us is unreasonable, unsafe and far from user-friendly. This is a life or death situation. Action is needed now – we don’t have another minute to waste. Arinna Earley

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 An open letter to Ken Wyatt and Brad Hazzard Dear Mr Ken Wyatt (Federal Minister for Aged Care) and Mr Brad Hazzard (NSW Minister for Health), One of the key clinical focuses in NSW Health hospitals is that of patient-centred care, also targeted by the Clinical Excellence Commission. Patient-centred care encompasses an individual’s whole health and wellbeing, with health being defined by the World Health Organization as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. In such context, I write to express my grave concerns over the ongoing care, or lack thereof, surrounding our elderly in the aged care sector. My first paid nursing job was as an assistant in nursing (AiN) in an aged care facility. We had many residents with dementia, chronic illnesses and physical incapacity who needed constant 24/7 care. There are currently no mandatory nurse-to-resident ratios in the aged care sector. Private providers of residential care are at liberty to decide the skill mix of their nursing staff and the accompanying

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.

ratio. The reality is two nurses and one carer to 300 residents on a night shift (RN comment on Ratios for Aged Care Campaign 2018: www. morestaffforagedcare.com.au). As nurses, we want to do our best and deliver quality care to each and every life that we are privileged to care for, yet there is simply not enough time without adequate staffing and skill mix competency. I now work as a registered nurse (RN) in both the acute hospital setting and in private practice. I view it as my ongoing duty of care to advocate for the benefit of my patients. In the acute hospital setting, we are receiving patients with ever-increasing health comorbidities and higher acuity needs. What often stands out to my colleagues and me is the “state” that an elderly patient is admitted in. How can it be acceptable that an elderly resident from a supposed high-level care facility is admitted in a permanent foetal position, with bilateral lower limb atrophy, pressure injuries on their sacrum and hips, progressive weight loss, fungal growth in their mouth, and the only sound now uttering from them a whimper of the greatest fear?

How can an elderly individual be left to deteriorate when such physical and emotional injuries were all preventable if there had been better ratio and skill mix of staffing? This letter is therefore an impassioned plea; a heartfelt plea for nurse to resident ratios in the aged care sector to be endorsed as law. Without it, the aged care sector continues to leave its residents in a state of neglect and abandonment. Many of these residents have proudly and selflessly served our country in wars. They have established communities, raised families, and built our society to what it is today. They have loved and deserve to be loved. It is often said that empathy is a nurse’s greatest gift to their patient. It is through empathy’s eyes that we are hurting with our elderly. Their every pain is our pain, and their every discomfort is ours too. Our elderly deserve to live the rest of their lives in dignity and with the utmost respect. They need more nurses to be by their bedside in the last home that they will know. Only with mandatory nurse-to-patient ratios can we deliver patientcentred care. RN (abridged and name withheld)

Letter of the month

NOTICE TO MEMBERS The Australian Electoral Commission has conducted the Election for the Australian Nursing and Midwifery Federation, New South Wales Branch Council (ANMF NSW branch). A post election report is available on the website www.nswnma.asn.au along with ANMF Branch response in accordance with FWA (ROC) S198 Reg 141.

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

Union Shopper Letter of the Month.indd 1

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

COVER STORY

ustralians have reacted with horror and anger to media exposure of poor treatment of the elderly in understaffed nursing homes. A Four Corners television special last month was the result of the ABC’s biggest crowd sourced investigation. More than 4,000 people – including 1300 current and former aged care staff – responded to a request to share their experiences.

‘ Every day that the government fails to act on dangerous understaffing in nursing homes is another day that vulnerable residents are still at risk.’

Presenter Sarah Ferguson said the program heard many “every day stories of neglect and inattention, poor quality food, lack of personal care, boredom and heartbreaking loneliness”.

ONE RN AND ONE EN TO 72 RESIDENTS

There were disturbing accounts of overworked staff and neglected residents.

Enrolled nurse Katrina Legzdins said she and a registered nurse were in charge of 72 residents.

Hidden camera footage revealed an elderly woman routinely left in a soiled bed for hours on end.

“There’s no ratio, I guess, for number of staff to residents, so they can just get away with bare bones, bare minimum.”

Staff condemned the widespread practice of rationing continence pads to three-a-day – and keeping them under lock and key in order to save money. Personal care assistant (PCA) Tanya Bosch described aged care as “very confronting and distressing work. It was really frustrating to know that on a daily basis, you were failing to meet the needs of some of the most vulnerable people in our society”. PCA Melanie Whiteley said she was speaking to Four Corners “because the truth about aged care needs to come out, so it can change”. “I think families think that they’re getting their loved one looked after. I think that they think that they’re paying for that to happen, and in reality, it’s just not. It can’t happen. There’s not enough staff,” she said. Facility manager and clinical consultant Tony Northcote said: “I believe our elderly deserve to have better care. We’re going the other way at the moment, we’re reducing the number of skilled staff and increasing the number of unskilled carers.” 8 | THE LAMP OCTOBER 2018

— ANMF Federal Secretary Annie Butler

Also interviewed was Sean Rooney, CEO of Leading Age Services Australia, the peak body representing private and not-for-profit nursing homes. He rejected staffing ratios as "a very blunt instrument" and defended nursing homes spending just $6 a day per resident on food and giving staff five to six minutes on average to get somebody out of bed, toileted, showered and dressed. Four Corners’ Facebook page drew more than 600 comments in the three days following the program. Many were scornful of Rooney’s suggestion that $6 per day was enough to feed people with “a low nutrition requirement”. A typical comment read: “Angry and extreme sadness is what I’m feeling after watching this. ‘Older people have a lower nutritional requirement.’ Well, Shaun Rooney let’s see if YOU can stomach some of the muck that is being served up.”

COVER STORY

‘I wouldn’t put a sick dog in some of these places’

FOUR CORNERS: PETA BORMANN

CONCERNED FAMILY AND STAFF TELL 4 CORNERS ABOUT APPALLING CONDITIONS AND PRACTICES IN AGED CARE.

Another wrote: “To say that the elderly don’t require nutritious food is just beyond ridiculous. These residents are people. Food should be a pleasure and a joy for them.” More than 36,600 viewers voted in a Four Corners online poll in the same period. Ninetyseven per cent said minimum staff to resident ratios should be enforced in aged care facilities. A day before the program went to air, Prime Minister Scott Morrison announced a Royal Commission into the sector. However, a Royal Commission will do nothing to fix the crisis in aged care unless the government introduces mandated staffing ratios urgently, the Australian Nursing and Midwifery Federation (ANMF) said. “Every day that the government fails to act on dangerous understaffing in nursing homes is another day that vulnerable residents are still at risk,” ANMF Federal Secretary Annie Butler said. “While the current aged care crisis clearly warrants a Royal Commission, we know what the problems are. We have two decades of reports and inquiries outlining the problems. It’s time to take action. Let’s start by introducing a safe staffing law.” ■

Watch the Four Corners special on aged care: http://www.abc.net.au/4corners/ who-cares/10258290

Aged care registered nurse Maree Wiseman hopes media exposure and the forthcoming Royal Commission will finally force the government to act to improve staffing of nursing homes. “It was horrifying to see how those residents were being treated – I wouldn’t put a sick dog in some of these places,” she said. “Congratulations to Four Corners and the staff and families who had the courage to speak out.” Maree works at a community-owned nursing home in northern NSW. She says most staff members watched the program and many are worried it will contribute to a public backlash against nursing home employees. “The union needs to continue its campaigning to make the public aware that the fault lies with owners and administrators who fail to provide enough staff. “We all know more staff are needed to achieve a better working environment that allows us to provide high quality care.” Maree hopes the Royal Commission will recommend mandatory staffing ratios and employment of more registered nurses. “There have been plenty of inquiries and the government has done nothing so far – maybe the Royal Commission will make a difference.” Unusually, her facility currently has a few empty beds. That has given carers more time to sit and talk with residents including some who never get family visits. “A couple of the team have even had time to take residents for a walk. That’s something that should happen every day.”

THE LAMP OCTOBER 2018 | 9

COVER STORY

Aged care giants under fire A Senate inquiry has shone a light on the murky financial and tax practices of Australia’s biggest for-profit aged care providers.

“

It raises questions about what they have to hide,” said the inquiry’s acting chair, NSW Labor Senator Jenny McAllister.

“Labor Senators are keen to hear from two of Australia’s largest for-profit aged care providers. We’ll be looking at what procedural options we have to make sure that happens.” The Tax Justice Network (TJN) said Bupa, which operates in several countries, appeared to be engaged in “a global pattern of aggressive tax avoidance”. TJN researcher Jason Ward said Bupa’s businesses in Australia, particularly aged care, had benefited heavily from government funding. Also, it appeared that Bupa had structured its business in ways to minimise corporate tax obligations. “Bupa’s sale of interests in its Australian partnership generated profits in the UK of over $568 million in 2016 and left an Australian entity with billions in debt,” Ward’s submission said. “The Bupa case provides a clear example of the need for government reforms to mandate greater transparency and public accountability for government funding given to for-profit companies.”

‘Australians rightly expect that this money will be used to provide care for vulnerable and older members of our community, not hidden using tricky accounting practices.’ — Senator Jenny McAllister

However, Jason Ward described the loan with its very high 15 per cent interest rate as a way for Allity’s investors “to extract a profit that is not subject to taxation in Australia”. “It is hard to imagine that this shareholder loan at 15 per cent was cheaper than other funding options or predominately for commercial purposes and not tax minimisation,” Ward said. “There is no doubt that these interest charges significantly reduced taxable income.”

Senator McAllister said tax officials told the inquiry they had concerns about tax arrangements used by some companies in the aged care sector.

Leading finance journalist Michael West said the 15 per cent interest rate on the Allity loan was seven times the prevailing cash rate.

“Senators heard that one of the sector’s largest operators – Opal – paid their owners more than $15 million in dividends in a year that their operating company paid no tax,” she said.

“One of the main tricks of the trade in avoiding tax is getting loans from a related party offshore and paying high interest rates on it to get the money out of the country in lieu of paying tax,” he wrote.

“Another large operator – Allity – were paying close to 15 per cent interest on a loan to a related party, an arrangement tax officials said could rarely if ever be described as arm’s length.

Ward said Regis appeared to pay a higher share of taxes than other for-profit companies.

“For-profit aged care providers depend on government subsidies. Australians rightly expect that this money will be used to provide care for vulnerable and older members of our community, not hidden using tricky accounting practices.” Allity told the inquiry the claim that the company engaged in aggressive tax planning and tax avoidance was “false and unsubstantiated”. 10 | THE LAMP OCTOBER 2018

However, this may have been motivated by the $33 million in fully-franked dividends (dividends on which the company has already paid tax) received by the company’s two founders and largest shareholders, he added. In addition, Regis’s top six executives and five nonexecutive directors received $5.4 million in total salaries and fees in 2017. This was equivalent to 7.4 per cent of Regis’s total net profit after tax. ■

COVER STORY

Care suffers in understaffed homes Allity, Bupa and Opal facilities were understaffed to the detriment of patient care, NSWNMA members reported in a survey conducted by the union and presented to the Senate inquiry. The NSWNMA surveyed its Allity members on staffing levels in late 2017. Only 14.9 per cent said staffing was always sufficient to enable quality care to residents, with over 28.7 per cent stating it was never or rarely sufficient. The reasons for the inability to provide quality care were not enough nurses on the roster (according to 59.3 per cent of members) and sick leave absences not being replaced (57.1 per cent). Opal made company-wide changes to rosters in 2015. As a result, 74.7 per cent of staff surveyed said their workload had increased due to reduced numbers of nurses on duty and having to undertake additional duties. More than 70 per cent stated that the new roster had not resulted in improved resident care. BUPA introduced a new model of care in mid-2016. As a result, 75.2 per cent of staff surveyed said it had a negative impact on staffing/workloads at their facility. â&#x20AC;&#x153;An incredible 92 per cent stated that they have worked short-staffed in the last week with leave not being replaced and not enough staff rostered as the main reasons,â&#x20AC;? the NSWNMA submission said.

