Lamp December 2018

SAFE STAFFING

PRIVATE HOSPITALS

PROFESSIONAL DAY

REGULARS

Mandated ratios will bring midwives back

Staffing improvements in Ramsay agreement

Complaints are an opportunity for insight

page 17

page 18

page 24

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. 11 DECEMBER 2018 / JANUARY 2019

THE EVERY DAY VIOLENCE OF HEALTH Print Post Approved: PP100007890

p.33 p.36 p.37 p.39

COVER STORY

“I want a super fund that understands my industry.”

Anne Mitchell, HESTA member

We’re the national industry super fund dedicated to health and community services, and have been for over 30 years.

We know how important your work is. And how well you do it.

We’re your fund. For life.

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.

2 | THE LAMP DECEMBER 2018 /JANUARY 2019

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. 11 DEC 2018 / JAN 2019

Hunter Office 8–14 Telford Street, Newcastle East NSW 2300

COVER STORY

NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962

Knife attack reveals safety failures Association inspects Blacktown Hospital as staff demand better security.

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

8

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.

68,727

14 17

COVER STORY Understaffed rural EDs face security risks

Narrandera nurses seek better staffing and improved security.

SAFE STAFFING

Mandated ratios will bring midwives back

18

Public sector midwives working part time or casual would work more hours if there were mandated minimum staffing requirements in maternity, new research finds.

PRIVATE HOSPITALS Staffing improvements

in new Ramsay agreement No ratios this time, but there are still significant staffing improvements and a five per cent pay rise over two years.

20 23

Avg Net Distribution per Issue

5 6 26 28 33 34 36 37 39 41 43 45 46

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

PRIVATE HOSPITALS Tough talks build a base for the future

A nurse and a midwife who were on the Ramsay bargaining committee speak to The Lamp about the year-long negotiations with the company.ios

PRIVATE HOSPITALS Surgery fall off leads to redundancies

24

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

Audit Period: 01/04/2018 - 30/09/2018 - Publisher Statement

REGULARS

at Berkeley Vale Approximately 50 nurses at Berkeley Vale Private Hospital will be laid off just prior to Christmas after Ramsay decided to shut down the hospital’s surgical unit. ios tios

NSWNMA PROFESSIONAL DAY Complaints are an opportunity for insight

Regulators are looking for more than reflection from nurses and midwives following a complaint.

They want to see insight, says Mary Chiarella.

OUR COVER: Photographed by John Sommer

THE LAMP DECEMBER 2018 /JANUARY 2019 | 3

4 | THE LAMP DECEMBER 2018 /JANUARY 2019

EDITORIAL

Brett

Holmes GENERAL SECRETARY

Labor sticks to its pledge on ratios The NSW Opposition has changed its leader but its policy on ratios remains the same.

The new NSW Opposition leader Michael Daley has quickly moved to re-commit his party to deliver new nurse to patient ratios if it wins office after the next state election in March.

Mr Daley re-committed Labor to: • Introduce a new shift-by-shift ratio system from 1 July 2019 • Introduce 1:3 ratios in emergency departments and pediatrics • Bring regional staffing levels up to city levels • Work to fix the specialling problem.

These commitments are completely consistent with Labor’s previous announcements.

This means we still have a clear pathway to ratios in our public health system that would reward many years of campaigning and advocacy by nurses and midwives to the benefit of patients.

The opportunity for new ratios remains alive and real in our public health system.

This continuity shows ratios are clearly embedded in ALP policy and are not dependent on any individual who may lead the party.

It reflects the strength of our arguments and the weight of evidence that shows ratios save lives and improve patient care.

In addition to the implementation of comprehensive shift-by-shift ratios, Michael Daley has also committed to an extra 250 security staff with additional powers that “will be placed in NSW hospitals to protect staff, patients and families”.

The NSW government has also announced an initiative to assess the threat to safety in our public hospitals.

The Minister for Health, Brad

Hazzard, has appointed Peter Anderson, a highly respected former Health and Police Minister, to review the impact of the 12-point plan on hospital security, established in 2016, and to consider any additional strategies to improve safety.

These measures from both Labor and the government are welcome in light of a new study conducted by researchers at the University of Technology, Sydney (see pp 10-11).

This comprehensive survey showed that there are alarming levels of violence against nurses and midwives across the entire health system.

Twenty four per cent had suffered physical violence. It is worth digesting that sentence more than once. A quarter of nurses had been the victim of physical violence in the course of doing their jobs delivering care.

As the researcher who conducted the survey said: This makes the job more dangerous than that of the police and prison officers.

Not only is the violence widespread, it is getting worse. Three quarters of nurses and midwives who responded to the survey believe the frequency of violent episodes was increasing.

There are many complex reasons why violence has become endemic in our health facilities. But it cannot be ignored that understaffing leaves nurses and midwives more vulnerable to aggression.

Labor’s promise to increase nursing and midwife numbers along with the deployment of more security and the government’s review of safety won’t solve this problem alone.

But they are a very good place to start.

‘ The opportunity for new ratios remains alive and real in our public health system.’

THANKS FOR YOUR ONGOING SUPPORT The Australian Electoral Commission recently announced that Judith Kiejda and I have been re-elected unopposed following the closure of nominations for the ANMF NSW Branch Secretary and Assistant Secretary positions (along with Branch Councillors).

This also means that we have been re-elected to the NSWNMA General Secretary and Assistant General Secretary positions.

We are both grateful for your ongoing support for our leadership of your unions. Much has changed since our first election in 2003 and we have had to lead that change.

Politicians have chosen to remove your traditional industrial rights and we have had to encourage you to engage with the politicians who, ultimately, are the decision makers.

Most members understand the reason for doing things differently.

We now face a further attack from the State Government that is trying to restrict our capacity to engage in the political debate as third party campaigners. We are relying on the High Court to give your public voice back so that your issues can be widely heard by the community in the lead up to elections.

Should the High Court decide otherwise - and in favour of politicians with their loud and dominating voices - then our union will have to make further changes to meet that challenge. We will ensure your voice is never silenced when it comes to advocating for safer patient care.

It is a great privilege to lead the ANMF NSW Branch and the NSWNMA. We do not take that for granted. Judith and I thank you for your support. ■

THE LAMP DECEMBER 2018 /JANUARY 2019 | 5

YOUR LETTERS

Have your

Say

Eyes opened on medicinal cannabis

THIS CHRISTMAS GIVE THE GIFT OF LIFE The perfect Christmas gift, stocking filler or secret Santa. ●

Stay organised ● Keep healthy with expert advice ● Fund life-saving breast cancer trials research

50 WOMEN EVERY DAY ARE DIAGNOSED WITH BREAST CANCER & YOU CAN HELP

$

18.95 from Newsagents, Woolworths,

& womenshealthdiary.com.au

breastcancertrials.org.au tel: 1800423444

MEMBERSHIP FEES 2019 NSW Nurses & Midwives’ Association – in association with the Australian Nursing & Midwifery Federation Year

Quarter

Month

Fortnight

Registered Nurse & Midwife: $764.00 $191.00 $63.66

$29.38

Enrolled Nurse: $649.00 $162.25

$24.96

$54.08

Firstly, I would like to thank the NSWNMA for providing a highly informative event for nurses. I am not only astounded by the amount of information and knowledge I received in the one event, but more so I am grateful this is now openly discussed for greater awareness and education for the public.

I found out about the forum through an advertisement I saw in The Lamp magazine. For years I’ve heard about the benefits of medicinal cannabis; however, I remained sceptical.

I met Lucy Haslam at the forum who is the Executive Director and Co-founder of United In Compassion, a not-for-profit organisation dedicated to advocating patient access to medical cannabis. A documentary directed

by Helen Kapalos was screened – A Life Of Its Own: The Truth About Medical Marijuana (now available on Netflix). Lucy’s son, Dan Haslam, who is the main subject of the documentary was 20 years old when he was diagnosed with stage-4 cancer. He used medicinal cannabis to manage his condition as he underwent chemotherapy. I feel touched by this story because if Dan were alive today, we would be the same age.

As the day continued at the forum, I began to understand the frustration nurses, patients and advocates feel together. From legal to request

Assistant in Nursing+ & Assistant in Midwifery: $535.00 $133.75 $44.58 $20.56 Undergraduate Bachelor of Nursing /Midwifery or Diploma of Nursing^: $267.00 $66.75 $22.25 $10.26 Membership fees are tax deductible Trainee AIN’s have fees waived for the duration of their traineeship Students working in a nursing role while undertaking an Undergraduate Bachelor of Nursing/Midwifery or Diploma of Nursing for the duration of the bachelor/diploma. *All membership fees include GST

+

Letter of the month The letter judged the best each month will win a $50 Coles Group & Myer gift card!

Union Shopper offers members BIG savings on a wide range of products!

^

unionshopper.com.au 1300 368 117

ABN 63 398 164 405

6 | THE LAMP DECEMBER 2018 /JANUARY 2019

Union Shopper Letter of the Month.indd 1

23/02/15 11:53

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 access, the process feels as if it can fail through timing and price and most doctors are reluctant to prescribe. Carol Ireland, who is the CEO and Managing Director of Epilepsy Action Australia, explained that it can cost an estimated $40,000 for parents of a child to pay for medicinal cannabis. How could one household afford that annual cost, especially a single parent?

It is a fact that nurses are at the forefront of patient care. I was shocked that when I met an Australian director of a medical cannabis producer, he said directly to me: “No, doctors are at the forefront”.

Rather than fuel my fury and switch to defend not only myself and all nurses, I decided to remain calm and let this director find out for himself that one day when he or a loved one is in a hospital bed and the call buzzer is pressed – who is at the forefront to answer that call?

Yes, that’s right ... a nurse.

Thank you again to the NSWNMA for allowing me to engage in the eye-opening field of medicinal cannabis.

Krista Mabagos, Registered Nurse

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

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

LETTER OF THE MONTH Ratios are a step towards more fairness I think a fair system of ratios will have a ripple-on effect towards fairness within the health system and society in general. An absence will continue to feed instability and anxiety within the system. Introducing an effective nurse to patient ratio system will result in widespread positive changes. Among other things, these include: • Nursing recruitment • Patient care • Workplace violence • Staff morale • Bullying and harassment, anxiety and depression amongst staff and patients.

Some may say waiting lists in hospitals will be longer or our government cannot financially sustain such a system. Waiting lists won't be longer because patients will be getting the thorough care that will result in timely discharges and lower re-admissions.

Nurses will do more than the bare minimum, thorough assessment and care, more client education, health promotion and discharge planning.

Why have hospitals with state of the art technology? Why finance nurse academia? Why put money into mental and physical health promotion? All to just ruin it by not putting the money into a proper system of nursing care.

Younger generations want to feel secure that in the future if they need to be cared for in a nursing home/hospital they will receive good care otherwise this creates a distrust of systems and social unrest.

Haven’t the elderly in nursing homes suffered enough?

‘Discrimination of the elderly’ is a major social issue.

Unless you remain independent or will be fortunate to have carers that can meet your needs, it will affect you personally and others involved.

Talia Perikleous

THE LAMP DECEMBER 2018 /JANUARY 2019 | 7

Knife attack reveals safety failures Association inspects Blacktown Hospital as staff demand better security and ratios.

A

35-year-old Blacktown Hospital nurse suffered knife wounds to her wrists and arms when attacked by a patient.

The assault happened in an unlocked staff tearoom in a medical ward.

Just a week before the attack, Blacktown nurses and midwives had rallied in support of the NSWNMA’s campaign for a new nurse-to-patient ratios system.

The campaign aims to address safety, workload and other issues linked to inadequate staffing.

At the time of the incident, three nurses were working in the ward. Under the safe staffing system sought by the NSWNMA, five nurses would have been rostered on.

Staffing levels at the hospital have been an ongoing concern. From January to June this year, the NSWNMA uncovered around 1250 hours of missed nursing shifts in breach of the award minimum.

Speaking to the media following the knife attack, NSWNMA Assistant General Secretary, Judith Kiejda, said violence in the public health system is spreading from high-risk areas, such as emergency departments and mental health units, to all hospital areas.

“Nurses are fed up with the current staffing system because there is no mandated ratio for every shift on every day. When incidents like this occur, nurses need all the support they can get,” she said.

“There must be more measures in place to protect nurses and midwives when they’re on the job, so their focus is on caring for patients, not the possibility of being violently assaulted.”

A meeting of Blacktown’s NSWNMA branch called for changes to hospital security, including swipe-access locks on doors to staff-only areas.

Members also resolved to wear grey armbands for two 8 | THE LAMP DECEMBER 2018 /JANUARY 2019

‘ This time we chose grey because black is worn for a death and we never want to have to wear that.’ — Christine Boxsell days to highlight violence in the workplace.

Branch president Christine Boxsell said members earlier wore red armbands in support of ratios.

“This time we chose grey because black is worn for a death and we never want to have to wear that,“ she said.

“Grey armbands were worn by all staff classifications throughout the hospital – nurses, doctors, allied health, cleaners, everyone.”

ACCESS EXISTS TO ITEMS USABLE AS WEAPONS Christine joined NSWNMA officers in a safety inspection following the attack.

The inspection identified improvements needed in access to staff-only areas, duress alarms, ward design, access to the emergency department and afterhours access to the whole hospital.

General Secretary Brett Holmes conveyed the inspection team’s findings in a letter to Western Sydney Local Health District.

