lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION
VOLUME 74 No.1 FEBRUARY 2017
A WAY FORWARD FOR AGED CARE NORTHERN BEACHES’ TOKEN CONSULTATION NEW GRADS WELCOMED IN BUSH THE DECLINE OF MIDDLE EASTERN HEALTH Print Post Approved: PP100007890
COVER STORY
2 | THE LAMP FEBRUARY 2017
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 74 No.1 FEBRUARY 2017
Hunter Office 8-14 Telford Street, Newcastle East NSW 2300
COVER STORY
8 | Aged care hours should double
NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962
A groundbreaking study has recommended the hours of care and skill mix needed for safe care of the elderly.
For all editorial enquiries letters and diary dates T 8595 1234 E lamp@nswnma.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au
Jocelyn Hofman, RN – Bodington Aged Care and Diane Lang RN – SE Regional Hospital. PHOTOGRAPH: SHARON HICKEY
REGULARS 5 6 26 33 35 37 39 41 43 44 46
COVER STORY
Editorial Your letters News in brief Ask Judith Nurse Uncut Social media Nursing Research Online Crossword Books Movies of the month Diary dates PRIVATISATION
10 | Missed care widespread in nursing homes Inadequate staff numbers are the most common reason for missed care, a survey of aged care facilities shows.
RURAL NURSING
14 | Northern Beaches privatisation still shrouded in secrecy
18 | Nursing opportunities galore in rural NSW Nurses in rural areas often have greater opportunities to develop their skills because of the range of work they are exposed to, while less competition means they often have opportunities to advance faster in their careers.
Northern Beaches Hospital staff are still in the dark about their future.
COMPETITION
6 | Shoe giveaway COMPETITION
Designed to support you Designed you when you areto onsupport your feet all--day! Designed to support you when when you you are are on on your your feet feet all all day! day!
Win one of five pairs of MBT Pata Classic Zip Black shoes.
WORLD
22 | Nurses’ flight worsens Middle Eastern health crisis The flight of health workers including nurses from conflict zones in the Middle East and North Africa is contributing to an alarming decline in the region’s health services.
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 and Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, Coordinator T 8595 2175 E gensec@nswnma.asn.au The Lamp ISSN: 0047-3936 General Disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised. Privacy Privacy statement: The NSWNMA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information, please contact the NSWNMA office. If you are still not satisfied that your privacy is being maintained, you can contact the Privacy Commission. Subscriptions for 2017 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30. Individuals $82, Institutions $138, Overseas $148.
66,436
Average Net Distribution per issue. The Lamp is independently under the AMAA's CAB Total Distribution Audit. Publisher's Statement for the period: 01/04/2016 - 30/09/2016
THE LAMP FEBRUARY 2017 | 3
your future, divided On average, Australian women have just over half the super of men.* Maybe it’s time to change that?
hesta.com.au/mindthegap 4 | THE LAMP FEBRUARY 2017
EDITORIAL BY JUDITH KIEJDA, ACTING GENERAL SECRETARY
A way forward for aged care If we want to have an aged care sector that has the capacity to care for older Australians to the standards the community expects then a good place to start is with an understanding of what the staffing requirements are to deliver that care.
The status quo is clearly failing older Australians. Successive governments and aged care providers have prioritised budgets and profits over standards of care.
Over the last two decades, numerous Productivity Commission reports and Senate Inquiries have consistently highlighted the need for a method of determining safe staffing levels and skills mix in the aged care sector. Incredibly, despite the interminable debate about aged care staffing there has been no empirically-based research to determine how to establish those staffing levels. As my colleague Lee Thomas, Secretary of the ANMF, has said: “There has been a monumental failure of successive governments to establish and legislate evidence-based staffing levels and skills mix that provide a minimum safe standard of quality care to vulnerable older Australians” (see p.8). The Productivity Commission recognised the difficulty in attracting and retaining a workforce in the sector for a myriad of reasons including a lack of competitive wages, poor management of facilities and lack of career opportunities. Its timid response was limited to addressing education and training opportunities. This crisis in the aged care workforce will undoubtedly be exacerbated by recent budget cuts by the Federal government that will reduce funding to the sector. It is obvious that much bolder initiatives are needed especially a methodology for aged care that considers both staffing levels (the right number) and skills mix (the right qualification). The ANMF Federal Executive recognised this critical gap and commissioned and funded the National Aged Care Staffing and Skills Mix Research. The evidence-based tools that have been established by this research will inform staffing and skills mix in aged care. Now, thanks to the ANMF (with the support of all its state branches including the NSWNMA), and in collaboration with researchers at Flinders University and the University of South Australia, we finally have a national aged care staffing and skills mix model which can provide a platform to take the sector forward.
IMPORTANT QUESTIONS ANSWERED The project is a first for Australia and provides important answers to questions about what needs to be done to provide appropriate, safe care for older Australians. The research was comprehensive and involved focus groups across the country with aged care nurses, a “Misscare” survey with over 3,200 participants and the imput of 102 invited experts. Key recommendations coming from the research include: • an average four hours and eighteen minutes of care per day, • a skills mix requirement of RN 30 per cent, EN 20 per cent and AiN 50 per cent. This is the minimum care requirement and skills mix to ensure safe residential and restorative care. The Misscare survey threw up some alarming results – only 8 per cent of aged care nurses thought staffing was always adequate. The survey identified inadequate staff numbers as the most common reason for missed care. 76.8 per cent indicated they could not request additional staff. Only 10 per cent indicated that extra staff were provided when requested. The status quo is clearly failing older Australians. Successive governments and aged care providers have prioritised budgets and profits over standards of care. The ANMF and the NSWNMA will not stand by and allow this to happen. The point of departure in any discussion about how aged care should go forward should be: What are the care needs of older Australians? We now have a clear idea of what the staffing requirements of the sector are and the next step of our campaign will be to fight for their implementation.
THE LAMP FEBRUARY 2017 | 5
COMPETITION
YOUR LETTERS
LE TTE RS OF THE MONTH
Questionable priorities First, I witnessed the incremental removal of a 30-bed hospital with local surgical facilities from a small country town, which is now left with an MPS of a few nursing home beds and a couple of A & E beds. Then I witnessed the crippling of a fully functional diabetes clinic with increasing budgetary restraints. Now I am witnessing the progressive clinical withdrawal of preventative community services in parallel with the development of the hospital’s surgical facilities, which will hopefully earn NSW Health an income from across-border waiting lists. NSW Health seems to be focused on budgetary management rather than the provision of health services, and I think that this Americanisation of our services will continue to jeopardise affordable, accessible health care.
Designed to support you Designed you when you areto onsupport your feet all--day! Designed to support you when when you you are are on on your your feet feet all all day! day!
Five pairs of MBT ! N I W Pata Classic Zip Black to give away! The Lamp is offering NSWNMA members the chance to win one of five pairs of MBT Pata Classic Zip Black shoes. To enter the competition, simply provide your name, address and membership number and email your entry with the subject: MBT Shoes to lamp@nswnma.asn.au
Simon CNS, Southern NSW
Simbum blues I have been a nurse for 40 years. I have seen a lot of change during this time, some good and some bad. It seems today that every time I come back from days off, someone who is being paid a lot more than me and who probably hasn’t worked in a clinical setting for some time has come up with a wonderful new policy designed to make me do my job better. Just when I thought nothing could surprise me, I was told about the “simbum”. Apparently, a suppository of wisdom has decided we are no longer able to insert suppositories in human bottoms without first being assessed carrying out the procedure on the “simbum”. Just imagine explaining to a synthetic bottom that you will be inserting a suppository into it. And the thought of obtaining consent boggles my mind. Have I really not given suppositories correctly for all these years because I haven’t had the simbum to practise on? Perhaps I am old and jaded but I was taught how to give suppositories on real patients as a student nurse and have been doing so ever since without any problems. Annette Alldrick RN RM, Tapitallee
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!
Find MBT online at www.mbtshop.com.au or instore at Level 2, 9-13 Hay St, Haymarket; 1/376 Victoria Ave, Chatswood. *Conditions apply. Competition entries from NSWNMA members only and limited to one entry per member. Competition opens 1 February 2017 and closes 28 February 2017. The prize is drawn on 1 March 2017. If a redraw is required for an unclaimed prize it must be held up to 3 months from the 6 | THE LAMP FEBRUARY 2017 original draw date. NSW Permit no: LTPM/16/00329
unionshopper.com.au 1300 368 117
Union Shopper Letter of the Month.indd 1
23/02/15 11:53 AM
YOUR LETTERS
A place for banter
Is euthanasia really ‘the right thing to do’?
I am in total support of Amanda Higgins (The Lamp, November 2016). I am a recently retired CNS from the public hospital system. I commenced my training, in the hospital system in 1973. Back then, there were always plenty of senior staff and educators to mentor students. Staff were allowed to banter with each other and work was fun. Alas, over the past decades, this bantering has been discouraged and life is way too serious and stressful. Horizontal bullying is ever present. The acuity of patient care has increased markedly, but not a parallel increase in nursing hours. The basics, e.g. patient teeth and pressure cares, are being neglected, not due to lack of willingness of staff, but lack of time. Middle and upper management are not supportive of the nurses, which is very disillusioning. They are quick to criticise, but very slow (or lacking) in praise. Many experienced nurses such as myself have left the profession earlier as a result of the lack of support. I do not believe anything positive comes from the Workplace Surveys. I believe they are done as lip service. When you are in a solo role, as I was in Research, management do not recruit someone to allow you to have your annual leave/LSL/manage the workload. This creates frustration and burnout! I am glad I am out of the crumbling NSW health system. I am concerned for the future caregivers. Pauline Keays RN, Coffs Harbour
It is with continuing concern that I have followed the debate on euthanasia. Euthanasia is a lovely euphemism for the act of painlessly killing people. As a nurse, I find that position to be untenable. I believe that as nurses we should be ensuring that people who are dying do so with dignity and be as pain free as possible. The World Health Organization defines palliative care as “…an approach that improves the quality of life of patients and their families facing the problem associated with lifethreatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual (my emphasis).” That there are cases of people suffering unbearable pain from terminal illnesses is a sad indictment on our profession that we are not delivering or advocating strenuously for the required level of care to be provided. If we are unable to deliver a standard of palliative care consistent with the WHO statement, then the answer is not to have assisted painless killings, but to improve the standard of palliative care. Where is the outcry from nurses and other healthcare providers? The overseas experience shows that the introduction of euthanasia opens a slippery slope and it changes from being only available to those suffering a terminal and painful death, but to also become available to those who no longer wish to live for whatever reason, despite being in reasonably good health. It may seem like “the right thing to do” but ends do not justify the means. Proponents citing examples of end stage suffering as evidence that we should allow euthanasia are mistaken. That ‘evidence’ highlights a downfall in the delivery of quality palliative care and loss of recognition of the sanctity and dignity of life. Life has value, purpose and meaning. If we do not recognise this, then we become Nietzschean in our thinking and accept that life is pointless and meaningless and the big question then is, “why do we not encourage suicide?” Michael Hamming RN NP, Taree
The Lamp wrap goes bio-degradable I noticed with my latest edition of The Lamp that the plastic wrap does not appear to be bio-degradable. Is this correct? If so, is there any reason why not? Russell J. Hewitt RN, Darlinghurst NSWNMA responds: Thank you, Russell – the December 2016 / January 2017 edition was wrapped in bio-degradable plastic and will continue in this wrap for all future editions.
Thanks for saving my job!
I am writing to say a big thanks to all the union staff who have assisted me in a most unfair dispute with my employer. The dispute may not be over yet but I want to thank all staff who supported me over the past six months and saved me from losing my job! Jenny Liu RN, Kogarah
HAVE YOUR SAY Send your letters to: Editorial Enquiries email lamp@nswnma.asn.au fax 9662 1414 mail 50 O’Dea Avenue, Waterloo NSW 2017.
Please include a high-resolution photo along with your name, address, phone and membership number. Letters may be edited for clarity and space. Anonymous letters will not be published.
NSWNMA responds: We recognise that there are nurses and midwives who are opposed to physician-assisted dying and we are absolutely committed to protecting their rights to refuse to be involved in assisted dying. We consider physician-assisted dying as a complement to the range of palliative care options available to relieve suffering and we respect the right of an individual to choose this option when all others are unacceptable to them. This issue has been debated by NSWNMA delegates on numerous occasions and at all times our public statements reflect the outcomes of those deliberations.
Advertise in The Lamp and reach more than 63,000 nurses and midwives.
To advertise please contact Danielle Nicholson 02 8595 2139 / 0429 269 750 dnicholson@nswnma.asn.au THE LAMP FEBRUARY 2017 | 7
COVER STORY
Aged care hours should double A groundbreaking study has recommended the hours of care and skill mix needed for safe care of the elderly.
Aged care residents should receive an average four hours and 18 minutes of care per day – almost double the 2.84 hours they currently get. The minimum skills mix needed to ensure safe care is registered nurses (RN) 30 per cent, enrolled nurses (EN) 20 per cent and assistants in nursing (AiN) or personal care workers (PCW) 50 per cent. Inadequate staffing is the main cause of incidents of missed care, which are common across all aspects of care. These are the main findings of the first Australian study aimed at finding a method of determining both the number and mix of qualifications of aged care nursing staff.
SUCCESSIVE GOVERNMENTS HAVE FAILED OLDER AUSTRALIANS
Productivity Commission reports and Senate inquiries have consistently recommended the need to establish a method of determining safe staffing levels and skills mix in aged care. “Despite these recommendations, there has been a monumental failure of successive governments to establish and legislate evidence-based staffing levels and skills mix that provide a minimum safe standard of quality care to vulnerable older Australians,” Lee said. “The current Aged Care Act 1997 indicates the numbers
“THERE HAS BEEN A MONUMENTAL FAILURE OF SUCCESSIVE GOVERNMENTS TO ESTABLISH AND LEGISLATE EVIDENCEBASED STAFFING LEVELS AND SKILLS MIX THAT PROVIDE A MINIMUM SAFE STANDARD OF QUALITY CARE TO VULNERABLE OLDER AUSTRALIANS.” — Lee Thomas, ANMF Federal Secretary. Called the National Aged Care Staffing and Skills Mix Project, the study was done by the Australian Nursing and Midwifery Federation (ANMF) in conjunction with the ANMF’s South Australian branch and researchers from Flinders University and the University of South Australia. The union carried out the study due to the “monumental failure” of governments to establish-evidence based staffing levels and skills mix in aged care, said ANMF Federal Secretary Lee Thomas. Over the past two decades, the number of residential aged care places nearly doubled from 134,810 in 1995 to 263,788 in 2014.