THE LAMP OCTOBER 2018 | 11

COVER STORY

Push to reveal staff ratios Community has the right to know staffing levels of publicly-funded aged care facilities, Senators told.

‘ These companies have the financial capacity to provide better care for their residents by employing more nurses and carers but are focusing on maximising profits.’ — Annie Butler

orcing aged care providers to publicly disclose their staffing levels would be “a wonderful first step” towards safe staffing, ANMF federal secretary Annie Butler told the Senate inquiry. Independent South Australian MP Rebekha Sharkie has introduced a bill into federal parliament that would require nursing homes to publish the numbers of nurses, carers and other staff they have rostered per number of residents. Annie said residents, families and the community have the right to know, given that the country’s top for-profit providers make big profits while getting more than $2 billion in taxpayer subsidies annually. She said if the bill became law it would at least give the public something to judge different facilities on. “While that reporting would be excellent, there’s still no standard being set. We would still argue for the setting of a standard.” The ANMF is campaigning for laws to make providers employ an adequate number of staff with the right mix of skills. Annie told the inquiry the agedcare sector was special because 70 per cent of its funding came directly 12 | THE LAMP OCTOBER 2018

from the taxpayer.

resident benefits.

“It’s not the same as Domino’s Pizza or a mining company.

Staff at Japara facilities were told they could no longer check residents at night due to so-called “privacy reasons”.

“The unique circumstance here is that they’re not just companies trying to run a business and make money; they’re meant to be providing a service to a large proportion of our population. “These companies have the financial capacity to provide better care for their residents by employing more nurses and carers but are focusing on maximising profits and shareholders first.”

CUTTING STAFF IS A COMMON STRATEGY She gave several examples of companies dependent on taxpayer funds that had shed staff and cut

“They can no longer check whether they are comfortable, whether they have fallen or anything like that,” Annie said. “So, what they might do is use mats that you can put on a bed that have an alarm – if they are working properly – that will tell you whether a resident has fallen out of bed. The problem is that the resident has already fallen out of bed. “We think, and we started to hear from members, that the strategy behind that is to cut staffing at night and remove registered nurses at night.”

COVER STORY

In Victoria, Bupa had cut nursing hours to cover a staff pay rise. In Tasmania, after Regis took over Presbyterian Aged Care, staff reported that employee numbers were cut, staff on sick leave were not replaced and meal sizes were halved for residents. Meanwhile, the two nonexecutive directors of Regis received $16 million each in the last financial year, Annie told the inquiry. These “excessive” sums were a “shocking” contrast to the $45,000 to $52,000 annual salary for a care worker. “If that money were first going into care provision instead of maximising profits and going to the different owners of the companies, we could see increased staff and, eventually, increased wages for those staff as some basic recognition of the job they’re trying to do. “When you dig in to see how money through Bupa goes back offshore, how money through Opal goes back to Singapore, and where staff hours are being cut and residents are being left uncared for, that’s our concern.” ■

Estia endorses more openness Estia Health has backed the ANMF’s call for greater transparency and accountability for companies that receive large amounts of government funding. Estia is one of Australia’s biggest for-profit nursing home companies with 68 homes and 7000 staff in four states including NSW. Estia’s chief executive officer and managing director, Norah Barlow, told the Senate inquiry the company “saw merit” in recommendations by the ANMF and Tax Justice Network. These would require companies that receive more than $10 million in Commonwealth funds in a year to file more detailed financial statements with the Australian Securities and Investments Commission (ASIC). They would also require full disclosure of related-party transactions which reduce tax liability. Ms Barlow told the inquiry: “We agree that accounts should be filed with ASIC and that the ability to have reduced disclosure for organisations receiving public funding should be removed.” “We also agree that related-party transactions must be fully disclosed. “It is clear that the revenues Estia receives from the government are directed to the provision of residential aged care. That is what we do. It is not so clear how others, including the very large and the small not-for-profit providers, utilise the subsidies they receive.” Nurses reported increased workloads following Estia’s 2015 purchase of NSW aged care facilities from Hutchinson Health and Kennedy Health Care. A survey of NSWNMA members at those facilities showed that workloads increased for most nurses following the acquisitions, the union said in a submission to the inquiry. 56.3 per cent of staff surveyed said their workload had increased, with 38.8 per cent giving fewer nurses as the reason. 46.3 per cent blamed additional duties and 19 per cent said shorter shifts were the cause. ■

THE LAMP OCTOBER 2018 | 13

COVER STORY

Veteran aged care campaigner bows out For the past 16 years, the NSWNMA state council has benefited from Lucille McKenna’s strong advocacy for the aged care sector.

ucille McKenna steps down from state council – the union’s highest administrative body – this month and will soon retire from the workforce after 58 years as a nurse. Lucille trained at Concord Repatriation Hospital and worked as a district nurse for Ashfield Council. After a further stint at Concord she embarked on a 50-year career in aged care including continuous service as a director of nursing since 1979. She has played a prominent part in vital aged care campaigns run by the NSWNMA and its federal body, the Australian Nursing and Midwifery Federation. They include the RN 24/7 campaign to convince the NSW government to keep the legal requirement that a registered nurse be on duty in nursing homes at all times. “Our level of engagement with politicians has been high and I note the government still hasn’t removed the RN 24/7 requirement from the Act, which it said it would do.” “I have lost count of the number 14 | THE LAMP OCTOBER 2018

‘ The Howard government legislation opened the door for big companies to buy nursing homes and float them on the stock exchange.’ — Lucille McKenna of inquiries I’ve given evidence to over the years. They expose problems but don’t always fix them. “I gave evidence to a Productivity Commission inquiry and talked about the dodg y trainers of Certificate 3 care workers but nothing changed. There are still people offering to provide training over two weekends.” Government aged care reforms have amounted to little more than bureaucratic reorganisation in recent years, she says. “They change the deckchairs all the time but conditions inside nursing homes will never improve until they are required to employ enough staff.” The Hawke Labor government reforms of the 1980s gave aged care

its “golden years”, Lucille says. “ Those reforms effectively gave us mandated staffing hours under the care aggregated module (CAM) system. “Residents were assigned a level of funding to be spent exclusively on direct nursing and personal care. A facility was funded for the total number of hours needed by all residents and managers had the freedom to spread the hours across whatever staff were needed. “If you didn’t use the money on direct care staff – RNs, AiNs, activities staff, physios and the like – you had to pay it back. “It was more generous than the current system and gave us the ability to employ more RNs. “I was running 84-bed Berkeley

COVER STORY

‘ 'They change the deckchairs all the time but conditions inside nursing homes will never improve until they are required to employ enough staff.’ — Lucille McKenna

Village nursing home on the central coast at that time. We had a DON, deputy DON, a full time educator, three RNs on the floor on morning shift plus a part-time RN in pharmacy. “Now in a facility of that size you’ll probably have someone called a care manager and just one or two RNs. “The CAM system couldn’t be undermined because staffing records were audited by the Department of Health. “People actually went to jail for fudging the books – for example, by using CAM money to pay builders instead of nurses.” Lucille says aged care has been on a “downhill slide” ever since the Howard Liberal government’s Aged Care Act of 1997. “The Howard legislation removed the requirement for a provider to be a person rather than a corporation. It opened the door for big companies to buy nursing homes and float them on the stock exchange. “Until the Howard period I could always speak to the owner even

if they owned a group of homes. Howard’s changes put a distance between the financial controllers of the business and the operators of the nursing home.

Lucille says the NSWNM A le a der sh ip h a s s t r ive d to improve union governance since the early 2000s.

“They reduced official oversight of the management of facilities and allowed facilities to replace RNs with personal care staff.

“The state council understands its responsibilities better, we are better educated and more informed and our union’s governance is very good.

“We now have a genera l requirement to provide adequate staff but no requirement to spend allocated money on staffing.”

“The union is financially sound and membership has risen from around 39,000 when I came onto council to more than 66,000 now.

Lucille says her most important task as a DON was to build a relationship of trust with residents, families and staff.

“Our campaigns have mostly been effective; we engage with the community more now and we have made sure that politicians are better informed about the issues.

“Engaging with all stakeholders and always being available to talk through issues with them is the key to running a good aged care facility.

“We started the Nurse Power fund which gives us the money to do effective campaigning.”

“The average nursing home stay is two years and families need to feel confident and know that their loved one is getting the care they need.

Luc i l le’s i nvolvement i n community life has not been limited to the NSWNMA and the battle for better aged care.

“I always spent a lot of time with families to make sure they felt that the staff and I would look after their family member and that I would make sure it all worked for them.”

She served as Mayor of Ashfield from 2013-16 and remains a councillor on the recently created Inner West Council. ■ THE LAMP OCTOBER 2018 | 15

RATIOS

Ratios debated in NSW parliament The Berejiklian Liberal government and the NSW Labor opposition have drastically different positions on nurse-to-patient ratios.

everal hundred nurses, midwives and supporters gathered outside Parliament House in Macquarie St on 18 September to push their claims for better ratios. The rally preceded a debate on ratios during Question Time inside the parliament that played out before a packed gallery. NSWNMA General Secretary Brett Holmes told the rally that politicians had to heed the community’s desire for a decent public health system. “For every politician in this place the delivery of care in their public hospitals should be a high priority. Your constituents will never criticise you if you have done all of the right things in trying to deliver better care in our public health system.

‘ Your constituents will never criticise you if you have done all of the right things in trying to deliver better care in our public health system. But they will castigate you or destroy you if you fail them.’ — Brett Holmes worked 52 hours of overtime in the previous weeks on top of her ordinary hours.

“But they will castigate you or destroy you if you fail them. They depend on our public health system and they have a right to expect a decent system.”

“You’ve never been as overworked as much as you are now. I want every patient in this state to know that hospitals will be properly staffed.”

Brett acknowledged the support of many in the parliament for better nurse-to-patient ratios.

Following the rally Labor MPs signed pledges to support safe nurse-to-patient ratios.

“(Labor leader) Luke Foley has stepped up to the mark and made very good commitments to us.

During Question Time the premier, Gladys Berejiklian, made clear her rejection of ratios, ironically by quoting a former Labor health minister.

“I want to acknowledge that we also have support from the Greens and the Shooters, Fishers and Farmers Party and some cross benchers. That is important support as well.”

“SHOCKING” TALES OF UNDERSTAFFING Speaking at the rally Labor leader Luke Foley restated his support for better ratios. “A government led by me will introduce shift by shift nurse-to-patient ratios in the state’s hospitals. “I visited 10 country hospitals this month and the tales I heard were frankly shocking. At Cooma Hospital one nurse told me she was caring for 11 patients all by herself. “I stood at Wagga Hospital and heard how a nurse had 16 | THE LAMP OCTOBER 2018

“I refer to Carmel Tebutt in 2010. She said, ‘I have made it very clear the government has concerns with the blunt nature of a nurse-to-patient ratios in that it does not provide flexibility’,” she said. The Premier failed to acknowledge that Carmel Tebbutt moved away from this position and agreed to the introduction of the first wave of ratios before leaving office in 2011. She also failed to acknowledge that the incoming Liberal government led by Barry O’Farrell agreed to honour the agreement to introduce one-to-four ratios into surgical and medical wards in our major hospitals as well as in a number of other wards and hospitals. ■

RATIOS

It’s the turn of country hospitals Sylvia Moon, NSWNMA branch president at Wagga Wagga Base Hospital welcomed the commitment by Luke Foley to better ratios for country hospitals. “I was pretty excited about Labor’s announcement to support ratios. I feel like they are really supporting us. It would be great for our area and our hospital, for our staff and our patients. “We were really happy when ratios were won in the city. We (in the country) definitely helped out there and I just think it is now our time. It’s the whole state’s time to get ratios. “I was happy the issue of ratios was brought into parliament in Question Time. Premier Gladys Berejiklian says there are a heap of nurses but I don’t know where these nurses are because they are not in our hospital. “We’re a heap of nurses down and we are opening new extra beds that weren’t originally funded and we have to staff them which puts a lot of pressure on us. We’re getting multiple texts from six in the morning asking us to work overtime. “Lucky for her and her government she’s got great nursing staff committed to the hospital, committed to the patients, committed to the town.”