Brett said it was good to see that electronic swipe access was being installed on the staff tearoom door at the time of the inspection.

However, he wrote, patients could access other areas of the hospital without lockable doors to obtain items such as knives, scissors and needles that could be used as weapons.

Also, doors with appropriate locks were propped open and staff toilets did not have measures to ensure staffonly access.

At the time of the inspection, ward B35 had two fixedpoint duress alarms at the nurses’ station and medication room and one personal duress alarm.

“There was no clear understanding from staff in the ward about the circumstances in which the personal duress device would be worn or who should wear it, with the result being that it appears to sit in a drawer.”

Brett said the assaulted nurse was unable to access a duress alarm and it was fortunate that another nurse was able to use the duress alarm in the nurses’ station in order to call for help.

In addition, there was no indication to the person operating the alarm that it worked when they pressed it.

ANYONE CAN ENTER MOST WARDS AT ANY TIME These and other failings fell short of standards set out in mandatory NSW Health policy.

Christine Boxsell told The Lamp that swipe access had since been installed on the B35 staff room and main hospital dining room.

However, the fire exit door was able to be accessed from outside and, due to renovations, access to the ED was now through the main hospital entry, which is unlocked 24 hours per day. That means anyone could access most of the wards at any time.

Christine said all nurses in B35 had been issued duress alarms following the union safety inspection.

“We had another episode in B35 the other day when a patient pulled a nurse by the hair.

‘ The NSWNMA uncovered around 1250 hours of missed nursing shifts in breach of the award minimum’.

“That’s an improvement, but we don’t know if and when nurses in other wards will be given personal alarms.”

The inspection team recommended the hospital investigate options to remove “entrapment points” in the ward such as the nurses’ station, which has only one entry/exit point.

The inspection noted serious problems in the ED including the inability to remotely lock it down, lack of secure staff areas, patient access to items that could be used as weapons and staff not wearing duress alarms.

Lockers provided for ED staff were too small, resulting in bags being kept on the floor, which posed a trip hazard.

This was a breach of the Nurses and Midwives’ State Award, which provides for “a full-length locker fitted with lock and key or other suitable place for the safekeeping of clothing and personal effects”.

Christine said Blacktown Hospital’s director of nursing and midwifery told the branch that management were working on an “action plan” in response to the safety inspection recommendations and would communicate the results to the branch. ■

“She immediately activated her duress alarm and security came straight away.

THE LAMP DECEMBER 2018 /JANUARY 2019 | 9

COVER STORY

The everyday violence of health The power of NSWNMA members will be crucial to force the systemic change needed to deal with violence in our hospitals, says expert.

N

urses are more likely to suffer violence at work than police and prison officers, a researcher at the University of Technology Sydney has found. Dr Jacqui Pich, who recently presented her research to an international conference in Toronto on violence in the health sector, told The Lamp we need to ask “why is it safer to work in a prison or be a police officer?”

Dr Pich’s findings come from more than 3500 NSWNMA member responses to a sur vey about workplace violence. The results found that younger nurses are more at risk than older nurses, and that the private sector is only slightly better than public (see story on pages 12–13 for all the survey results). There was no difference, however, in the types of violence nurses experienced across sectors.

“Emergency departments and mental health and drug and alcohol nursing have been places where we think about violence. But the findings are telling us it doesn’t really matter where you work; you can be in a public hospital in

10 | THE LAMP DECEMBER 2018 /JANUARY 2019

‘76 per cent of respondents believed the frequency of violent episodes was increasing.’ a big city or you can be in a small country hospital, you are still exposed to risks.”

The high response rate Dr Pich received from nurses and midwives to her survey shows that violence is an “issue close to their heart: they take it very seriously and we have an obligation to do something with the results”.

Dr Pich said she was surprised both by the degree that violence extended outside of the workplace, and how long lasting the impact of violence can be: “We tend to think when we call it ‘workplace violence’ that it happens in your workplace.

But it happens outside of work, and it happens in cyberspace.

“The use of social media has taken off and we haven’t managed to deal with it effectively. People are using social media to take photos, to threaten and to stalk

people in ways that extend well beyond the workplace.”

IMPACT OF VIOLENCE IS LONG LASTING Workplace-related violence is having long-term personal and professional impacts on nurses and midwives too. More than three quarters of those surveyed reported verbal and non-physical forms of abuse, and these experiences can “cause a lot of symptoms like you would have with PTSD, such as trouble sleeping and flashbacks”, said Dr Pich.

“Pe ople a re le av i n g t he profession, withdrawing from certain types of patients, and experiencing feelings of professional incompetence or self-doubt.”

The responses to the survey i n clu de d “r e a l ly de s p e r a t e comments that people are so unhappy that they are scared to

COVER STORY

go to work, and that they attempted self-harm”.

The result is a decline in the quality of care and a climate where errors are more likely to occur.

“The bottom line is it is going to have an impact on patients’ safety.”

Dr Pich said while reaction in Canada to her findings was shock, researchers also recognise that it is an international trend.

“It is a similar experience with nurses overseas, so it is not just isolated to Australia.”

REPORTING SYSTEM BROKEN One of the major hurdles to addressing workplace-related violence is that it is hugely underreported, said Dr Pich.

“Often management will say ‘I haven’t got any reports and this is not a big problem’. But we know that it is happening and nurses aren’t reporting it for a multitude of reasons.

“Often the system is designed so that they won’t report it because it is going to take time, or it is a difficult system, or because the

violence is so common, or they know if they report it nothing will happen. There is a big gap between what happens out there and the policies to protect people.”

Dr Pich says what is needed is systemic change driven by the power of the NSWNMA. “Nurses are the most vulnerable and experience the most violence of all the healthcare professions.

The NSWNMA is in a good position to drive this push for change.”

Dr Pich says this research provides a solid basis for the union to take evidence to the NSW health minister and say “this is not good enough” and use it to drive change.

“We need to have a series of recommendations for change, and it needs to include ways to evaluate those changes and it needs to be an ongoing process.”

“And we need to really keep it out there. Because if something really bad happens it hits the media and everyone is really interested, but things like this are happening every day.” ■

Examples of violence reported by nurses and midwives “ Doused with diesel and threatened with weapon.” “ I was physically assaulted by a patient 18 months ago and the repeat exposure to verbal and physical assaults on ward have continued to have an impact on not only my physical self but mental health and family life.” “ Stalking me at my home and threats towards family members” “ I do not feel safe at my place of work and have increased anxiety and thoughts of leaving nursing due to this.”

THE LAMP DECEMBER 2018 /JANUARY 2019 | 11

COVER STORY

Aggression is widespread – and on the increase Survey exposes alarming levels of violence against nurses.

E

ighty per cent of nurses and midwives experienced at least one episode of verbal and/or physical violence in the six months before answering a survey of NSWNMA members.

Forty-seven per cent of nurses and midwives reported an episode of violence in the week prior to completing the survey.

Older and more experienced nurses were less likely to be subjected to violence and men were more likely to experience it.

A total of 3416 members took part in the survey, which was sent to all members.

Members were asked about signs and symptoms exhibited by people who inflicted violence. Members said mental health issues were apparent in 78 per cent of cases. Substance abuse (57 per cent) and alcohol intoxication (46 per cent) were also common.

The survey asked about violence from patients and family/friends/visitors of patients.

Of those who responded to her survey, 77 per cent were RNs and 87 per cent were women.

Almost one quarter (24 per cent) had suffered physical violence with 76 per cent receiving verbal/nonphysical abuse.

Among members who reported physical abuse, 35 per cent of cases involved use of a “traditional or opportunistic” weapon. Inappropriate physical or sexual contact occurred in 41 per cent of cases and sexual assault occurred in two per cent.

Among members who reported verbal abuse, 14 per cent involved use of social media and taking of photos and 25 per cent involved “sexually inappropriate” behaviour.

MORE VIOLENCE IN PUBLIC SECTOR Emergency department, drug and alcohol and mental health services were the clinical areas most likely to be subjected to violence.

Public sector workers were more likely to experience violence (82 per cent compared to 69 per cent for the private sector) and there was slightly more physical violence in regional areas compared to metropolitan.

The number of reported violent episodes ranged from 1 to 100 with the majority (80 per cent) reporting between one to 20 episodes.

12 | THE LAMP DECEMBER 2018 /JANUARY 2019

The survey indicates the workplace is becoming more violent. Of those who responded to the survey, 76 per cent believed the frequency of violent episodes was increasing.

COVER STORY

PSYCHOLOGICAL INJURIES ARE CONSEQUENCES OF VIOLENCE The survey also examined the impact violence is having.

Twenty-eight per cent of respondents reported that they had suffered a physical or psychological injury/ illness as a consequence of violence. In this group, psychological injury was the most common (71 per cent).

Almost 52 per cent of those who reported violence said it had an impact on their professional practice.

Impacts included lack of empathy towards patients, decline in quality of care, avoidance of patients, feeling of professional incompetence and self-doubt.

Members were asked about employer responses to violence and any risk-prevention strategies in place.

Only 12 per cent thought their organisation’s policies and procedures related to prevention and management of violence were effective.

Almost half (48 per cent) of survey participants were not satisfied with their employer’s immediate response to the most significant episode of violence in the preceding six months. In this group, just over 10 per cent said the employer blamed them for the violence.

Sixty-seven per cent said they were not provided with adequate information, support and follow-up after the episode.

The survey indicates that incidents of violence are greatly under-reported. Only 33.45 per cent of staff subject to physical abuse said they reported all episodes.

When asked why they did not report these episodes, almost 41 per cent said they were “an accepted/expected part of the job”. A higher percentage – 56 per cent – said they did not make a report because they did not expect anything to change in the long term as a result. ■

‘76 per cent of respondents believed the frequency of violent episodes was increasing.’

Key findings

47%

of respondents reported that they had been involved in a violent episode in the previous week

80%

had experienced at least one violent episode in the previous six months

76%

had experienced verbal/ non-physical abuse

24%

had experienced physical abuse

What nurses and midwives had to say about violence in our health system: Managers don’t seem to be concerned about the safety of staff.

I am currently very unhappy with my job, I am in tears, suffer anxiety, physically throw up before work, lost 7kg in a month.

I work in an unsafe hospital.

Security monitoring company 160km away. Police frequently out of town. Facility frequently unprotected, may take hours for help to arrive. No onsite security at all.

Could all be dead before help arrives.

Violent people get away with their behaviour. Nurses are losing control of a safe working environment.

Too many good nurses are being harmed and no one seems to care.

THE LAMP DECEMBER 2018 /JANUARY 2019 | 13

COVER STORY

Understaffed rural EDs face security risks Narrandera nurses seek better staffing and improved security.

T

he NSWNMA has warned of security risks facing small country hospitals that have emergency departments gazetted as mental health assessment centres.

These hospitals do not have mental health beds or trained mental health nurses.

They must care for patients at least until a telehealth assessment can determine the next step in the treatment process.

The 34-bed Narrandera Hospital in the Riverina region is one of about 12 NSW facilities in this category.

Following an NSWNMA safety inspection of the hospital, General Secretary Brett Holmes wrote to Murrumbidgee Local Health District warning that Narrandera nurses are at serious risk from violence and aggression.

This was due to inadequate nurse-to-patient staffing ratios, inadequate security coverage and poor facility design.

“Add to this that Narrandera is a declared mental health emergency assessment centre and it is only a matter of time before a major incident occurs,” Brett said.

Overnight, the hospital is staffed by three nurses with no security guard working across the ED and 20-bed ward. The nearest full-time police service is 90km 14 | THE LAMP DECEMBER 2018 /JANUARY 2019

‘ A nurse could be unconscious or dead on the floor and we in the ward would be none the wiser.’ — Linda Sommerfield away at Griffith.

security for several years.

Nurses must often work in isolation in the ED or ward, which does not allow for an effective duress response in an emergency.

“The LHD gave us a new duress alarm system in 2016 but they are the most cumbersome devices ever invented. They have a button at each end and you must be sure to press the correct button twice.

That’s not always easy when you are being assaulted.

This is in breach of NSW Health’s “Protecting People and Property” policy and Australasian health facility guidelines, which say no nurse should work alone or in isolation, Brett pointed out.

“Staffing numbers must not only take into account patient numbers, but also the safety of staff,” he said.

He recommended a minimum of four nurses be rostered to work at night to ensure that none were forced to work in isolation and an additional security guard be employed.

VULNERABLE IN THE ED NSWNMA delegate and branch secretary Linda Sommerfield told The Lamp the hospital employs just one security guard from 2pm to 11pm Wednesday to Sunday. The guard is not replaced when sick or on leave.

She said the branch had asked for better staffing and improved

“The duress rings through to a security company in a remote location, which then calls the hospital to find out if there is a problem. If there is, security calls the police who could be 100km away as the local station is not staffed 24 hours.

“The police always arrive in pairs, yet we are expected to deal with these patients in isolation. In the last 6–12 months ED has been very busy with at least one nurse working down there for a whole eight-hour shift.

“We don’t have a safety lockdown area or triage area in the ED. We open the door to the public and they can walk straight in to access the whole department and go through to the ward.

COVER STORY

“We have no cameras in ED and, if a nurse working in isolation can’t get to their personal duress or the duress emergency button behind the nurses’ station, that nurse could be unconscious or dead on the floor and we in the ward would be none the wiser.

“If a nurse is concerned about someone’s behav iour in ED they have to ring the ward for assistance, which leaves one ward nurse alone with up to 20 patients on a night shift. That includes patients with dementia and at high risk of falls and three closeobservation patients.”

