The Lamp April 2021

PHS CLAIM

INDUSTRIAL RELATIONS

PROFESSIONAL ISSUES

REGULARS

Time for better ratios

Wage increases essential

AHPRA warns against anti-vaccine claims

page 17

page 22

page 26

Your rights and entitlements at work p.32 Nursing research online p.41 Crossword p.43 Reviews p.45

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 78 NO. 2 APRIL/MAY 2021

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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 Hunter Office 8–14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962 For all editorial enquiries, letters and diary dates T 8595 1234 E lamp@nswnma.asn.au 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au Editorial Committee Brett Holmes, NSWNMA General Secretary Judith Kiejda, NSWNMA Assistant General Secretary O’Bray Smith, NSWNMA President Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health Liz McCall, Byron Central Hospital Diane Lang, South East Regional Hospital, Bega Valley

VOLUME 78 NO. 2 APRIL / MAY 2021

8

COVER STORY

Royal commission backs staffing ratios The Royal Commission into Aged Care Quality and Safety has delivered its verdict – Australia’s nursing homes cannot provide decent care without mandatory minimum staffing levels.

Printed by Ovato Print Pty Ltd 37-49 Browns Road, Clayton VIC 3168 Advertising Danielle Nicholson T 8595 2139 or 0429 269 750 F 9662 1414 E dnicholson@nswnma.asn.au Information & Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Adrian Hayward, Coordinator.

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

Privacy Statement The NSWNMA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information.

Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information, please contact the NSWNMA office. If you are still not satisfied that your privacy is being maintained, you can contact the Privacy Commission.

Subscriptions for 2019 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30.

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73,652

17

PHS CLAIM

It’s time for better ratios and a respectful pay rise After a tumultuous year, it’s appropriate the government prioritises our public health system and the nurses and midwives who have kept our community safe.

22

INDUSTRIAL RELATIONS

Wage increases essential for economic recovery: RBA Improved wages remain central to any recovery from the pandemic, according to the Reserve Bank of Australia.

26

REGULARS

5 6 32 34 36 41

Editorial Your letters Ask Judith What’s on News in brief Nursing Research Online and Professional Issues 43 Crossword 45 Book Club 47 At the Movies

PROFESSIONAL ISSUES

AHPRA warns against anti-vaccine claims There are serious penalties for practitioners who spread COVID anti-vaccination information, including loss of registration.

28

PROFESSIONAL ISSUES

Nurse Practitioners done over by medical cartel The final report of the Medicare Benefits Schedule Taskforce Review (MBSTR) is “a perverse, offensive and oppressive rejection of nurses”, say experts.

30

PROFESSIONAL ISSUES

It’s the system, stupid Violence in hospitals can’t be tackled without addressing underlying systemic causes.

PHS CLAIM

INDUSTRIAL RELATIONS

PROFESSIONAL ISSUES

REGULARS

Time for better ratios

Wage increases essential

AHPRA warns against anti-vaccine claims

page 17

page 22

page 26

Your rights and entitlements at work p.32 Nursing research online p.41 Crossword p.43 Reviews p.45

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 78 NO. 2 APRIL/MAY 2021

ROYAL COMMISSION BACKS RATIOS Print Post Approved: PP100007890

COVER: Sharon Hickey

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

Audit Period: 01/04/2020 - 30/09/2020 (Publisher Statement)

THE LAMP APRIL/MAY 2021 | 3

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4 | THE LAMP APRIL/MAY 2021

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EDITORIAL

BRETT

Holmes GENERAL SECRETARY

A road map forward The Royal Commission into Aged Care final report is not perfect but there are strong recommendations in key areas such as workforce and governance that can drive the sector to a much better place.

There is much to digest in the commission’s final report which runs to eight hard-copy volumes and has an executive summary of over 120 pages.

There are some in the sector who are disappointed by the report but a close analysis reveals a vision for the aged care workforce that is underpinned by values and policy recommendations that the ANMF and the NSWNMA have been advocating for more than a decade.

The commissioners, Tony Pagone and Lynelle Briggs, recognise that the 1997 Aged Care Act introduced by the Howard government, which is the foundation stone that has shaped the profit-driven sector we now have, has failed.

That legislation allowed providers to decide for themselves what staffing numbers were adequate and how taxpayers’ funding was used.

It was from this moment that the replacement of nursing staff with unregulated care workers began.