‘ We’re a heap of nurses down and we are opening new extra beds that weren’t originally funded and we have to staff them which puts a lot of pressure on us.’

Where are all these nurses and midwives Gladys? Tracey Coyte, an EN from Cooma Hospital who attended the rally outside parliament, says the disparity in ratios between the country and city hospitals is “absolutely disgusting”. “The area we encompass goes all the way to Canberra – a hundred kilometres away and then beyond Delegate and Bombala.” The hospitals in Delegate and Bombala have been converted into Multi Purpose Services leading to an increase in the workload at Cooma. Patient demand also spikes drastically during the ski season, she says. “At the end of the day if someone is injured in a ski accident or a mountain biking accident in the summer months they come to Cooma hospital. “I can’t see why we can’t have equal if not better nurseto-patient ratios than the bigger hospitals in the city which might have another hospital in the next suburb.” Tracey says she has been disappointed with the position of her local MP John Barilaro on ratios and also to Gladys Berejiklian’s reaction during Question Time. “She’s willing to say – and she said the same thing to me when I met her in Cooma – ‘Yes Tracey, I understand. My mother was a nurse. That’s why our government has put on a thousand extra nurses’. “I said: ‘Gladys, not in Cooma’.”

‘ I can’t see why we can’t have equal if not better nurse-to-patient ratios than the bigger hospitals in the city.’ THE LAMP OCTOBER 2018 | 17

RATIOS

Rallies for ratios Nurses and midwives in a number of our large Sydney hospitals have been taking our campaign for better nurse-to-patient ratios to their local communities. FOLEY GETS APPLAUSE – AND A REMINDER Labor leader Luke Foley’s promise to improve nurse-to-patient ratios got warm applause at the NSWNMA’s Auburn Hospital rally – along with a reminder that maternity units need action too. The Labor leader spoke at the rally outside the hospital, which is in his electorate. NSWNMA branch delegate and president Kelly Wright, a midwife in the hospital's birth unit, also spoke. She thanked Mr Foley for his commitment but said he should include midwifery in his ratios plan. She said babies born in hospital are not counted as patients and therefore not counted in a midwife’s patient load. At the same time, an increasing number of women have complicated pregnancies with the result that workloads are becoming heavier and unmanageable. “I’m not sure he is aware of the staffing situation in maternity units so it is our job to tell him all about it,” she said. This month, Auburn Hospital members will hold a community rally to educate the public about the need for ratios. “We are getting flyers made up and talking to leaders who have influence in the community, with the aim of getting them to support the rally,” she said. “ T he ca mpa ig n is get t ing more people interested in the staffing issue. We are definitely building momentum.” LOCAL MP AND OPPOSITION LEADER LUKE FOLEY ADDRESSES NURSES AT AUBURN HOSPITAL.

SUPPORT FOR WESTMEAD NURSES AND MIDWIVES ALP CANDIDATE FOR SEVEN HILLS, DURGA OWEN, AND JULIA FINN, MP FOR GRANVILLE, ADDRESS NSWNMA MEMBERS AT WESTMEAD HOSPITAL.

18 | THE LAMP OCTOBER 2018

RATIOS

MPs BACK RATIOS CAMPAIGN AT BLACKTOWN RALLY Four NSW Labor MPs and candidates pledged to support the NSWNMA ratios campaign at a NSWNMA rally outside Blacktown Hospital. Shadow Health Minister Walt Secord, Blacktown MP Stephen Bali, Prospect MP Hugh McDermott and ALP candidate for Seven Hills Durga Owen all spoke at the rally and signed campaign pledge cards. Christine Boxsell, president of the Blacktown branch of the NSWNMA, said the local politicians spoke about their close personal interest in the hospital. “Durga Owen had her babies at Blacktown and Stephen Bali had a tear in his eye when he spoke about the wonderful care his dying mother received at the hospital. It was nice for the nurses to hear that,” she said.

SHADOW HEALTH MINISTER WALT SECORD, BLACKTOWN MP STEPHEN BALI, PROSPECT MP HUGH MCDERMOTT AND ALP CANDIDATE FOR SEVEN HILLS DURGA OWEN STOOD TOGETHER WITH NSWNMA MEMBERS AT BLACKTOWN HOSPITAL.

About 50 nurses and midwives from all areas of the hospital attended the rally at the end of morning shift. Christine told the rally that “the community deserves the best care we can give them – and the best care they can get will come in a hospital that benefits from nurse-to-patient ratios.” She said the branch was planning a follow-up community rally to get the public more involved in the issue. Branch delegate Maureen Buckley said she heard the same staffing stories in all the wards: “Poor skill mix, not enough time, terrible stories about not being able to sit with a dying patient: that is not what you went into your nursing career for.” Opposition leader Luke Foley has promised to introduce a new ratios system including one nurse to every four patients on morning and afternoon shift and one to seven on night shift in medical and surgical wards – along with ratios in emergency departments and paediatric wards. Foley has also promised if he wins in the March election, an incoming Labor government will apply ratios to all B and C group hospitals, giving them the same staffing as large tertiary referral hospitals in the city.

THE LAMP OCTOBER 2018 | 19

RATIOS

Talking to the community

UNDERFUNDED

The Association has taken to TV, radio and social media to get our message to the public about the importance of shift-by-shift nurse-to-patient ratios.

UNDERSTAFFED

UNSAFE

IN CHILDRENâ&#x20AC;&#x2122;S WARDS AND EMERGENCY, SAFE NURSE-TO-PATIENT RATIOS DO NOT EXIST 20 | THE LAMP OCTOBER 2018

RATIOS

NEW SOUTH WALES NEEDS SAFE NURSE-TO-PATIENT RATIOS

Actions you can take to help The Association has set up a dedicated campaign area online (www.ratioslifeordeath.org.au) with resources nurses and midwives can use to continue the conversation about ratios with the community: Watch and share the ad View our latest TV ad on Facebook and share it with your friends, family and colleagues: https://www.facebook.com/nswnma/ videos/755149658192772/

ON EVERY WARD

Share your story If you or a family member has been a patient in a public hospital recently we want to hear your story. Tell us about your experience and why you think we need safe nurse-to-patient ratios. http://www.nswnma.asn.au/ratioslifeordeath/ tell-your-ratios-story/ Sign up for our campaign Visit our campaign site and sign up to join our fight for safe ratios: http://www.nswnma.asn.au/ratioslifeordeath/

ON EVERY SHIFT

Download and use our resources Here you will find information about ratios, supporting research, our claim at a glance and pamphlets and signs you can use to help spread our message: http://www.nswnma.asn.au/ ratioslifeordeath/ratios_resources/ Email your MP Get your MP to support ratios in our public health system: http://www.nswnma.asn.au/ ratioslifeordeath/emailmp/

IN EVERY HOSPITAL, CITY AND COUNTRY

SAFE NURSE-TOPATIENT RATIOS ITâ&#x20AC;&#x2122;S A MATTER OF LIFE OR DEATH THE LAMP OCTOBER 2018 | 21

CHANGE THE RULES

Staffing for fairness Campaigns for safe staffing of hospitals and nursing homes are part of the union movement’s overall campaign for a fairer society, says Australian Council of Trade Unions Secretary Sally McManus.

he ACTU’s “Change the Rules” campaign is aimed at giving working people a greater say over the rules that govern wages and working cond it ion s, ACT U Secret a r y Sally McManus told the NSWNMA annual conference. “We are talking about changing the rules that have led to record inequality, which is now at a 70-year high,” she said. “Within that broad campaign there are lots of battles within industries and across the whole of the workforce. The one that you are having for safe staffing is one of those. “Your safe staffing campaign for ratios is not just about your working conditions and you being run off your feet. It’s also about fairness for the whole of society.” Sally said the share of income held by the richest 1 per cent of the population had been steadily rising since neo-liberal approaches began to dominate economic policy in the 1980s. “The idea that the only people entitled to make the rules are those people at the top is an ideology called neoliberalism. “The idea is that you get rid of everything that stands in the way of the market and everything that stands in the way of companies returning the best profits they can to shareholders.” Sally said private sector wages were growing at 1.9 per cent per

22 | THE LAMP OCTOBER 2018

‘ Your safe staffing campaign for ratios is not just about your working conditions and you being run off your feet. It’s also about fairness for the whole of society.’ — Sally McManus

annum while prices were rising by 2.1 per cent.

decent pay rises and ensure we get our fair share.

“That means the wages of 85 per cent of working people are going backwards because they are not keeping up with the cost of living. At the same time, companies are earning big profits and the average pay increase for a CEO is 12 per cent.

“It is about organising, sticking together in our unions and putting enough pressure on decision makers until they agree.”

“We need the power to demand

Sally said the ACTU was seeking two major reforms to achieve a fairer society.

CHANGE THE RULES

ACTU SECRETARY SALLY McMANUS WITH BRETT HOLMES, JUDITH KIEJDA, CORAL LEVETT AND NSWNMA COUNCILLORS

“The first is to make sure everyone pays their fair share of tax so we have enough money to fund health and other basic services. “A total of 732 profitable companies don’t pay tax in our country. And 62 people who made more than $1 million last year paid no tax – not even the Medicare levy. “The second reform is to change your rights at work to make them stronger and ensure we have the bargaining power to win fair pay rises.” Changing the rules would also help deliver greater job security, she said. “We have a huge problem with job insecurity with less than half of Australian workers in full-time, permanent jobs. “Employers can decide whether someone remains a casual forever or remains on a fixed-term contract that gets renewed over and over again. “Employers use labour hire to take away job security and one in ten workers in Australia are here on temporary work visas.” She said the trade union movement had always fought for a fair go. “Remember our history and all the times people have had to fight, in tougher circumstances than we are in now, to bring about fairness. “It’s our historical responsibility to do the same. So be mighty, be unbreakable in our unions and let’s change the rules!” n

Deregulation drives down wages – IMF For the first time, International Monetary Fund research has acknowledged that policies that take rights away from working people have caused wages to fall. Workers are missing out on wage rises because the deregulation of job protections has gone too far, International Monetary Fund (IMF) research has found. In a study of 26 advanced economies including Australia, the IMF researchers found “a statistically significant, economically large and robust negative effect of deregulation on the labour share” of national income. Research recently released by the Australia Institute found the decline of the labour share of GDP since 1975 was costing working Australians $16,750 per year each, on average. ACTU Secretary Sally McManus said electricity prices, housing, childcare, transport and health insurance premiums were rising much faster than pay, which meant “working people need every cent of that $16,000 a year”. “Right now, big business has too much power and corporate bosses and wealthy shareholders are taking more for themselves and leaving us struggling,” she said. Australian economist Saul Eslake told the Sydney Morning Herald a number of influential mainstream economists around the world were now finding that job protection deregulation had gone too far and the evidence presented by IMF researchers was “difficult to ignore”. In August, workplace relations Professor Emeritus Joe Isaac AO, FASSA from University of Melbourne argued workers and unions need more power to address the growing problem of wages falling behind productivity growth. “Although a number of factors appear to have been involved in this development, an important explanation is also to be found in the change in the balance of power in favour of employers and against workers and unions,” he said. “As changes in industrial relations laws have contributed substantially to this imbalance, a return to the earlier laws may be necessary to restore the institutional mechanism for wages growth. n THE LAMP OCTOBER 2018 | 23

NSWNMA PROFESSIONAL DAY

Don’t stay silent over unsafe staffing Violating a professional standard could expose nurse and midwives to sanctions.