MULTIPLE ISSUES WITH MENTAL HEALTH PATIENTS Linda said despite the hospital being listed as a mental health emergency assessment centre, none of the nurses are mental health-trained apart from doing a 30-minute online course.

“Given our staffing situation, how are we supposed to give mental health patients the best-possible care while ensuring our own safety and that of our other patients?

“Quite often, mental health patients have to be sedated before

‘ It is only a matter of time before a major incident occurs.’ — Brett Holmes being admitted to our facility. ED presentation is only supposed to be for four hours, but they are sometimes here for up to eight hours waiting for a telehealth linkup or transport. That’s not fair on the patient, their loved ones or staff.”

There have been several violent incidents at Narrandera hospital in the past 2–3 years.

A patient held a doctor and two nurses hostage for several hours; a handcuffed patient in police custody tried to strangle a nurse, dragging her to the ground; a security guard was badly bitten and permanently scarred; and a nurse was forced to change work patterns following threats and verbal abuse.

Linda said the LHD has made some improvements including: more swipe card access; installation of an internal door to prevent free access to wards and to isolate aggressive ED patients from wards once the door is closed; and enhanced safety in the doctors’ consulting room.

In a letter to Brett Holmes, t he ac t i ng Ch ief E xec ut ive of Murrumbidgee LHD said an “action plan” to improve security had been developed.

Narrandera Shire councillor Barbara Bryon told the Narrandera Argus newspaper that violence towards nurses was on the increase and security must be improved.

“John Barilaro, Minister for Reg iona l Development, ta lk s about money into the regions and the regional funds and grants available. But at the same time, the state government is pulling ser vices out of the regions,” councillor Bryon said.

“If there is a violent incident, who do you phone? We don’t have 24-hour police services, because that’s another arm of government that they’re pulling out of the regional centres.” ■

THE LAMP DECEMBER 2018 /JANUARY 2019 | 15

COVER STORY

‘Grave concerns’ over forensic hospital assaults NSWNMA urges Safework to act on “imminent danger” to mental health nurses.

N

urses at Sydney’s Long Bay forensic hospital are at “imminent risk” of serious injury or death as a result of management’s failure to reduce exposure to violence from patients, the NSWNMA has warned.

The warning follows another serious assault in September in which six nurses were injured and two needed hospital treatment.

In March 2017, a nurse suffered a broken jaw, broken nose and two fractured eye sockets when assaulted by a patient.

The high-security forensic hospital cares for patients deemed unfit to stand trial or not criminally responsible due to mental illness.

In a letter to the workplace health and safety regulator, Safework NSW, NSWNMA General Secretary Brett Holmes said the union had “grave concerns” for members’ safety “arising from a failure of the Justice and Forensic Mental Health Network to eliminate or minimise” nurses’ exposure to high levels of violence.

“We strongly believe there is an imminent risk of serious injury or fatality to our members at the site,” Brett wrote to Safework’s executive director, operations, Anthony Williams.

Brett said Safework inspectors had been “engaging with the hospital” since March 2017 and issued improvement notices with no consequent reduction in risk to nurses.

He asked Mr Williams to outline what Safework now intended to do to minimise risk.

The hospita l’s NSW NM A branch secretar y and delegate, Michael Sparks, said staff called in Safework last year after five nurses were injured in two separate attacks.

“Safework asked the hospital to improve staff numbers, install security cameras, implement safety procedures and provide appropriate training.

16 | THE LAMP DECEMBER 2018 /JANUARY 2019

‘ Safework asked the hospital to improve staff numbers.’

— Michael Sparks

“They only thing they have done is install CCTV cameras. These are not monitored by security or clinical staff and are there only for post-incident investigation.

They will not stop assaults from happening.”

MANY STAFF LEFT AFTER 12-HOUR SHIFTS ABOLISHED He said the hospital had been “chronically short staffed” since management switched from 12-hour shifts to eight-hour shifts.

“About one-third of staff resigned soon after 12-hour shifts were abolished and we now have vacancy rates in excess of 25 per cent.

“Those who resigned were experienced mental health nurses. A large number of current staff are agency nurses and new graduates who do not have the necessary experience and training to manage the level of violence exhibited by patients.

“Staff fatigue is a big factor given the high-stress nature of the job combined with excessive overtime.”

Michael said the hospital has no security guards except a private contractor who manages the front gate.

“It is the nurses who provide security within the hospital and consequently get assaulted.”

“The branch has called for security guards but if we can’t get them we at least need to be fully staffed with a trained response team.

“The police hate coming here because it is such a dangerous situation. Often the local police will call the police Public Order and Riot Squad.” ■

SAFE STAFFING

Mandated ratios will bring midwives back Public sector midwives working part-time or casual would work more hours if there were mandated minimum staffing requirements in maternity, new research finds.

O

ver the last year The Lamp has reported on the chronic shortage of midwives in hospitals across NSW yet a new survey has found that large numbers of midwives would work more hours in our maternity suites and post-natal wards if ratios were introduced.

The survey of over 1000 NSW midwives found that 62 per cent work part time or as a casual and 93 per cent of these say they would increase the number of hours they would work if there were ma ndated minimum sta ff ing requirements in maternity.

All had thought about leaving the profession with 80 per cent highlighting understaffing as the main reason they would act.

Currently there are no ratios of midwives to mothers in post-natal units in NSW hospitals.

The survey comes on the heels of the annual statistical report on births in NSW, released last month by the Centre for Epidemiology and Evidence, which found that the proportion of babies fully breastfed has dropped by 8.4 per cent to 73.7 per cent since 2012.

Other studies have found that babies discharged quickly from hospital are less likely to breastfeed.

A part of the problem, says NSW NM A A s sist a nt G enera l Secretary Judith Kiejda, is the lack of time to give mothers the

‘ I feel that the women of western Sydney are being ripped off.’ — Renalla Fairley level of support they need before they discharge.

“Midwives are responsible for educating mothers and providing physical and emotional support to both women and their babies,” she said.

YOUR POSTCODE COUNTS IN POST-NATAL CARE “Under the current system there is not enough time for midwives to provide the level of support and education mothers need during these vital days.”

west where, on average, mothers and babies are sent home a day earlier than those from hospitals in the east and north, the statistics reveal.

“I feel that the women of Western Sydney are being ripped off. They don’t get the one-on-one care, they don’t get the education that they need because we just don’t have the time to spend with them, We’re putting women out the door when they want to stay and be cared for in hospital,” Renalla Fairley from the NSWNMA Nepean Branch told a recent rally outside the hospital. ■

This is particularly so in Sydney’s THE LAMP DECEMBER 2018 /JANUARY 2019 | 17

PRIVATE HOSPITALS

Staffing improvements in new Ramsay agreement No ratios this time, but there are still significant staffing improvements and a five per cent pay rise over two years.

s The Lamp goes to print and after a year of widespread consultation with staff followed by tough negotiations with the employer, a new enterprise agreement is about to go to Ramsay nurses and midwives for a vote.

While the goal of ratios has not yet been achieved there are still significant staffing improvements, pay rises without trade-offs or contingencies and an upgrade in conditions.

A

NSWNMA General Secretary Brett Holmes says it was disappointing that Ramsay would not agree to ratios but acknowledged the agreement still delivered “a lot of progress” on safer staffing.

There was a 2.5 per cent increase in pay and allowances paid in July 2018. There will be a further 2.5 per cent increase from July 2019.

“We will continue to push for ratios in private hospitals including Ramsay because we know they are vital for our patients’ safety and care.”

There are a number of tools to enforce safer staffing at Ramsay hospitals including: • s tronger recognition of professional standards and obligations • on-call to access staff for emergencies not to support routine theatre lists • r eplacement of leave absences with equivalent skill level • c riteria for in-charge of hospital and ward/unit for a patient load and current supernumerary arrangements protected • dedicated staff for ‘Specials’ • protection for new grads who can now refuse to be In-Charge.

18 | THE LAMP DECEMBER 2018 /JANUARY 2019

“Ramsay refused to agree to ratios and ACORN standards for safe patient care. But we have been here before. It took many years of resolute campaigning to win ratios in the public sector and we are still fighting hard to get improvements there,” he said.

Brett says it also took strong pressure from members and tough bargaining to get an acceptable pay offer on the table.

Ramsay outraged members when they initially tied the amount of the second year increase to an unknown federal election outcome and a potential change in private health insurance policy.

The company’s accounts show that Ramsay is highly profitable with a seven per cent increase in profits for the year and according to CEO Craig McNally, is performing well despite industry headwinds.

Ramsay has also just consolidated its position as one of the world’s largest and most profitable private hospital groups with the purchase of a European healthcare provider, Capio, for $1.3 billion.

PRIVATE HOSPITALS

THE RAMSAY BARGAINING COMMITTEE (FROM LEFT TO RIGHT): MATT HENDERSON (NSWNMA), LYN WHITLAM (RN, NORTH SHORE PRIVATE), KATARINA OLRICH (EN, TAMARA PRIVATE), KERRIE HARRINGTON (RN, KAREENA PRIVATE), KAREN ATCHESON (EN, WOLBRETT WITH XXX LONGONG PRIVATE), MICHELLE VAN-AALST (RN, LAKE MACQUARIE PRIVATE), BRETT HOLMES (NSWNMA), HELEN VINCENT (RM, ST GEORGE PRIVATE), JASON HART (NSWNMA), JANE COOPER (RN, WOLLONGONG PRIVATE), LIZ ROBINSON (NSWNMA)

It was clear to the bargaining team, Brett says, that Ramsay could afford to pay its staff properly.

Nearly 800 nurses and midwives signed a petition in support of increased rates for ENs.

“Eventually, after our members held firm, Ramsay offered 2.5 per cent per annum with no strings attached.”

A GOOD PLATFORM FOR NEXT TIME

MEMBER ACTION KEY TO MOVING THE EMPLOYER The new enterprise agreement is the culmination of sustained workplace activity by NSWNMA members across the spectrum of Ramsay facilities in NSW. Over 1100 Ramsay staff filled out “safe staffing messages”, which were given to the Ramsay Healthcare Australia CEO, Danny Sims, outlining shocking and consistent experiences where safe patient care had been compromised.

Hundreds of Ramsay theatre nurses participated in an audit that compared their staffing levels with ACORN standards – widely accepted as the national benchmark for safety and quality care by perioperative nurses.

The results were alarming: 77 per cent reported they did not have enough staff for breaks; 33 per cent said that staffing levels compromised patient safety.

Fifty-six per cent of nurses in recovery reported that patient safety was compromised due to inadequate staffing, especially for patients requiring airway support and for paediatric patients.

Kerrie Harrington, who works in theatres at Kareena Private and was part of the bargaining committee, says although ratios weren’t achieved this time a solid platform has been laid to continue that fight.

“I’ve spoken to some people who were disappointed we didn’t get ratios.

“But having sat in over 12 months of meetings and heard what the company started off by saying I thought we did a great job and we got far more than I thought we would when we started out. I came away from the final draft optimistic that we’ll be able to achieve even more in the next agreement.”

She says she is also buoyed by the growth of interest in the union in Ramsay facilities and that too will help achieve improvements when the next agreement talks start in 12 months.

“This campaign has built our branch base up.

People are becoming more involved. More people have joined the union. People are more motivated and want to fight for the things we want incorporated in to the agreement,” she said. ■

THE LAMP DECEMBER 2018 /JANUARY 2019 | 19

PRIVATE HOSPITALS

Tough talks build a base for the future A nurse and a midwife who were on the Ramsay bargaining committee speak to The Lamp about the year-long negotiations with the company.

Staffing is a big issue Helen Vincent is a midwife and works for Ramsay in both the maternity suite and a post-natal ward. She said staffing was a big issue for her during the talks.

“As midwives in delivery suites we miss out on meal breaks altogether because there is no one to give us a meal break. There are no supernumeraries who can take over so you can get away and have half an hour.

“It is very busy with mothers with caesarean sections, babies with problems that we have to monitor. Also just helping with breastfeeding and the usual baby stuff. We just feel there is too much work and it is hard to manage in a civilised way.”

Helen says the delivery suites have been “frantically busy” lately.

“We are staffed for patient numbers of 18 women and we’ve had 30 and 32 over September and October. We’ve spilled all the way down to gynaecology and we’ve just occupied their beds and their patients have had to go elsewhere in the hospital.”

Helen says Ramsay seemed to take a hardline position on staffing from the beginning of the negotiations.

“I wouldn’t say they don’t care about us, but either they didn’t believe what we said about staffing or they really have a bottomline philosophy where they’re not going to give an inch regardless of how burnt out people get or how tired they are on the shifts that they do.”

Even though Ramsay wouldn’t agree to ratios, Helen believes there were still important wins in the agreement.

“I’m really happy that those nurses having babies will have another week’s maternity leave. That makes a difference to pregnant midwives. That’s good. I think the missed meal break after 6 hours – being able to claim that makes a difference. Also the new criteria for in-charge of hospital without a patient load. That is moving forward as well. But in the future, I’d certainly like to see more reasonable workloads.”

Helen says the issue of ratios will not go away for Ramsay.

“I know the Labor Opposition has said they will make staffing ratios mandatory in all public hospitals in NSW. That would put a lot of pressure on Ramsay because nursing staff and midwives do compare.