The consequences of this have been dire and the commissioners have identified key issues that need to be addressed if the sector is to be salvaged.

They point out that there are not enough workers to provide high quality and safe, person-centred care and that the proportion of qualified staff, such as registered nurses and allied health workers is too low.

This is in circumstances where the acuity of people receiving care has increased.

The commissioners agree that the aged care workforce is poorly paid for difficult and important work.

They also observe that some staff are untrained or insufficiently trained for the work they do.

‘ The commissioners leave no space for excuses by the federal government to abdicate its responsibility for the governance of the system.’

CURRENT STAFFING LEVELS ARE UNACCEPTABLE They accept the evidence that there is a link between staffing levels and care outcomes and observe that currently, staffing levels within large parts of residential aged care, fall well short of acceptable practice standards.

To remedy these deficiencies in the workforce the report recommends that the sector needs: • the right number of staff with the right mix of staff and skills • a greater proportion of registered nurses, nurse practitioners, and allied health professionals • better education and training to achieve a more highly professional workforce • registered personal care workers/AiNs • minimum qualifications for personal care workers/AiNs • improved pay and conditions.

These recommendations match the key objectives of our long, hard-fought campaign for a better and viable aged care sector.

The commissioners recognise that the aged care workforce needs to be professionalised which will require improvements to education, wages and conditions.

They agree that there is a wages gap between aged care workers and workers performing equivalent functions in the public health sector. They are in no doubt that a registration scheme is needed for personal care workers/AiNs.

The commissioners see a clear link between more staff, safety of care, a safe work environment and attraction and retention of staff.

THE FEDERAL GOVERNMENT’S INTEGRITY IS ON THE LINE The responsibility for implementing the commission’s recommendations now falls to the federal government.

The ball is now in Scott Morrison’s court and it is not an understatement to say the integrity of his government is on the line.

The testimonies and revelations in the lead up and during the course of the commission’s inquiry about the way many aged care residents have been neglected in a sector whose reason-for-being is care of our elders have been heart-rending.

The commission’s report clearly shows that the problems of the sector are deeply structural. The commissioners leave no space for excuses by the federal government to abdicate its responsibility for the governance of the system.

There have been many commissions, inquiries, analyses and reports about aged care in the past that have resulted in absolutely zero change.

We cannot allow that to happen with this pivotal report. Despite its flaws it is a significant step in the right direction.

The NSWNMA and the ANMF will campaign hard to have the commission’s recommendations implemented including through a paid advertising campaign. n THE LAMP APRIL/MAY 2021 | 5

COMPETITION

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YOUR LETTERS

Have your

Say And still we wait …

Why is the fight for the care, dignity and respect for our older Australians in residential aged care facilities so painfully hard?

There have been 20 years’ worth of reviews and inquiries, and now two years for the royal commission to uncover harrowing personal stories and chronic understaffing. And still we wait.

I find it heart-breaking that it took a global pandemic and a two-year royal commission for the federal government to take notice.

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The final report acknowledged the direct link between dangerous levels of understaffing in privately run nursing homes and residents’ neglect. The report recommended that ratios be introduced.

If only the government listened to nurses, who have been campaigning for mandated ratios in the aged care sector long before the COVID pandemic hit our shores.

It is now in the hands of our prime minister to address this chronic understaffing in residential aged care facilities.

Every day we delay, our older Australians will be suffering from neglect. Our older Australians have the right to safe, quality care, just like you and me.

Jocelyn Hofman, RN

Big safety win at Birunji NSWNMA members at the Campbelltown Hospital Mental Health Branch have had a major safety issue win at the Birunji Acute Mental Health Unit, which involved the Association, SafeWork and the committed determination of the staff at the unit.

In August 1999, an aggressive patient destroyed the protective barrier around the main access door to the nurses’ station. This removal now allowed patients to directly approach the main door and presented a real safety risk to staff who opened the door to deal directly with patients. Despite the easy solution of replacing the barrier, management chose to ignore the requests of the members and refused to replace it.

Negotiations continued with management, who stated that it was more therapeutic to allow patients to have direct access to staff with the barrier gone. However, members were concerned was that this easier access also allowed patients to assault staff.

Despite many meetings called by management to assuage staff concerns, members stuck together.