8 | THE LAMP FEBRUARY 2017
of care staff should be adequate to meet the assessed care needs. “However, it provides no parameters on what the volume or skill mix of workers must be based on to safely meet the needs and care requirements of residents. “The report’s findings reflect feedback from ANMF members working on the ground in aged care and are consistent with stories from members about the increasing difficulty they experience in providing decent care to residents, many with dementia and other high-complex needs. “As the report shows, missed care is a regular occurrence in residential aged care.”
Michelle Saul, AiN – Macleay Valley House, Jocelyn Hofman, RN – Bodington Aged Care, Diane Lang RN – SE Regional Hospital and Rachel Crouch AiN – BUPA Banora Point.
REPORT NOW IN THE HANDS OF THE SENATE
The ANMF has given the report to a Senate inquiry into the aged care workforce, which has also heard evidence from the NSWNMA. Nursing unions hope the Senate committee will use the report’s evidence to recommend legislation to establish minimum staffing levels and skills mix in residential care. Recommendations from the committee are due in April 2017. Meanwhile, the NSWNMA will join unions from every state and territory at a national meeting of age care campaigners in February 2017. The meeting will help draw up a campaign to promote the report’s recommendations. The study adds to a growing body of national and international research showing that inadequate levels of qualified nursing staff lead to an increase in negative outcomes for those in their care, which results in increased costs. In acute care, the implementation of safe mandated minimum staffing has been shown to prevent adverse incidents and outcomes, reduce mortality and prevent readmissions, thereby cutting health care costs. “It is widely agreed that the same improvements could be achieved in the aged care sector – but this is reliant on appropriate number and mix of skilled and experienced staff,” Lee said.
Aged care report – main recommendations
1
A staffing methodology be adopted for aged care facilities.
2
A methodology for staffing facilities needs to incorporate the time taken for both direct and indirect nursing, and personal care tasks and assessment of residents; it also needs to reflect the level of care required by residents.
3
An average four hours and eighteen minutes of care per day, with a skills-mix requirement of RN 30 per cent, EN 20 per cent and AiN 50 per cent is the evidencebased minimum care requirement and skills mix to ensure safe residential and restorative care.
n average four hours A and eighteen minutes of care per day, with a skills-mix requirement of:
30% RN
20% EN
50% AiN
More information National Aged Care Staffing and Skills Mix Project Report 2016 http://www. anmf.org.au/documents/ reports/National_Aged_ Care_Staffing_Skills_Mix_ Project_Report_2016.pdf A four-page summary of the report can be found at http://www.anmf.org.au/ documents/Overview_Aged_ Care_Report.pdf THE LAMP FEBRUARY 2017 | 9
COVER STORY
Missed care widespread in nursing homes Inadequate staff numbers are the most common reason for missed care, a survey of aged care facilities shows.
Only a tiny proportion of aged care nursing staff believes that staffing in their facility is always adequate. This is shown by a “Misscare� survey of 3,206 RNs, ENs and AiNs from the aged care sector. Designed by university researchers, the survey was part of the National Aged Care Staffing and Skills Mix report recently released by the Australian Nursing and Midwifery Federation (ANMF). The Misscare survey asked staff about the interventions they believed were being missed and the reasons why they were missed. The survey found that all types of nursing services and personal care interventions were missed at least some of the time. Only 8.2 per cent of respondents indicated that staffing was always adequate. Just under one-third (30.6 per cent) identified staffing levels to be adequate 75 per cent of the time, while more than a quarter (27.2 per cent) viewed staffing as adequate half the time. Staffing levels were viewed as never adequate by 14.2 per cent of surveyed staff. The types and frequencies of missed care were consistent across 24 hours and were not influenced by shift times. A majority (76.8 per cent) of respondents indicated they could not request additional staff. Only 10 per cent indicated that extra staff were provided when requested.
8.2%
Only 8.2 per cent of respondents indicated that staffing was always adequate.
10 | THE LAMP FEBRUARY 2017
14.2%
Staffing levels were viewed as never adequate by 14.2 per cent of surveyed staff.
WITH MORE STAFF, LESS CARE IS MISSED
Where nurses were able to request extra staff when needed, less care was missed. Employees in private-for-profit facilities were significantly more likely to report difficulties in both asking for, and receiving, extra staff when compared to both government and private not-forprofit facilities. Tasks that were reported as most frequently missed across all shifts were assisting residents with toileting needs within five minutes of request, and answering the call bell within five minutes. The interventions that are least frequently missed are some of the more complex care tasks undertaken by nurses. They included providing stoma care, maintaining nasogastric or PEG tubes, suctioning airways, measuring and monitoring blood glucose levels, and maintaining IV or subcutaneous sites. When an RN was not available on-site during the last shift, staff expressed less workplace satisfaction. Lower levels of staff satisfaction with their current job, lower levels of workplace teamwork and reduced intention to stay in their current job were all associated with an absence of a RN in the workplace. The absence of an RN also had a direct correlation with reported care delivery, with higher levels of missed care reported when an RN was not on-site.
76.8%
A majority (76.8 per cent) of respondents indicated they could not request additional staff.
10%
Only 10 per cent indicated that extra staff were provided when requested.
Pain management, falls among missed care issues Episodes of missed care due to understaffing and too few RNs are relatively common in nursing homes, says registered nurse and TAFE teacher Diane Lang. Diane worked as an aged care assistant in nursing for 10 years before doing a nursing degree. She now teaches Certificate 3 aged care workers at Bega on the NSW south coast. She says delayed pain management due to an RN not being available is a widespread problem. “Also, people who suffer falls but can’t be assessed by an RN are whisked off to hospital. That places a greater burden on the public hospital system and the resident is thrust into a confusing, noisy environment, which increases the risk of delirium-related behaviours. “Residents get chest infections when they aspirated from eating improperly because an RN was not available to assess their swallowing ability. “Untrained staff are not usually able to assess changes in cognitive behaviour or detect the fact that someone has a mild TIA (mini stroke). “Medications are sometimes missed or not given at the correct time because there are just not enough staff available to give 30-40 people their medications in the allotted time frame.” Diane says residents miss out on adequate meals when there are not enough staff to feed all residents in the allotted time. “In an effort to get everyone fed, staff often feel the quickest way is to rush the person by forcing food before they have finished the last mouthful. Sometimes people go without a meal as it is removed before staff can attend to them.” Diane says that with the distinction between high and low care facilities now eliminated, more and more people are staying longer in what used to be low care places with hardly any skilled staffing. “As soon as they have any episode at all they are rushed off to hospital and taking up a public bed.”
AGED CARE IS GROSSLY UNDERFUNDED
Diane says the national aged care report points to gross underfunding of aged care. “The current federal government has cut funding to aged care to such an extent that nursing homes will cut staff numbers even further. “Aged care should be getting more money, not less, with greater accountability to make sure additional funds go to increased staffing. “The elderly have been paying taxes their whole lives and deserve to be treated with respect and dignity – not as commodities which is how many of them are treated now.” Diane said residents were often “lonely, depressed, and totally dependent on someone else to care for them”. However, if the report’s findings were implemented, “they would actually get respectful and good quality care towards the end of their lives”. “And nurses who enter that profession are less likely to leave after 12 months due to exhaustion.”
“ THE ELDERLY HAVE BEEN PAYING TAXES THEIR WHOLE LIVES AND DESERVE TO BE TREATED WITH RESPECT AND DIGNITY – NOT AS COMMODITIES.” — Diane Lang THE LAMP FEBRUARY 2017 | 11
COVER STORY
Surveys pinpoint aged care staffing flaws Focus group surveys show an inadequate mix of staff skills adversely affects health care in nursing homes.
Focus groups of nurses have recommended that baseline nursing and personal care hours received by aged care residents be increased by half an hour per day on average. Seven focus groups mostly involving registered nurses (RNs)were conducted in different parts of Australia as part of the National Aged Care Staffing and Skills Mix Project. The aim was to determine the validity of nursing interventions and timings for six typical resident profiles used as models in the report. While the resident profiles were not real people, they were based on real-life examples. Participants in all focus groups recommended that care hours be increased by half an hour per day on average “due to the impact of indirect care services on the delivery of direct nursing care”. They agreed that aged care facilities were admitting a greater number of residents with more complex needs who had shorter lengths of stay than previously. Participants associated a low ratio of RNs to assistants in nursing or personal care workers, with poor reporting and delayed management of emerging health issues.
12 | THE LAMP FEBRUARY 2017
THE LACK OF RNS IS UNSAFE
Participants worked under various staffing models but there was often only one RN to manage large numbers of care workers and residents, irrespective of the size and geographical layout of the facility. One participant described her work situation: “I work in a 100-bed facility, in charge of the same situation all afternoons, and we have 1, 2, 3, 4 ENs that I need to oversee; I have my own floor to look after as well and medications to do. And so I’ve got to do all the DDAs. They are prescribed that we have to have two people to do insulins. So, I’m all over five floors as well as looking after my own floor, as well as staffing, taking outside phone calls, etc., etc. It’s become very untenable actually and quite dangerous, I feel.” Having insufficient RNs forced nurses to rely on less qualified staff to report emerging issues with residents. “This may be problematic if insufficient time is allowed for change of shift reporting or handovers,” the report noted. “It may also be problematic if the knowledge and skill set of care workers is insufficient to recognise emerging issues and to manage the complexity of having many residents. Some participants identified workload as leading to a task orientation among care workers which may compromise care.”
Aged care needs RNs more than ever
Ann Gaffney
RNS WEIGHED DOWN BY ADMIN LOAD
Participants also agreed the administrative load undertaken by RNs limited their ability to provide direct nursing care. This was particularly evident after hours and on weekends when other staff, such as reception and diversional therapists, worked reduced hours or not at all. Many nurses said they were responsible for care delivery in more than one geographically dispersed site, or had to cover care for residents in facilities widely spread out over one level or on multiple floors. “One consequence of geographical dispersion is remote decision-making, in which the RN is required to make decisions about care without seeing the resident.” One nurse “described disciplinary action arising from their refusal to provide pain relief at a distance”. Nursing hours also failed to adequately account for time spent in travelling between floors and/ or in fetching equipment at geographically dispersed facilities. Participants said the need to provide emotional support and promote social interaction for residents was not sufficiently reflected in the timings and resident care hours per day. Lack of appropriate resources to provide optimum care was “a recurring theme across the focus groups”. This included discussion about inappropriate chairs, and the lack of availability of imprest/stock items and pharmaceuticals. Focus group participants argued that time chasing missing equipment needed to be factored into indirect timings.
The introduction of nurse-to-resident ratios in aged care may make it easier to recruit and retain aged care nurses, providing their ongoing training and clinical supervision needs are met, says clinical nurse consultant Ann Gaffney. A senior clinician in aged care, Ann took part in focus groups organised to gauge nurses’ views as part of the National Aged Care Staffing and Skills Mix study. She says aged care recipients experience extremely complex health problems, which require more nursing time. “Today, the aged have multiple co-morbidities and complex family dynamics. I have worked in many settings and have found the aged care setting to be the one where a high level of skill is most keenly needed, yet it is not the preferred choice of many nurses.
“I HAVE WORKED IN MANY SETTINGS AND HAVE FOUND THE AGED CARE SETTING TO BE THE ONE WHERE A HIGH LEVEL OF SKILL IS MOST KEENLY NEEDED, YET IT IS NOT THE PREFERRED CHOICE OF MANY NURSES.”— Ann Gaffney “In my current organisation, we are striving to address this problem through continuing education, especially in the areas of dementia and mental health care. “I have been practising since 1975 and I find today’s complex care needs RNs who can perform in advanced practice roles, much more so than in the past. “As we shift away from task-centred care towards personcentred care, the more ‘invisible, innate’ interpersonal skills of nurses are required. “If we fail to use these skills, or do not know how to use them, aged care recipients will suffer. “Recovery from highly prevalent conditions will be prolonged because we are not picking up on signs and symptoms and intervening early in the illness trajectory. “It takes nursing skill to recognise and diagnose symptoms so that they can be treated, and to recognise that ‘recovery’ is a concept applicable to aged care as well as to other specialities. “We are all about promoting the wellness of our care recipients so as to ultimately relieve the pressure on the system.”
THE LAMP FEBRUARY 2017 | 13
PRIVATISATION
Northern Beaches privatisation still shrouded in secrecy Northern Beaches Hospital staff are still in the dark about their future, three and a half years after the first announcement of the privatisation and over two years after Healthscope was named as the provider.
Health unions including the NSWNMA have gone to the state Industrial Relations Commission to try to get answers to vital questions about Sydney’s new, privatised Northern Beaches Hospital. The unions notified the commission of a dispute after trying for more than three years to get answers about employee transitions, staffing arrangements and work conditions. Commissioner Peter Newall recommended that a senior representative of the Ministry of Health attend the next union-employer consultation meeting (held in December). Commissioner Newall said employees should not be required to make a decision regarding a possible transfer of employment without having all the fundamental answers available. The NSW government announced the start of a process to choose a private operator to build and operate a new northern beaches hospital at Frenchs Forest in May 2013. The new hospital is to replace public health services provided at Manly and Mona Vale hospitals, with Manly Hospital closing entirely, and residual services remaining at Mona Vale Hospital. The government did not consult with employees or unions before the announcement. In October 2014, the government announced it had chosen Healthscope to build and operate the new hospital.
Due to open in 2018, Northern Beaches Hospital is the first of five new public-private partnerships (PPPs) to be run under a new model that will essentially hand over public hospitals to private operators. Other hospitals are Maitland, Wyong, Shellharbour and Bowral. UNIONS SOUGHT ASSISTANCE FROM IRC
Acting NSWNMA General Secretary, Judith Kiejda, said timelines regarding staffing and transition, along with arrangements covering workplace rights, had continuously been postponed or delayed. “It is almost beyond belief that critical information can still be outstanding some three and a half years after the first announcement seeking expressions of interest (from private operators) and over two years after selecting Healthscope as the provider. “The ministry has not provided requested and necessary information about staffing, transitions and all aspects of the employment conditions. “That has left unions no option but to seek the commission’s assistance.” Judith said it was unacceptable that nurses and midwives who will transfer to the new hospital were still fighting to find out what all their rights will be under the new provider. “This is a prime example of the government failing in its duty to manage our public health system by shutting out workers, unions
“THE SECRECY SURROUNDING THE DEAL BETWEEN THE GOVERNMENT AND HEALTHSCOPE IS EXTREMELY CONCERNING.” — Judith Kiejda
14 | THE LAMP FEBRUARY 2017
“ A framework to clarify issues is now in place. It has only occurred through the persistence of members. This persistence found its reward with the welcome intervention of the Commission.”
and the community from the consultation process with the private operator. “It is one thing to have meetings, and there have been plenty of those, but meaningful consultation requires transparent and timely provision of information. It also requires decision makers to be present. “This has been sorely absent from this process. “The public keeps being reassured that public patients will not be affected in these PPPs but the secrecy surrounding the deal between the government and Healthscope is extremely concerning. “How can we trust what they say if we still have no clear details around how this model will work?” STILL LITTLE CONSULTATION FROM LHD AND GOVERNMENT
Judith said health unions and employee representatives had repeatedly sought vital information from the Northern Sydney Local Health District and the ministry. The ministry had been unwilling to send a representative to the district-level consultation meetings despite repeated requests from unions.