“I think if (Labor introduced new ratios in public hospitals) many midwives would think: ‘If I go to a public hospital to work I’ve got less women, I’ve got less pressure, I can sit with them longer and give better care and I’m getting the same money. Why would I bother working my guts out here’.”

‘ We are staffed for patient numbers of 18 women and we’ve had 30 and 32 over September and October.’

— Helen Vincent 20 | THE LAMP DECEMBER 2018 /JANUARY 2019

PRIVATE HOSPITALS

Things have changed Kerrie Harrington works in theatres. She has worked at Ramsay in two stints – once for five years and now for six years.

“I’ve noticed a big change in those two time periods with staffing levels within the hospital. I just feel nurses are not being given the opportunity to provide the quality care that they want to.

“Every nurse and midwife on the bargaining committee had terrifying stories to tell about staffing levels: never having meal breaks, working overtime, running the whole shift trying to provide care to mothers and babies safely and going home at the end of it worried about their registration because there were not enough midwives to provide safe care.

“In some of the rural hospitals there would be one nurse on and if they needed an RN to come and check drugs or provide back up, it wouldn’t be there or there would be delays.”

Kerrie says these staffing examples from nurses had an impact during the negotiations.

“A lot of people on the company side of the negotiating committee were not directly involved in patient care so I think it was quite confronting when we would tell why we felt so strongly about these things we wanted in the agreement.

We would be talking about patients. It was quite emotional sometimes.

“We were not talking about one facility or two. We had a good range of rural, metropolitan, large and small facilities and I think it was the sheer number of staffing examples we gave them that allowed us to draw out some of the concessions they did not really want to give.”

Kerrie says the agreement about the use of specials was significant.

“What we won is that specials will not come out of the regular staffing. There will be an additional staff member. So that is one way of alleviating the poor nurse-to-patient ratio. It’s a small step towards mandated ratios.”

Kerrie says the bargaining committee pushed hard for the adoption of ACORN standards, in theatres “so we can be comfortably looking after these acute patients with the knowledge that staffing levels are adequate to meet the patients’ needs”.

“We got a mention of ACORN standards but they have not committed to adhering to the standards. Adhering to the standards still remains our goal.”

Kerrie says participating in the bargaining gave her “new insights” into issues at other Ramsay facilities.

“I loved meeting and collaborating with nurses from other facilities.”

‘ We had a good range of rural, metropolitan, large and small facilities and I think it was the sheer number of staffing examples we gave them that allowed us to draw out some of the concessions they did not really want to give.’ — Kerrie Harrington THE LAMP DECEMBER 2018 /JANUARY 2019 | 21

PRIVATE HOSPITALS

At a glance: the gains in the new Ramsay enterprise agreement Ramsay has not agreed to ratios this time but the following improvements provide the tools for safer staffing at Ramsay facilities: • Stronger recognition of professional standards and obligations.

• On-call for emergencies not routine theatre lists.

• Protection for existing supernumerary In-Charge of Hospital, and new criteria for patient load when In-Charge of Hospital and In-Charge of Ward.

• New Professional Standards clause with consideration of ACORN Standards.

• Where NUM/MUM identifies that patient needs can’t be sufficiently met, a process to follow.

• NUM/MUMs to prioritise access to meal and rest breaks when establishing rosters.

• Replacement of leave absences with a nurse/midwife of the same level.

• Dedicated staff for ‘specials’ in addition to the numbers.

• Face-to-face training upon request for de-escalation/ mental health/emergencies.

• Protection for new graduates – can refuse In-Charge of Ward if considered unsafe practice.

22 | THE LAMP DECEMBER 2018 /JANUARY 2019

The pay increases won • 2.5 per cent increase to pay and allowances from July 2018.

• 2.5 per cent increase to pay and allowances from July 2019 (with no strings attached).

Other improvements to conditions • All existing conditions protected.

• Ten minute paid change time now at the start of shift and 10 minutes at the end of shift.

• Where a meal break is not taken by six hours due to employer direction, the employee is entitled to a paid missed meal break at overtime rates regardless of any breaks taken after six hours. Where employee agrees to finish shift early then missed meal break is not paid.

• A nurse or midwife working alone will be paid for missed meal break unless specific rostering arrangements ensure they are covered for breaks.

• Extra paid time for tea breaks for 12-hour shifts.

• Improved paid parental leave to 10 weeks.

• Employee can request access to pro-rata long service leave after five years.

• Commitment to full-time employee ADOs. • Increase to $40 In-Charge of Hospital and Ward rates.

• Higher duties payment for all shifts if you regularly act up.

• Team leader to be recognised and paid as in-charge (not in team nursing context).

• Up to five days paid leave and support measures for staff experiencing family violence.

• Up to five days paid natural disaster leave.

• Annual Leave requests will be responded to in a fortnight except for high demand holiday periods.

• Part-timers able to request a review of contracted hours once every six months.

• Consecutive days off unless agreed otherwise.

PRIVATE HOSPITALS

BERKELEY VALE PRIVATE HOSPITAL SURGICAL STAFF

Surgery fall off leads to redundancies at Berkeley Vale

A

pproximately 50 nurses at Berkeley Vale Private Hospital will be laid off just prior to Christmas after Ramsay decided to shut down the hospital’s surgical unit.

“They stopped all surgical services in November, and it has affected all the surgical staff and the theatre staff and some administrative staff,” said Janine Barton, president of the local NSWNMA local branch.

“Giving us five weeks’ notice just before Christmas has been really difficult. It has been a roller-coaster; it has affected our home life as well”, she said.

Janine said the reason Ramsay gave for the closure is that the hospital’s surgical services had dropped off, and they intended increasing the mental health side of the business.

T he de c i sion h a s b e en particularly difficult for the closeknit staff, most of whom have worked at the hospital for an average of 15 years.

“I had personally been there for 18

‘ It has been a roller coaster, it has affected our home life as well.’ — Janine Barton and a half years”, Janine says.

“Berkeley Vale has had such an amazing reputation. The public and the community are really disappointed to see it go. The staff are a family, and the patients love that it has that family feeling. We know the patients that come in for their procedures.”

NSWNMA Assistant General Secretary Judith Kiejda said Ramsay didn’t hold any consultations before announcing the redundancies.

“Staff were given a termination notice from the day they were originally told of the closure. We got involved and had that extended by about two weeks. That meant most people got an extra week of pay after the facility closed,” she said.

“We also advocated for a person who was pregnant and who had been planning to take parental leave. We

secured the payment of her parental leave and her redundancy as well.”

NSWNMA representatives and some 24 members held a meeting with the National Executive Operations Manager of Ramsay and “that communal meeting with him really put him on the spot, and that is how we got some of these concessions”, Judith says.

Ramsay also agreed to bring in representatives from the major hospitals in the area with lists of other jobs available.

“Pretty much everybody has been given casual work elsewhere,” Janine says. “We have had a lot of support from North Gosford Private and Brisbane Waters Private and Gosford Public and Wyong Public.

“But it will be a really sad day when we all walk out the door for the last time.” ■ THE LAMP DECEMBER 2018 /JANUARY 2019 | 23

NSWNMA PROFESSIONAL DAY

Complaints are an opportunity for insight Regulators are looking for more than reflection from nurses and midwives following a complaint. They want to see insight, says Mary Chiarella.

S

peaking at the NSWNMA Professional Day, Mary Chiarella, a professor of nursing at the University of Sydney, said one of the key things regulators are looking for when nurses and midwives respond to complaints is that they “show some ownership of the registrant’s role in the issue, regardless of what that might be”.

Professor Chiarella’s study of 712 responses by nurses and midwives to complaints made to the Nursing and Midwifery Council of New South Wales (NMCNSW) also found that regulators are looking for evidence that nurses and midwives have taken some action in response to the complaint.

“That action might be a demonstration of lessons learnt through discussion, or how the registrant might respond if such an incident happened again, and perhaps some learning if the complaint relates to something such as poor medication administration technique errors.”

Professor Chiarella explained that her study’s aim was to research the link between reflecting on an adverse incident and a practitioner’s competence.

If nurses and midwives are all registered as competent practitioners then why, she wondered, do we need a complaints process? “We’re all competent, so why would we ever end up having a complaint about competence?”

“My view was there was this missing thread, and this was this concept of insight. What we felt was if you were aware you were competent then you were safe, and if you were aware you were incompetent then you were probably safe. Certainly, if you were unaware you were incompetent then you were definitely not safe.”

24 | THE LAMP DECEMBER 2018 /JANUARY 2019

‘ If you were unaware you were incompetent then you were definitely not safe.’

— Professor Mary Chiarella To test this theory, the reflective responses required by NMCNSW from nurses and midwives to complaints about their competence at work proved an ideal research database.

What Professor Chiarella found was a difference in the self-reflections that showed real insight compared to those who didn’t. She says the NMCNSW are looking for nurses and midwives to show some or all of following in their responses: • They accept the incident occurred and their role in it.

• They reflect on and analyse the incident.

• They reflect on where they were that day, what they were thinking and doing.

• They analyse the context in which the incident occurred.

• They recognise their own failures

or mistakes.

• They express remorse or regret.

• They show a commitment to improving oneself.

• They show some thinking about what you would do differently next time.

• They have sought out some counselling or mentorship.

Professor Chiarella gave the example of a nurse who acknowledged that external and unaddressed stress in her life was making her erratic. In her response the nurse outlined a plan to address her stress. The NMCNSW, seeing that she showed insight into her behaviour, “didn’t even bring her in”.

“What we know is that reflection alone does not constitute reassurance about the insight that the regulators are seeking.”■

OBITUARY

VA L E

Lynne Vaughan

L

ynne Vaughan was a much-loved and well respected nurse, colleague and friend to many.

It is with great sadness that we report Lynne passed away suddenly.

Lynne worked in many and varied roles across both the Northern NSW and Mid-North Coast Local Health Districts, including in theatres, wound product purchasing and supply, wound management, continence and stoma.

Lynne was a key member in the highly motivated and professional leadership group of nursing colleagues within the Stoma, Wound and Continence network, and she was passionate about her work, colleagues and most of all, her clients.

Lynne easily developed a special bond with her clients and would often make the time to call in and see them on the way to and from work, with many expressing their sorrow and great sense of loss at her passing.

Lynne will be remembered as a wonderful nurse, clinician, educator and patient advocate; a truly resourceful

and fabulous co-worker.

Lynne was a bright and spirited lady, a generous friend, traveller and photographer, who loved to celebrate life.

All who knew her will always remember Lynne fondly as a dedicated nurse. ■

THE HUMAN EXPERIENCE CAN BE COMPLEX.

DO I...

CALL OUT BAD BEHAVIOUR AT WORK THAT DOESN’T FEEL RIGHT?

MAKE YOUR WAY THROUGH LIFE’S TOUGHEST CHALLE NG E S.

ETHI-CALL

A F R E E , I N D E P E N D E N T H E LP LI N E AVA I L A B LE TO A LL .

A SERVICE OF

THE ETHICS CE NTR E

BOOK A CALL NOW

LAMP DECEMBER 2018 /JANUARY 2019 | 25 W W THE W.ETH I- CALL.C OM

COMPETITION

Merry Christmas From the NSWNMA

Wishing all our members a Merry Christmas and offering you the chance to be part of this year’s Christmas giveaway. + HOW TO ENTER To be in the draw to win one of these fabulous prizes, simply provide your name, membership number and the prize you would like to win (a separate email is required for each prize) and email your entry with the subject: Christmas giveaway (prize title) to lamp@nswnma.asn.au Important: Only one entry per member for each competition will be accepted.

Entries must indicate which prize you would like to win in the email subject.

1 | SYDNEY FESTIVAL: 9–27 JANUARY 2019 Returning in January, Sydney Festival transforms Sydney with a cultural celebration based on the highest quality art and ideas. The diverse program includes everything from disco–burlesque–cabaret spectaculars to free outdoor concerts; from international theatre to family offerings and world premiere Indigenous works.

To celebrate, Sydney Festival is giving away two double passes to Shànghǎ i MiMi*, at the Riverside Theatres, Parramatta for the 11 January 2019 performance commencing at 8pm.

Dress to the nines and immerse yourself in the intoxicating world of Shànghǎi MiMi, a sumptuous cabaret of delights. Inspired by 1930s Shanghai, a city famous for its flamboyant clubs and heady nights, Shànghǎi MiMi is directed by Australia’s ground-breaking and multi-awardwinning performer and director, Moira Finucane. A hotshot live band plays vintage Chinese jazz and blues, while dancers, acrobats, aerialists and singers from China, Cameroon, Australia and France give thrilling performances, flying overhead, dazzling your eyes and winning your hearts.

Sydney Festival will commence on 9 January and conclude 27 January 2019. To book go to www.sydneyfestival.org.au *Tickets are for the performance on 11 January 2019 at 8pm.

*Conditions apply. Competition entries from NSWNMA members only and limited to one entry per member per prize. All entries must be in by Friday, 14 December 2018. The prizes will be drawn on Monday, 17 December 2018. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/18/02955.

26 | THE LAMP DECEMBER 2018 /JANUARY 2019

4 | SPLASH INTO SUMMER AT WET‘N’WILD SYDNEY Wet‘n’Wild Sydney is the biggest and best water theme park and has cemented its place as an iconic and exciting attraction in Sydney. With over 40 slides and attractions to suit the whole family, plenty of shade and delicious food outlets, Wet’n’Wild Sydney is the best place to spend time with your friends and family this summer.