Finally, SafeWork were called in and not only did they acknowledge the safety concerns raised by the staff,

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.

they were also concerned over the poor working conditions at the ward.

As a result of SafeWork’s intervention, the ward’s nurses’ station has also been upgraded to have a window through which patients can now freely communicate with staff without exposing the nursing staff to a possible physical assault.

This is a major safety win for Campbelltown Hospital Mental Health Staff!

Mark Hardacre, RN

People living in parallel universes The 0.3 per cent pay rise offered to health staff this year was absolutely insulting. That worked out to be about $250 for a year.

In contrast, the police commissioner received an $87,000 annual pay rise!

That works out to be the pay rise total for 348 nurses.

What exactly has the police commissioner done to earn 348 times the pay rise of any nurse in the state?

The NSW Liberal government is so out of touch with the reality of frontline workers’ lives.

Jamie Loutides, RN CNC

If there’s something on your mind, send us a letter and have your say.

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LETTER OF THE MONTH Money cannot be used as an excuse for failure in aged care For years, staffing ratios in many aged care facilities have been appallingly inadequate. Without sufficient staff, it is impossible to provide the level of service that families think their loved ones are receiving.

Since the Howard government’s Aged Care Act 1997, the federal government has sought to distance itself from responsibility for aged care outcomes.

It is as though there is a deal between government and providers that the former gives the money, and the latter wears the odium for less-than-adequate service. This situation continued along happily until the ABC’s Four Corners exposed the extent of problems in the sector. Recent financial stresses have caused additional fractures to this arrangement.

Suddenly, we had a problem that someone had to own and then fix.

Media, since the publication of the Aged Care Royal Commission’s final report, has focused on two issues.

Firstly, who is going to manage and implement the Commission’s recommendations? Commissioner Briggs called for a revised management structure to be developed within government; Commissioner Pagone wants government responding to a structure outside its control. I have eight hard-copy volumes from 1A to 4C to consume before I can form a valid opinion.

The second and most important issue is: where will the money come from? This issue will dog this debate unless we get a few things clear.

Money cannot be used as an excuse for failure. The only true shortage can be of labour and resources. If we lack the staff needed to fill key roles, we must train them. If we lack the resources to support these staff, we must use money to obtain them. We have just seen through the recent COVID-19 crisis that money is not the problem if the battle is to save our economic system. The superficial financial needs of this system have been placed above our social needs for far too long.

The support I have seen in two community rallies I have been part of in the Blue Mountains showed us there is a strong will in communities to see these problems fixed. We now need to locate a comparable political will.

Politicians who play games do so at their peril.

Warren Ross, AiN EDITOR’S NOTE Any government funding for aged care must be used to properly resource caring for our elderly, whether in the for-profit or not-forprofit sectors. Providers must be held to account and made to meet set criteria for transparency (see pp 14–15).

THE LAMP APRIL/MAY 2021 | 7

COVER STORY

Royal commission backs staffing ratios The Royal Commission into Aged Care Quality and Safety has delivered its verdict – Australia’s nursing homes cannot provide decent care without mandatory minimum staffing levels.

I

n a win for aged care workers, the royal commission has recommended ma ndator y minimum staffing hours for all residential facilities.

The commission recommends that a minimum staff time per resident be set to improve the quality and safety of care, and attract and keep workers in the sector.

The recommendation represents a win for NSWNMA members and others who have campaigned for minimum staffing for many years.

Prime Minister Scott Morrison said the government would respond to the commission’s report in full by 31 May. If the government accepts the commission’s recommendations, staffing will increase in two stages.

By 1 July 2022, providers will have to engage enough staff for at least 200 minutes per average resident per day, adjusted for the needs of each resident.

“Staff” includes registered nurses, enrolled nurses, AiNs and personal care workers. At least 40 minutes of that time must be provided by an RN. In addition, at least one RN must be on site for the morning and afternoon shifts (16 hours per day).

From 1 July 2024, the minimum increases to at least 215 minutes per resident per day on average, with at least 44 minutes provided by an RN. At least one RN is to be on site at all times.

To meet the 2024 targets, staffing will have to increase by more than one-third, the commission says.

It describes this objective as

8 | THE LAMP APRIL/MAY 2021

‘ Quality and safety ‘cannot be achieved without the sector having enough staff with the skills and time to care.’

— Royal Commission Report

“challenging but achievable”.