Judith said the ministry had given Healthscope a “service schedule” that lists nursing positions that Healthscope “should consider”. The schedule does not list the positions as mandatory and there is no definition or criteria of what constitutes ”should consider” in the schedule or the trust deed. For example, the schedule says only that the operator “should consider” providing access to a clinical nurse educator and clinical nurse specialist in the cardiology service. Clinical assistants to NUMs are another omission from the service schedule. “They currently exist at Manly and Mona Vale hospitals and their omission at Northern Beaches Hospital would leave NUMs stuck behind a computer instead of supervising nursing care on the floor,” she said. A framework to clarify issues is now in place following the December meeting, says Judith. “It has only occurred through the persistence of members. This persistence found its reward with the welcome intervention of the Commission. “The Commission now retains a watching brief on the matter as well as the capacity to intervene if any further blockages occur,” she said.
THE LAMP FEBRUARY 2017 | 15
PRIVATISATION
Token consultation Consultation and information sessions involving staff affected by the Northern Beaches Hospital privatisation amount to “the most ineffectual consultation process I’ve ever experienced,” said NSWNMA Vice President Lyn Hopper. Lyn is an intensive care nurse at Manly Hospital and the union’s branch president. She has been a union activist for more than 20 years.
‘THEY ARE GOING THROUGH THE MOTIONS AND PAYING LIP SERVICE TO CONSULTATION, BUT THERE HAS BEEN ALMOST NO INFORMATION PROVIDED.’ — Lyn Hopper
“There has been more consultation than you can poke a stick at, but it has been totally ineffectual. They are going through the motions and paying lip service to consultation, but there has been almost no information provided,” Lyn said. Healthscope has arranged consultative committee meetings with unions, made presentations at staff forums, held meetings for various nursing specialties, and a further set of meetings for different departments. “As a result of all these meetings, the only thing we know definitively is that all floor nurses will be offered a job. “We don’t know what will happen to clinical nurse educators, clinical nurse consultants or nurse unit managers. “None of the HSU members and the engineers, plumbers – and allied health people – know if they will have a job.” She said the union had been unable to clarify arrangements concerning a two-year employment guarantee and the five-year transition period during which public sector employment conditions would be maintained as a minimum standard. NEW REGULATIONS DENY VOLUNTARY REDUNDANCIES TO PUBLIC SECTOR WORKERS
In addition, Baird government changes to regulations in June 2016 mean public sector employees being transitioned to the private sector are no longer eligible for voluntary redundancies. “The Northern Beaches Hospital privatisation process started in 2013 so the new regulations should not apply to us, but we can’t even get that clarified 16 | THE LAMP FEBRUARY 2017
at the various meetings,” Lyn said. “When the government announced the privatisation they said public and private patients in the new hospital would be treated exactly the same. In fact, that’s not the case. “For example, intensive care private patients will get level 6 treatment, but public patients will get level 5. “Private patients will be entitled to certain procedures that public patients won’t be entitled to. “If you need cardiothoracic surgery and you’re a public patient you won’t get it at the new hospital, but if you’re a private patient you will get it. “Private patients will be placed in a private wing and public patients in a public wing. “During the transition period, staffing for public patients will be by ratios (or nursing hours per patient day), but that won’t apply to private patients.” In December, the NSW Industrial Commission recommended that the ministry send a senior representative to a union-employer consultative meeting. Lyn said the ministry official arrived one hour and twenty minutes late and the regular Healthscope senior representative did not even attend. “It was the biggest slap in the face,” Lyn said. “If the unions hadn’t attended we would have been accused of not being interested in finding solutions. “It has been an incredibly frustrating process. Despite all the consultation no one is any wiser and we’ve all wasted hours. “This is meant to be the government’s shining example of how privatisation is to be done. I hate to think what is going to happen to the other four hospitals to be privatised.”
26%
of Joondalup urgent patients were treated within 30 minutes of arrival at the ED, compared to its national peer group performance of 63 per cent.
50%
in the semi-urgent category were treated within 60 minutes of arrival at the Joondalup ED, compared to its national peer group performance of 73 per cent.
34.4%
Average percentage of Joondalup patients moved from ambulance care within 20 minutes.
45.66%
Average percentage of Royal Perth Hospital patients moved from ambulance care within 20 minutes.
Doubts over privatisation model A privatised Perth hospital held up as a model “public-private partnership” has a poor record for patient waiting times. In announcing the new Northern Beaches Hospital “public-private partnership” (PPP) in 2013, NSW Health Minister Jillian Skinner said the government had learned lessons from the disastrous privatisation of Port Macquarie hospital. The NSW Auditor-General found that the final cost of the Port Macquarie privatisation had substantially exceeded the cost to government that would have occurred had the hospital been operated by the public sector. The government was forced to buy back Port Macquarie in 2004 and the Auditor-General likened the privatisation process to “paying for the hospital twice then giving it away”. The privately operated Northern Beaches Hospital will replace Mona Vale and Manly public hospitals and will deliver “better value for the taxpayers,” Mrs Skinner promised in 2013. She said the Northern Beaches privatisation would be “similar” to the model used at Joondalup Health Campus in Perth.
Joondalup is the largest health care facility in Perth’s northern suburbs and has featured combined public and private services for 20 years. Originally an 80-bed public district hospital, Joondalup was handed to the private sector in 1996 with public and private hospitals sharing the same emergency department, operating theatres and intensive care facilities. But if patient wait times are anything to go by, Joondalup is a dubious model. Overall, NSW has a better record on emergency department wait times than Western Australia. In NSW, 81 per cent of emergency presentations were seen on time during 2015-2016. WA could only achieve 65 per cent, according to statistics released by the Australian Institute of Health and Welfare. Even using WA’s inferior benchmark, Joondalup’s emergency department within the “public” hospital operated by Ramsay Health Care did particularly poorly. According to the MyHospitals website, in 2015-16, only 26 per cent of
Joondalup urgent patients were treated within 30 minutes of arrival at the ED, compared to its national peer group performance of 63 per cent. In the semi-urgent category, 50 per cent of patients were treated within 60 minutes of arrival at the Joondalup ED, compared to its national peer group performance of 73 per cent. Joondalup also rates poorly by comparison with other WA emergency departments. An examination of Triage 4 waiting times at nine WA EDs shows Joondalup to be bottom or near bottom almost every day. The WA Labor opposition raised issues about the Joondalup model last August, with Opposition health spokesman Roger Cook criticising its “off-stretcher” times. He said that in the previous week, the campus was the worst performer for off-stretcher times in Perth with an average 34.4 per cent of patients moved from ambulance care within 20 minutes. By comparison, Royal Perth Hospital had a 45.66 per cent average, he said.
More information
http://www.myhospitals.gov.au/our-reports/ time-in-emergency-departments/december-2016/overview THE LAMP FEBRUARY 2017 | 17
RURAL NURSING
Nursing opportunities galore in rural NSW Nurses in rural areas often have greater opportunities to develop their skills because of the range of work they are exposed to, while less competition means they often have opportunities to advance faster in their careers. The lack of awareness of rural nursing opportunities means many rural communities are in need of nursing professionals, says Jacqui Blackshaw, Manager, Nursing and Midwifery Transition and Workforce for the Western NSW local health district. “There is currently a strong demand for rural nurses in Western NSW, and recruiting enthusiastic, skilled nurses to work in rural areas is a key focus for the Western NSW Local Health District,” she says. Blackshaw says that working in rural health facilities can significantly enhance nurses’ skills because “they often have to work across all areas of nursing, such as community, emergency and inpatient care”. She adds: “Rural clinicians also have access to clinical support from district and metropolitan hospitals using the Critical Care Advisory Service and Telehealth, which allow real-time
“Affordability, being part of community and getting to spend more time with family are some of the main personal benefits according to many clinicians who have moved to rural and remote areas.” And nurses in rural areas can often advance their careers faster in smaller health services, she says, “simply because there is less competition for the roles”. “In addition, rural nurses often find they are able to build stronger relationships with other staff and patients, making it a rewarding place to work.” A student placement in a rural area often led to students taking up rural careers, the Heck Yes report found.
“MOVING TO A RURAL COMMUNITY IS USUALLY A VERY REWARDING EXPERIENCE, BOTH PROFESSIONALLY AND PERSONALLY.” video interaction with the relevant doctors or specialists if advice is required.” This is backed up by a recent study by Monash University and the University of Newcastle of nursing students who did rural placements. It found students had practice opportunities they would not have had in a city. “They were able to experience a broader scope of practice, not being confined to one specific area of practice and were therefore challenged to learn new skills,” the report, titled Heck Yes, found. Rural placements also allowed students to be more autonomous in their practice, the report concluded. And for new graduates, a graduate program position in rural areas was attractive because of “the opportunity to diversify their exposure and upskill their clinical competencies”. Encouraging nurses to relocate their families to rural areas can sometimes be challenging, Blackshaw admits. “However, moving to a rural community is usually a very rewarding experience, both professionally and personally. 18 | THE LAMP FEBRUARY 2017
“Having an opportunity to experience living and working in a rural or remote area are central to [a graduate’s] practice location decision making,” the report, conducted by Rural Health Workforce Australia, found. The report recommended improving marketing efforts to promote the career benef its of rural placements. It also recommended improving incentives for students and new graduates, including help with relocation and accommodation costs, as well as strong support structures for students and graduate nurses starting rural careers. It also called on universities to increase intake of students from rural areas, who are more likely to take up rural careers.
“Being in a new place is a lot of fun” Registered nurse Ignat Kozlov wasn’t planning on a nursing career in a regional hospital, but a clinical placement at Wagga Wagga Rural Referral Hospital when he was a student exposed him to some of the advantages of rural nursing. “Almost all my placements were in the city, but at the beginning of 2014 I did a two-week placement in the mental health unit at Wagga Wagga,” Ignat says. The placement exposed him to a wide range of medicine: “As a big hospital in a regional area we get referrals from all of the small hospitals in the region”. “The biggest difference I noticed at Wagga Wagga [compared to city placements] was less with the actual work than being exposed to a wide range of situations.” Ignat returned to Sydney, but when he completed his training he successfully applied for a position at Wagga Wagga, and he is now working at the hospital in general medicine. “I’m mainly working with heart and lungs in general ward nursing. But we get all kinds of patients admitted to the hospital so there’s a big variety.” One of the things that has impressed Ignat about being at Wagga Wagga is the program for new RNs. “I found it to be a really good new graduate program. After your first year they have a development program in your second year. It’s an extension of the new graduate program where you spend a year in a particular area. “I told them what I was interested in and they organised that,” he says. The hospital provided Ignat with an opportunity to work in an angiography suite, as well as opportunities to work in theatre and airway management. “There’s an advantage to being able to specialise, but also having the opportunity to see a lot of things.” There are other benefits to a rural placement, he adds: “I like the lifestyle. It’s five minutes to walk to work. I’ve made a lot of new friends and I’ve seen parts of NSW I would never have seen. It’s cheaper to live here, and the pay is the same for nurses as it is in the city.” Students who do placements at Wagga Wagga can stay in the old nurses quarters, which offers affordable accommodation. And they can apply for a placement grant from the government to help cover the costs of a rural placement: Ignat says he received “around $500”. “I think everyone should try and do a placement out in the country, and when you’re looking for work, consider moving out of Sydney,” he says. “Just being in a new place is a lot of fun.”
“I LIKE THE LIFESTYLE. I’VE MADE A LOT OF NEW FRIENDS AND I’VE SEEN PARTS OF NSW I WOULD NEVER HAVE SEEN. IT’S CHEAPER TO LIVE HERE, AND THE PAY IS THE SAME FOR NURSES AS IT IS IN THE CITY.”
More information
Western NSW LHD has a website – Y Not Make It You! (www.ynotmakeityou.com.au) which outlines the benefits of working in rural NSW, the job opportunities and how to register your interest.
Ignat Kozlov RN THE LAMP FEBRUARY 2017 | 19
INDUSTRIAL
Fair Work Commission: EN must be supervised by an RN Fair Work Commission accepts an enrolled nurse cannot be put in charge of a hospital unit and orders back pay for registered nurse.
The NSWNMA has won payment of a dual in-charge allowance for a registered nurse working night shifts at Wesley Hospital in Ashfield, Sydney. Antony Parkin RN will get more than two years back pay after the Fair Work Commission found he should have been paid the in-charge-of-ward/unit allowance in addition to the in charge-of-hospital allowance he was receiving. Over the past two years, Antony was rostered to be in charge of the 38-bed hospital while working night shifts. The hospital has three wards: the General Psychiatry Unit (GPU), overseen by Antony, the Eating Disorder Unit (EDU); overseen by a second RN; and the Alcohol and Drugs Unit (AOD); overseen by an enrolled nurse. Antony concluded he was entitled to a dual allowance after reading the Wesley Hospital enterprise bargaining agreement (EBA). “I took the time to read the EBA and realised I and others were being underpaid,” he said. In two letters to management he said he was entitled to the dual allowance because in addition to being in charge of the GPU and the hospital he was responsible for supervising the EN in the AOD. Management replied he was not entitled to the dual allowance but did not explain why. Antony took his case to the union, which wrote to hospital management seeking payment of the dual allowance. GOOD SUPPORT FROM THE ASSOCIATION
Antony said it was the first time he had sought support from the NSWNMA. “The union has been fantastic; I can’t fault them at all,” he said. “Union staff were always available to take my calls and they acted immediately whenever an issue arose. “They even attended meetings outside of their working hours, so I was very impressed with the union’s 20 | THE LAMP FEBRUARY 2017
efforts for me and other Wesley members.” When management failed to respond to NSWNMA correspondence, the union lodged a dispute with the commission. Fair Work Commissioner Leigh Johns said the NSWNMA presented “unchallenged” evidence that it was outside the scope of practice for an EN to work autonomously and be in charge of the AOD unit. This was in accordance with the Nursing & Midwifery Board of Australia’s Enrolled Nurses’ Standards for Practice, which say the EN, is “generally required to work under the direct or indirect supervision of the RN.” According to the union’s evidence, the EN Standard makes it clear that the EN must work under the direct or indirect supervision of a RN at all times. “The need for the EN to have a named and accessible RN at all times and in all contexts of care for support and guidance is critical to patient safety,” the Standard says. Antony gave evidence that both the RN (in the EDU) and the EN (in the AOD) reported directly to him (as the nurse in charge of the hospital) on all aspects of clinical care for all patients. “The evidence of RN Parkin remained intact after cross-examination,” Commissioner Johns noted. Management’s evidence was that the EN reported to the Director of Nursing (DoN) and, though the DoN was not on duty at night, the EN could phone the DoN during the night shift. That argument was not successful. Commissioner Johns said management “had every opportunity to lead evidence from either the Director of Nursing and/or the EN which could have contradicted the evidence of RN Parkin, but, for reasons which remain a mystery, it chose not to do so.” “I am entitled to draw the adverse inference that the evidence of both would not have assisted (management).”