Win one of 4 x double passes to Wet’n’Wild Sydney*. To book your tickets go to wetnwildsydney. com.au/plan-a-visit/tickets *Conditions apply. Offer only valid for Season 6, which commences 29 September 2018 until 24 April 2019. Tickets are valid for one single day use per ticket only. Unless otherwise stated, fees for food, merchandise, locker rentals, pay-per-ride attractions (Sydney SkyCoaster), special concerts or events are not included in the admission prices. Prices and product offerings are subject to change without notice. Children 3 years and under free.

2 | CHARLIE AND THE CHOCOLATE FACTORY AND RYDGES SYDNEY CENTRAL STAY PACKAGE Win a double pass to see Charlie and the Chocolate Factory* at the Capitol Theatre plus a two-night stay (for two) at the Rydges Sydney Central with breakfast each morning and parking included for the duration of your stay^.

Step inside a world of pure imagination! Experience the wonders of Willy Wonka when Roald Dahl’s delicious tale, Charlie and the Chocolate Factory opens its doors in Sydney from January 2019. It’s a delectable treat featuring songs from the original film, Pure Imagination and I’ve Got A Golden Ticket. To book go to www.ticketmaster.com.au

3 | RELAX AND UNWIND IN THE LUXURIOUS RYDGES SYDNEY CENTRAL 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 away from Sydney’s Darling Harbour, China Town and the Royal Botanic Gardens, you will be in the perfect location to explore the city of Sydney. The hotel bar Sydney Brewery Surry Hills is now open. With its focus on craft beer and good food, it’s the perfect location to enjoy your day, night or both!

The Lamp is offering members the chance to win two nights’ accommodation in an Executive King Room with breakfast daily and complimentary parking (valued at over $700). * Conditions apply. Charlie and the Chocolate Factory performance dates include Wednesday 6, 13, 20, 27 February 1pm or 7.30pm OR Thursday 7, 14, 28 February 7.30pm. Major prize is two separate prizes. Winner can choose to use Charlie and the Chocolate Factory tickets and accommodation package at the same time or separately. ^Accommodation package is valid until 30/6/19 and not valid during long weekends or special event periods (not valid on New Years Eve).

Rooms subject to availability. Voucher is non-transferable and not redeemable for cash. Voucher must be presented on arrival.

5 | ROME: CITY AND EMPIRE AND FORREST HOTEL & APARTMENTS CANBERRA ACCOMMODATION Located in a quiet street in Canberra’s garden district, Forrest Hotel and Apartments is situated just a stone’s throw away from major tourist attractions.

The Lamp is offering members the chance to win a two-night stay in a one-bedroom apartment with breakfast at the Forrest Hotel & Apartments and entry for two to see Rome: City and Empire at the National Museum of Australia.

Family-owned and operated, Forrest Hotel & Apartments are renowned for their hospitality and you will enjoy all the comforts of home complimented with outstanding service and facilities.

Go to www.forresthotel.com for more dining, event and accommodation details and bookings.

Stories of Rome and its vast empire continue to captivate and intrigue people almost 3,000 years after their foundation. Rome: City and Empire brings to Canberra more than 200 of the British Museums most engaging and beautiful Roman objects.

Explore how the empire was won and held, witness the grandeur of Rome and appreciate the rich diversity of its people.

Exhibition on show at the National Museum of Australia, Canberra until 3 February 2019. To book visit www.nma.gov.au/Rome THE LAMP DECEMBER 2018 /JANUARY 2019 | 27

NEWS IN BRIEF

AUSTRALIA

UNITED STATES

Wage theft rampant among overseas workers A comprehensive survey of international workers and temporary migrants in Australia has found a third earned $12 an hour or less, or half the legal minimum wage.

The survey, published as a report called Wage Theft in Australia, was conducted by academics from the University of NSW and University of Technology, Sydney.

The online survey covered 4,322 respondents from 107 countries. It was open to anyone who had worked in Australia on a temporary visa and was made available in 13 languages.

The survey found large-scale wage theft was worst in fruit and vegetable-picking and farm work, where 15 per cent of workers earned $5 an hour or less. Almost a third (31 per cent) earned $10 an hour or less.

The study also found that for every 100 underpaid migrant workers, only three went to the fair work ombudsman. Of those, more than half recovered nothing.

There were several barriers to reporting wage theft. Many overseas workers were unsure of the process or believed it would be too difficult to recover the wages, and more than a quarter said they would not speak up because of fears of losing their visa.

One of the researchers, Bassina Farbenblum, a senior law lecturer at University of NSW, said the study confirmed “Australia has a large, silent underclass of underpaid migrant workers”.

“The scale of unclaimed wages is likely well over a billion dollars.”

Unions NSW secretary, Mark Morey, told The Guardian that migrant exploitation was a “national shame that Australia must confront and fix”.

WAGE THEFT IN AUSTRALIA Findings of the National Temporary Migrant Work Survey Laurie Berg and Bassina Farbenblum I

November 2017

‘ Australia has a large, silent underclass of underpaid migrant workers.

The scale of unclaimed wages is likely well over a billion dollars.’

28 | THE LAMP DECEMBER 2018 /JANUARY 2019

Surge in premature births among Latinas linked to Trump’s election win A US study found premature births spiked among Latin women in New York following Donald Trump’s presidential election win.

The study, conducted by the New York health department and Harvard’s TH Chan School of Public Health, compared births in the city in the months before Trump won the Republican presidential nomination with births in the months after he was inaugurated (Journal of Epidemiology and Community Health, October 2018).

There was no change in babies born prematurely among American-born women. But among foreign-born women, the rate increased from 6.7 per cent to 7 per cent.

The biggest jump was among immigrant Latinas, especially those born in Mexico and Central America, whose rates rose from 7.3 per cent to 8.4 per cent.

The researchers concluded that: “Severe sociopolitical stressors may contribute to increases in the risk of preterm births among targeted populations.”

The study identified such stressors as: “social and economic threats, interpersonal violence, hate crimes and severe sociopolitical stressors (arising from political leaders’ threatening rhetoric or from political legislation)”.

The study highlighted the “robust evidence … that in the USA, exposure to severe sociopolitical stressors for targeted racial/ ethnic, immigrant and Muslim populations, and also hate crimes, has been on the rise since the fall 2015 start of the US presidential campaigns and as reflected in the policies and rhetoric of the Trump Administration”.

“This analysis highlights how the stress caused by racism and discrimination may induce preterm births, which are extremely harmful to both mothers and babies,” said New York’s acting health commissioner Dr Oxiris Barbot.

‘ This analysis highlights how the stress caused by racism and discrimination may induce preterm births.’

NEWS IN BRIEF

AUSTRALIA

13.5 million lives a year could be saved if mental illness is addressed Every country in the world is facing a mental health crisis, according to a commission of 28 global mental health experts assembled by the Lancet medical journal.

The Commission says there is a “collective failure to respond to this global health crisis, which results in monumental loss of human capabilities and avoidable suffering”.

“The quality of mental health services is routinely worse than the quality of those for physical health.

Government investment and development assistance for mental health remain pitifully small,” it says in its report.

Previous World Bank research had found that $16 trillion will be lost to the global economy by 2030 due to people of working age incapacitated by mental health problems.

Prof Vikram Patel of the Harvard Medical School, the Commission leader, said mental ill health caused “colossal human suffering”.

He said substantial numbers of deaths resulting from mental ill health were attributed to other causes. Suicides are attributed to deaths from injuries and opioid deaths are considered to be drug misuse instead of being attributed to underlying mental health issues.

The Commission proposes that the global mental agenda should be expanded from a focus on reducing the treatment gap, to improving the mental health of whole populations and reducing the global burden of mental disorders by addressing gaps in prevention and quality of care.

The Commission outlines a blueprint for action to promote mental wellbeing, prevent mental health problems, and enable recovery from mental disorders.

‘ Government investment and development assistance for mental health remain pitifully small.’

Read the report: https://www.thelancet.com/ commissions/global-mental-health

WORLD

Green the food sector or eat up the planet Livestock provide just 18 per cent of calories but take up 83 per cent of farmland and are responsible for 60 per cent of agriculture’s greenhouse emissions.

Massive changes to food production and people’s diets are essential to maintain the planet’s capacity to feed a growing population according to the biggest analysis ever conducted of the food system’s impact on the environment.

The comprehensive study, published in Nature magazine (October 2018), created and used a database of 40,000 farms in 119 countries covering 40 food products that represent 90 per cent of all food that is eaten.

It analysed the full impact of these foods on land use, climate change emissions, freshwater use and water pollution and air pollution.

The lead researcher, Marco Springmann from the University of Oxford, said the current trajectory of food production would smash critical environmental limits, beyond which humanity would struggle to live.

“We are really risking the sustainability of the whole system. There is no magic bullet. But dietary and technological change [on farms] are the two essential things,” he said.

The researchers found a global shift in diet was needed to keep climate change even under 2°C, let alone the 1.5°C recently recommended by a landmark United Nations report.

This diet would require the average world citizen to eat 75 per cent less beef, 90 per cent less pork and half the number of eggs, while tripling consumption of beans and pulses and quadrupling nuts and seeds.

‘ We are really risking the sustainability of the whole system.’ — Marco Springmann, University of Oxford THE LAMP DECEMBER 2018 /JANUARY 2019 | 29

NEWS IN BRIEF

UNITED KINGDOM

TV and online advertising feeds children’s junk food habits The results of a study of 2500 children commissioned by Cancer Research UK suggests using internet sites with advertising may be linked to children’s desire for highsugar, high-fat and high-salt foods they see advertised.

The study found that each additional hour children spent watching commercial TV was linked to: • a 22 per cent increased chance of children asking for food they’d seen advertised • a 21 per cent increased chance of children buying food they’d seen advertised • a 23 per cent increased chance of them consuming sugary drinks •a n 18 per cent increased chance of consuming pastries and sweet biscuits.

Each additional hour children spent online was linked to: •a 19 per cent increased chance of children asking for food they’d seen advertised • a 19 per cent increased chance of children buying food they’d seen advertised •a 9 per cent increased chance of them consuming sugary drinks • a 13 per cent increased chance of them consuming pastries and sweet biscuits Those who used the internet more than three hours a day were 79 per cent more likely to be overweight or obese than children who used the internet half an hour a day or less.

Cancer Research UK has called for the British government to ban junk food advertising altogether on TV before 9pm and bring in similar protection for children exposed to advertising online.

‘Cancer Research UK has called for the British government to ban junk food advertising altogether on TV before 9pm.’

AUSTRLIA

Labor promises $400 million to reduce super gender gap Women, on average, retire with $113,000 less in superannuation than men. Labor has announced measures to bridge the gap if they win office.

The two main measures announced by Labor are: • to pay someone super when they are on parental leave; and • t o phase out the $450 per month minimum income threshold for eligibility for super, which will help people in part-time and casual work.

Deputy leader of the Opposition Tanya Plibersek told ABC News that over 200,000 people will benefit from being paid super on parental leave and hundreds of thousands more will gain from the phasing out of the $450 threshold.

“Women retire on average with a 40 per cent gap in superannuation. We know that older women are the fastest growing group of people moving into homelessness.

“Poverty in old age is completely unacceptable. We need to make sure that we reduce this gap in superannuation as one of the steps to ensure that men and women retire with dignity,” she said.

The independent Parliamentary Budget Office has costed the changes at $409.2 million over four years.

Industry Super Fund, HESTA, welcomed the changes.

“This is a comprehensive package of measures to address the gender super gap and it is pleasing to see reforms we’ve long supported taken up such as phasing out the antiquated $450 minimum monthly super threshold and considering the future super changes on women,” HESTA chief executive, Debby Blakey said.

‘ We know that older women are the fastest growing group of people moving into homelessness.’

— Tanya Plibersek, Deputy leader of the Opposition.

30 | THE LAMP DECEMBER 2018 /JANUARY 2019

NEWS IN BRIEF

AUSTRALIA

170,000 rally for a pay rise Massive rallies of union members – “aimed directly at the Morrison government” – send home the message that workers want a fair go in the workplace.

The ACTU estimated that over 150,000 rallied in Melbourne in support of its Change the Rules campaign aimed at changing Australia’s workplace laws. More than 10,000 rallied in Sydney. There were other major rallies in Darwin, Wollongong, Cairns, Townsville and other regional centres.

Addressing the Melbourne rally ACTU secretary Sally McManus blasted the Scott Morrison-led Coalition government for failing to address the decline in living standards of Australian workers.

“They are the ones that can do something about penalty rates being cut,’’ she said. “They can do something about the minimum wage ... we want them to make a big change in direction.”

Victoria’s Premier, Daniel Andrews, also addressed the Melbourne rally and took aim at large private companies raking in massive profits without adequately rewarding workers for their contribution.

“There is a real imbalance between corporate profits and some of the pay rises, particularly in the private sector,” he said.

The ACTU is calling for legislation to raise the minimum wage to 60 per cent of the median income and expand rights to bargain across sectors to address persistent low-wage growth.

“We can't be stuck in the early 90s where there’s only one option and that's enterprise bargaining,” said Sally McManus.

“We’re one of the few countries in the OECD that doesn’t give workers options to bargain across the sector – it’s actually quite normal for that to happen.”

‘ There is a real imbalance between corporate profits and some of the pay rises, particularly in the private sector.’ — Daniel Andrews

WORLD

Resistant infections could kill 2.4 million people by 2050 The Organisation for Economic Cooperation and Development (OECD) says antibiotic-resistant superbugs are “one of the biggest threats to modern medicine”.