SWNMA General Secretary Brett Holmes has urged nurses and midwives faced with unsafe staffing not to put their patients and careers at risk by staying silent. Speaking at the union’s annual conference, Brett said every registered nurse, enrolled nurse and midwife was obliged to meet standards and codes set out in the Nursing and Midwifery Board of Australia’s professional practice framework. “Codes and standards require that nurses and midwives take action if they believe staffing levels and/ or skill mix is inadequate for them to be able to provide safe and professional care,” he said. “If you are registered as a nurse or midwife, you have a professional obligation to report your concerns if your ability to provide safe care is compromised by poor staffing levels or poor skill mix.” He said violating a professional standard could expose nurse and midwives to sanctions. “If there is an adverse event and inadequate staffing is identified as a contributing factor, and that a nurse or midwife was aware of this, you may be held accountable. “Don't risk your career or the safety of your patients by bowing to management pressure to perform your duties without question ... if you believe staffing levels and/or skill mix is inadequate.” He said codes of conduct for nurses and midwives state that nurses must document and report concerns if they believe the practice environment is compromising the health and safety of people receiving care. “I encourage every single member, in whatever role you work in, to read and be familiar with these documents and use them to guide your practice. “I understand that you are all doing your best in busy 24 | THE LAMP OCTOBER 2018

‘ If you are registered as a nurse or midwife, you have a professional obligation to report your concerns if your ability to provide safe care is compromised by poor staffing levels or poor skill mix.’ — Brett Holmes and stressful workplaces. I understand that sometimes you are just trying to get through a shift and are often staying back to complete handover and your notes. “I understand that finding time to report the issue to the after-hours manager or complete an incident report or send an email will often be an extra task that can feel like an additional burden on an already heavy workload. “Being an autonomous professional involves taking responsibility for identifying problems and risks and taking appropriate action to ameliorate those risks.”

PICK UP THE PHONE AND ASK THE UNION Brett said if management refused to cooperate then the best and safest way to solve problems was to join the union and take action as a collective through a local branch of the union. “If you don’t have a local branch, pick up the phone and ask the union for assistance,” he urged. Brett said it would take “strong and persistent campaigning” to force the current state government, private companies and aged care providers to deliver evidence-based staffing and skill mix.

NSWNMA PROFESSIONAL DAY

The state government had delivered several budget surpluses yet continued to ignore safe staffing. “Not only has it not delivered the critical second phase of ratios, which extends them fully to rural and regional hospitals or into specialty areas such as emergency departments, critical care units and paediatrics, but some areas are not even meeting their existing commitments.” He said understaffing in public hospitals had cut nursing hours below the numbers legally required under the public health system award. Data collected by the union showed at least 40,000 hours of nurse time had been withheld from patients in the last year in just 13 public hospitals amongst those checked so far. “We have not yet quantified the thousands of midwifery hours not delivered to mothers and babies, nor are we able to quantify the hours not delivered in wards and units outside the nursing hours wards. “As a result of the rules being broken and stacked against us we have very few choices. We must lobby government and all parties to change the rules.” n

Download Brett Holmes’ presentation http://www.nswnma.asn.au/ publications/reports

Professional standards apply to nurse managers too Nurse managers should resist pressure from above to force nurses and midwives to comply with unsafe practices, Brett Holmes told conference. He said nurses in management roles were also required to meet standards outlined in the Nursing and Midwifery Board of Australia’s professional practice framework. The NSWNMA was aware that some nurses and midwives who tried to raise concerns about staffing felt bullied by their managers. “I want to remind everyone here that bullying of nurses and midwives attempting to act in the public interest is contrary to professional standards,” he said. “I understand that many managers feel pressure from above to force nurses and midwives to comply with unsafe practices because that will cover up a problem and get higher management off their backs. “Repeatedly forcing compliance against the professional judgement of a nurse or midwife is likely to be perceived as bullying. “To anyone who finds themselves in such a situation, remember your obligations under the professional practice framework. You are autonomous professionals accountable for your own actions. You need to be able to justify your actions under the terms of the professional practice framework.”

THE LAMP OCTOBER 2018 | 25

NSWNMA PROFESSIONAL DAY

How 3D printing is changing health 3D printing has come a long way in recent years and offers the health sector exciting opportunities that are innovative and cost effective says Neil Sharwood.

surgeon practising removing a tumour on a 3D model to prepare for an operation and a pharmacist printing out tablets for a one-off prescription are just two ways 3D printing will transform health care in the near future. Neil Sharwood, the founder of the Australian 3D Manufacturing Association, spoke at the NSWNMA’s recent annual conference about the way converging technologies a re br ing ing about a not her industrial revolution, one where manufacturing is more customised and decentralised than ever. “We are in another industrial revolution. There are all these technologies coming at the same time, and where they intersect lots of exciting things are happening. “What we are seeing now is a big decentralisation. We are all carrying computing power in our pockets that decades ago only governments and multinational corporations had. “You don’t need a large factory any more for a lot of things. Smaller businesses and fabrication faci l it ie s a l low for sma l ler productions, greater customisation, less waste and reductions in shipping and handling.” Sharwood outlined many new 26 | THE LAMP OCTOBER 2018

NEIL SHARWOOD, FOUND OF THE AUSTRALIAN 3D MANUFACTURING ASSOCIATION

and developing medical applications for the emerging technolog y of 3D printing. When used to make prosthetics, for example, suppliers can not only “produce them for about a tenth of the cost”, the patient can be involved in the design process. “The patient can have their own taste and say ‘you know what, I wish

it was like this’.” 3D models of human parts are now being printed from medical scans and 3D imaging to allow for better operation planning. “Surgeons have even practised on the model with a tumour highlighted so they can sit around and plan procedure before the operation,” Sharwood said.

NSWNMA PROFESSIONAL DAY

‘ You can have an idea for an invention in the morning; have a prototype in the afternoon.’ “They can take them into the operating theatre and cut the model before they cut the patient. Surgeons have already found using 3D models has led to better outcomes.”

PRINTING THE HUMAN BODY The technology can also be used to print tablets customised to individual patients, he explained. “You can combine a couple of medicines at the same time to make a polypill that is tailor-made to the patient. And you can structure it to deliver medicine as it passes through the body at the right time to get the right results.” While 3D printing machines have been used to print houses and clothes for some time, the technology is now being turned to print human bodies to teach anatomy students. By doing away with the costs associated with embalming and licensing to use cadavers, a body can be “printed for a tenth of the cost that it costs to buy it,” according to Sharwood. “Teachers find people are more willing to pick up a printed model and play with it than they are [when given] a pickled part,” he added. “And imagine what it costs to run an operating theatre, as opposed to just students being together and using a model.” 3D printing machines can also be used to print biomaterials that can be used to repair body parts. The University of Wollongong is a leader in this field, Sharwood said, with scientists building new parts from living cells and using the technology to “regenerate and reconnect severed nerves”. This emerging technology, Sharwood said, is rapidly moving us into the new industrial era. “You can have an idea for an invention in the morning, have a prototype in the afternoon.” ■

Listen to the podcast You can listen to Neil Sharwood’s full presentation at: http://www.nswnma.asn.au/ podcast-neil-sharwood-distributedmanufacturing-applications-andimpact-for-the-health-sector/

AUSTRALIAN NURSING & MIDWIFERY FEDERATION FEDERAL OFFICE

Financial Report

The ANMF Federal Office Financial Report for the year ended 30 June 2018 is now available at www.anmf.org.au. Members without internet access may obtain a hard copy of the report by applying in writing to: Australian Nursing & Midwifery Federation Finance Officer Level 1, 365 Queen Street Melbourne VIC 3000

Australian Nursing and Midwifery Federation NSW Branch

FINANCIAL STATEMENTS & DISCLOSURES From 16 October 2018, the Australian Nursing and Midwifery Federation New South Wales Branch will make available to members the following reports and disclosures for the year ended 30 June 2018: • Audited Financial Statements • Officer & Related Party Disclosures They will be available on the Members Only page at online.nswnma.asn.au. Members without internet access may obtain a hard copy of the statements by applying in writing to: Brett Holmes, Branch Secretary ANMF NSW Branch 50 O’Dea Avenue, Waterloo NSW 2017 THE LAMP OCTOBER 2018 | 27

ANUM

CNS

NUM

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 it’s that reason why your family member members are eligible to join us too.

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-10/18

Join us on the Sydney Harbour night shift We know you deserve a reward. Book now and save up to 40%.

Cruise aboard the prestigious MV Sydney 2000 and discover the world’s most beautiful harbour. Enjoy 3-course à la carte dining & entertainment.

Exclusive Reward Save up to 40% Oct-Nov Captains Dinner $99pp Valid for NSW Nurses & Midwives’ Association Normally up to $165pp. Valid travel to 30 November 2018. Book online & use promocode L8UGL3A. T&C’s apply.

Call us 02 9206 1111 or visit captaincook.com.au 28 | THE LAMP OCTOBER 2018

OBITUARY

VA L E

Susan Gay Sides Registered nurse and midwife 14 September 1941 – 16 April 2018

he passing of Sue Sides in April, while visiting family in Malaysia, was sudden and unexpected, and at a time when she was enjoying her life in retirement. Sue was born in Hay, NSW. Like many at the time, she moved to Sydney to study nursing at Royal Prince Alfred Hospital as nursing provided a chance for a clever girl to leave difficult family circumstances and find her own way in the world. She valued her friends from those RPA days throughout her life. Many still meet every year. Sue was a long-term member of the Association, joining in 1975 when she was working at Glen Innes District Hospital as a Nurse Educator, before moving to Sydney in 1983 to work as a Nurse Educator at Royal North Shore Hospital. She later took the opportunity to continue her own education – becoming a midwife and eventual NUMIII of Maternity at RNSH. In late 2000, Sue, and her beloved husband John Ivimey, moved to Tamworth where she continued working as a midwife at the Tamara Private Hospital until her retirement in 2014. Always active, Sue became involved in Association activities and held official positions on the RNSH branch for 15 years and continued that activism on the Tamara Private Hospital branch. Her very strongly held view was, if you could, you should make a contribution – get involved, make a change from inside an organisation, not just commentate from the sidelines. Sue’s contribution to the NSW Nurses’ Association (as it was then) was noteworthy. Between 1989 and 2001, she was elected to the NSWNA Council and at the same time, she was also a Branch Councillor on the Australian Nursing Federation NSW Branch. Sue had the ability to show her strength, compassion and a firmness in expressing her very valid points of view whilst maintaining her dignity and grace. Many will remember her extremely polite, but charmingly pointed, questions of visiting Health Ministers at the Association’s Annual Conference. Sue was a strong and committed advocate for midwives’ education and dedicated to advancing midwifery practice wherever possible.

This was evident in her role as a Trustee on the Edith Cavell Trust, a role she deeply treasured. She brought maturity and expertise to the decision making of the Trust in a position that provided her with a great amount of personal satisfaction with the ability to foster education through the awarding of scholarships to nurses and midwives. The Association recognised Sue’s contribution over many years by awarding her Life Membership, which was presented to her at the 2015 Annual Conference. Sue is survived by her daughters, Nicole (her “Doctor one”) and Kim (her “Lawyer one”) and grandchildren, Helena, James, David, Luke and Kit. ■

Sue’s memorial service A memorial service will be held on Saturday, 13 October 2018 at 2.00pm at St John the Evangelist Church, 754 Pacific Highway, Gordon. Friends and colleagues are welcome to attend. THE LAMP OCTOBER 2018 | 29

SAFE STAFFING UNSIGHTLY VEINS? TIRED, THROBBING, ACHING LEGS? For more information or advice on our treatments visit theveininstitute.com.au/nurses/ or call 1300 701 221.

SURGERY FREE

SPECIAL

Nursing is one of the most common professions to suffer from varicose veins â&#x20AC;&#x201C; and when you work as hard as you do, the last thing you need to worry about is tired, aching legs.

OFFER

START YOUR NEXT SHIFT WITH A SPRING IN YOUR STEP!

All NSWNMA members will receive

25 %

OFF

the fee for the first consultation with The Vein Institute.*

VARICOSE VEIN TREATMENTS Endovenous Laser Ablation (EVLA) is the very latest in surgery free varicose vein treatment. Benefits include: 98% effective Walk-in walk-out treatment No significant scarring 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.

T H E R E S U LT S S P E A K F O R T H E M S E LV E S *Offer valid until 30th Dec 2018. Only valid for current NSWNMA members.