RNS CRITICAL TO PATIENT SAFETY
Commissioner Johns said a NSWNMA witness, professional officer Susan Taylor, brought “a high degree of expertise and specialist knowledge to an understanding of industrial arrangements that apply to nurses. Her evidence about Standards of Registration and Standards of Practice was instructive. Ms Taylor was cross-examined to no effect.” He said her “unchallenged” evidence was that “in practice the EN Standard requires that an EN must be supervised by a named RN and have reasonable access to the RN at all times for support and guidance which is critical to patient safety.” He found that, during the night shift, Antony was in charge of the EN and therefore entitled to the IC W/U & H Allowance. He ordered that Antony receive back pay. “The hospital argued in the Commission that the EN can be in charge of the unit, which has never been the case anywhere I have worked,” Antony said. In a further twist, Wesley management argued that the Fair Work Commission had no power to make an order for back payment because it was not a judicial body. However, Commissioner Johns ruled that he had the authority to order back payment because he was acting as a private arbitrator under the dispute resolution clause of the Wesley enterprise agreement.
“I TOOK THE TIME TO READ THE EBA AND REALISED I AND OTHERS WERE BEING UNDERPAID.” — ANTONY PARKIN, RN
More information To help other Wesley nurses get back pay the union has written to members asking them to provide copies of payslips for periods when they have been in charge on night shift. For more information call the Association on 8595 1234.
Get more out of life with
Union Member Benefits • Banking • Movies • Gift Cards • Travel
• Wine • Tyres • New Cars • Car Rental
Get the app! www.nswnma.asn.au/member-benefits Unions Member Benefit Third.indd 1
T H E L A M P F E B R U23/11/2016 A R Y 2 0 12:53 7 | PM 21
Nurses’ flight worsens Middle Eastern health crisis The flight of health workers, including nurses from conflict zones in the Middle East and North Africa, is contributing to an alarming decline in the region’s health services.
The exodus of health workers due to conflict is particularly serious in Syria, Iraq, Libya and Nigeria, says a report by the Safeguarding Health in Conflict Coalition of international non-government organisations. In Libya, 80 per cent of foreign nurses, who were the backbone of the country’s medical staff before 2011, have been evacuated since rebels overthrew the government in 2011. Half of the health workers who practiced in Syria before the outbreak of war in 2011 have left the country. In Iraq, 45 per cent of health workers have emigrated since 2014. In northern Nigeria, almost all health workers have fled areas controlled by the Islamic extremist group Boko Haram, resulting in the closure of 450 health facilities. The health care crisis in the Middle East and North Africa was discussed at the recent annual conference of Global Nurses United, an international coalition of nursing unions including the NSWNMA. Wars and political unrest appear to have reversed much of the progress in health outcomes experienced in the region, particularly Egypt, Jordan, Libya, Syria, Tunisia and Yemen, according to a recent study reported in Lancet Global Health (June 2016). “Before 2010, these countries were experiencing increased life expectancy as well as reduced infectious disease burdens and infant and maternal mortality,” wrote University of Washington Professor Ali H. Mokdad, who co‐authored the study. “Today, however, disruptions to their health systems have compounded the trauma and misery that have arisen from the region’s many conflicts.” On Syria, for example, the study found that if the 1990‐2008 rate of increase for life expectancy had continued, it would have been five years higher for women and six years higher for men than it is now. Equally alarming, Syria’s infant mortality rate has risen by 9.3 per cent in recent years after declining at an average annual rate of 5.6 per cent between 1990 and 2010.
In Libya, life expectancy declined by six years for women and nine years for men. Areas neighbouring conflict zones are also increasingly burdened by the largest refugee crisis in 70 years. “The flood of people into camps in Lebanon and Jordan has overwhelmed sanitation measures, leading to outbreaks of infectious diseases and resurgence in some areas of diseases that had been nearly eradicated, such as polio among Syrian refugees in Iraq,” said Professor Mokdad. “A resumption of progress in the region is impossible without political solutions that reduce violence and social unrest.” Negative health trends in the Middle East and North Africa are apparent even in countries at peace and experiencing economic growth, the study finds. There has been a rapid increase in the burden of mental and drug-use disorders. Both Qatar and the United Arab Emirates are experiencing increased drug and alcohol use, for example. “Mental health is not viewed as a major burden by many countries and is not discussed in the agendas of many international agencies and health ministries,” Professor Mokdad said. He said the rapid rise in non-communicable diseases such as diabetes and heart disease is also alarming. Commenting on the study in The Lancet, Iraqi public health specialist Dr Riyadh K Lafta observed that most eastern Mediterranean countries are “in a state of epidemiological transition”. They display health problems common to developing countries, such as infectious diseases related to sanitation and nutrition. At the same time, their populations are starting to have health problems more typical of developed countries, such as heart disease, cancer, road-traffic injuries and psychological problems. “This transition has increased the burden of diseases on the community and exhausted the health system,” Dr Lafta said.
‘IN LIBYA, 80 PER CENT OF FOREIGN NURSES, WHO WERE THE BACKBONE OF THE COUNTRY’S MEDICAL STAFF, HAVE BEEN EVACUATED.’
22 | THE LAMP FEBRUARY 2017
Sanctions worsen health crisis Before war broke out in Syria in 2011, the country’s immunisation program was one of the best in the Eastern Mediterranean region. Since then, routine vaccination coverage has dropped from 95 per cent to below 50 per cent with polio briefly returning to parts of Syria in 2013, reports the World Health Organisation (WHO).
6
yrs
9
yrs
The WHO says almost two-thirds of Syrians have no access to clean water, putting them at risk of diseases like typhoid and cholera. Despite this dire emergency, sanctions on Syria are blocking access to life-saving medicines and medical devices, a United Nations report reveals. The leaked report describes the sanctions as exceptionally harsh “regarding provision of humanitarian aid”. Before the war, Syria produced almost all its own medicines. Today, most pharmaceutical factories are either non-operational or destroyed, so the country must import almost all medical equipment, medicines and pharmaceutical products. Of thousands of medical items and medicines identified by the WHO many are subject to some level of EU export control or US sanctions embargo. Sanctions “make the import of medical instruments and other medical supplies immensely difficult, nearly impossible. It also makes it far more expensive,” said a European doctor quoted in the UN report.
In Libya, life expectancy declined by six years for women and nine years for men.
9.3%
Syria’s infant mortality rate has risen by 9.3 per cent in recent years after declining at an average annual rate of 5.6 per cent between 1990 and 2010. The is the largest refugee crisis in
70 years
THE LAMP FEBRUARY 2017 | 23
NSWNMA
education calendar TRANSITIONING TO THE WORKPLACE
– 1 Day n WATERLOO Fri 24 February For newly registered nurses and midwives Members: $20 | non-members: $40
PREPPING FOR INTERVIEWS – ½ Day n WATERLOO Fri 28 July For undergraduates Members: $10 | non-members: $30
MEDICATION SAFETY
– ½ Day n WATERLOO Wed 8 March / Thurs 18 May / Wed 29 November n LIVERPOOL Wed 26 April n NEWCASTLE Wed 27 September For all nurses and midwives Members: $40 | non-members: $85
PRACTICAL, POSITIVE LEADERSHIP SERIES – 4 Days n WATERLOO MODULE 1 – Monday 3 April MODULE 2 – Monday 1 May MODULE 3 – Monday 5 June MODULE 4 – Monday 3 July For all N/MUM, CNS, CNC, Nurse/Midwife Educator, senior RNs & midwives Members: $340 | non-members: $600
THE INFLUENTIAL THOUGHT LEADERS IN LEADING – 1 Day n WATERLOO Mon 19 June n PARRAMATTA Wed 1 November For new managers, senior managers, senior RNs, DONs, DDONs Members: $125 | non-members: $225 24 | THE LAMP FEBRUARY 2017
MANAGING OVERTHINKING
– 1 Day n WATERLOO Fri 17 March n WAITARA/HORNSBY Mon 10 July For all nurses and midwives Members: $85 | non-members: $170
ARE YOU MEETING YOUR CPD REQUIREMENTS?
– ½ Day n BATEMANS BAY Tue 28 March n GYMEA Fri 7 April n WATERLOO Fri 5 May n NEWCASTLE Wed 10 May n PORT MACQUARIE Tue 23 May n ARMIDALE Tue 20 June n DUBBO Wed 12 July n WAGGA WAGGA Wed 9 August n COFFS HARBOUR Tue 29 August n BALLINA Thurs 2 November For all nurses and midwives Members: $40 | non-members: $85
LEGAL AND PROFESSIONAL ISSUES FOR NURSES AND MIDWIVES – ½ Day n BATEMANS BAY Wed 29 March n NEWCASTLE Thurs 11 May n PORT MACQUARIE Wed 24 May n ARMIDALE Wed 21 June n DUBBO Thurs 13 July n WAGGA WAGGA Fri 11 August n COFFS HARBOUR Wed 30 August n BALLINA Fri 3 November n GYMEA Fri 17 November For all nurses and midwives Members: $40 | non-members: $85
PRACTICAL SKILLS IN GETTING PEOPLE ON-SIDE – 1 Day n WATERLOO Fri 31 March, Wed 8 November For all nurses and midwives Members: $85 | non-members: $170
FOOT CARE FOR NURSES
– 2 Days n WATERLOO Thurs 6 & Fri 7 April / Thurs 16 & Fri 17 November n COFFS HARBOUR Thurs 6 & Fri 7 July For RNs, ENs and AINs Members: $203 | non-members: $350
PRACTICAL STRATEGIES IN MANAGING STRESS AND PREVENTING BURNOUT – 1 Day n WATERLOO Wed 12 April n LIVERPOOL Fri 11 August For all nurses and midwives Members: $85 | non-members: $170
TOOLS IN MANAGING CONFLICT AND DISAGREEMENT – 1 Day n PARRAMATTA Fri 12 May n WATERLOO Mon 9 October For all nurses and midwives Members: $85 | non-members: $170
PRACTICAL SKILLS IN MANAGING DIFFICULT AND AGGRESSIVE CLIENTS – 1 Day n WATERLOO Wed 31 May n GYMEA Fri 20 October For all nurses and midwives Members: $85 | non-members: $170
nswnma forums
POLICY AND GUIDELINE WRITING FOR NURSES AND MIDWIVES – 1 Day n WATERLOO Fri 21 April / Fri 1 September n LIVERPOOL Fri 9 June For all nurses and midwives Members: $85 | non-members: $170
SUBMISSION AND IMPLEMENTATION OF GUIDELINES AND POLICIES – 1 Day Prerequisite to registering for this course is the completion of the Policy and Guideline Writing for nurses and midwives workshop n WATERLOO Fri 24 November Members: $85 | non-members: $170
APPROPRIATE WORKPLACE BEHAVIOUR FOR NURSES AND MIDWIVES – 1 Day n NEWCASTLE Wed 5 July n WAGGA WAGGA Thurs 10 August n GYMEA Fri 1 December For all nurses and midwives Members: $85 | non-members: $170
FINANCIAL WELLNESS SEMINAR – ½ day
A HESTA, First State Super and NSWNMA collaboration. Seminars will be held in these locations (dates TBA): n WATERLOO n PORT MACQUARIE n WAGGA WAGGA n BALLINA n NOWRA n NEWCASTLE n DUBBO n PARRAMATTA FREE, members only
FAR NORTH COAST TRAINING DAY 1 Day | For all nurses and midwives Tuesday 28 February Ballina Members: $75 | non-members: $150
ENROLLED NURSES’ FORUM 1 Day | For enrolled nurses Friday 26 May Waterloo Members $30 | non-members $60
MENTAL HEALTH DRUG AND ALCOHOL NURSES’ FORUM 1 Day | For all nurses Friday 8 September Waterloo Members $30 | non-members $60
AGED CARE NURSES’ FORUM 1 Day | For all nurses Friday 20 October Waterloo Members $30 | non-members $60
MIDWIFERY FORUM 1 Day | For all midwives Friday 10 November Waterloo Members $30 | non-members $60
Register online
bit.ly/ NSWNMAeducation For enquiries contact NSWNMA Metro: 8595 1234 Rural: 1300 367 962 THE LAMP FEBRUARY 2017 | 25
NEWS IN BRIEF
Denmark
Less Facebook makes you happier Brazil
Brazilian women are avoiding pregnancy Brazil needs to urgently reconsider its policies on family planning in response to the impact of the Zika virus, say health experts. More than half of adult women of reproductive age in Brazil have actively tried to avoid pregnancy because of the Zika virus epidemic, according to a survey. The survey carried out by academics in Brazil, found that 56 per cent of women tried to avoid becoming pregnant as a result of their health concerns over Zika. This response even came from those with religious beliefs - 58 per cent of Catholics and 55 per cent of Evangelicals in the survey said they were avoiding pregnancy.