The OECD says if nothing is done about drug resistance, superbugs could kill some 2.4 million people in Europe, North America and Australia alone over the next 30 years.

The World Health Organization has warned that without drastic action, a post-antibiotic era where basic healthcare becomes life threatening due to risk of infection during routine operations could arrive over the next 30 years.

In a report released last month, the OECD said, “a short-term investment to stem the superbug tide would save lives and money”.

It estimates that halting the rise of resistant infections would cost just $2 per person a year.

It proposes a “five-pronged assault” on antimicrobial resistance (AMR), including promoting better hygiene, ending over-prescription of antibiotics, rapidly testing patients to ensure they get the right drug for infections, delaying antibiotic prescriptions and delivering mass media campaigns, reported Reuters.

Across the OECD, resistance to second and third-line antibiotics is expected to be 70 per cent higher in 2030 compared to AMR rates in 2005.

In low and middle-income countries, drug resistance is high and projected to grow rapidly. In Brazil, Indonesia and Russia, between 40 per cent and 60 per cent of infections are already drug resistant, compared to an OECD average of 17 per cent.

‘ Just $2 per person a year could halt deadly superbugs’ — OECD

THE LAMP DECEMBER 2018 /JANUARY 2019 | 31

EN

ANUM

RN

CNS

RN

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-12/18

Clinical Supervision for Role Development Training

CPD

48

8-DAY COURSE IN 2019

13, 14, 15 March; 4, 5, 6 June; 3 & 4 Sept 2019. 9am – 4.30pm 50 O’Dea Avenue, Waterloo All

$3,300 (inc. GST) or $375/day + GST Pay as you go negotiable/ invoice available for organisations supporting staff to attend. Lunch & refreshments provided.

Clinical Supervision is a regular, dedicated time for reflection on all aspects of professional practice. Clinical supervision aims to improve care, and support the professional development and well being of staff.

This eight-day foundational training equips potential clinical supervisors with a variety of techniques and approaches to conduct quality individual and group clinical supervision.

For many professions, clinical supervision is now a mandatory condition of registration and ongoing practice and forms an integral part of Continued Professional Development (CPD).

COURSE CONTENT: The training provides clinical supervisors with an understanding of the Role Development Model of clinical supervision, the supervisor role and a framework for clinical supervision practice. The learning includes utilisation of role theory, role analysis, concretisation techniques, action-learning techniques and role training as clinical supervision interventions. Other innovative interventions such as ‘this year/next year’ are included.

LEARNING OUTCOMES: • Appreciate the benefits of clinical supervision in participant’s work area • Identify other models of clinical supervision and the theories informing the Role Development Model • Understand and explore concepts and techniques used in clinical supervision • Conduct effective individual and group clinical supervision sessions within the framework • Demonstrated confidence and competence in applying advanced clinical supervision techniques.

CONTACT Paul Spurr, 0410 033 342 / paul@spurrcsc.com Provided in partnership with

$

PROFESSIONAL EDUCATION 2019

32 | THE LAMP DECEMBER 2018 /JANUARY 2019 Clinical Supervision.indd 1

26/11/18 9:26 am

YOUR RIGHTS

Ask

Judith Breaking News The year that was…

As we head towards Christmas and the opportunity to enjoy festivities with family and friends, it is an appropriate moment to pause and reflect on what has been a most extraordinary year of activity and events. Members throughout this state, regardless of the industry they work in, have demonstrated heightened activity and collective engagement. Whether in public health, private health, aged care, disability or in other clinical and support services, the pivotal role that nurses, midwives, enrolled nurses and assistants in nursing have undertaken on behalf of their patients, their profession, and in support of one another has been exceptional.

As your elected officer, it has provided me with enormous pride and nourished my own enthusiasm and energy when fighting the good fight, whether it is with politicians or employers.

Of course we need to continue and build upon this momentum as we enter 2019.

This will be a significant and pivotal year for the professions of nursing and midwifery; perhaps more than we have experienced in decades. It offers enormous potential. But it will not be realised unless we keep our voice heard and members maintain their collective solidarity across all workplaces.

We truly have a chance to achieve great things in the coming year. Let’s accept the challenge and make sure in the years to come we can tell those who follow in our footsteps that we were a part of bringing about such change.

In closing, can I wish all members, along with your families and friends, a very merry Christmas and a happy New Year. For those who will continue to work over the festive period to ensure that we remain safe or those in need are cared for and supported, my thanks on behalf of all in our community.

Backfilling absences I am a registered nurse working in a public hospital. The ward I work in has a staffing arrangement of 5.5 NHPPD (nursing hours per patient day).

Often, however, absences are filled by casuals working a shift of shorter duration. Is that right?

This question unfortunately continues to arise. The short answer is no. Clause 53 (Staffing Arrangements) of the Public Health

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

System Nurses’ and Midwives’ (State) Award talks about the requirements to backfill an absence.

Where an absence is to be filled to maintain the required NHPPD, the default position requires that it be fully backfilled and not partially backfilled (for example, an absence that creates an 8.5-hour vacancy should, as a default, be filled with an 8.5-hour replacement). This approach has been adopted (or agreed) during various disputes before the Industrial Relations Commission of NSW.

Cashing in annual leave

I am a registered nurse working in a hospital operated by Healthscope. I have a fair bit of annual leave and was wondering if I could cash some of this out?

Under Clause 24(ix) of the Healthscope Group – NSWNMA/ ANMF – NSW Nurses and Midwives’ – Enterprise Agreement 2015–2019, annual leave can be cashed out in certain circumstances. This includes that any cashing out cannot reduce your remaining annual leave entitlement to less than four weeks. The agreement to cash out annual leave must also be in writing for each request made and processed.

Shift span at Estia

I work in a facility operated by Estia. What is the maximum length of a rostered shift?

Under Clause 19 of the Estia Health NSW Enterprise Agreement 2016, the ordinary rostered hours of an employee (other than a casual) will not exceed ten hours per day (not counting the unpaid meal break).

Multiple assignments and leave

I have two separate nursing assignments within the same local health district. Can I access annual leave accrued in one assignment while on holidays in the other assignment?

Under sub clause 4A Leave (n) of the Public Health System Nurses’ and Midwives’ (State) Award, employees

with multiple assignments in the same LHD can take all forms of leave in any of their assignments.

Accordingly, leave accrued through work done in one assignment can be taken in your other assignment.

A different approach applies if the multiple assignments are across different LHDs.

Accruing annual leave at Opal I work in a nursing home run by Opal. I have been saving up my annual leave for – hopefully – a long break next year to see my daughter in Queensland. Is there anything to prevent me from doing this?

Under clause 34.7(c) of the Opal Aged Care (NSW) Enterprise Agreement 2016, there is a discretion available to allow you to accrue more than 30 days’ annual leave if you have plans to take that leave in a reasonable timeframe. If you have dates in mind for next year, and it will involve an extended absence, it would be best to talk to your manager so it can be scheduled and agreed to well in advance.

Working beyond 10 hours at Hardi I work part time in a nursing home run by Hardi Aged Care.

What happens if I work more than ten hours on a day?

Under Clause 16.2(b) of the Hardi Aged Care Nursing Staff Enterprise Agreement 2016, all time worked by a part-time employee that exceeds 10 hours on a day/shift, will be paid at the applicable overtime rates.

Extra public holiday Just wondering if the extra public holiday has been decided for the NSW Ambulance Service yet?

Yes, the nominated date for the extra public holiday in the NSW Ambulance Service is Thursday, 27 December 2018. Remember, as previously advised, in the NSW Health Service it is Monday, 31 December 2018.

THE LAMP DECEMBER 2018 /JANUARY 2019 | 33

Welcome to the new look NSWNMA’s education calendar!

We have a range of new and updated face-to-face professional courses on offer throughout 2019 covering all areas of NSW. Check the Lamp “What’s On” page each month for upcoming courses (see next page for courses being held January to March 2019) or go online to our Education page to view all our education events throughout the year (you will also find other educational resources here including podcasts, professional issues papers, online courses and more).

Remember to book in early as the majority of our courses have strict class size limits.

Regional members, please encourage workmates and colleagues to join our education days – we hate having to cancel events! If you don’t come to us, we can’t come to you!

See right for all the locations we will be visiting and range of courses we will be delivering throughout 2019.

LOCATIONS Sydney Metro Area: Waterloo, Blacktown, Campbelltown, Dee Why, Gymea, Hornsby (Waitara) Far West Area: Broken Hill Hunter New England Area: Armidale, Maitland, Newcastle, Scone Illawarra Shoalhaven Area: Shoalhaven Heads, Wollongong (Dapto) Mid-North Coast Area: Coffs Harbour, Macksville, Port Macquarie Nepean Blue Mountains Area: Springwood Northern NSW Area: Ballina, Byron Bay, Grafton, Tweed Heads Southern NSW Area: Goulburn, Queanbeyan Western NSW Area: Coonabarabran, Dubbo, Orange

COURSES • Ageing and Disability: New Challenges in Service Delivery • Alcohol and Other Drugs: The Current Situation • Bullying: Let’s put an end to it • Clinical Communication and Documentation • Clinical Supervision: The Role Development Model • Dementia Management Training • Diabetes for Clinical Staff • Discovery of Self for the Practising nurse/midwife • Emotional Intelligence Training • Foot Care: A Nurses Role • Increasing Resilience in Stressful and Changing Times

• Know where you stand with Law, Ethics and Professional Standards • Medication Administration for Clinical Staff • Medications: How we do it better • Practical, Positive Leadership Series • Skill-Set for New Managers and Senior Nurses and Midwives • Standard Mental Health First Aid • The Deteriorating Client • The Influential Thought Leader at Work • Transitioning to the Workplace • Understanding the Four Human Behavioural Styles • Wound Care Series – Four different wound care subjects • Your Annual CPD Obligations

We will also be holding our annual seminars for Mental Health and Drug & Alcohol, Midwifery, Enrolled Nursing, Self-Care and Environmental seminars. The Aged Care Seminar will be held in 5 locations across NSW and we will also be adding a Child and Family Heath seminar to our education program.

PROFESSIONAL EDUCATION

NSW REGIONAL SYDNEY METRO

January to March 2019 Education Waterloo

Your Annual CPD Obligations, Thurs 17 January, $50 / $100, 4 CPD Hours, RN, EN, MW

Ageing and Disability: New Challenges in Service Delivery, Fri 8 March, $95 / $190, 6 CPD Hours

Standard Mental Health First Aid, 2 day course, Thurs 24 & 31 January, $190 / $380, 12 CPD Hours

Clinical Supervision, The Role Development Model, 8 Day course commencing Wed 13 March – See ad on page 32

Dementia Management Training, Wed 6 February, $95 / $190, 7 CPD Hours

Wound Care: Negative Pressure Wound Therapy, Fri 15 March, $95 / $190, 6 CPD Hours

The Deteriorating Client, Wed 13 February, $95 / $190, 5 CPD Hours

Alcohol and Other Drugs: The Current Situation – an update for all nurses and midwives, Thurs 21 March, $95 / $190, 6 CPD Hours

Foot Care: A Nurses Role, Wed 20 February, $95 / $190, 6 CPD Hours The Influential Thought Leader at Work, Thurs 28 February, $95 / $190, 6 CPD Hours

Know where you stand with Law, Ethics and Professional Standards in Nursing and Midwifery, Thurs 28 March, $95 / $190, 6 CPD Hours

HUNTER NEW ENGLAND Newcastle

NORTHERN NSW Tweed Heads

Understanding the Four Human Behavioural Styles, Thurs 21 February, $95 / $190, 6 CPD Hours Diabetes for Clinical Staff, Wed 6 March, $95 / $190, 5 CPD Hours Foot Care: A Nurses Role, Wed 13 March, $95 / $190, 6 CPD Hours

ILLAWARRA SHOALHAVEN Dapto Transitioning to the Workplace, Thurs 31 January, $30 / $60, 6 CPD Hours, New Grad RN, EN, Midwife

Medication Administration for Clinical Staff, Fri 15 March, $95 / $190, 6 CPD Hours

Shoalhaven Heads

Aged Care Seminar, Fri 22 February, $60 / $120, 6 CPD Hours

Know where you stand with Law, Ethics and Professional Standards in Nursing and Midwifery, Wed 6 February, $95 / $190, 6 CPD Hours

Ballina

Discovery of Self for the Practising nurse/midwife: Visioning and selfcare workshop, Tues 19 February, $95 / $190, 6 CPD Hours

Byron Bay

Medications: How we do it better, Wed 20 February, $95 / $190, 6 CPD Hours Clinical Communication and Documentation, Thurs 21 February, $95 / $190, 6 CPD Hours

Blacktown

Dementia Management Training, Thurs 21 February, $95 / $190, 7 CPD Hours Your Annual CPD Obligations, Thurs 21 March, $50 / $100, 4 CPD Hours, RN, EN, MW

Campbelltown

Transitioning to the Workplace, Mon 18 February, $30 / $60, 6 CPD Hours, New Grad RN, EN, Midwife

Gymea

Medications: How we do it better, Wed 20 March, $95 / $190, 6 CPD Hours

MURRUMBIDGEE Wagga Wagga

Dementia Management Training, Thurs 28 March, $95 / $190, 7 CPD Hours

SOUTHERN NSW Queanbeyan

Medications: How we do it better, Mon 4 March, $95 / $190, 6 CPD Hours Clinical Communication and Documentation, Tues 5 March, $95 / $190, 6 CPD Hours

WESTERN NSW Coonabarabran

Clinical Communication and Documentation, Wed 27 February, $95 / $190, 6 CPD Hours Your Annual CPD Obligations, Thurs 28 February, $50 / $100, 4 CPD Hours, RN, EN, MW

For full details of courses including course content, venue and times, please go to the Association website www.nswnma.asn.au CPD

REGISTER ONLINE bit.ly/educationNSWNMA 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. Unless otherwise noted, our courses are suitable for all Nurses, Midwives and Assistants in Nursing/Midwifery.