Currently, on average, each resident receives 180 minutes of care per day, of which 36 minutes are provided by RNs, according to research done for the royal commission.

The commission says, “High quality and safe” care… “cannot be achieved without the sector having enough staff with the skills and time to care.”

A SYSTEM TO RATE QUALITY OF CARE RECOMMENDED The commission recognises that the current Aged Care Act 1997 has failed residents by allowing providers to judge for themselves what staffing levels are “adequate” and what skill levels are “appropriate”.

T h is ha s not prevente d inadequate staffing and substandard care “and may have in fact have encouraged those outcomes,” the commission says.

The commission also recommends more transparent reporting of staffing levels linked to a five-star system to rate quality of care.

This would be modelled on a United States government quality rating system known as Nursing Home Compare.

If the government accepts the commission’s recommendations, the whole sector will be brought up to at least a three-star rating by 1 July 2022.

Currently, almost 60 per cent of facilities have the equivalent of one or two-star staffing, which the commission calls “unacceptable”.

According to research done for the commission by the University of Wollongong’s Centre for Health Ser v ice D evelopment, t he se “unacceptable” facilities would experience an increase in staffing hours of about 37 per cent in stage one.

In the second phase, to be implemented by 1 July 2024, the entire sector will be brought up to a minimum of four-star staffing.

Only 15.5 per cent of facilities are currently staffed to this level, with the remaining 84.5 per cent at three stars or lower.

The University of Wollongong report estimates an average 37.2 per cent increase in total care staffing is needed to bring all facilities with three stars or lower, up to four stars.

The amount of care time provided by RNs would go up by 22 per cent on average to meet the 2024 requirement. n

COVER STORY

‘Time for action is now’ – ANMF

ROYAL COMMISSIONERS TONY PAGONE AND LYNELLE BRIGGS

Royal commission’s proposed staffing timeline By 1 July 2022: minimum staff time is at least 200 minutes per resident per day on average, with at least 40 minutes of that time with an RN.

The Australian Nursing and Midwifery Federation (ANMF) has called on the Morrison government to urgently respond to the Royal Commission’s recognition that mandatory minimum staffing ratios are needed in aged care.

“This government and many previous governments have done nothing to address shortages of RNs and qualified carers working in aged care,” said ANMF Federal Secretary, Annie Butler.

“The Morrison government must act now.

“Every day the government delays taking action to address dangerous understaffing, is another sad day that vulnerable residents will continue to suffer,” she said.

Annie thanked commissioners Tony Pagone and Lynelle Briggs for “acknowledging the importance of the right numbers of the right types of staff in guaranteeing safe, dignified care for every older Australian”.

‘Every day the government delays taking action to address dangerous understaffing, is another sad day that vulnerable residents will continue to suffer.’ — Annie Butler

By 1 July 2024: the minimum increases to at least 215 minutes per resident per day on average, with at least 44 minutes provided by an RN.

“Their recommendations are certainly a step in the right direction.

“They see the clear link between more staff, safety of care, a safe work environment and attraction and retention of workers.”

Annie said the commissioners recognised that inadequate staffing levels are linked to worse outcomes for staff, including burnout, lower retention and high turnover.

“The report also highlights research indicating the superior performance of government-run nursing homes on a wide range of quality indicators – especially when compared to for-profit facilities.

In addition, at least one RN is on site at all times.

“The report notes that the key difference is the presence of minimum staff ratios in public facilities.”

At least one RN is required on site for the morning and afternoon shifts (16 hours per day).

THE LAMP APRIL/MAY 2021 | 9

COVER STORY

Commission sets deadline for 24/7 RNs The aged care royal commission says every residential facility should have a registered nurse on duty at all times by July 2024.

E

very residential aged care facility should have at least one registered nurse on site 24 hours a day, the royal commission recommends.

By 1 July 2022, at least one RN should be on site for the morning and afternoon shifts (16 hours per day).

By 1 July 2024, at least one RN should be on site at all times.

“The evidence is compelling that overall staffing levels in aged care are linked to quality of care, and that registered nurse numbers are particularly important,” says the commission’s final report.

NSWNMA General Secretary Brett Holmes points out that the NSWNMA has waged a long campaign to prevent the state government from abolishing a legal requirement to have an RN on duty at all times in aged care facilities.