“58% OF CATHOLICS AND 55% OF EVANGELICALS IN THE SURVEY SAID THEY WERE AVOIDING PREGNANCY.” Brazil has reported far more malformations of the brain in babies born to mothers who were infected with Zika than any other country. So far, there have been 1845 confirmed cases of what is now being called congenital Zika syndrome. A further 7246 cases are suspected, but the link to the virus has not yet been firmly established. Dr Debora Diniz from the University of Brasilia, writing in the Journal of Family Planning and Reproductive Healthcare, said there is an urgent need for Brazil to reconsider its policies on family planning and abortion, to help women who want to avoid the risk of having a baby with brain malformation. “As indicated by the high proportion of women who avoided pregnancy because of Zika, the Brazilian government must place reproductive health concerns at the centre of its response, including reviewing its continued criminalisation of abortion,” she argued.
MASTER OF NURSING Avondale’s Master of Nursing is designed to extend and deepen a registered nurse’s knowledge, skills and appreciation of advanced practice within complex health care environments. Students are given the choice to develop nursing specialist qualifications in either Clinical Nursing, Clinical Teaching or Leadership and Management. Mode: Distance education (Online)
APPLY NOW FOR 2017 for February and August intakes. To find out more, visit www.avondale.edu.au/nursing, phone +61 2 4980 2377, or email study@avondale.edu.au
26 | THE LAMP FEBRUARY 2017
A Danish study has found that regular users who took a week-long break from Facebook reported increased wellbeing. The study conducted by the University of Copenhagen and reported in the peer-reviewed journal Cyberphysiology, Behaviour and Social Networking found people experienced greater levels of satisfaction with their life when not using Facebook for one week, compared with regular Facebook users. The effect of quitting Facebook was greatest for users who felt the highest levels of “Facebook envy”. “First, the present study provides causal evidence that quitting Facebook leads to higher levels of both cognitive and affective wellbeing,” the researchers found. “The participants who took a one-week break from Facebook reported significantly higher levels of life satisfaction and a significantly improved emotional life. “Second, the study showed that the (causal) gain of wellbeing varied in relation to how people use Facebook. “The gain proved to be greatest for heavy Facebook users, users who passively use Facebook, and users who tend to envy others on Facebook. “These findings indicate that it might not be necessary to quit Facebook for good to increase one’s wellbeing – instead an adjustment of one’s behaviour on Facebook could potentially cause a change.”
“THE GAIN PROVED TO BE GREATEST FOR HEAVY FACEBOOK USERS, USERS WHO PASSIVELY USE FACEBOOK, AND USERS WHO TEND TO ENVY OTHERS ON FACEBOOK.”
NEWS IN BRIEF
Britain
Women workers more stressed Professions where women predominate – including nursing and teaching – have the highest levels of workplace stress, according to a British government report. Figures for 2015/2016 published by the British Health and Safety Executive (HSE) reveal that from the age of 25, women feel much more stress than men, and this continues throughout their working lives. Women aged 25–34, 35–44 and 45–54 were all statistically higher than average, with statisticians attributing this partly due to the fact that they predominate in some of the most taxing frontline roles, such as teaching and nursing, reported The Guardian (December 2016). “The occupations and industries reporting the highest rates of work-related stress remain consistently in the health and public sectors of the economy. The reasons cited as causes of workrelated stress are workload, lack of managerial support and organisational change,” the HSE said. The report showed that work-related stress, depression and anxiety accounted for 37 per cent of work-related ill health and 45 per cent of days lost in 2015-16. The HSE figures are based on the Labour Force Survey that interviews 38,000 households quarterly. The survey is the British government’s primary employment dataset. Some 200,000 men reported work-related stress averaged over the past three years compared to 272,000 women, according to the HSE’s figures. This means women were 1.4 times more likely to suffer from stress, anxiety and depression.
“THE REASONS CITED AS CAUSES OF WORKRELATED STRESS ARE WORKLOAD, LACK OF MANAGERIAL SUPPORT AND ORGANISATIONAL CHANGE.”
“THIS PATTERN SUGGESTS THAT THERE IS A LINK NOT ONLY BETWEEN HELPING AND BENEFICIAL HEALTH EFFECTS, BUT ALSO BETWEEN HELPING AND MORTALITY.” Germany
Grandparents who babysit “live longer” Grandparents who babysit their grandchildren tend to live longer than seniors who do not care for other people, a German study has found. Researchers found grandparent babysitters had a 37 per cent lower mortality risk than adults of the same age with no caring responsibilities. The study included around 500 adults from the Berlin Aging Study (BASE) – a database of people aged 70 or older living in the former West Berlin. The researchers offered a number of explanations, such as spending time with grandchildren, are a good way for older people to have a sense of purpose, while keeping them physically and mentally active. Researchers from the University of Basel, University of Western Australia, and the Max Planck Institute for Human Development in Berlin carried out the study. The study was published in the peer-reviewed medical journal Evolution and Human Behavior (December 2016). “All helper groups – grandparents who gave care to their grandchildren; parents who provided instrumental help to adult children; and childless participants who helped others in their social network – had higher survival probabilities than the respective non-helper group. “This pattern suggests that there is a link not only between helping and beneficial health effects, but also between helping and mortality, and specifically between grandparental caregiving and mortality,” the researchers concluded. THE LAMP FEBRUARY 2017 | 27
NEWS IN BRIEF
European Union
New laser therapy for low-risk prostate cancer A new technique involving a drug activated by laser light to destroy early prostate cancer is showing promising results. The new technique may offer an alternative treatment to the current “wait and see” approach, also known as active surveillance. The results of the study, carried out in hospitals across 10 European countries, were published in the peer-reviewed journal, The Lancet Oncology (December 2016). In the study, researchers compared active surveillance with a new technique known as vascular-targeted photodynamic therapy. This involves injecting a light-sensitive drug into the prostate and activating it with a laser when it reaches cancer cells. Fibre-optic laser fibres are positioned in the target positions in the prostate under general anaesthetic. The men then receive an intravenous infusion of a drug called padeliporfin. This drug is made from bacteria living in almost complete darkness at the bottom of the sea, which only become toxic in the presence of light. When the laser is switched on, the drug becomes activated and kills the cancer, but leaves healthy tissue unharmed. The benefit of this new approach is damage to healthy prostate tissue is minimised, reducing the risk of side effects. Two years after having this treatment, almost half of the men in the treatment group were cancer-free and only 6 per cent of patients needed further treatment, compared with 14 per cent being cancer-free and 30 per cent needing further treatment in the active surveillance group. Side effects were mostly mild.
“THE BENEFIT OF THIS NEW APPROACH IS DAMAGE TO HEALTHY PROSTATE TISSUE IS MINIMISED, REDUCING THE RISK OF SIDE EFFECTS.”
28 | THE LAMP FEBRUARY 2017
Australia
When Christmas is fatal Heart attacks and strokes are more likely to occur over the Christmas break. Researchers from the University of Melbourne found that the Christmas holidays are a time of higher cardiac deaths, with a significantly higher death rate – of around four additional deaths per year. This translates to around 4 per cent extra deaths during Christmas relative to the weeks surrounding these holidays. The study has been published in the Journal of the American Heart Association (December 2016) and was reported in The Conversation. The study replicated a study conducted in the United States from a decade ago but extended the analysis to see if the findings hold true in different populations and conditions. In the northern hemisphere, the Christmas holidays coincide with winter. This is known to be a time of high deaths from heart attack due to temperature as well as seasonal variations in levels of vitamin D and cholesterol. The Melbourne researchers looked at whether Christmas holidays have a similar effect during summer in the southern hemisphere. The study suggests that changes in diet and alcohol consumption and general stress cannot be ruled out as a causal factor, as they are common to Christmas everywhere. “Another factor could be that people who experience heart troubles delay seeking care over the holidays due to travelling away from their usual place of residence. Interestingly, we found the average age of those dying is slightly younger, which is consistent with this type of explanation,” they reported.
“PEOPLE WHO EXPERIENCE HEART TROUBLES DELAY SEEKING CARE OVER THE HOLIDAYS DUE TO TRAVELLING AWAY FROM THEIR USUAL PLACE OF RESIDENCE.”
GET YOUR FREE EXPO PASS* Visit: expo.austhealthweek.com.au
8th-9th March 2017 | International Convention Centre, Darling Harbour, Sydney
GET YOUR FREE EXPO PASS NOW AND RESERVE A SEAT ^ AT OUR ON-FLOOR PROGRAMS
Topic Areas Covered:
Topic Areas Covered:
♦ The Digital Hospital of 2020 and beyond
♦ ♦ ♦ ♦
♦ The emerging role of the Chief Nursing Information Officer ♦ Developing and implementing nursing leadership programs ♦ Overcoming the challenges EMR systems pose for nursing staff ♦ Workforce redesign to achieve operational efficiency and improved
care outcomes ♦ The supply, installation and commissioning of a learning management
system into the new hospital ♦ and many more!
Healthcare 2025 How the Internet of Things is transforming healthcare Inside the future of robotic surgery Understanding the steps that need to be taken to ensure that disruptive technologies and medical innovations can change healthcare for the better ♦ The hospitals of the future - doctorless healthcare environment ♦ The race to be the first to 3D print a transplantable human organ ♦ and many more!
WHO SHOULD ATTEND THIS EXPO? All health professionals and healthcare management involved in the design, development, operation, technology provision, patient experience, procurement and project management of hospitals, health facilities and aged care facilities. Don’t miss out! Claim your FREE Expo Pass* at expo.austhealthweek.com.au
*The expo pass does not include entry to the Australian Healthcare Week conferences (Health Facilities Design & Development, Digital Healthcare and Aged Care Summits). To find out more about the conferences, visit austhealthweek.com.au ^On-floor programs have limited seating, please reserve your spot at one of the two free to attend on-floor programs when you register for your free expo pass. To get your free expo pass, visit expo.austhealthweek.com.au
THE LAMP FEBRUARY 2017 | 29
Do you have a story to tell? INTERNATIONAL MIDWIVES’ DAY & INTERNATIONAL NURSES’ DAY
2017 Short Story & Poetry Competition Nurses and midwives have always talked about the amazing, uplifting and special moments they experience in their work. These stories inspire the nurses and midwives who hear them, as well as some who, after hearing such poignant stories, decide to take up the profession. So without breaching confidentiality, let’s celebrate International Midwives’ and International Nurses’ Days 2017 by sharing our stories in prose or poetry. First State Super is once again proud to help celebrate this short story and poetry competition by sponsoring the FIRST PRIZE OF $2000, and the 2 RUNNER-UP PRIZES OF $500. These prizes will be awarded to members or associate members of the NSWNMA who can tell an entertaining and inspiring story that promotes the wonderful work of nurses and midwives. As well, readers will have an opportunity to select the winner of the READERS’ CHOICE AWARD OF $500 sponsored by the NSWNMA.
. Conditions of Entry Z Z Z Z Z Z Z Z Z Z
Entrant must be a financial or associate member of the NSWNMA Entry must be original and the work of the entrant Entry must not have been published previously Stories/poems to be no longer than 2500 words Confidentiality must not be breached, patient/client names must not be used. And the facility in which your story takes place must not be identifiable Please keep a copy of your story as your entry/entries will not be returned The NSWNMA reserves the right to retain and publish copies of the entries, in The Lamp and on NSWNMA online (including nurseuncut.com.au) Copyright remains with the author Judges’ decision will be final Failure to meet the conditions above will render entries ineligible.
. How to enter Z There is no limit on the number of entries, but each entry must have its own entry form Z Complete the online entry form Z Number and title each page of your story or poem Z Do not include your name and address anywhere on your story/ poem copies Z Keep within the word limit Z Three (3) copies of the story to be included for the judges and to be double spaced on one side only with a 2cm margin.
First prize Readers’ Choice Award
Two runner-up prizes of
Entries close 5 pm Friday 17 March 2017 Winners will be announced on 2 May 2017 Readers’ Choice winner will be notified on 9 June 2017 30 | THE LAMP FEBRUARY 2017
www.nswnma.asn.au
United Kingdom
Sugar is the alcohol of the child English children are eating sugar at more than three times the healthy limit but parents still believe their kids’ diet is healthy. Children in England consume half their recommended maximum daily intake of sugar at breakfast, and by the end of the day have had more than three times the healthy limit, according to research from Public Health England (PHE), reports The Guardian. The study, based on the annual National Diet and Nutrition Survey, found that on average children have the equivalent of three cubes – about 11g – of sugar before they go to school, mainly in sugary cereals, drinks and spreads. Despite this, researchers found that eight out of ten parents believed their children’s breakfast was healthy. PHE has launching a campaign to raise awareness of health problems linked to excessive sugar intake. It has developed an app that allows people to scan products’ barcodes to see how much sugar, saturated fat and salt they contain.
The Obesity Health Alliance, a coalition of more than 30 leading charities, medical colleges and campaign groups, welcomed the move, saying online tools that allowed people to check sugar and fat in products could help parents and families make better food choices. More than one in five children in England are overweight or obese when they start primary school, rising to more than a third when they leave.
“ON AVERAGE CHILDREN HAVE THE EQUIVALENT OF THREE CUBES – ABOUT 11g – OF SUGAR BEFORE THEY GO TO SCHOOL, MAINLY IN SUGARY CEREALS, DRINKS AND SPREADS.”
Australia
Nominations open for 2017 HESTA Awards If you know an outstanding nurse or midwife who deserves recognition, now is the time to nominate them for the 2017 HESTA Australian Nursing and Midwifery Awards. In its 11th year, this is the first time the Awards have included ‘midwifery’ in its title and awards category. The annual Awards recognise graduates, individuals and teams for their professionalism, innovation and care, across a range of health settings. Nominations for the Awards are being sought from colleagues, patients and employers and are open until 24 February 2017. HESTA CEO, Debby Blakey, said this year the Awards are especially significant, shining a spotlight on nursing and midwifery as individual professions, and acknowledging their vital work. “Whilst we have always acknowledged midwives in the awards, we wanted to bring special attention to the important role they play. The inclusion of midwifery recognises the advancement of the sector, differing educational requirements and the significant impact both professions have on the lives of Australians,” she said. “The Awards are a way of acknowledging the hard work of individuals and teams who go above and beyond to provide exceptional care and support to patients; they are also an opportunity to highlight innovations that lead to improvements in clinical practice and improved patient care.” ME, a longstanding Awards sponsor, is generously providing a $30,000 prize pool, to be divided among the winners in three award categories — Nurse or Midwife of the Year, Outstanding Graduate, and Team Excellence. Go to https://www.hesta.com.au/awards/nursing-midwiferyawards.html to nominate a colleague for the 2017 Hesta Awards.