THE LAMP DECEMBER 2018 /JANUARY 2019 | 35

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

CHANGE THE RULES RALLY If you missed this month’s Rally to Change the Rules, you can watch a recap: http://bit.ly/ctr2018oct

“When we raise our serious concerns for others, it is important those in power take notice” NSWNMA General Secretary Brett Holmes pens an open letter to Prime Minister Scott Morrison, urging him to end the injustice against children and families being held on Nauru and Manus Island. https://www. nurseuncut. com.au/the-government-cannotignore-us-when-we-raise-ourserious-concerns-for-others/

Mandated nurse-toresident ratios not the only change needed in aged care The lack of nurse-to-resident ratios, the failure to tie government funding to care and the overall public perception of aged care are not the only issues to be resolved in Residential Aged Care facilities (RACF). This nurse describes what else needs to be considered. https://www.nurseuncut. com.au/ mandated-nurse-to-resident-ratiosnot-only-change-needed-in-agedcare/

BOB FENWICK MENTORING PROGRAM CEREMONY 2018 A recap of the Bob Fenwick Mentoring Program for 2018. http://bit.ly/bobfenwick18 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!

36 | THE LAMP DECEMBER 2018 /JANUARY 2019

Reducing hospital inpatients’ sedentary time Researchers from Federation University, Monash University and the University of Canberra are looking for nurses to share their experiences of helping patients to reduce their sedentary time. https:// www.nurseuncut.com.au/reducingsedentary-time-in-hospitalinpatients-survey-for-nurses/

Diabetes in practice for nurses – online course Nurses play a pivotal role in supporting people living with diabetes – the fastest growing chronic condition in Australia.

Diabetes Qualified has developed a course on diabetes specific to the educational requirements of nurses. https://www.nurseuncut.com.au/ diabetes-in-practice/

Perinatal anxiety and depression is more serious and common than many people realise Nurses and midwives work closely with expecting and new parents and can help play a key role in helping to raise awareness about Perinatal Anxiety and Depression, which affects up to one in five expecting or new mums and one in 10 dads. https://www.nurseuncut.com. au/ perinatal-anxiety-and-depressionis-more-serious-and-common-thanmany-people-realise/

Listen to our podcast Dan’s Story – Lucy Hasslam. http://bit.ly/ dansstory2018

SOCIAL MEDIA

your

Say

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

the gallery

everywhere, too many money-hungry people.

Relentless shifts We shared a nurse’s story of being overworked and unable to take her breaks – an experience shared by many.

Try taking a break in ED. Every time you think you’re up to date and about to go for a break, bam – you get another patient.

What’s lunch? I take two breaks – bathroom, drink water, as I slam down half a sandwich.

Management say “If you don’t get your break and/or finish late it is because you can't prioritise or manage your time”.

A nurse’s job is never easy we do our best where we can. We signed up to be nurses and most love the job regardless of the stress.

Management takes advantage of nurses’ good nature and the fact that nurses are the patients’ advocates. I worked a long time in the health industry.

If we didn’t stay back, work overtime, work through our breaks, who would be there for the patients and our colleagues?

Is there any wonder they have burnout! Double shifts, not enough staffing, patient overload and not enough time between shifts, but somehow nurses get into their work and never complain to patients. I should know, having spent nearly 5 months in hospital.

There are never enough staff! Nurses do such a great job under pressure.

The unconscionable rationing of incontinence pads You showed your disgust about the trend of aged care facilities to limit the number of incontinence pads that residents could use on a daily basis.

My grandmother died of sepsis because she was not allocated pads as she technically wasn’t incontinent, but was unable to self-care or mobilise so would end up sitting in wet clothes because they just never got her up to the toilet. Her skin broke down. And she basically willed herself to die. She lasted two months in that so-called nursing home, and died a terrible death.

This is so spot on! I can’t blame the staff. They have a lot of residents to attend to, so if the government doesn’t want to put more staff on, they need to build more places and have fewer in each!

This is why there is such a high incidence of residents suffering from UTI and thrush, which is the leading cause of sepsis in the elderly.

When I was in my first year of uni, we did an aged care placement. It really did shock me that they controlled the use of continence aids, even though the residents and their families supplied them out of their own pockets and were more than happy to supply more if needed. In many child care facilities they have to change as required for bowel movements, or at least that’s how often my daughter’s childcare does it. The same or similar needs to be brought into aged care.

They are happy to cut cost to make the CEOs more profit. It happens

/1

/2

/3

Aged care facilities should provide adequate care

/4

Another Bupa facility has been sanctioned because of breaches to care standards. You have made your disgust clear.

It’s all about minimal care at minimal cost for maximum profit. The government should be ashamed of themselves. It’s funny how all governmentrun nursing homes have ratios and heaps better pay and conditions.

This is why big businesses have moved into aged care – huge profits to be made with little regulation and able to bully and pay their staff minimum wages.

I had my mother in a Bupa facility. Took her out in less than a year. After she broke her hip, hand and shoulder. I was not happy with her care.

/5 1/ N urse Heather Ryan is joined by some Halloween zombies who think it’s time for a new ratios system 2/ A ged Care nurses stand up for Ratios in their sector at a recent Aged Care Nurses’ Forum 3/ N urses join the community in the Northern Rivers to say: “Kids Off Nauru” 4/ Maroubra MP Michael Daley signs our pledge to support a new ratios system, alongside members from Prince of Wales Hospital Branch 5/ Nurses from the Combined Randwick Branches were joined by Labor and Greens candidates for Coogee to campaign for ratios

THE LAMP DECEMBER 2018 /JANUARY 2019 | 37

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 – 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.

We are currently reviewing how the NSWNMA communicates with members via The Lamp and online to ensure we remain relevant and easily accessible to all nurses and midwives.

Please take the time to complete a short 3 minute survey, the results will help shape the future direction of The Lamp.

Everyone who completes the survey will go into the draw to win an Apple Watch Series 4. The survey will close Thursday 28 February 2019.

SURVEY LINK:

www.surveymonkey.com/r/LampSurvey 38 | THE LAMP DECEMBER 2018 /JANUARY 2019

WIN APPLE

WATCH SERIES 4

NURSING RESEARCH AND PROFESSIONAL ISSUES Analysis & Policy Observatory (APO) is an award-winning, open-access knowledge hub and information service providing easy access to policy and practice research and resources.

Established in 2002 at Swinburne University of Technology in Melbourne, APO is a not-forprofit collaborative knowledge infrastructure and web platform working with partners from universities and organisations across Australia, New Zealand and beyond.

Security check of Australia’s healthcare sector Health Informatics Society of Australia There are those who ask, “Who would be interested in hacking patient data?”

It is precisely this attitude, together with the rate at which healthcare refreshes its technology, that exposes healthcare organisations to a high risk of cyber attack. Professor Trish Williams presents a list of reasons why the healthcare sector is appealing to hackers: ransom for money; denial of service for malice and money; stealing confidential data; compromising data; identity theft and compromising devices. The scale of disruption and impact to busy healthcare settings already operating at capacity caused by a cyber attack needs no explanation.

To better understand the current state of perceptions and cybersecurity practice in Australian healthcare, the HISA’s Cybersecurity Community of Practice (CoP) conducted a survey over a period of five weeks in September/October 2017. The survey posed questions across four broad domains to assess awareness and maturity across the healthcare ecosystem.

http://apo.org.au/node/196171

Digital health beyond My Health Record Australian Digital Health Agency The casual reader could be forgiven for thinking that My Health Record is the be all and end all of digital health. But that’s far from the case. Genomics, precision medicine, AI-based decision support, and epidemiological applications of “big data” are just some of the other aspects of digital health. This article focuses on a less grandiose topic: “Smart” medical devices that incorporate digital health technologies to enable new and better ways of monitoring health and delivering care. Examples include: • asthma monitors that detect imminent attacks before the user notices any symptoms • an Australian-developed smart stethoscope with a “beat finder” that helps to determine optimal location, and collects data that can be shared remotely for specialists to interpret • blood glucose monitors that actively predict

a patient’s insulin needs, instead of passively responding to spikes in blood sugar • smartphone-based tools that diagnose blood pressure, body temperature, respiratory problems and blood disorders.

A common theme in such developments is not just improved performance, but greatly improved ease of use. Patients are already expected to monitor their own health in various ways, and the existence of such devices raises the prospect of much greater patient autonomy than has previously been possible. One formal study has found that untrained users may be able to measure their vital signs with an accuracy comparable to that of trained nurses.

http://apo.org.au/node/190856

Confronting Dr Robot: Creating a peoplepowered future for AI in health John Loder, Lydia Nickolas Artificial intelligence (AI) looks like it could be one of the transformative technologies of our era.

Healthcare is rich in the data that AI thrives on, and in the kinds of questions that it can tackle. While the use of AI in healthcare is at an earlier stage than the hyperbole surrounding the technology might suggest, it is developing at pace, and this raises both significant opportunities and risks.

AI has delivered some striking results. There have been research trials that successfully use machine learning on images from, for example, radiology, dermatology and ophthalmology, to a level of accuracy that matches clinicians’ own abilities. This, and other AI developments, has led to the suggestion that machines are poised take the place of doctors.

However, today’s AI is narrow and not capable of the holistic thinking and complex judgement required for many clinical tasks. While there are significant areas of medicine where more narrow applications of decision-making rules and expert pattern matching predominate, the path towards AI replacing humans is not solely determined by technical capability.

Technology implementation will need to address trust, accountability and similar factors. And, at the same time, humans remain especially good at certain tasks, such as learning to identify rare situations from small amounts of data.

http://apo.org.au/node/171371 THE LAMP DECEMBER 2018 /JANUARY 2019 | 39

Registered Nurses working in NSW Public Mental Health Services

BOB FENWICK MENTORING GRANTS PROGRAM Can help towards your CPD hours

OPPORTUNITY FOR CAREER DEVELOPMENT What is it?

The Program aims to encourage less experienced mental health nurses to take the opportunity to be mentored by a more experienced colleague, assisting them to achieve their mental health professional practice goals.

Who can apply?

Any registered nurse currently working in NSW public mental health services is eligible to apply. Mental health nurses with less than two years’ experience or working in NSW rural and remote areas as well as Aboriginal or Torres Strait Islander nurses currently working in mental health are all strongly encouraged to apply.

What will each mentoring grant include? n Matching with a mentor in a Local Health District (LHD) other than their own for up to five consecutive days to pursue their mental health areas of interest. n Being provided with travel, accommodation and meal allowance, while remaining a fully paid employee of their regular mental health service during their placement.

Seeking mentors for the Program

APPLICATIONS OPEN 1 FEBRUARY 2019 CLOSE 17 MARCH 2019

Applications are open to registered nurses who want a unique opportunity to further their mental health nursing career by participating in this innovative Program.

If you are a senior mental health nurse, you can help build the specialty of mental health nursing by nominating yourself to become a mentor. Simply use the Mentor Details Form or contact the Program Manager for more information.

How do I apply?

More detailed information about the Program (including a video interview of past participants) can be found on the NSW Nurses and Midwives’ Association website www.nswnma.asn.au 2019 EXPRESSION OF INTEREST FORMS WILL BE AVAILABLE FROM 1 FEBRUARY 2019. If you require more information contact the Program Manager by email: mhmgrant@nswnma.asn.au or contact Matt West on 1300 367 962.

Bob Fenwick-advert half.indd 1

20/11/18 11:09 am

Union Shopper’s Christmas savings are unreal!

LOOK NO FURTHER!

We’ve got Christmas covered!

You can save time and money on a HUGE range of products and services when using Union Shopper. discounted gift cards • wine • electrical appliances cameras • computers • printers • manchester • flowers theme park tickets • travel • hotels & resorts • car hire and lots more...