“The commissioner’s recommendation on RNs in aged care effectively endorses the union’s stand on this issue,” he says.

The royal commission notes

that so-called reforms enacted by the Howard government in 1997 allowed providers to cut costs by replacing nursing staff with care workers, resulting in compromised care for residents.

Charles Sturt University Associate Professor Maree Bernoth says the commission’s recommendation is a welcome move away from the trend towards regarding old people as commodities.

Associate Professor Bernoth, who is an RN and NSWNMA member, says RNs were more common in nursing homes before governments shifted the focus to accommodation and lifestyle rather than health care.

“When you’ve got an industry that’s focused mainly on profit, and when that industry has such power over government, (the result has been) the commodifying of older people,” she says.

“The emphasis shifted to making profits and paying shareholder dividends, and not on the person needing care and the staff providing that care.

‘ The commissioner’s recommendation on RNs in aged care effectively endorses the union’s stand on this issue.’

— Brett Holmes

10 | THE LAMP APRIL/MAY 2021

“Even questioning the need for an RN is beyond my comprehension.

It’s a no brainer, really.”

SUPPORT BY A MULTIDISCIPLINARY TEAM Associate Professor Bernoth has worked in residential aged care, palliative care and acute care and has been a senior nurse educator at a number of large aged care facilities.

She welcomes the royal commission’s recommendation that aged care facilities have access to multidisciplinary outreach services based at local hospitals.

“These would make people like nurse practitioners, allied health practitioners, pharmacists, geriatricians, and palliative care specialists and other specialists, available for older people in nursing homes and at home,” she says.

“That makes my heart sing, because nursing homes would have care workers and RNs being supported by the multidisciplinary team.

“Unless we break these silos and have institutions working together, we’re going to keep tripping over these issues.”

Associate Professor Bernoth recently gave evidence to an NSW Upper House inquiry into whether there is a need to have an RN on duty at all times in nursing homes.

COVER STORY

‘ The emphasis shifted to making profits and paying shareholder dividends, and not on the person needing care and the staff providing that care.’ — Maree Bernoth

RN’s role in home care

She told inquiry members that it takes a skilled RN to be able to assess an older person to see if they have a delirium, which is treatable, or dementia.

“The issue there, is that failing to identify and address a delirium can lead to serious illness – sepsis, for example – and death,” she said.

“A n unt ra ined per son will have diff iculty with differentiating between delirium and dementia.”

She told the inquiry that skilled RNs were also needed to communicate effectively with a person with dementia and recognise that “challenging behaviour or an angry outburst could be caused by pain or distress, or an inability to communicate a need, rather than a need to be restrained physically or chemically”. n

All personal care workers/ AiNs providing care in the home should be supervised by an RN or allied health professional, the royal commission recommends.

RN numbers fall According to royal commission research, RNs comprised 21 per cent of the residential direct care workforce in 2003, but by 2016 this had dropped to around 15 per cent.

The proportion of enrolled nurses also dropped, from 13 per cent to 10 per cent.

Over the same period, the proportion of the residential direct care workforce who were personal care workers/ AiNs increased from around 58 per cent to around 70 per cent.

The commission is not suggesting an RN necessarily accompany the care worker to a client’s home.

It wants care workers to have an RN or other health professional they can go to for advice and support, and who can provide supervision and training.

“As well as helping care workers provide better quality care to people in their homes, supervision protects older people from the risk that they will receive substandard care or, worse, be the subject of abuse or neglect in their home,” the commission says.

THE LAMP APRIL/MAY 2021 | 11

COVER STORY

Education and professional development vital The aged care royal commission wants the federal government to establish a national registration scheme for carers.

T

he royal commission says registration of carers should incorporate a mandatory minimum qualification of a Certificate III, ongoing training requirement s a nd minimum English-language levels.

The registration scheme should be up and running by 1 July 2022, it says.

It suggests transitional arrangements be put in place for existing care workers who do not meet minimum requirements.

They should be allowed to apply for registration based on their experience and prior learning.

The commissioners ag ree with the Australian Nursing and Midwifery Federation (ANMF) that “personal care workers should be provided with support to complete t he qua lif icat ion, includ ing reasonable time to enrol, paid study leave, workplace mentoring support and technological supports to complete coursework”.

“We are in no doubt that a registration scheme is required for personal care workers.”