POST GRADUATE NURSING COURSES
• Graduate Certificate in Nursing (non-specialisation)
• Graduate Diploma of Nursing • Graduate Diploma of Nursing (Specialisation - Paediatric Nursing)
Benefits: • Advance your career with a Postgraduate qualification • On-campus/Online delivery options • Easy payment plans, alumni scholarships available • Study while you work with online delivery • Career assistance available
Free CPD courses visit www.nurseshub.com.au
Institute of Health and Management Pty. Ltd. CRICOS Provider: 03407G I ABN: 19 155 760 437 I ACN:155 760 437
HEALTH CAREERS
Institute of Health and Management Postgraduate Nursing Institute
Head Office and Online Learning Centre
Campus
Level 1, 76 - 80 Turnham Avenue, Rosanna, Victoria 3084, Australia
Level 7, 33 Argyle Street, Parramatta, NSW, 2150
Web: www.ihm.edu.au I Email: enquiry@ihm.edu.au Toll Free: 1800 763 757
THE LAMP FEBRUARY 2017 | 31
EDUCATION@NSWNMA
what’s ON
Edith
Cavell
FAR NORTH COAST TRAINING DAY
TRUST BEQUESTS
Tuesday 28 February • Ballina
T
he Edith Cavell Trust is now able to receive non-tax deductable donations/ bequests.
The Trust – named in honour of Edith Cavell assists in the advancement of NSW nurses and midwives through further studies and research, made available through scholarship. The knowledge and expertise gained by nurses and midwives, supported by the Edith Cavell Scholarships, is an asset to the care of their patients and clients. Bequests to the trust would continue to support this important work. Edith, a British nurse serving in Belgium in WW I, is a hero to most nurses and midwives. She helped some 200 Allied soldiers escape from German-occupied Belgium. Her actions saw her arrested, accused of treason, found guilty by a court-martial and sentenced to death. Despite international pressure for mercy, she was shot by a German firing squad.
Training day for all RNs, RMs, ENs and AINs in residential, community, aged care and hospital settings across the private and public sectors. Hear from a range of speakers, network with colleagues and gain some valuable CPD hours.
OBJECTIVES • Identify what is bullying and relate the processes required to manage • Identify and define the principles of documentation
NAME
• Attain the value of mindfulness in practice
ADDRESS
• Identify and understand WH&S consultation processes.
PHONE EMAIL BEQUEST/ DONATION AMOUNT
BALLINA RSL
$
Preferred method of payment ELECTRONIC FUND TRANSFER ACCOUNT NAME: New South Wales Nurses and Midwives’ Association BANK: Commonwealth Bank BSB: 062-017 ACCOUNT NO: 10017908 CREDIT CARD I authorise the NSWNMA to debit my credit card for the amount of Mastercard
Visa
CARD NO NAME ON CARD SIGNATURE OF CARDHOLDER 32 | THE LAMP FEBRUARY 2017
Members $75 Non-Members $150
Lunch and refreshments provided
Numbers strictly limited!
$
EXPIRY DATE
240 River Street Ballina
9.00AM TO 4.30PM
/
Register online
bit.ly/ NSWNMAeducation For enquiries contact NSWNMA Metro: 8595 1234 Rural: 1300 367 962
ASK JUDITH WHEN IT COMES TO YOUR RIGHTS AND ENTITLEMENTS AT WORK, NSWNMA ASSISTANT GENERAL SECRETARY JUDITH KIEJDA HAS THE ANSWERS. Day worker and public holiday I am a registered nurse working in a public hospital. I am a day worker and normally have a public holiday off on pay when it falls on one of my ordinary working days. This year, however, I was required to work on one of them. How should I be paid? Under Clause 30(ii)(c) ~ Annual Leave ~ of the Public Health System Nurses’ and Midwives’ (State) Award, as a day worker (i.e. someone under the Award who receives four weeks of annual leave per year) the default position is that you receive your normal rate of pay plus 50 per cent extra for the time worked and have one day added to your annual leave. Alternatively, you may elect to be paid your normal rate of pay plus 150 per cent extra instead of having the additional day added to your annual leave. This election is generally completed each year on your anniversary date.
Working on my ADO I work in a public hospital and my NUM has asked in advance that I cancel my ADO and work instead. Must I cancel my ADO if given sufficient notice? Under Clause 4(vi) ~ Hours of Work ~ of the Public Health System Nurses’ and Midwives’ (State) Award, the additional day off duty (ADO) may not be changed in a current cycle unless there are genuine unforeseen circumstances prevailing. Where such circumstances exist and the ADO is changed, another day shall be substituted in the current cycle. Should this not be possible, the day must be given and taken in the next roster cycle. Clause 8 - Rosters - of the Award also has a role to play, and provides some guidance to the circumstances that may warrant such a change. A posted roster may only be altered to enable the nursing service of the hospital to be carried on where another employee is absent from duty on account of illness or in an emergency, provided that where any such alteration involves an employee working on a day that would otherwise have been the employee’s day off, the day off in lieu shall be mutually arranged. Unless mutually agreeable, the amount of notice provided is not the defining feature - it is the circumstances as to why the change is being sought that will determine whether the request is reasonable and should occur.
BREAKING NEWS Review of Recruitment policy in NSW Health The Ministry of Health has commenced a review in consultation with public health unions on PD2015_026 (Recruitment and Selection of Staff to the NSW Health Service). The Ministry states that this review is aligned with the ongoing work of the HCM Program Recruitment & Onboarding Project. The revised module would appear to still outline the mandatory standards for all recruitment and selection processes in the NSW Health Service, while attempting to reflect the outcomes of the consultation process said to have occurred around system requirements and design. Public health unions, including your Association, will work collectively to ensure that any redrafted policy directive is reviewed with precision to ensure that it properly deals with merit, process and timeliness.
Leave Matters Manual Work continues on the review of PD2014_029 (Leave Matters in the NSW Health Service), as flagged with members in our December Lamp. This policy directive is of some considerable significance as it has traditionally over several decades ‘filled in the gaps’ on how some award entitlements are applied and utilised. The Association has and is continuing to work collectively with other public health unions to ensure that this resource is reviewed meticulously, and is also able to address some of the issues impacting on members when attempting to access leave.
Attack on redundancy rights We previously reported how the Baird NSW Government, without any prior warning or consideration to consult (sound familiar!), had the Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation 2016 (‘Regulation’) gazetted. The Regulation further eroded the rights of government sector workers whose role may be subject to privatisation. Unions NSW and affiliates have agitated with cross-bench members of the NSW Legislative Council to support a disallowance motion on the Regulation tabled by the ALP Opposition. After numerous postponements, this debate is now scheduled to occur on 23 February 2017.
SCR record created I am an enrolled nurse working in a public hospital. Recently I received a letter setting out allegations regarding my conduct. It also said that a Service Check Register record had been created. Isn’t that prejudging me? Under PD2013_036 (Service Check Register for NSW Health), specified criteria are identified as to when an SCR record is to be created. Section 4.3 sets these out, and based on the information you have provided, the only reason that an SCR record can be made is if a decision has been made to take administrative action in relation to you to mitigate any immediate concerns relating to the alleged misconduct whilst the investigation is ongoing. For example, a risk assessment may lead to a decision to direct a person who is the subject of allegations to a changed place of work, and/or a limitation is placed on their scope of practice, or in the most extreme situations, suspended from work altogether until the investigation is completed. In such situations an SCR record is contemplated. Under the policy directive, you are obliged to be notified of such a decision prior to the SCR record being created, except in the case of a significant risk management issue.
Additional or replacement public holidays Over the recent Christmas/New Year period, my employer advised that the extra public holidays were replacing those falling on a Sunday and were not additional. Is this right? No, both 27 December 2016 and 2 January 2017 were additional public holidays and not in substitution of Christmas Day and New Year’s Day, both which fell on a Sunday. The Public Holidays Act 2010 provides for an additional public holiday to be added when New Year’s Day, Christmas Day or Boxing Day falls on a weekend. Information regarding public holidays can be readily obtained from NSW Industrial Relations – http://www. industrialrelations.nsw.gov.au. How you are paid on public holidays should be sourced from the award or agreement applicable to your employment and place of work.
THE LAMP FEBRUARY 2017 | 33
INTERNATIONAL NURSES AND MIDWIVES’ DAY 2 0 1 7 NSW NURSES AND MIDWIVES’ ASSOCIATION
nurses & midwives’ short film festival
MEMBERS & ASSOCIATE MEMBERS
We look forward to receiving your entries in the 2017 Film Festival
$5000 FIRST PRIZE
ENTRIES CLOSE FRIDAY 14 APRIL 2017 Tell your unique story in 5 minutes or less for a chance to win the festival’s $5000 first prize, $2000 second prize and $1000 third prize. There is also a prize of $1000 Maureen Puhlmann Encouragement Award for a first time entrant. Festival will be screened 23 May 2017. So if you haven’t already started your film yet – it’s time to get started.
Sponsored by FSS
Check out the Rules of Entry and some of the entries from previous NSWNMA film festivals on
www.nswnma.asn.au/short-film-festival
34 | THE LAMP FEBRUARY 2017
SOCIAL MEDIA | Nurse Uncut
A BLOG FOR AUSTRALIAN NURSES AND MIDWIVES
WHAT’S HOT THIS MONTH
www.nurseuncut.com.au
Do you have a story to tell? An opinion to share?
Nurse Uncut is written by everyday nurses and midwives. We welcome your ideas at nurseuncut@nswnma.asn.au
Not enough nurses in the nursing home
A heartfelt letter from a daughter: ‘it breaks my heart to witness this every day’.
Patricia’s tale: 50 years of nursing
Open letter from a nurse on Paid Parental Leave
http://www.nurseuncut.com.au/notenough-nurses-in-the-nursing-home/
Without PPL, Phoebe’s twin pregnancy would have been financially and emotionally crippling. http://www.nurseuncut.com.au/openletter-from-a-nurse-on-paid-parentalleave/
Cracked – an unfinished story Half a century as a nurse with so many changes, lots of hard work and lots of fun! http://www.nurseuncut.com.au/ patricias-story-50-years-of-nursing/ A harrowing death at work one Christmas Day has never left Ruth’s mind. http://www.nurseuncut.com.au/ cracked-an-unfinished-story/
Talking about HIV testing
My nursing friend is a Muslim
Midwifery mentoring in the Solomons Helping set up a Perinatal Death audit was one of Sharyn’s proudest achievements as a volunteer. http://www.nurseuncut.com.au/ sharyns-story-midwifery-mentoring-inthe-solomons/
Mark writes in support of his operating theatre colleague, after overhearing hurtful remarks. http://www.nurseuncut.com.au/ my-nursing-friend-is-a-muslim/g
Testing for HIV has been made easier – and you don’t have to work in sexual health to do it. http://www.nurseuncut.com.au/ talking-about-hiv-testing/
We’re on
Instagram! Share your photos by tagging @nswnma and don’t forget to use the hashtag #nswnma!
New on SupportNurses YouTube channel FLIGHT NURSE GAYLE The Lions Scholarship helps Gayle look after seriously ill kids. http://bit.ly/ Gayleflightnurse
MIDWIFE SHARI You never know when you’re going to have an accident! http://bit.ly/ insuranceshari
Listen to our podcast ENROLLED NURSES FORUM Three podcasts especially for ENs. http://bit.ly/culturalhealth
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
Follow us on Twitter
@nswnma @nurseuncut
Look for your local branch on our Facebook page www.facebook. com/nswnma
THE LAMP FEBRUARY 2017 | 35
NURSES & MIDWIVES: There are many benefits of being a financial member of the NSWNMA — did you know that
Authorised by B.Holmes, General Secretary, NSWNMA
YOUR MEMBERSHIP FEES COVER YOU FOR TRAVEL TO AND FROM WORK? If you are involved in an accident while travelling to or from work, NSWNMA’s Journey Accident Insurance provides you with peace of mind. In recent years this insurance has been a financial safety net for many members who have met unfortunate circumstances travelling to or from work. As a financial member of the NSWNMA you are automatically covered by this policy. It’s important to remember however, that it can only be accessed if you are a financial member at the time of the accident. So make sure your membership remains financial at all times by paying your fees by Direct Debit or Credit. Watch Alexis talk about Journey Accident Insurance
JOURNEY ACCIDENT INSURANCE
Your journey injury safety net
UNSURE IF YOU ARE FINANCIAL? IT’S EASY! Ring and check today on 8595 1234 (metro) or 1300 367 962 (rural). Change your payment information online at
36 | THE LAMP FEBRUARY 2017
www.nswnma.asn.au
SOCIAL MEDIA | Facebook
WHAT NURSES & MIDWIVES
SAID & LIKED on Facebook www.facebook.com/nswnma Action on violence
Please make a note that this doesn’t only happen in ED but also in every other ward. With an increase in geriatric wards as well. We have the NSWNMA violence app so we can report violent incidents or near misses in the workplace. Use the union; that’s why you pay your fees!
Blacktown Hospital’s emergency department will be home to a violence prevention program to tackle the spate of staff being punched, spat at and grabbed while on the job.
The great Victorian nursing strike Can you imagine being on strike for 50 days? That’s what Victorian nurses and midwives did 30 years ago. Now there’s an online exhibition of this important historic event.
Birth and out There’s a growing trend of hospitals sending new mothers and their babies home as soon as four hours after birth. The AMA labelled the move a cost-saving measure that has to stop. What do midwives think?
A letter to ED from an aged care nurse A letter from an aged care nurse to Emergency Department nurses pleads for the elderly to get better care when they’re sent to hospital from a facility.
Supporting 10 days’ domestic violence leave for all.
What an interesting read! I cannot imagine the strain of going without pay for 50 days, but I’m sure glad they did! It was harder than most people could realise. Everyone said it wouldn’t happen. Those in power banked on it. They used psychological blackmail. It is a nurse’s duty to care for people. How could we walk out and leave them? Nurses do feel that need to care and this made it worse. But the nurses prevailed. A victory. The planning that went into that victory, ensuring that patients weren’t compromised, was unseen and immense. I took part in this; will never forget it! That was a huge sacrifice for those nurses, who demonstrated that they would not be bullied or undervalued by the government or hospital administrators. A great effort and well won. Hopefully we are all going to take a similar stance soon on the privatisation of our public hospital system... before it’s too late! I think the only pertinent question here should have been “what do new mums think”. New mums have the choice to discharge home 4-6 hours after birth if they have had no complications, however, they have ZERO choice about being sent home sometimes as early as 24 hours after giving birth. So [they are] expected to get breastfeeding and settling sorted with little support. It’s ridiculous and also ends up costing the system more with readmissions into the nursery for jaundice and other complications. We need better home maternity services! Women are best off in their own environments, if they’re well! I think it should be a choice, but I do think young mums are being booted out the door too quick. It should cover 3-day blues to see how they’re coping as well. Breastfeeding and other skills need to be taught. My daughter was discharged 4 hrs after birthing her 2nd baby that baby had a respiratory arrest that evening while I was holding her. I shudder to think! Yes, too soon. Baby spent 2 nights in NICU. I think each case needs to be treated individually. Doesn’t the research show early discharge leads to better outcomes for the family? And so say all of us aged care workers! Not the ED Nurses’ fault, however - always comes down to funding and ratios. I agree, the ED do a fantastic job and are probably stretched to the limit like we all are, but the frail definitely need more attention. I think this is the horror of every aged care nurse. We send them because we know they are not well, we give you all relevant documentation, but you still ring and ask questions that you have the answers for in front of you. They are our family treat them as such. Please never dismiss someone with dementia. They do have pain, treat them as if they were your family member. Please do not send them back with no paperwork or explanation of treatment given; you might see them once but we see them every day and know when something is not right; every person going through ED should be treated with the same dignity of care whether a child or a resident from a facility.