30 | THE LAMP OCTOBER 2018

WORKPLACE SAFETY

#TheWorkplaceToo Unions, labour lawyers, barristers and women’s rights activists are using the momentum of the #MeToo movement to fight against workplace sexual harassment.

he NSWNMA Assistant General Secretary Judith Kiejda met with 50 other women at a roundtable at NSW Parliament in August to discuss ways to prevent sexual harassment and empower victims. “We are a female-dominated union; this is the time for us to capitalise on this movement against sexual harassment and try to get some remedies in place,” Judith said. Incredibly, sexual harassment is not explicitly outlawed under the current Fair Work Act, even though 68 per cent of sexual harassment complaints are workplace-related. The roundtable heard of cases of sexual harassment where the victims were blamed, moved on to other jobs or sacked, and suffered enormous mental and financial consequences. “Quite f r a n k l y, sexual harassment and bullying are huge issues in the nursing world,” Judith told The Lamp. “I think a whole lot of people just put up with it because the remedy for them, if they are brave enough to speak up, just doesn’t work out for them.” Unions NSW Assistant Secretary Emma Maiden said that “apart from general obligations under workplace health and safety legislation, employers don’t have to do anything to prevent sexual harassment”. A discussion paper prepared by Unions NSW is calling for a “positive

‘ If we could put the onus on the employer rather than the individual making the complaint, and back it up with legislative reform that would make a huge difference.’ duty” on employers to prevent sexual harassment. “If we could put the onus on the employer rather than the individual making the complaint and back it up with legislative reform, that would make a huge difference,” Judith said.

FAIR WORK COMMISSION SHOULD COVER SEXUAL HARASSMENT Un ion s NSW ’s d isc u s sion paper recommends that “sexual harassment should be subject to risk management” under workplace health and safety legislation. And it calls for the Fair Work Act to include provisions specifically dealing with sexual harassment matters. T h i s wou ld g ive s ex u a l harassment victims access to the conciliation processes of the Fair Work Commission and the option of a hearing in the Fair Work jurisdiction of the Federal Court or Federal Circuit Court. Currently workers can take complaints to general courts, often at great personal and financial cost, or through the Human Rights Commission, which has limited powers and lengthy processes.

“Workers and their unions should also have the ability to bring disputes to the Fair Work Commission on behalf of a member of group of members,” the paper said. T he day-long meet ing at Parliament House discussed how casual and contract workers, and those from non-English speaking and migrant backgrounds on temporary visas, were particularly vulnerable to sexual harassment. B y s t a nder s a nd wh i s t le blowers also need greater rights and responsibilities. “ T he nu r si ng com mu n it y is just like a microcosm of the community in general”, Judith says. “If somebody does speak up and you go and dig a little bit, there are witnesses but they are just not brave enough to speak up. If we had a framework that allowed people to speak up, I think people would be in a much better place.” “We’ve been fighting for these clauses for a long, long time,” Judith said. “But with #MeToo we are closer than ever before to fixing some of these things.” n

THE LAMP OCTOBER 2018 | 31

NEWS IN BRIEF

WORLD

Physical inactivity “a global pandemic” More than a quarter of the world’s adult population – 1.4 billion people – are at risk of disease from not doing enough physical activity, a World Health Organization study has found.

UNITED STATES

A strike to end “modern slavery” Prisoners in United States (US) jails went on a 19day strike during August, putting a spotlight on the exploitation of prisoners on very low or no wages. The strike was led by incarcerated members of Jailhouse Lawyers Speak, who put together a list of 10 national demands including the end to imposed labour in return for paltry wages – what they called a “modern form of slavery”. According to the Prison Policy Initiative, the average minimum daily wage paid to incarcerated workers in the US is now 86 cents, down from 93 cents reported in 2001. The average maximum daily wage for the same prison jobs has declined more significantly, from $4.73 in 2001 to $3.45 today. Ruben Garcia, a professor of law at the University of Nevada, told CBS News that “examples of what incarcerated people do or have done include answering customer phone calls, fighting wildfires, packaging coffee and producing consumer goods such as lingerie”. It has been estimated that inmates produce more than $2 billion worth of commodities, both goods and services, annually. Many US corporations, including Victoria’s Secret, Starbucks and Microsoft, use prison labour. Garcia points out that the International Labour Organization (ILO) has a core convention that requires the elimination of forced labour within a country’s borders. “[The ILO] makes clear that while governments in some circumstances can use forced labour, the work cannot be ‘hired or placed at the disposal of private individuals, companies, or organisations’,” he said. The US is one of only nine countries not to have ratified this convention. The US has the world’s largest prison population at 2.3 million men and women.

‘ Many US corporations, including Victoria’s Secret, Starbucks and Microsoft, use prison labour.’ 32 | THE LAMP OCTOBER 2018

The research, published in the Lancet Global Health Journal, found that one in three women and one in four men do not take enough exercise or move about enough, too often sitting at desks all day at work, in front of the TV in the evening and travelling by car. That puts them at greater risk of heart disease, type-2 diabetes, dementia, and some cancers. The minimum amount of movement recommended by the WHO is 150 minutes of moderate-intensity, or 75 minutes of vigorousintensity physical activity per week. Inactivity has worsened over the last 15 years among the more affluent Western countries – rising from 31 per cent in 2001 to 37 per cent in 2016, and was described in Lancet as “a global pandemic”. “Unlike other major global health risks, levels of insufficient physical activity are not falling worldwide, on average, and over a quarter of all adults are not reaching the recommended levels of physical activity for good health,” said the lead author, Dr Regina Guthold of the WHO. “National policy needs to be implemented to encourage nonmotorised modes of transportation, such as walking and cycling, and to promote participation in active recreation and sports in leisure time.” The study also called for “more opportunities for safe and accessible leisure-time activity” for women.

‘ National policy needs to be implemented to promote participation in active recreation and sports in leisure time.’

NEWS IN BRIEF

EUROPE

Sleep’s sweet spot Too much or too little sleep may be bad for the heart. Six to eight hours of sleep a night is most beneficial for the heart, while more or less than that could increase the risk of coronary artery disease or a stroke, a study presented at the European Society of Cardiology Congress has found. Data from more than a million adults from 11 studies was analysed as part of the research conducted by the Onassis cardiac surgery centre in Athens. NEW ZEALAND

New Zealand considers miscarriage leave A bill legislating three days’ paid bereavement leave for women and their partners after a miscarriage will be considered by New Zealand’s parliament reports The Guardian. At present, New Zealanders are entitled to bereavement leave after the loss of a family member or child but that does not include the loss of a child, who is not born alive. The ministry of health describes miscarriages as “fairly common” and says one or two out of every 10 pregnant women will miscarry a baby. “The lack of clarity has meant some women have been in the position of having to argue with their employer about whether they are entitled to leave because they have lost their unborn child,” said Labour MP Ginny Andersen, who sponsored the bill. Iain Lees-Galloway, the New Zealand minister for workplace relations and safety, said he would support the bill. “A miscarriage is a terrible time for parents and this bill provides certainty for parents and employers around the definition of a miscarriage so that parents can grieve and spend time to work through the personal toll of a miscarriage,” he said.

Compared with adults who got six to eight hours of sleep a night, “short sleepers” had an 11 per cent greater risk, while “long sleepers” had 33 per cent increased risk over the next nine years. “Having the odd short night or lie-in is unlikely to be detrimental to health, but evidence is accumulating that prolonged nightly sleep deprivation or excessive sleeping should be avoided,” the study’s author, Dr Epameinondas Fountas said. Meanwhile, another study from Uppsala University in Sweden, published in the journal Science Advances (August 2018), has found that disrupted sleep has a direct influence on metabolism and the body’s balance between fat and muscle mass. After sleep deprivation, people’s fat tissue showed changes in gene activity that are linked to cells increasing their tendency to absorb lipids and also to proliferate. By contrast, in muscle the scientists saw reduced levels of structural proteins, which are the building blocks the body requires to maintain and build muscle mass.

‘ Having the odd short night or lie-in is unlikely to be detrimental to health, but evidence is accumulating that prolonged nightly sleep deprivation or excessive sleeping should be avoided.’

Andersen said she expected cross-party support from other parties like NZ First and the Greens for her bill. She said she had also had positive responses from a number of opposition National MPs. “A lot of people are saying this is a very sensible idea, and we want to take the politics out of this one and have the whole house support it.”

‘ A lot of people are saying this is a very sensible idea, and we want to take the politics out of this one.’ THE LAMP OCTOBER 2018 | 33

NEWS IN BRIEF

AUSTRALIA

New rules for cosmetic surgery It is now an offence to perform cosmetic surgical procedures in an unlicensed private health facility. The Private Health Facilities Act 2007 has been amended to make it an offence to perform cosmetic services or treatments in an unlicensed private health facility. This amendment, which introduced a new s33A into the Act, followed a recommendation in the Report on the Review of the Regulation of Cosmetic Procedures. According to the “second reading speech” for the bill, the new offence was intended to “ensure that the practitioners performing cosmetic surgery are responsible for checking that the facility they are operating in is licensed, as well as safely performing the procedure”. From 17 September 2018, cosmetic surgery will be prescribed in the regulation as a class of services or treatments for the purpose of the new offence in s33A of the Act. It will therefore be an offence, attracting a maximum penalty of up to $55,000, to perform cosmetic surgery in an unlicensed private health facility. As such, there will be an onus on persons performing cosmetic surgery to check that the facility they are operating in is licensed as required under the Act. This can be done by searching the list of currently licensed private health facilities on the NSW Health website (see www.health.nsw.gov.au). The regulation also requires licensed private health facilities to display a copy of their licence in the entrance foyer.

BRITAIN

Brexit risks drug shortages and disease A leaked letter from NHS Providers warns that a no-deal Brexit could negatively impact on “the entire supply chain of pharmaceuticals”. The letter, published in The Times, says ministers and health service bosses have failed to prepare for Britain crashing out of the European Union and hospitals will be in danger of drug shortages in the event of a no-deal Brexit. Written by the organisation’s chief executive Chris Hopson it also warns that Brexit could jeopardise the status of EU workers “on which the NHS relies”. Hopson’s letter was sent to the NHS England chief executive Simon Stevens and NHS Improvement chief Ian Dalton. Hopson said the possibility of a no-deal or hard Brexit “with minimal regulatory alignment appears to be growing. For as long as that risk remains it is important that detailed operation planning is undertaken across the NHS”. “Trusts tell us that their work in this area is being hampered by the lack of visible and appropriate communication.” Hopson added that poor national co-ordination could mean “both stockpiles and shortages of medicines and medical devices”. Days before the letter was published in The Times the British Medical Association warned that leaving the EU without a deal would leave Britain more vulnerable to outbreaks of deadly infectious diseases and increase the risk of a Europe-wide pandemic.

‘ The British Medical Association warned that ‘ Practitioners performing leaving the EU without a deal cosmetic surgery are responsible for checking that would leave Britain more the facility they are operating vulnerable to outbreaks of in is licensed, as well as safely deadly infectious diseases.’ performing the procedure.’

34 | THE LAMP OCTOBER 2018

NEWS IN BRIEF

AUSTRALIA

Low wage growth now a top election issue A ReachTEL poll commissioned by the ACTU reveals low wage growth is an increasingly important issue for Australians. The poll of 2,453 people was conducted in August. Almost half the respondents (47.6 per cent) said they had had “no pay rise at all” in the past year. A further 32.9 per cent said they had “a pay rise but not enough to cover my cost of living”, and 19.5 per cent said they had “a pay rise that covered my costs of living”. When asked how significant low wage growth was to how they would vote 28.2 per cent said it was “the top issue”, 54 per cent said it was “important but not the top issue”, while 17.9 per cent said it was not important. Meanwhile, GDP figures released by the Australian Bureau of Statistics show that big business and employers are continuing to enjoy significant growth in their profit margins, while working people watch their wages go backwards. Working people’s share of overall income has fallen 0.3 per cent in the last year, and more than two per cent over the last couple of years. “Massive profits for the big end of town will never generate pay rises if working people don’t have the tools and rights to win them,” said ACTU secretary Sally McManus.

‘Massive profits for the big end of town will never generate pay rises if working people don’t have the tools and rights to win them.’