They say that “regulation of personal care workers by registration, with a mandatory minimum qualification requirement, ongoing training requirements, a code of conduct, and a complaint process, will help to professionalise

12 | THE LAMP APRIL/MAY 2021

‘ We are in no doubt that a registration scheme is required for personal care workers.’ — Royal Commission and improve the quality of the personal care worker workforce”.

ment for existing and new personal care workers”.

They point out there is “currently no formal industry standard for an entry-level qualification to work as a personal care worker”.

“Approved providers must support the aged care workforce to access ongoing training through financial assistance to cover or partcover the training, paid leave to attend training, and promotion of an organisational culture that values skills development.”

“Aged care workers need to have good quality, and easily accessible, ongoing training and professional development opportunities available to them.

“Such training and professional development opportunities must ref lect the contemporary and future care needs of older people.”

TIE FUNDING TO EDUCATION The commission says that from 1 July 2021, federal, state and territory governments should “fasttrack the development of accredited, nationally recognised short courses, skills sets and micro-credentials”.

It points out that the federal government contributes 80 per cent of the cost of aged care.

The commission says the government should therefore tie aged care subsidies to “a standard amount per employee to support ongoing training and develop-

The commission points out that training courses are not always available locally and workers cannot always attend courses in person due to work and family commitments.

It therefore recommends that short courses be made available and delivered electronically.

“High-quality and targeted short courses, including micro-credentials, are a suitable way to address skills gaps, satisfy continuing professional development requirements, or enable people to gradually work towards a formal qualification in the new aged care system.

“They can enable new and existing employees to build specific skills of high relevance to aged care work.” n

COVER STORY

‘We will have to keep pressure on the government’ Aged care workers will have to campaign to ensure all government funding is linked to increased staffing and higher wages, says commission witness.

An NSWNMA member who gave evidence to the aged care royal commission has welcomed its findings – and urged unions and the public to maintain pressure on the government to promptly implement them.

Assistant in Nursing Susan Walton gave evidence to the commission about what it was like to work at a chronically understaffed nursing home.

Susan joined with other NSWNMA members in campaigning at election time and travelling to Canberra to lobby MPs for aged care improvements.

Susan welcomes the commission’s recognition that aged care is understaffed and its workforce is underpaid and under-skilled.

“The commission recognises that a better system will cost more, and that extra funding needs to lead to more staff and higher pay.

“We will have to keep pressure on the government to make sure this happens.”

She says the commission’s recommendation for mandatory minimum staff times per resident is a good move.

“We have to make sure that the recommendations lead to employment of more staff.

“We can’t keep on working short and doing double shifts as normal practice.”

‘ We can’t keep on working short and doing double shifts as normal practice.’

— Susan Walton

LINK FUNDING TO CARE AND WAGES

It will be vital to ensure that all government funding is linked to direct care and staff wages, Susan says.

She points to a current campaign by aged care employers for more funding for the sector.

The ‘It’s Time to Care About Aged Care’ campaign is being run by the new Australian Aged Care Collaboration (AACC) alliance, which includes not-forprofit providers and a number of private operators.

“Their petition for more government support makes no mention of what they intend to do with the extra funding,” she points out.

She describes the commission’s recommendation for a registration scheme for care workers as “a fantastic idea that should have been brought in long ago”.

“Staff need to be fully qualified to deal with our vulnerable elderly people. A six-week course is not enough, and you need to be able to speak English adequately.

“Also, further education and training should be delivered by organisations and people who are properly qualified. It should be

paid for by the employers, from the extra funding they will receive, but it shouldn’t necessarily be delivered by them.”

Susan says it’s essential for care workers to learn how to deal sympathetically and effectively with people with dementia.

“I see inexperienced carers who do not know how to care for our elderly who have dementia.

“They don’t realise they can’t change their behaviour, don’t recognise the signs of their disease, and don’t know how to approach their challenging behaviour.

“When a carer takes the wrong approach, it can change the resident’s behaviour immediately and make it extremely difficult for the resident.

“It’s not hard to realise that having more qualified staff, and staff to resident ratios would change the lives of residents and staff members dramatically for the better.

“Following the Royal Commission report there is now no excuse not to immediately start to implement these improvements.” n

THE LAMP APRIL/MAY 2021 | 13

COVER STORY

Make providers accountable for funding, commission says The royal commission says transparency and accountability should be embedded in the new aged care system.