More power to their elbows! They won’t wait for DV leave for all.
Midwife Jacqui Myers spoke at a rally against giving funds to the giant Adani coalmine.
Wyong nurses – still fighting to keep their local hospital public.
All they wanted for Christmas – and in 2017 – is to keep Shellharbour Hospital public!
THE LAMP FEBRUARY 2017 | 37
Registered Nurses working in NSW Public Mental Health Services
BOB FENWICK MEMORIAL MENTORING GRANTS PROGRAM Can help towards your CPD hours
APPLICATIONS OPEN 1 FEBRUARY 2017 CLOSE 5 MARCH 2017
Applications are now open to registered nurses who want a unique opportunity to further their mental health nursing career by participating in this innovative Program.
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. Those with less than 2 years experience and/or working in NSW rural or remote services are particularly 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 5 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
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?
Expressions of Interest forms and 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 You can contact the Program Manager by email: mhmgrant@nswnma.asn.au or contact Matt West on 1300 367 962. Completed applications must be in the hands of the Program Manager no later than 5 March 2017.
Bob Fenwick-advert half.indd 1
2/12/2016 8:46 AM
Family Planning NSW
Upcoming courses for nurses NEW Reproductive and Sexual Health Course for Midwives
90 CPD hours
March & July Increase your ability to provide holistic care for women and their families during their reproductive years with this course written by midwives for midwives. Specifically focused at midwives and registered nurses working in and around the maternity field, this is a 16 week blended learning program which includes a 2 day interactive workshop and online learning modules.
Well Women’s Screening Course 40 CPD hours
This blended delivery course helps nurses, midwives and enrolled nurses develop confidence and competence in the provision of cervical screening. Course content includes current and future cervical screening methods, history taking and breast awareness. Orange: 28 April • Ballina: 21 July
Clinical Forum/Nurse Education Day
7 CPD hours
Update your knowledge on the latest in reproductive and sexual health at one day forums for nurses and other health professionals. Ashfield: 24 March • Orange: 29 April • Ballina: 22 July Newcastle: 18 August • Wagga Wagga: 11 Nov
Now taking enrolments. For more information or to enrol now, visit www.fpnsw.org.au or email education@fpnsw.org.au 38 | THE LAMP FEBRUARY 2017
NURSING RESEARCH ONLINE
Men: the “outsiders within” nursing A nursing workforce shortage is anticipated and when seeking solutions, the vast gender disparity within nursing warrants attention. Why do many people not consider nursing a career for men? Recent research published in the latest edition of Australian Journal of Advanced Nursing (ajan.com.au) explores some of the initial challenges men face to becoming registered. CHALLENGES MEN FACE ON THEIR JOURNEY TO NURSE REGISTRATION Within Australian health workforce management, there is an emphasis on the retention of newly graduated registered nurses and the recruitment of males to generate a sustainable nursing workforce to replace those retiring and leaving the nursing profession (HWA 2013; AIHW 2012). However, there is a consistent, slow increase in men entering nursing due to nursing still being regarded as a femalepredominant profession (Moore and Dienemann 2014). Of concern is that men employed in female-dominated workplaces leave at a greater rate than women (Bygren 2010). Furthermore, there is still resistance from both staff and patients to men in nursing where high intimate nursing care is required, (Inoue et al 2006). Strains around gender-based roles and issues around intimate-touch nursing care have been suggested as a reason why men in nursing migrate more towards the technical, rapid assessment areas of emergency and intensive care (MacWilliams et al 2013; Harding et al 2008). Although the reasons for the higher percentage of nurses who are male in these areas are not really known, “these areas may be perceived as more acceptable or masculine” and have “a preference for male employee in these areas” (HWA 2013, p15). Men who enter nursing have usually “thought long and hard” about their decision to undertake this career path and are aware of the nuances such as
the female image and stereotyping in nursing (Moore and Dienemann 2014). When the men in this study were asked, “how has your journey as a male nurse been so far?” the majority of them respond by indicating that they had enjoyed the study and learning aspect of their journey. Comments included: “loved the whole experience of nursing so far”; “loved the study and clinical practice”; and “the whole identity of being a nurse”. A misconception about their role emerged from the gender stereotyping and marginalisation that participants experienced on their journey to registration. Gender stereotyping included being mistaken for a medical student and even a doctor. Some of them said that patients were often surprised that they were doing nursing. Comments included “what’s a guy doing nursing?”; “didn’t you want to be a doctor?” Another participant stated, “I think society has a skewed view of what nurses do and how males fit into the nurse role”. A SENSITIVITY ABOUT INTIMATE TOUCH The majority of the men in one study initially felt overwhelmed with feelings of being the “outsider within”. Comments included “initially coming into the large student group was daunting”; “sometimes you feel a bit on the periphery”. Hence, they gravitated towards self-formed male groups in an attempt to nullify the “outsider within” feeling. One participant said that through his clinical placements he “felt like an
outsider most of the time”. Another participant told of mothers and the female nursing staff questioning his presence in a mother and baby unit. He said he “felt a kind of hostility towards me for being a guy; this was actually hanging over me while I was there”. Marginalisation also related to intimatetouch, with most men taking it as a given barrier in the career they had chosen. Most stated that as student nurses they were always supervised when performing intimate touch nursing care. So they felt it was not a real issue for them as yet. It was seen as more of an issue for the nurses who allocated patient loads, with comments such as the “coordinator will avoid assigning a guy to a specific patient”.
More information Read the latest edition of Australian Journal of Advanced Nursing at http://www.ajan. com.au/Vol34/Issue2/34-2.pdf
Contribute to the discussion A longer version of this article can be found on Nurse Uncut (nurseuncut.com.au). We encourage you to contribute to this discussion. Search Nurse Uncut for the tag: men in nursing, and find many other perspectives on this topic. All feedback is welcome. THE LAMP FEBRUARY 2017 | 39
e n i l n o s l i Upd ate your membership deta raw to win d e t o t & go in
5-NIGHT BATEMANS BAY ESCAPE Eurobodalla, land of many waters, sits less than 4 hours’ drive south of Sydney and 2 hours east of Canberra on the NSW South Coast. Eurobodalla is over 110kms of unspoilt beauty. The region is known for award winning Montague Island; home to thousands of fur seals and colonies of penguins, 83 spectacular beaches and ancient headlands, four major rivers and vast tracts of wilderness, national parks and forest. Abundant wildlife dominates the visitor experience while vibrant communities and the picturesque historic and coastal villages connect the main towns of Batemans Bay, Moruya and Narooma. UPDATE YOUR DETAILS ONLINE AT WWW.NSWNMA.ASN.AU AND YOU WILL AUTOMATICALLY BE ENTERED IN THE DRAW TO WIN A 5 NIGHT ESCAPE FOR TWO TO BATEMANS BAY. You and a friend will stay at Corrigans Cove for 5 nights in a gorgeous pool view room with continental breakfast daily. This fantastic package also includes dinner for two on two nights of your stay at Corrigans Cove; entry for two to the fantastic Mogo Zoo and a double pass to the Original Gold Rush Colony Mogo.
VALU ED AT $150 0.
For your chance to win, simply login online at www.nswnma.asn.au to register or update your details. You can now change your details at a time that suits you, pay membership fees online, print a tax statement or request a reprint of your membership card – it’s simple! All members who use our online portal from 1 December 2016 until 30 June 2017 will automatically be entered in to the draw to win this fantastic escape. *Conditions apply. Rooms subject to availability. Prize must be redeemed by June 2018 and is not valid for use during school holidays or public holidays. The prize is non-redeemable for cash or any unused portion of the prize. Competition entries from NSWNMA members only and limited to one entry per member. Competition opens 1 December 2016 and closes 30 June 2017. The prize is drawn on 1 July 2017. 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/14/00042 40 | THE LAMP FEBRUARY 2017
TEST YOUR KNOWLEDGE 2
1
3
4
9
5
6
10
11
7
8
12
13 15
14
16
17
18
19
23
24
20
21
22
25 26
27
28
29
30
31
33
37
34
35
32
36
38
39 40
Across 1. Above the ventricles (16) 9. A storage place or cavity (9) 11. The lower of the two bracts that enclose each floret in a grass spikelet (5) 13. An antibiotic used for preoperative sterilisation (8) 14. Nevus cell aggregate (1.1.1) 15. A flavour-enhancing amino acid used in fast foods (1.1.1) 16. A type of contraceptive device (1.1.1) 17. Inhalation of these fibres can lead to pulmonary fibrosis (8) 18. Amount produced (5) 19. The inability to understand information presented (10) 23. Relating to the sense of smell (9) 26. A long, sharp spine projecting from the coverings about a seed (3) 27. Defeats completely (8) 29. Slight natural depressions on a body surface (7)
30. Gastrointestinal (1.1) 31. A device for measuring ocular refraction (9) 33. To cause a patient’s condition to deteriorate (9) 36. The tension present in resting muscles (4) 37. Thalassophobia is a morbid fear of this (3) 38. Symbol for xenon (1.1) 39. Any separating membrane or structure (9) 40. One of the bony segments of the sternum (9) Down 1. Threadworm infection (16) 2. An opening, channel, route, or gap (7) 3. Relating to medical treatment of disorders associated with air or space travel (11) 4. Processes of increasing in length (11) 5. An abnormally low number of platelets in the blood (16) 6. A technique used in therapeutic irradiation by infrared rays (8)
7. Bundles of nerve fibres ascending from sensory relay nuclei to the thalamus (8) 8. A malignant tumour of striated, or voluntary, muscle (16) 10. That is (1.1) 12. Erythema induratum (1.1) 20. Nodal rhythm (1.1) 21. The primary or original form of an object or organism (9) 22. Muscles with the same function (9) 24. To disinfect by exposing an area or object to pesticidal smoke or fumes (8) 25. The number of pairs of cranial nerves in a human body (6) 28. To quote or refer to (4) 31. Occupational therapy (1.1) 32. Symbol for molybdenum (1.1) 34. Symbol for germanium (1.1) 35. A process of a neuron that conducts impulses away from the cell body (4) 39. Diabetic retinopathy (1.1) THE LAMP FEBRUARY 2017 | 41
RECRUIT A NEW MEMBER & GO INTO THE DRAW TO WIN A 4-NIGHT STAY AT
LOCKYER VALLEY, QUEENSLAND
PRIZE DRAWN 30 JUNE 2017
THE 2016 – 2017 NSWNMA MEMBER RECRUITMENT SCHEME PRIZE The winner will experience all the style and comfort of a luxury retreat with the warmest of country welcomes. A four-night (midweek) stay for two with: • Wine and cheese plate on arrival; • Breakfast daily; • Two x 2-course lunches; • Two x 3-course dinners; • Two x 60-minute facial or massage for 2 guests (4 in total); • Four-wheel-drive tour for 2 guests. 42 | THE LAMP FEBRUARY 2017
The NSWNMA will arrange return flights for two from Sydney to Brisbane and car hire for the duration of the prize. Spicers Retreat Hidden Vale is a gem, an uncomplicated escape just an hour’s drive from Brisbane. Experience the uniquely revitalising effect of spending time on 12,000 acres of true Australia bush. Space to relax. Space to listen, to laugh and to embark on an adventure amongst the abundant wildlife. Every member you sign up over the year gives you an entry in the draw!
RECRUITERS NOTE:
Join online at www.nswnma.asn.au If you refer a member to join online, make sure you ask them to put your name and workplace on the online application form. You will then be entitled to your vouchers and entry in the NSWNMA Recruitment Incentive scheme. SPICERSRETREATS .COM
Conditions apply. Prize must be redeemed by 30 June 2018 and is for stays outside of school holidays, midweek (Monday to Thursday). Competition opens on 1 August 2016 and closes 30 June 2017. The prize will be drawn on 30 June 2017. 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/16/00329.
BOOK ME All the latest Book Me reviews from The Lamp can be read online at www.nswnma.asn.au/library-services/book-reviews. HEALTHY AGEING AND AGED CARE Edited by Maree Bernoth and Denise Winkler Palgrave (available from Booktopia): http://www.booktopia.com.au RRP$45.95. ISBN 9781137398468 Healthy Ageing and Aged Care takes an interdisciplinary approach to supporting older people in the community and in residential aged care. It presents current Australian and New Zealand policies and practices and makes useful connections to the workplace. The text uses everyday scenarios to focus readers’ attention towards ethical and professional decision-making. It covers a broad range of contemporary issues in aged care including recent legislative inquires and implications for practice. A well-referenced, musthave text for all aspiring and established health practitioners.
POTTER AND PERRY’S FUNDAMENTALS OF NURSING – AUSTRALIAN VERSION (5TH EDITION) Jackie Crisp, RN, PhD, Clint Douglas, RN, OhD, Geraldine Rebeiro, RN, Ed, BAppSc(AdvNursing), Med, PhD (candidate) and Donna Waters, RN, BA, MPH, PhD FACN Elsevier Health: https://elsevierhealth.com.au RRP $143.96. ISBN 9780729542364 In this edition, the core format of a fundamentals text has been maintained, while taking a more active and overt approach to partnerships with people and families in decisions about the delivery of nursing care. Emphasis is maintained on the important basics – the fundamentals of care that are the building blocks on which professional nursing practice is built. The clinical skills sections have been updated and reflect current best practice and are designed to support your preparation for practical learning within the ever changing and increasingly technological world in which health care is delivered.