SCOTLAND

A seriously strong nurse An Australian nurse, Leigh Holland-Keen, has become only the second woman to lift Scotland’s legendary Dinnie Stones. The Dinnie Stones are two granite boulders weighing nearly 332.5kg and named after Donald Dinnie, who carried them across the Potarch bridge in Aberdeenshire in 1860. Only 90 men have been able to lift them since the tradition was revived in the 1950s. Only one other woman has ever lifted them – nearly 40 years ago. 29-year-old Leigh still works as a registered nurse in Townsville. She had previously come third in the under-75kg class at the 2012 World’s Most Powerful Woman competition – seen as the pinnacle event for “strongwoman competitors”. And what exactly is a strongwoman competitor? “Most people are familiar with ‘world’s strongest man’ competitions where they pull trucks and heavy tyres. Well it’s exactly that. Except it’s women,” she told ABC News. While preparing to lift the stones, Leigh juggled her training schedule between full-time nursing while also studying personal training. To prepare she borrowed some replica Dinnie Stones rings and loaded them with weights and trained in her garage three to four times a week. Leigh said it was “a common myth that if you lift heavy weights then you’re going to look very manly and it’s not a feminine thing to do”. “The idea that it’s healthy for your body to be stronger is slowly progressing. You feel pretty badass when you can lift heavy weights.”

‘ You feel pretty badass when you can lift heavy weights.’

THE LAMP OCTOBER 2018 | 35

PROFESSIONAL EDUCATION Increasing Resilience in Stressful and Changing Times

Medicinal Cannabis Forum: Debunking the Myths

All

CPD Friday 12 October, Central Coast 6 $ 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.

How to be an effective Preceptor and Mentor All

CPD

Friday 12 October, Dubbo Wednesday 28 November, Taree Thursday 6 December, Waterloo $ Members $95 / non-members $190 Learn how to be an effective Preceptor and Mentor. Understand the differences in an effort to appreciate the contribution such relationships can make to the novice nurse / midwife. Legal, Ethical and Professional Issues for Nurses and Midwives

CPD

All

Thursday 25 October, Grafton Thursday 1 November, Goulburn Friday 9 November, Gymea $ Members $95 / non-members $190 Learn about potential liability, disciplinary tribunals, NMC and HCCC complaints, Coroners Court and identify the fundamental ethical standards and values to which the nursing and midwifery profession is committed. CPD Made Easy

Friday 26 October, Grafton Friday 2 November, Goulburn Friday 16 November, Hornsby $ Members $50 / non-members $100 This seminar is designed to assist nurses and midwives to better understand the key concepts and relevant information to ensure effective recording and completion of CPD that meets NMBA standards.

CPD

All

Wednesday 24 October, Waterloo Members $60 / non-members $120 Hear from a range of speakers, network with colleagues and share experiences across the aged care sector. $

Bullying: Letâ&#x20AC;&#x2122;s put an end to it

CPD

All

Wednesday 24 October, Grafton Friday 7 December, Gymea $ Members $95 / non-members $190 This seminar covers topics such as anti-discrimination law, identifying unlawful harassment and bullying, understanding what can be done if subjected to harassment and bullying and also assists managers and supervisors to identify, prevent and resolve bullying and harassment. CPD

6 Monday 12 November, Waterloo Wednesday 12 December, Waterloo $ Members $20 / non-members $40 The objective of the training is to ensure that newly registered nurses and midwives are provided with some basic skills to start their professional journey transitioning into the workforce. New Grad EN New Grad MW

Finding Evidence and Implementing into Practice All

CPD

Friday 30 November, Wollongong 6 $ Members $95 / non-members $190 This interactive workshop is designed to give nurses and midwives the tools to find evidence to support and appraise guidelines and policies.

CPD

NEW! Diabetes Management for Clinical Staff All

All

Aged Care Nurses Forum

New Grad RN

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

CPD

Transitioning to the Workplace

CPD

RN EN MW

All

Friday 19 October, Newcastle Members $60 / non-members $120

CPD

Wednesday 14 November, Waterloo Members $95 / non-members $190

Wednesday 17 October, Lismore Friday 26 October, Bathurst Thursday 15 November, Griffith Members $95 / non-members $190

Look out for January to March courses in the December-January Lamp and go online for more courses throughout 2019!

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 nurses, midwives & assistants in nursing

36 | THE LAMP OCTOBER 2018

AiN

Midwives

Grad RN

Graduate RNs

Grad EN

Graduate ENs

Grad MW

Graduate midwives

YOUR RIGHTS

Ask

Judith Breaking News Provision of offices in public health As mentioned last month, if you learn of any proposal to remove office space for existing nursing and midwifery roles, please contact your local branch and have them escalate the issue to ensure proper consultation occurs. The Association and other public health unions continue to try and prevent a slavish adoption of the NSW government approach to office accommodation of “… agile, active and/or flexible models” (i.e. no offices). A new Managing Complaints and Concerns about Clinicians PD I mentioned earlier this year that the Ministry of Health was consulting public health unions on a proposed new Managing Complaints and Concerns about Clinicians Policy Directive, along with some ancillary changes to related policies and information sheets. After protracted discussions, the Ministry has now released PD2018_032, which has superseded the previous policy (PD2006_007) and the associated Guidelines (GL2006_002). It has also resulted in PD2018_031 (Managing Misconduct) being issued to ensure both approaches are consistent and reflect that these should be reserved for the more serious issues requiring a formal approach, and not those that should be dealt with at a local level between staff and their supervisor/manager. The Association continues to review both to see if there is any devil in the detail. Posting Rosters A reminder that arising from changes to Clause 8(ii) of the Public Health System Nurses’ and Midwives’ (State) Award, from 1 October 2018 your roster needs to be displayed at least four weeks prior to the first working day of the roster.

Overpayments I am a registered nurse working in a public hospital. My pay was recently reduced by a deduction for an overpayment they say I received from previous pay periods. Is this right? Unfortunately, this issue continues to arise. Under Clause 27(v)(b)(i) of the Public Health System Nurses’ and Midwives’ (State) Award, you must be notified of both the

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

circumstances of the overpayment and the amount involved before any action is taken. You should also be advised in advance as to how they intend to approach its recovery. You have a right to be both satisfied of the alleged overpayment and have a say in its recovery if it will cause you financial hardship.

LSL with Estia

I work in a facility operated by Estia. It was previously a Kennedy Health site. I am a bit confused about my LSL under the Estia agreement. The Estia Health NSW Enterprise Agreement 2016 had the challenging task of bringing together a number of other agreements with varying entitlements. Pleasingly, a number of protections were put in place for existing employees who had more beneficial entitlements under other agreements. Schedule 6 of the Estia agreement sets out a mechanism that preserves LSL accrual/value for ex-Kennedy employees. Discuss this with your payroll office or contact the Association for further assistance.

Posting rosters in Healthscope

I work in a hospital operated by Healthscope. What is the minimum notice of my roster under the agreement? Clause 8(ii) of the Healthscope Group – NSWNMA/ANMF – NSW Nurses and Midwives’ – Enterprise Agreement 2015–2019 sets out that no less than two weeks’ notice will be provided for full-time and parttime employees. Some alteration to the posted roster is permitted due to emergencies that impact on service delivery. An employee may also change a posted roster on reasonable grounds by agreement.

Employment guarantee

I am a former FACS nurse who was forced over to an NGO provider. I thought I was protected for two years but they say for a casual it is six months. Is that right? Unfortunately, that is correct. The

safety net that the NSW government provided to casuals working at FACS was that “you will be retained on the new operator’s casual roster for at least the six month Employment Guarantee period.” The two-year period was made available to fulltime and part-time staff.

12-hour shifts I work in a rural facility operated by RSL LifeCare. There has been a recent discussion about 12 hour shifts. Is that permitted? Schedule F of the RSL LifeCare, NSWNMA and HSU NSW Enterprise Agreement 2017 – 2020 permits registered nurses only at nominated regional locations to work 12-hour shifts. If employed prior to this agreement coming into effect, a registered nurse may agree to work on a 12-hour shift basis but will have a three-month trial period to decide whether they wish to continue or opt out of the arrangement. Ask your local manager to see Schedule F as it goes to some detail as how these shifts will be worked. Otherwise, contact the Association and we can provide you with a copy.

Recognition of service I am about to return to permanent part-time work in a public hospital after a bit of a break. Will my previous public health service be recognised for LSL? Clause 33(ii)(a)(1) of the Public Health System Nurses’ and Midwives’ (State) Award defines service as being full-time and/or permanent part-time employment “in one or more hospitals, public health organisations, Local Health Districts or former NSW Area Health Services.” Such service should be included to determine your accrual rate for LSL on your recommencement. If your previous service included periods of temporary or casual employment, or leave without pay, it is best to query this with the District or get advice from for your particular issue from the Association. THE LAMP OCTOBER 2018 | 37

PROFESSIONAL EDUCATION 2018

Medicinal Cannabis

DEBUNKING THE MYTHS NEWCASTLE • 1-DAY SEMINAR

Friday 19 October 9am – 4pm

Wests New Lambton, Bowls Club

Greenhouse Function Rm, 1a Tauranga Rd

CPD 6

Hear from a leading Israeli nurse with extensive paediatric experience in a major medicinal cannabis clinic in Israel, Tikum Olam. Tikum Olam is a leading supplier and researcher of medicinal cannabis in Israel since 2006 and runs a cannabis nursing clinic for all ages of patients from paediatrics to geriatrics. As Australia is on the threshold of a new era of medicinal cannabis, nurses will have the opportunity to learn about medicinal cannabis and the role of nurses internationally.

PROGRAM:

Lunch and refreshments provided

• ‘Dan’s Story’, Lucy Haslam, CEO, United in Compassion • What is Medicinal Cannabis? The Facts and the Fiction, Justin Sinclair, Research Fellow, NICM • The Epilepsy Journey, Carol Ireland, CEO and Managing Director, Epilepsy Action Australia • Cannabis Medicines – Access in NSW, Dr Jan Fizzell, Medical Advisor, Office of the Chief Health Officer • Na’ama Saban, RN BcS, Head paediatric nurse, Tikum Olam Ltd. Na’ama is an expert in the education and administration of medical cannabis treatment for paediatric care; specialising in cancer, epilepsy, movement disorders, CP and autism.

This forum is bound to sell out. So book your place early to avoid disappointment.

There will be a special screening at 8.15am of acclaimed journalist, Helen Kapalos’ documentary ‘A life of its own: The truth about medicinal marijuana’. The first half will be shown in the morning prior to the main forum and the second half during lunch. For those who do not wish to see the documentary, the start time for the day will be 9am.

All $ Members $60 Non-members $120

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 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.

CPD EN

All

All nurses, midwives & assistants in nursing

We reserve the right to change the program without notice

Authorised by B.Holmes, General Secretary, NSWNMA

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 Have we lost the Spirit of Nursing? BLACKTOWN HOSPITAL NURSE ATTACKED Assistant General Secretary Judith Kiejda speaks to the media following the horrific attack on a nurse at Blacktown Hospital bit.ly/JudithBlacktown

SYDNEY/SYDNEY EYE HOSPITAL RALLY Nurses and midwives from Sydney/ Sydney Eye Hospital rally outside of NSW Parliament for ratios in their emergency department. bit.ly/SHSEH18 Connect with us on Facebook Nurse Uncut www.facebook. com/NurseUncutAustralia New South Wales Nurses and Midwives’ Association www.facebook.com/nswnma Ratios put patient safety first www.facebook.com/ safepatientcare Aged Care Nurses www.facebook.com/ agedcarenurses Look for your local branch on our Facebook page www.facebook.com/nswnma Follow us on Twitter @nswnma / @nurseuncut Share on Instagram by tagging @nswnma and don’t forget to use the hashtag #nswnma!