BIG Savings For NSWNMA Members 1300 368 117 unionshopper.com.au

40 | THE LAMP DECEMBER 2018 /JANUARY 2019

CROSSWORD

test your

Knowledge 1

2

9

3

10

4

11

5

6

12

14

13 16

15

17

8

7

18

19 20

21

22 23

17 24

25 26 29

28

27

30 31

32

33

34

35 36 37

ACROSS 1. A rare and often highly malignant tumour of muscle (16) 9. A fungus infection of the beard (5.6) 14. Selling tax (1.1.1) 15. To wink (9) 17. Pertaining to the stimulating action of acetylcholine agents (9) 19. Interleukin (1.1) 20. A group of mass of nerve cells in the brain or spinal cord in which nerve fibers form connections (6) 21. Relating to the air passages to and from the lungs (9) 23. Inflammation of a gland (8) 24. Loss or impairment of the

ability to make decisions or act independently (7) 26. Spinal anesthesia (8) 28. Abnormally rapid heart rate, over 100 beats per minute (11) 32. Pulmonary stenosis (1.1) 34. A person of racially mixed ancestry (7) 35. Improve (10) 36. Boredom (5) 37. A drug used to lower the levels of both cholesterol and triglycerides in the plasma (12) DOWN 1. Inheritable tumours of the eye (16) 2. A nursing classification (3)

3. Acting in extreme manner (11) 4. Methacrylic acid (1.1.1) 5. Made in the form of an orb (11) 6. The presence of acetone or acetone bodies in relatively large amounts in the blood (11) 7. Relating to the urinary bladder or gallbladder (6) 8. Hardening of the arteries (16) 10. A person's consciousness of self (3) 11. Bacillus thuringiensis israelensis (1.1.1) 12. Reference nutrient intake (1.1.1) 13. Symbol for actinium (2) 16. A speech disorder where words beginning with the same consonant sound are used excessively (12) 18. A unit of radioactivity (1.1.1) 22. An instrument for examining the ear (8) 25. A winglike process (3) 27. Any coloring matter of the body (7) 29. ĂĽVividness, intensity, saturation (6) 30. Edit or revise (6) 31. Bloodless, pale (5) 33. To pronounce indistinctly (4)

THE LAMP DECEMBER 2018 /JANUARY 2019 | 41

TRAVEL

Fabulous holiday offers Saving over $900pp

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

Carnival Spirit 10 Nights New Caledonia & Vanuatu Cruise

Sanctuary Rarotonga – Cook Islands

DEPART SYDNEY 28 DEC

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

FLASH SALE – Inside Twin Room 10 nights $1299 pp* (BASED ON 2 ADULTS) • All main meals on-board coffee, tea and milk 24-hrs • Sit-down or anytime dining choice • Alternative dining (extra charge) • Use of ship facilities – indoor & outdoor • Entertainment – live music and/or shows, movies • Activities – organised & individual • Kids to teen programs (2-17 yrs) • Ship-shore-ship transfers • Gratuities included

Risata Bali Resort – Kuta, Bali The very epitome of zen, Risata Bali Resort & Spa is nestled in a tropical green oasis. Prepare to relax in a wellness paradise every bit as indulgent as you can imagine.

Superior Room – 5 nights $334* (2 ADULTS AND 1 CHILD)

• Daily Breakfast • Return airport transfers • 1 bucket of beer or 2 pizzas • Welcome drink and 10 minute welcome massage • Free wifi • 10% discount on food (not room service) • 50% discount on spa treatment (not valid for package treatment). *Carnival Spirit: limited time sale valid until sold out. Inside Twin room – other room categories available, go to unionshopper.ubookdirect.com Sanctuary Rarotonga: valid for travel until 31 March 2020. High season 20 December 2018 – 11 January 2019 and 1 April 2019 – 31 March 2020.

Rate is based on 2 adults. Extra adult $60 / night. Risata Bali Resort: valid for travel until 27 December 2019. Rate is based on 2 adults and 1 child (under 12 sharing existing bedding). Extra adult will be charged at $30 / night.

Child aged 6-10 years charged at $15 / night. Surcharge applies 28 December 2018 – 3 January 2019 and 1 July – 31 August 2019. Amora Hotel Riverwalk: valid for travel until 1 November 2018 – 30 December 2019. Rate is based on 2 adult. All subject to availability. Full T&C's at unionshopper.ubookdirect.com 42 | THE LAMP DECEMBER 2018 /JANUARY 2019

Absolute beachfront. Where the ocean meets the sky you have found your sanctuary. A boutique 4.5 star, adults only beach resort.

Beachfront Suite – 7 nights $1353* (2 ADULTS)

• Low Season special valid 1 Nov – 19 Dec 2018 and 11 Jan – 31 Mar 2019 • Welcome drink • Tropical buffet breakfast • 1 x bottle of wine per stay • Spa Polynesia credit valued at NZD$100 per room • All rates include complimentary resort activities including stand up paddle boarding, kayaking, tennis, gym and more .

Amora Hotel Riverwalk – Melbourne Situated on the Yarra River, this luxury hotel is winthin 5kms of the Melbourne Cricket Ground and Royal Botanic Gardens. Overlooking the banks of Melbourne’s Yarra River, this award winning hotel is located in Richmond, known for its culinary delights, trendy cafes and vibrant nightlife.

Deluxe Queen Courtyard – 2 nights $328* (2 ADULTS) • Daily breakfast • 12pm late check out (subject to availability) • Free wifi • Complimentary bike hire • $20 Fresco Restaurant voucher to be used toward dinner – voted 2017 Hotel Restaurant of the Year.

REVIEWS 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.

INTE IAL

ST RE

The Daughters of Mars

SPE C

book club

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

Nurses of Australia - the illustrated story Deborah Burrows

National Library of Australia: booktopia.com RRP $34.99 ISBN 9780642279309

From the First Nation caregivers who healed, birthed and nursed for millennia to the untrained and ill-equipped convict men and women who cared for the sick in the fledgling colony of New South Wales, nursing has always been practised in Australia.

It would take the arrival of a group of dedicated Irish nuns, followed

by Florence Nightingale-trained nurses and decades of constant and continuing campaigning to transform nursing into what it is today: the most trusted profession in Australia.

Nurses have operated in hastily erected tents and vermin-ridden hospitals, out of the back of utes and in planes flying across remote corners of the country, under fire and under extreme pressure. In a time when medical knowledge was limited, they applied starch or mustard poultices, administered soap and water enemas and tranquilised patients with alcohol.

Modern nurses process patient data, carry out research and make complex clinical decisions. But the core nursing values of kindness, compassion and courage have remained unchanged.

Psychiatric Mental Health Nursing: Concepts of Care in Evidence-based Practice 9th Edition Mary Townsend and Karyn Morgan F.A. Davis Company: amazon.com $119.95 ISBN 9780803660540

This comprehensive coverage of psychiatric mental-health nursing delivers what nursing students need to meet the challenges of health care today. Its evidence-based, holistic approach to nursing practice focuses on both physiological and psychological disorders. It is designed to be used in longer psychiatric mental-health nursing courses and provides students with a comprehensive grounding in therapeutic approaches and nursing interventions.

T

ES

R

S PE

Thomas Keneally Atria Books: Amazon.com: RRP $28.00 ISBN 9781476734613 In 1915, Naomi and Sally Durance, two spirited Australian sisters, join the CI war effort as nurses, escaping the confines of their father’s farm and A L carrying IN T E a guilty secret with them. Though they are used to tending the sick, nothing could have prepared them for what they confront, first on a hospital ship near Gallipoli, then on the Western Front.

Yet amid the carnage, the sisters become the friends they never were at home and are courageous in the face of extreme danger and also the hostility from some on their own side. There is humour and compassion, too, and the inspiring example of the remarkable women they serve alongside.

The Daughters of Mars brings World War I vividly to life from an uncommon perspective. Thomas Keneally has written a remarkable novel about suffering and transcendence, despair and triumph, and the simple acts of decency that make us human even in a world gone mad.

The Clinical Placement: An essential guide for nursing students, 4th edition Tracy LevettJones, Kerry ReidSearl, and Sharon Bourgeois

Elsevier - Health Sciences Division - RRP $40.25 ISBN 9780729542845

With a focus on preparation, expectations and how to think, act and communicate, The Clinical Placement: An essential guide for nursing students, 4th edition, is a valuable guide and companion for nursing students undertaking clinical placements. Written by Tracy Levett-Jones, Kerry ReidSearl and Sharon Beourgeois, it provides insights into the real world of practice, practical strategies for dealing with difficult and challenging situations, and a wealth of ideas to maximise learning and professional growth.

The Clinical Placement is supported by an engaging series of videos.

These ‘Insights from Experts’ feature nurses from a diverse range of clinical practice areas who share insights, advice, challenges and opportunities for learning in a range of clinical settings.

THE LAMP DECEMBER 2018 /JANUARY 2019 | 43

JOURNEY ACCIDENT INSURANCE

For NSWNMA Members

DID YOU KNOW

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

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

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

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

Unsure if you are financial?

It’s easy!

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

www.nswnma.asn.au 44 | THE LAMP DECEMBER 2018 /JANUARY 2019

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

V E A WA

VI

Y

WA

WI N

A

MET R O

Y

E

GI

N

M

M O VI

WI

EM OM B

ER

RO M ET

BER EM

M

at the movies

E GIV E

Vice

Green Book

Machiavellian vice Oscar winning writer/director Adam McKay (The Big Short) brings his trademark wit to the true story of US Vice President Dick Cheney in Vice. George W. Bush (Rockwell) wins the 2000 election, but it’s Cheney (Bale) who quietly takes charge, wielding his newfound power as vice president to reshape the country and the world – with lasting consequences. Starring Christian Bale, Amy Adams, Steve Carell and Sam Rockwell, Vice is a smart, irreverent comedydrama that will shock and entertain in equal measure.

In cinemas 26 December.

A road trip through Old Dixie Starring Viggo Mortensen and Mahershala Ali, Green Book is the uplifting true story of a friendship that defied the odds.

Set in 1962, the film follows Italian-American Tony Lip (Mortensen), who is hired to chauffeur African–American pianist Dr Don Shirley (Ali) on a concert tour through the Deep South of the United States in the era of the civil rights movement. In cinemas 24 January 2019.

Email The Lamp by the end of December to be in the draw to win one of 10 double passes to Vice thanks to Entertainment One. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

Email The Lamp by the end of January to be in the draw to win one of 10 double passes to Green Book thanks to Entertainment One. Email your name, membership number, address and telephone numberto lamp@nswnma.asn.au for a chance to win!

AY

IE

W

MO

V

MEM AL

R BE

RUR

Bulletproof

GIV E

A

Adrenaline-fuelled and explosive, Bulletproof follows two undercover cops, Bishop (Noel Clarke) and Pike (Ashley Walters) as they chase down hardened criminals in London’s East End. On the surface Bishop and Pike have a lot in common despite very different backgrounds: they’re cool, smart, unapologetically streetwise and tough, and they always have each other’s backs. Bonded by their moral code they are two sides of the same coin and, using their own special brand of policing they cause chaos, leaving a trail of destruction wherever they go. Disobeying orders and taking matters into their own hands they get results, but at what cost?

Full of high-speed chases, gun fights and swagger, Bulletproof shows two men who, addicted to the thrill of the chase, work brilliantly well together even when the chemistry between them looks set to explode.

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

THE LAMP DECEMBER 2018 /JANUARY 2019 | 45

DIARY DATES

make a date

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

EVENTS: NSW Omnicare Alliance: The RED Conference

A Regional Experience in Practical Dementia Care 28–29 March 2019 Sails Port Macquarie, Port Macquarie

red.omnicare.org.au 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/ 2nd Women’s and Newborn Health Conference

3–4 May, 2019, Westmead Hospital Marjan.Khajehei@health.nsw.gov.au

EVENTS: INTERSTATE 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-lowitjainstitute-international-indigenous-healthand-wellbeing-conference/

INTERNATIONAL World Congress of Cardiology and Cardiovascular Health

5–8 December 2018 Dubai, United Arab Emirates

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

46 | THE LAMP DECEMBER 2018 /JANUARY 2019

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.

EuroSciCon Conference on Clinical Pathology and Bacterial Diseases 2019

RPAH – February 1984 PCB 35 year reunion

27–28 February 2019 Prague, Czech Republic

Saturday 16 February 2019 Venue: TBH

Enriched family – enhanced care 5–8 May 2019, Auckland, New Zealand

Possibly March 2019

https://clinicalpathology.euroscicon.com/ Council of International Neonatal Nurses Conference www.coinn2019.com 7th World Congress on Nursing and Healthcare

Recent Innovations for Better Healthcare and The Facets of Nursing 17–18 June 2019 London, UK https://www.scientificfederation.com/ wcnh-2019/ International Council of Nurses 2019 Congress 27 June–1 July 2019

Marina Bay Sands Expo and Convention Centre, Singapore

http://www.icn.ch/events/ ICN-Congress-Singapore-June-2019/ International Council of Nurses (ICN) 21st International Conference on Nursing

25–26 September 2019 London, United Kingdom www.icn.ch/ EVENTS: REUNIONS

WWBH PTS 1979 40-Year Nursing Reunion

Saturday 2 February 2019

Alison Meek (Giese) 0402 612 240 Sharyn Wellham (Noonan) 0432 416 419 Steph Taggart (Heenan) 0457 414 503 Hornby Ku Ring Gai Hospital Reunion

Orange group 40-Years 1976–79 Saturday 9 February2019

Helen Sim (Anderson) 0418 654 757 Gillian Linton (Frame) 0403 430 989

Rebecca Burke (Hartwell) beckburke@ bigbond.com 0408430662 NEC Group February 1976 Intake Reunion – 40 Years since Graduation Marie Sansotta-Allen tealhealthsolutions@gmail.com 0408 979 465 Royal Canberra Hospital PTS March 1979 40-Year Nursing Reunion

Saturday 16 March 2019 Canberra

Ruth Snowball: 0417062019 ruthsnowball@ outlook.com Kerry Taliaferro (Hockley): Kerry.Taliaferro@act.gov.au

CROSSWORD SOLUTION

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

Conditions apply. Prize must be redeemed by 30 June 2020 and is subject to room availability. Block-out dates include all Australian and NZ school holidays and Christmas / New Year period. The prize will be drawn on 30 June 2019. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/18/02955

REGULARS

Profits that go to members, not shareholders.

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.

48 | THE LAMP MARCH 2017