TABBNER’S NURSING CARE: THEORY AND PRACTICE (7TH EDITION) Gabby Koutoukidis, Kate Stainton and Jodie Hughson
Elsevier Health: https://elsevierhealth.com. au RRP$125.96. ISBN 9780729542272 Tabbner’s Nursing Care: Theory and Practice, 7th edition, provides a solid foundation of theoretical knowledge and skills for nursing students embarking on an enrolled nurse career. Reflecting the current issues and scope of practice for enrolled
DISCOUNT BOOKS FOR MEMBERS! The Library is pleased to announce that McGraw Hill Publishers are now offering members a 25% discount off the RRP! The offer currently covers medical as well as a range of other professional series books. Please see the online Book Me reviews for a link to the promotion code and further instructions, or contact the Library directly for further information.
SPECIAL INTEREST THE EASY WAY OUT Steven Amsterdam
Hachette Australia (available through Booktopia): http://www.booktopia.com.au RRP $29.99. ISBN 9780733636271
Evan is a nurse; a suicide assistant. His job is legal. Just. He is the one at the hospital who hands out the last drink to those who ask for it. As he helps one patient after another to die, he pushes against legality, his own mortality and the best intentions of those closest to him, discovering that his own path will be neither quick nor painless. In this powerful novel, Steven Amsterdam challenges readers to face the most taboo and heartbreaking of dilemmas. Would you help someone end their life? nurses in Australia, this new edition focuses on the delivery of person-centred care, emphasises critical thinking throughout and demonstrates the application of the decision-making framework across multiple scenarios. New to this edition are two new chapters – Nursing informatics and technology in healthcare; and Quality and safety in healthcare.
WHISTLEBLOWING AND ETHICS IN HEALTH AND SOCIAL CARE Angie Ash Jessica Kingsley Publications: http://www.jkp.com RRP £17.99. ISBN 978-1-84905-632-8 This timely book explores our understanding of the ethics of whistleblowing and shows how managers and organisations can support individuals speaking out. While some professional guidelines formalise duties to speak out where there are concerns about poor or harmful practice, workplace cultures often do not encourage or support this, and individuals frequently find themselves the victims of a backlash. This book looks at the social, cultural and systemic reasons that make speaking out about poor care so risky.
All books can be ordered through the publisher or your local bookshop. NSWNMA members can borrow the books featured here via the Library’s Online Catalogue: visit http://www.nswnma.asn.au/library-services. Call 8595 1234 or 1300 367 962, or email gensec@nswnma.asn.au for assistance with loans or research. Some books are reviewed using information supplied and have not been independently reviewed. THE LAMP FEBRUARY 2017 | 43
MOVIES OF THE MONTH
METRO MEMBER GIVEAWAY A Monster Calls A hallucinatory tale This movie begins “with a boy too old to be a kid, too young to be a man and a nightmare.” A Monster Calls is based on a book of the same title written by Patrick Ness. Fans of the book will not be disappointed. Ness wrote the screenplay so it was always going to be a great adaptation of the book. The film follows 12-year-old Conor O’Malley (Lewis MacDougall) and how he is coping with his mother’s illness (Felicity Jones). We are whisked away on his journey of self-discovery when one night at 12:07am the monster from the title appears out of the yew tree Conor can see from his bedroom window. The monster looks like a mix of an Ent, a transformer and Groot. He comes to life with the voice of Liam Neeson and amazing CGI work. The monster tells Conor that he will tell him three stories and after the third story it will be Conor’s turn to tell the fourth: his truth. Conor believes the monster was called to help him vanquish his foes, get rid of his grandma (Sigourney Weaver) and most of all to help cure his mother.
RURAL MEMBER GIVEAWAY DVD 44 | THE LAMP FEBRUARY 2017
Conor becomes very frustrated with the monster as each story is told because he thinks they are useless and that they do not make sense. With each story, we are taken into what seems to be a mix of Conor’s imagination and a vision provided by the monster. The boy becomes entwined in the monster’s ‘branchy’ grip. We see the stories unfold before our eyes as bright watercolours, beautiful in contrast to the bleak and colour-muted world that Conor lives in. Conor believes that the monster and the stories are just a dream, but as his dreams begin to bleed into his real life, the lines begin to blur between the monster’s actions and Conor’s, some with disastrous consequences. All the actors perform well in their roles, but it’s MacDougall’s performance as Conor that carries the film. He is funny, quick-witted, and heart breaking – a fantastic performance from a relative newcomer. J.A. Bayona, a director with an eclectic career, adds another feather to his cap. He has done a magnificent job bringing Ness’s world to life. The ending of the film will not be a surprise to most people, but the journey to get there makes it all worth it. A “messily ever after” indeed. A must see, but bring your tissues. Sarah Jones, RN, Nepean Hospital.
EMAIL The Lamp BY THE 12TH OF THE MONTH TO BE IN THE DRAW TO WIN A DOUBLE PASS TO A MONSTER CALLS THANKS TO ENTERTAINMENT ONE AUSTRALIA. EMAIL YOUR NAME, MEMBERSHIP NUMBER, ADDRESS AND TELEPHONE NUMBER TO lamp@ nswnma.asn.au FOR A CHANCE TO WIN!
The American West The American West is a factual docudrama that recently aired on Foxtel’s History Channel, which catapults you into a violent world of cowboys, Native Americans, outlaws and gunslingers. The ground runs red with the blood of their stories, from Jesse James to Billy the Kid. These men were the first to live the American dream, and the first to die for it. The 8-episode series chronicles the personal, little-known stories of American Western legends such as Jesse James, Billy the Kid, Wyatt Earp,
METRO MEMBER GIVEAWAY Perfect Strangers
Hiding in plain sight It was like any other night: a group of long-time friends gather at a typical dinner party. Cosmetic surgeon Rocco and his therapist wife Eva are hosts to their friends, newlyweds Cosimo and Bianca, married couple Lele and Carlotta, and Peppe, who was to introduce his new girlfriend to the group but she has fallen ill. Around the table they laugh, they dine. Until Eva suggests that they all play a game: that they put all their phones on the dinner table and make all calls, messages and e-mails public. Peppe quips: “What secrets do we have? We know each other too well.” It was a night of the eclipse of the sun. The evening progresses, laughter, intrigue and ultimately confrontation ensues. We begin to see each one unravel, along with their friendships, relationships, their lives.
Crazy Horse and Sitting Bull. Executive Producer Robert Redford’s knowledge and passion for this period is apparent in each of the eight episodes, as well as appearances from Ed Harris, James Caan, Kris Kristofferson, Mark Harmon, Tom Selleck, Burt Reynolds and Kiefer Sutherland.
Rocco, albeit reluctantly, agrees to play. He aptly describes the smart phones as the ‘black box’ to people’s lives, a mundane device that has now become so fundamental in daily living. This seemingly innocent game proves hard for the players to get out of unscathed. An apparent tightknit group of friends emerge as perfect strangers. This multi-award winning comedy by Paolo Genovese provides insight to modern lives and probes modern relationships. The actors effectively engage with viewers – these are characters that embody us all with frailties, flaws and strengths. The film is brilliantly written. It fearlessly delves into drama and the awkwardness of being out in the open. It poses the timely question: has technology broken down walls for people to become more open, or has it in fact enabled people to hide? Chris Ladera CCU RN at St. Vincent’s Hospital, Darlinghurst.
In the December Lamp we attributed the review of A United Kingdom to the wrong person. In fact the review was by Stephanie Di Nallo, a Registered Nurse with the Australian Red Cross Blood Service.
EMAIL The Lamp BY THE 12TH OF THE MONTH TO BE IN THE DRAW TO WIN A DOUBLE PASS TO PERFECT STRANGERS THANKS TO PALACE CINEMAS EMAIL YOUR NAME, MEMBERSHIP NUMBER, ADDRESS AND TELEPHONE NUMBER TO lamp@ nswnma.asn.au FOR A CHANCE TO WIN!
MAIL THE LAMP BY THE 15TH OF THIS MONTH TO BE IN THE DRAW TO WIN A DVD OF THE AMERICAN WEST THANKS TO RLJ ENTERTAINMENT RELEASES. EMAIL YOUR NAME, MEMBERSHIP NUMBER, ADDRESS AND TELEPHONE NUMBER TO lamp@nswnma. asn.au FOR A CHANCE TO WIN! THE LAMP FEBRUARY 2017 | 45
COVER STORY DIARY DATES — CONFERENCES, SEMINARS, MEETINGS
DIARY DATES IS A FREE SERVICE FOR MEMBERS Please send event details in the format used here: event name, date and location, contact details – by the 5th of each 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.
DIARY DATES IS A FREE SERVICE FOR MEMBERS lamp @ nswnma.asn.au NSW Compassionate Communities Symposium 20-21 February 2017 International Convention Centre, Sydney https://kerrie-noonan-z7tk. squarespace.com/symposium#ccs Royal Hospital for Women Midwifery Conference 24th February 2017 Royal Hospital for Women, Randwick Anne.lainchbury@health.nsw.gov.au 26th Nepean Midwifery Conference 10 March 2017 Hawkesbury Valley Race Club, Clarendon Juanita Taylor: 0417 123 900 Nepean Blue Mountains Nursing and Midwifery Research and Practice Development Conference 12 March 2017 Penrith Panthers, NSW Call for abstracts now open (closing 10 March) Contact Leigh Burns at leigh.burns@ westernsydney.edu.au or (02) 4734 3180 Blacktown and Mount Druitt Hospital Nursing and Midwifery Research Symposium 12 April 2017 Call for abstracts now open Contact Caroline O’Donnell at caroline.odonnell@health.nsw.gov.au 2017 Westmead Women’s and Newborn Health Conference 5-6 May 2017 Education and Conference Centre, Westmead Hospital WSLHD-Women&newbornhealth@ health.nsw.gov/au Resus at the Park 1-2 June 2017 Luna Park, Sydney http://resusatthepark.org.au/ 4th International Collaboration of Perianaesthesia Nurses [ICPAN] Conference 1-4 November 2017 Luna Park, Sydney www.icpan2017.com.au INTERSTATE Impact of Mass-Gatherings on Emergency Departments 46 | THE LAMP FEBRUARY 2017
16 March 2017 Flinders University, Victoria Square, Adelaide Register at https://www.stickytickets. com.au/46188 Digital Health Show 29-30 March 2017 Melbourne http://www.digitalhealthshow.com. au/ 15th World Congress on Public Health 3-7 April 2017 Melbourne www.wcph2017.com 14th World Rural Health Conference 29 April – 2 May 2017 Cairns https://acrrm.eventsair.com/ QuickEventWebsitePortal/ ruralwonca2017/home/ Australian & New Zealand Addiction Conference 15-16 May 2017 Gold Coast https://www.vision6.com.au/ No More Harm National Conference 26-27 June 2017 Brisbane http://nomoreharm.com.au/ 4th National Eating Disorders and Obesity Conference 7-8 August 2017 Gold Coast http://eatingdisordersaustralia.org. au/ 18th International Mental Health Conference 21-23 August 2017 Gold Coast http://anzmh.asn.au/conference/ INTERNATIONAL Emergency Care Conference 6-10 February 2017 Hokkaido, Japan www.emsconferences.com.au Patient Safety Congress 4-5 July 2017 Manchester, UK https://www.patientsafetycongress. co.uk 6th World Congress of Clinical Safety
6-8 September 2017 Rome, Italy www.iarmm.org/6WCCS 10th European Congress on Violence in Clinical Psychiatry 26-28 October 2017 Crown Plaza, Dublin, Ireland http://www.oudconsultancy.nl/ dublin_10_ECVCP/index.html REUNIONS St Vincent’s Darlinghurst PTS Class January 1977 40-year Reunion Mary Piechowski (nee Morris): piechow@grapevine.com.au Anne Barudi (nee Whelan): annebarudi@optusnet.com.au Tamworth Base Hospital February 1976 intake 40-year Reunion Contacts: Sandra Cox: sandra.cox@ hnehealth.nsw Sean O’Connor: 0408 349 126 Gerard Jeffery: 0417 664 993 RAHC Royal Alexandra Hospital for Children PTS 1977 40-year Reunion 4-5 February 2017 Coleen Holland (Argall): bobandcolh@yahoo.com.au St Vincents Darlinghurst PTS Class March 1977 40-year Reunion 25 March 2017 Frances O’Connor (nee Pugh): 0415764131 or fgoconnor@optusnet. com.au 25 Year Reunion: 1992 UWS Nepean Graduating Class July 2017, Sydney, NSW Bede McKinnon: bede01@bigpond. com
CROSSWORD SOLUTION
NISSAN
Savings DEMO MICRA TI
• 5.8” colour touch screen display • Integrated satellite navigation • 15” alloy wheels • Rear view camera • DKG67Y
FROM
14,888
$
PULSAR HATCH ST-L
ALTIMA ST
• 16” alloy wheels • Rear parking sensors • Bluetooth • Rear spoiler
• Intelligent key & push button start • Advanced drive assist display • Dual zone climate control • 16” alloy wheels
FROM
FROM
18,888
23,888
$
DRIVE AWAY ^
$
DRIVE AWAY ^
DRIVE AWAY ^
FREE $500 FUEL CARD WITH E NEW & DEMO SOLD WHEN YOU MENTIO VERY N THIS AD ^
QASHQAI ST • Bluetooth • Reversing camera • 17” alloy wheels • Electronic park brake
FROM
25,888
$
DRIVE AWAY ^
X-TRAIL ST
• Intelligent key with push button start • Bluetooth • 17” alloy wheels • Rear view camera
• 7 seats as standard • Tri-zone automatic climate control • Push button start • Reversing camera and rear parking sensors
FROM
26,990
$
PATHFINDER ST
DRIVE AWAY ^
FROM
38,888
$
DRIVE AWAY ^
^Advertised offers available on new cars sold & delivered between 1 Feb 2017 and 28 Feb 2017. All offers end 28 February 2017. Highland Kackell Pty Ltd trading as Lander Nissan dealer license MD20305. YPA2595-FP
NISSAN
ONLY 4 MINS FROM PROSPECT HWY TURN OFF ON THE M4
02 8884 4477 | 37 Blacktown Road | Blacktown www.landernissan.com.au
ahg.com.au
THE LAMP FEBRUARY 2017 | 47
COVER STORY
Winner. Outstanding value Superannuation.
firststatesuper.com.au | 1300 650 873 Consider our product disclosure statement before making a decision about First State Super. Call us or visit our website for a copy. FSS Trustee Corporation ABN 11 118 202 672 ASFL 293340 is the trustee of the First State Superannuation Scheme ABN 53 226 460 365. 48 | THE LAMP FEBRUARY 2017