This nurse’s parents were recently admitted to the local public hospital on three occasions between them. Their experience on all occasions was less than satisfactory and at times very disappointing. https://www.nurseuncut.com.au/ have-we-lost-the-spirit-of-nursing/

Silver Rainbow: LGBTI Aged Care Awareness in-person training The Silver Rainbow LGBTI Aged Care Awareness Training Project is managed by the National LGBTI Health Alliance and is being delivered collaboratively with project partners across every state and territory in Australia. https://www.nurseuncut.com. au/silver-rainbow-lgbti-aged-careawareness-in-person-training/

Banks have no place in super We all deserve a dignified retirement after a lifetime of work. Our union-won superannuation system works to make this a reality. But this right is currently under threat as for-profit banks try to take over workers’ superannuation. https://www.nurseuncut.com.au/ banks-have-no-place-in-super/

Ride to fight MS: This nurse is going the extra mile

My grave concerns for our elderly in aged care As nurses, we want to do our best and deliver quality care to each and every life that we are privileged to care for, yet there is simply not enough time without adequate staffing and skill mix. https://www.nurseuncut.com.au/ my-grave-concerns-for-our-elderlyin-aged-care-a-nurses-open-letter-tothe-ministers/

Mark Quealy is a registered nurse who is taking part in the Sydney To The Gong: Ride to fight MS on Sunday 4 November this year. It is so popular that 10,000 riders have already signed up and it has sold out! https://www.nurseuncut.com.au/rideto-fight-ms-this-nurse-is-going-theextra-mile-55-miles-in-total/

Listen to our podcast Brett Holmes delivers his report at the 73rd NSWNMA Annual Conference. bit.ly/BH73AC

THE LAMP OCTOBER 2018 | 39

PROFESSIONAL EDUCATION 2018

Midwifery Forum Friday 2 November

CPD

9am – 4pm • NSWNMA

50 O’Dea Avenue, Waterloo

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

PROGRAM: • NSW Perinatal Advice Line – Supporting clinicians and women across NSW/ACT – what’s it all about? – Lyn Passant, Clinical Midwifery Consultant; • Waminda and Birthing on Country – Melanie Briggs and Cherisse Buzzacott, co-chairs of the National Strategic Committee for Birthing on Country; • Antenatal Classes for LGBTIQ parents – Janet Broady, Midwife; • Introducing the new Midwife Standards for Practice – Petrina Halloran, Policy Manager, Nursing and Midwifery, Nursing and Midwifery Board of Australia; • The experience of privately practising midwives in Australia – Jo Hunter, Privately Practising Midwife; • Complementary and Alternative Medicine and Maternity Care: Evidence based practice? – Dr Lyndall Mollart, Midwife, RN, PhD; • Engaging the Community for Change – Rita Martin, Government and Community Relations Officer, NSWNMA.

Enrolled Nurses’ Forum WOLLONGONG • 1 DAY SEMINAR

Friday 9 November 9am – 4pm

City Diggers

Corner Church and Burelli Streets

CPD

EN $

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

The enrolled nurse is a valued and pertinent member to the health workforce. This forum is an opportunity for enrolled nurses to gain some education on practice and professional issues related to their role. Hear from a range of speakers, network with colleagues and gain some valuable CPD hours. PROGRAM: • Wound Care • Measuring a Glasgow Coma Scale (GCS) • Culturally Appropriate Healthcare • Professional Obligations and the NMBA Decision Making Framework • Mindfulness: Looking after yourself in times of stress.

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. 40 | THE LAMP OCTOBER 2018 EN EN MW Midwives Authorised by B. Holmes, General Secretary, NSWNMA

SOCIAL MEDIA

your

Say When adequate means not nearly enough

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

ourselves and the residents we care for at risk. We do not get time to give the aged the care that they deserve. You can bet there would be a ratio for making profits. Plus a ratio for CEO’s bonus. No staff ratio means more profit for the owners.Why isn’t the federal government stepping in to address this?

The Aged Care Act only requires aged care operators to “maintain an adequate number” of staff at any time. Here’s what you thought about that. This “adequate number” is not a firm ratio and very open to “interpretation” by homes across the country. Dubious policy and seriously, not good enough! Adequate as determined by whom? Not by the patients or their carers. “Satisfactory or acceptable in quality or quantity” is the definition of the word ‘adequate”. Care staff have absolutely no time to spend any quality time with residents. Every day, staff go home exhausted. I have absolutely no faith in this or the federal government to do anything about the aged care crisis. I do have faith however, in my colleagues who come to work every day to do their best and work so hard to care for our residents. Adequate care? What a joke! Too many staff are stressed and getting sick because of the workload, and managers can’t get the staff to fill shifts. I have been sick on and off for the last year, but the workload remains the same. I think aged care workers will eventually leave and find a job elsewhere with less stress. We are putting

with introduction to our society of dangerous substances like ice. Plus, there are more and more angry people who feel disconnected from their human family. Nurses and other healthcare workers do NOT deserve this.

the gallery

Everyone is horrified, but what is being done to protect our great nurses and medical staff? /2

Inexcusable violence When a patient at Blacktown Hospital attacked a nurse while at work, you were outraged. I work at Blacktown, and this is just horrific! I hope the nurse is okay. Cut backs on security, short-staffing, and then the inevitable happens … nurses should not have to deal with this. I worry about the nurses in my family. Some have already been attacked. It is such a shame when they are there to help the patients. I know they are to look after patients whatever their medical state, but people still need to be kind to nurses. This is disgusting and this is why I fight for my and my patients’ safety every day! I hope this nurse is okay, and I hope her NUM and the general managers are supporting her! Why are we still in danger? The management and the ministry need to seriously re-think security. Danger potential has risen along

Appalling consequences of midwives shortage We shared about the shortage of midwives currently gripping NSW, and you were appalled by the risks mothers, babies and midwives are put under. Midwives are leaving their jobs because of poor workloads and poor job satisfaction. How can you care for eight maternity patients on your own and if you work in a postnatal ward? Plus, you get extra patients such as babies, but they are not counted. Maternity services in NSW are in a very poor state. As a midwife, I am constantly keeping up with the impossible. My hair is literally turning white and I’m 23. Is there really a shortage of midwives or are the hospitals actually just not employing? Look on the NSW Health job site. There are not a lot of job vacancies advertised. It does not help that the government are totally out of touch!!!

/5 1/ D emanding action on staffing issues: nurses and midwives from Sydney Eye Hospital were joined by politicians at their rally outside NSW parliament 2/ D ancing nurses at a CPD Education seminar on self-care 3/ N urses and midwives from the Tweed hear NSW Labor Leader Luke Foley speak about his commitment to ratios 4/ Narrendera supports ratios 5/ Grafton nurses say YES to mandated ratios in aged care.

THE LAMP OCTOBER 2018 | 41

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!

Recruiter’s 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

42 | apply. THE Prize LAMP OCTOBER 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 Conditions must be redeemed 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/18/02955

NURSING RESEARCH ONLINE Patient safety and quality of care is at the heart of the Association’s campaign for mandated minimum staffing ratios in public hospitals and the aged care sector. Research and evidence in relation to patient safety is vital and all of us need to reflect on how we can contribute to better care. Hospital-acquired complications (HACs) information kit Australian Commission of Safety and Quality in Health Care, June 2018 The Commission, in consultation with clinical experts from across Australia, has developed the hospital-acquired complications (HACs) information kit. The kit has been developed to improve the safety and quality of health services, and outcomes for Australian patients. The information kit includes a suite of resources for clinicians, safety and quality professionals, managers and executives, governing bodies and others, to put in place strategies that reduce the occurrence of HACs. Monitoring HACs, and using strategies in the information kit to reduce the occurrence of HACs, can be used as evidence during accreditation against the National Safety and Quality Health Service standards. The HACs information kit includes three elements: • Introductory content – this material defines the 16 HACs, explains their development, why they are important, and how monitoring and responding to HACs can help provide the best care for patients. • Short fact sheets – these short documents are designed as quick reference guides for each HAC for frontline clinicians. They focus on the impact of the HACs on Australian health services. • Detailed fact sheets – these fact sheets are designed for clinicians, safety and quality professionals, managers and executives, and governing bodies. They include an overview of the governance structures and quality improvement processes needed to minimise the occurrence of a HAC. They also outline key steps to develop and deliver a comprehensive care plan for the patient. https://www.safetyandquality.gov.au/our-work/ indicators/hospital-acquired-complications/ hacs-information-kit/

Safer care saves money: How to improve patient care and save public money at the same time Stephen Duckett & Christine Jorm, Grattan Institute, August 2018 Australia could save $1.5 billion a year on health spending by improving the safety of patient care in hospitals. Safer hospital care doesn’t just reduce harm to patients, it also saves money for taxpayers. One in nine patients who go into hospital in Australia

suffers a complication. Those complications cost public hospitals more than $4 billion a year, and private hospitals more than $1 billion a year. If all hospitals in Australia lifted their safety performance to match the best 10 per cent of hospitals, an extra 250,000 patients would go home complication-free each year and the health system would save about $1.5 billion every year, freeing up beds and resources so another 300,000 patients could be treated. Public hospitals get extra funding for treating a sicker patient even if the patient became sicker because of a complication suffered in the hospital. But analysis of Australia’s 20 biggest public hospitals shows that in every case, the cost of complications to the hospital was larger than the extra funding. On average, a complication cost the hospital more than three times the extra revenue it received. Hospitals don’t need extra financial incentives to reduce complications. Instead, they need better information, and accreditation systems that encourage useful improvements rather than ticking boxes. Complication rates and accreditation outcomes should be public, so that governments are held to account. And medical students should learn only in hospitals with lower complication rates. State governments should make it clearer to their hospitals that improving patient safety also boosts the bottom line. States should give public hospitals – and the public – information on the estimated cost of, and revenue, from complications. Private health insurers also benefit from lower complication rates: their costs and future premiums fall. Insurers should increase pressure on hospitals to improve their safety performance through contract negotiations and by making information on complication rates available to their members, either directly or through GPs. Australia’s hospital accreditation system has failed: it does not improve patient outcomes. ‘One size fits all’ accreditation should be replaced with a system based on measurable safety outcomes, tailored to each hospital’s situation. Hospitals would no longer be spruced up for a once-a-year visit by accreditation inspectors. Instead, surveyors would conduct safety tests without notice, but concentrate on helping hospitals to give safer care. And for the first time, patients and taxpayers would have access to detailed accreditation reports on all hospitals, so Australians could hold their governments to account on the quality and safety of hospital care. https://grattan.edu.au/report/safer-care-savesmoney/ THE LAMP OCTOBER 2018 | 43

We’ve got the look

Stylish and comfortable, NSWNMA favourites are also affordable and sold at cost to members.

NEW

1 Navy Aus Vests $40. Sizes: XS-3XL. Australian made and owned. Poly/cotton zip front and side zip pockets. 2 & 3 NEW: Snowy Puffer Jacket $50. Sizes: Ladies 10-18 and Unisex S-3XL. Light, warm and comfortable to wear. 380T nylon outer, poly fill padding. Two zippered pockets and elasticated cuffs. Top value for cold winter conditions.

ORDER FORM

Name Address

1 Navy Aus Vests $40. Quantity:

Size:

Postcode XL

2XL

3XL

Phone H

2 & 3Snowy Puffer Jacket $50. Quantity:

Size:

10 S

12 M

14 L

16 XL

18 2XL

MOB 3XL

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

TO ORDER » WWW.NSWNMA.ASN.AU

FAX (02) 9662 1414 POST NSWNMA, 50 O’Dea Ave. Waterloo NSW 2017 44 | THE LAMP OCTOBER 2018

Email Method of Payment Cheque MasterCard

Visa

Name of card holder Card number Expiry date

Signature

Money Order

CROSSWORD

test your

Knowledge 1

10 11

14 16

21 22

23 25

26 28

29 31

32 33

ACROSS 1. Coeliac disease (11.5) 9. Remembrance, anamnesis (12) 11. Furl, form into a cylinder (4.2) 13. An antibody class concerned with protection against virus and other infections in the mucous membranes (1.1.1) 14. A low-frequency brainwave that originates in the frontal part of the brain during deep sleep (5.4)

16. Symbol for terbium (1.1) 18. A citizen of a Middle Eastern Muslim country (5) 20. A malignant tumour of the central nervous system (12) 22. Bones (2) 23. Big (5) 24. Something newly introduced (12) 27. Symbol for methyl (1.1) 28. Vacuum Gauge (1.1) 30. The colour of chlorophyll (5) 31. A soft tumour

usually located on a nerve (12) 32. A hormone that helps your kidneys manage the amount of water in your body (1.1.1) 33. Instruments for examination of canals or hollow organs (7) 35. Relating to bone or to the skeleton (6) 36. Obstructed labour where the anterior shoulder of the infant cannot pass below (8.8)

DOWN 1. The patient problem identified by the nurse for nursing intervention (7.9) 2. Winking (9) 3. Boring in the earth that is designed to bring petroleum hydrocarbons to the surface (3.4) 4. Provokes (7) 5. Apnoeaâ&#x20AC;&#x201C;hypopnea index (1.1.1) 6. One of the large synovial folds in a joint (8.8) 7. Tangible (4) 8. A skin disorder associated with elevated triglyceride levels in the blood (8.8) 10. Edges, margins (3) 12. Light Emitting Resistor (1.1.1) 15. Courting (6) 17. A womanâ&#x20AC;&#x2122;s breast (5) 19. Marked or affected by enlargement or hypertrophy of the extremities or the face (11) 21. To occur before the usual time of onset (10) 25. A vote that blocks a decision (4) 26. An excess over what is normal or needed (8) 29. Semiformal evening dress for men (6) 34. The address of a web page (1.1.1) THE LAMP OCTOBER 2018 | 45

Recently changed your email? Classification changed? Log on

online.nswnma.asn.au

Update details

WIN AN APPLE WATCH

Go into the draw

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.

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 Nurses Scholarship.indd 1 46Lion | THE LAMP OCTOBER 2018

19/6/18 11:09 am

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

T ES

Brave, illuminating and inspiring, Somebody I Used to Know gets to the very heart of what it means to be human.

S PE

Wendy Mitchell Bloomsbury Publishing: RRP $22.50. ISBN 9781408893364

INTE IAL

ST RE

Somebody I Used To Know

SPE C

book club

IN T E

When she was diagnosed with dementia at the age of fiftyeight, Wendy Mitchell was confronted with the most profound questions about life and identity. All at once, she had to say goodbye to the woman she used to be. Her demanding career in the NHS, her ability to drive, cook and run – the various shades of her independence – were suddenly gone. Philosophical, profoundly moving, insightful and ultimately full of hope, Somebody I Used to Know is both a heart-rending tribute to the woman Wendy once was, and a brave affirmation of the woman dementia has seen her become.

Tintinalli’s Emergency Medicine Manual Rita K. Cydulka, Michael T. Fitch, Scott A. Joing, Vincent J. Wang, David M. Cline, O. John Ma McGraw Hill Education: RRP $132.00 ISBN 9780071837026

This portable manual encapsulates the most clinically relevant content of Tintinalli’s Emergency Medicine, Eighth Edition – the world’s bestselling text on the topic. Covering the full spectrum of emergency medicine in all patient populations – adult and paediatric – this full-colour guide is composed of concise chapters that focus on clinical features, diagnosis and differential, and emergency management and disposition. This new edition includes extensive updates to all sections, incorporating the latest guidelines, evidence-based protocols, and relevant research.

Nursing Diagnosis Manual Marilynn E. Doenges, Mary Frances Moorhouse and Alice C. Murr FA Davis: amazon.com.au RRP $42.45 ISBN 9780803622210

Everything you need to develop a safe and effective care plan ... whenever you need it. It will help you select the appropriate diagnosis and to plan, individualise, and document care for more than 850 diseases and disorders. A new, streamlined design makes reference easier than ever. In the Nursing Diagnosis Manual you will find for each diagnosis... defining characteristics presented subjectively and objectively, sample clinical applications to ensure you have selected the appropriate diagnoses, prioritised action/ interventions with rationales, a documentation section, and much more.

All books can be ordered through the publisher or your local bookshop. 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.

Varcarolis’ Foundations Of Psychiatric-Mental Health Nursing Margaret Jordan Halter

Elsevier http://www.amazon.com RRP $70.57 ISBN 9780323389679

This text simplifies the oftenintimidating subject of psychiatric–mental health nursing with a practical, clinical perspective. Chapters follow the nursing process framework and progress from theory to application, preparing students for clinical practice with real-world examples. New to this edition are full-page illustrated explanations about the neurobiology of disorders and associated medications, criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) for major disorders, completely revised Evidence-Based Practice boxes, and a fully rewritten chapter on Dying, Death and Grieving, to provide students with essential information about difficult topics.

THE LAMP OCTOBER 2018 | 47

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 48 | THE LAMP OCTOBER 2018

REVIEWS

EM OM B

WI N

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

MET R

at the movies E GIV E

Lean On Pete From acclaimed filmmaker Andrew Haigh (Weekend, 45 Years), and based on the beloved novel by Willy Vlautin, comes Lean on Pete, a deeply moving story about love, loneliness, family, and friendship, told through the unique prism of one boy’s connection to a very special racehorse. Fifteen-year-old Charley Thompson (Charlie Plummer) arrives in Portland, Oregon with his single father Ray (Travis Fimmel), both eager for a fresh start after a series of hard knocks. While Ray descends into personal turmoil, Charley finds acceptance and camaraderie at a local racetrack where he lands a job caring for an aging quarter horse named Lean On Pete. The horse’s gruff owner Del Montgomery (Steve Buscemi) and his seasoned jockey Bonnie (Chloë Sevigny) help Charley fill the void of his father’s absence — until he discovers that Pete is bound for slaughter, prompting him to take extreme measures

to spare his new friend’s life. Charley and Pete head out into the great unknown, embarking on an odyssey across the new American frontier in search of a loving aunt Charley hasn’t seen in years. They experience adventure and heartbreak in equal measure, but never lose their irrepressible hope and resilience as they pursue their dream of finding a place they can call home. Featuring an incredible breakout turn by Charlie Plummer (The Dinner, King Jack, All The Money in the World) and memorable supporting work by indie stalwarts Buscemi, Sevigny and Steve Zahn, Lean on Pete is a compassionate and heartrending look at the desire for love, family, and acceptance that drives all of us. In cinemas 25 October 2018. Email The Lamp by 20 October to be in the draw to win one of 10 x double passes to Lean on Pete thanks to Transmission Films. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win! THE LAMP OCTOBER 2018 | 49

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 Manly Hospital Farewell Celebrations MultiFaith Celebration Friday 12 October 2018 5pm–8pm Farewell Feast Wednesday 17 October, 2018 1.30pm–2.30pm Numbers are limited, please contact Diane Curtis via email at diane.curtis@health.nsw.gov.au or phone on 9976 9793

Transplant Nurses Association National Conference 24–26 October 2018 Rydges World Square, Sydney www.tnaconference.com.au./

Audiometry Nurses Association of Australia Conference 36th Annual Conference and AGM 24–26 October 2018 Orange Ex-Services Club 231-243 Anson Street Orange NSW 2800 www.anaa.asn.au

State Staff Health Conference 25–26 October 2018 Noah’s on the Beach, Newcastle www.staffhealthconference.com.au

Andrew Dickson – 02 49246844 2018 Adoptees DNA Workshop at The Society of Genealogists 27 October 2018 The Workshop and lunch at the Lord Nelson Brewery, Sydney lynne@lynnew.org

Please send event details in the format used here: event name, date and location, contact details – by the 5th of each preceding month. Send your event details to: lamp@nswnma.asn.au Fax 02 9662 1414 Post 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space. Priority is given to non-profit professional events.

EVENTS: INTERSTATE 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, Tasmania 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

Palliative Care NSW 2018 Biennial State Conference “Riding the Waves of Change” 8–10 November 2018 The Pavilion, Kiama

World Congress of Cardiology and Cardiovascular Health 5–8 December 2018 Dubai, United Arab Emirates

http://pc nsw2018.com.au

www.world-heart-federation.org/wcc-2018/

Critical Care Nursing Conference 9 November 2018 Westmead Hospital

EuroSciCon Conference on Clinical Pathology and Bacterial Diseases 2019 27–28 February 2019 Prague, Czech Republic

Jennifer.Yanga@health.nsw.gov.au

NSW Society of Vascular Nursing Annual Professional Development Day Infection in Patients with Vascular Dysfunction Friday 23 November 2018 Burwood RSL

https://clinicalpathology.euroscicon.com/

suemonaro@health.nsw.gov.au

http://www.icn.ch/events/ ICN-Congress-Singapore-June-2019/

42nd Australian Association Of Stomal Therapy Nurses Conference: Power Of Connections – Coming Together 19 –22 May 2019, SMC Conference and Function Centre Sydney. http://www.stomaltherapyconference.com/

International Council of Nurses 2019 Congress 27 June–1 July 2019 Marina Bay Sands Expo and Convention Centre, Singapore International Council of Nurses (ICN) 21st International Conference on Nursing 25–26 September 2019 London United Kingdom www.icn.ch/

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 50 | THE LAMP OCTOBER 2018

EVENTS: REUNIONS Susan Sides – Life Member Memorial 13 October 2018 St John The Evangelist Church, Pacific Highway, Gordon NSW at 2pm Fellow nurses or NSWNMA members welcome to attend kesides@bigpond.com

St George Hospital Graduate Nurses Association Annual Reunion 20 October 2018 Joan Wagstaff 9771 2508 joanlwagstaff@gmail.com

Wallsend District Hospital Graduate Nurses Association 60th Reunion Saturday 27 October 2018, 10am–4pm Wallsend Diggers Function Room 5 Tyrrell Street, Wallsend $55 includes morning tea and lunch Contact: wdhgrads@gmail.com or Gaye McCauley 0409915209 Facebook: WDH Grads

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

Thames Hospital Staff – New Zealand Nursing Reunion Commemorationg 150 years 2–4 November 2018 facebook.com/thameshospital

Balmain Hospital Graduate Nurses Reunion Saturday 10 November 2018 Balmain Hospital Conference Centre All past and present staff welcome Contact: Merril 0419 221 762

Prince Henry Hospital PTS 75 REUNION Saturday 24 November 2018 from 6:30pm Harbourview Hotel, Dawes Point near The Rocks Partners welcome Please contact Conrad for further information dogbox2@optusnet.com.au

WWBH PTS 1979 40-Year Nursing Reunion 2 February 2019 Contact:

Alison Meek (Giese) 0402612240 Sharyn Wellham (Noonan) 0432416419 Steph Taggart (Heenan) 0457414503

CROSSWORD SOLUTION

“I want a super fund that thinks about my future world, as well as my account balance.” Rachael Sydir, HESTA member

At HESTA we’re committed to improving our members’ financial future. But we believe we can achieve so much more. We want our actions to drive long-term, meaningful change. So the world you retire into is a healthy, happy and fair one. That’s the HESTA impact.

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 any relevant risks (hesta.com.au/understandingrisk). Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321.

ChloraPrep with Tint

REGULARS

™

Cutaneous solution minimises hospital acquired infections Here’s how you could single-handedly reduce CVC *-related bloodstream infections by**

62%. 1

ChloraPrep™ cut surgical site infections by**

41%.

Product code

Description

Packaging

Shelf life

600415

3 mL tint

25/bx., 100/cs. UOM cs.

24 months

600715

10.5 mL tint

25/bx., 100/cs. UOM cs.

24 months

600815

26 mL tint

25/bx., UOM cs.

24 months

Temperature-control recommendations3

Store below 25°C.

Please contact your local representative for more information. References 1 Garcia R, Jendresky L, Landesman S, Maher A, Nicolas F. Three years experience in implementing HICPAC recommendations for the reduction of central venous catheter–related bloodstream infections. Manag Infect Control. 2003;10:42–49. 2 Darouiche RO, Wall MJ, Itani KMF, et al. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis N Engl J Med. 2010;362:18-26. 3 CareFusion Data on file as per Instructions for Use (IFU). * Central venous catheter. ** When compared to 10% povidone-iodine.

ChloraPrep™ with Tint

Cutaneous Solution 2% w/v chlorhexidine gluconate (CHG) 70% v/v isopropyl alcohol (IPA)

CareFusion Australia 316 Pty Ltd Unit 3/167 Prospect Highway Seven Hills NSW 2147 Ph: 1800 833 372

CareFusion NZ 313 Ltd 14B George Bourke Drive Mt Wellington Auckland 1060 Ph: 0508 422 734

52 | THE LAMP MARCH 2017