T

he a ged ca re roya l com m ission ha s put forward recommendations to make providers more accountable for the expenditure of taxpayer funds.

It says residential care providers get about $11.7 billion in federal government care subsidies.

“However, there is no specific requirement on residential aged care providers to spend any portion of the money they receive on care,” it points out.

It recommends that all residential care providers should report, on a quarterly basis, the “total direct care staffing hours” provided each day at each facility they conduct.

Reports should specify the different employment categories, including personal care workers/ AiNs, enrolled nurses, registered nurses and allied health care professionals engaged in direct care provision.

The commission wants the government regulator to assess the reports against minimum staffing requirements and take action if providers don’t meet standards.

The commission also wants greater transparency by home care providers.

At present, they are paid subsidies for each month in advance, regardless of the services 14 | THE LAMP APRIL/MAY 2021

‘ There is no specific requirement on residential aged care providers to spend any portion of the money they receive on care.’ — Royal Commission actually provided.

“This means the Australian Government is wholly reliant on approve d prov ider s for accurate f ina ncia l repor t ing and reconciliation of funds,” the commission points out.

University Associate Professor Maree Bernoth, an NSWNMA member, to respond to the claim.

Professor Bernoth asked, “How do we know that, when there is no transparency required of aged care facilities?”

“This arrangement has several undesirable effects, including the accumulation of ‘unspent funds’ and a lack of clarity regarding what services are delivered.”

“Except for those in Queensland, I believe these facilities do not have to share with us their financials.

We do not know how much they are spending on staff.

To i nc r e a s e “ef f ic ie nc y, transparency and accountability” the commission recommends that home care providers be paid from home care packages after services have been delivered or after “liability to deliver them has been incurred”.

“We do not know how much they are spending on equipment. We do not know where our taxpayer money is being used.

PROVIDERS CRY POOR – BUT NO TRANSPARENCY Owners of some rural and regional aged care facilities recently told an NSW Upper House inquiry they will “go out of business” if they are required to have a registered nurse on site 24/7.

Inquiry chairperson Courtney Houssos asked Charles Sturt

“That lack of transparency … means that the aged care facilities cannot claim that they are going out of business. We need to see where their money is being spent, and then maybe we can make some comment, but until then we cannot.

“Secondly, if that is so, why do we have so many aged care facilities in rural areas that are doing very well? There are quite a few aged care facilities that have registered nurses and are doing very well.” n

COVER STORY

Skills ‘inadequate’ for sub-acute patients NSWNMA member Mary Gibbs, when giving evidence to an NSW Upper House inquiry, underlined the need to raise skill levels in aged care.

R

N Mary Gibbs has worked in both private and public hospitals and in for-profit and non-profit aged care.

She has held senior leadership roles in the last 20 years.

She recently gave evidence to an NSW Upper House inquiry into whether RNs should be on duty in nursing homes at all times.

Mary said regulations covering the aged care sector are insufficient to help staff provide the fundamental care needed.

“My colleagues and I have always felt that aged care here is the second cousin to the health industry,” she said.

She told the inquiry that the workforce generally lacks the skills required by modern aged care facilities.

“Aged care facilities are now all sub-acute units – extensions of subacute units from the hospitals with the complexity of the residents that are coming out of those facilities.

“We are getting early discharges and complex care. We are getting residents with behavioural and mental health issues.

“The junior workforce is not skilled to manage that. It is solely reliant on an RN’s ability to do

‘ Aged care facilities are now all sub-acute units – extensions of sub-acute units from the hospitals with the complexity of the residents that are coming out of those facilities’ — Mary Gibbs

clinical assessments and work with the general practitioners in the community.”

Mary said the current workforce skill mix includes aged care workers with only three to six months’ experience.

“That experience is basically ticking the boxes and doing 120 hours of clinical practice wherever they have been sent.

that they have to put in place.”

She said some in the aged care workforce see aged care as a stepping stone to other career paths.

Mary told the inquiry that aged care needs to be treated as a part of and similar to the health system and be given “the resources that they have in the hospital system, particularly if we are expected to take sub-acute residents”. n

“They do not understand the concept of aged care and gerontology.

They do not understand (dementia).

They do not understand the behaviour management strategies THE LAMP APRIL/MAY 2021 | 15

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16 | THE LAMP APRIL/MAY 2021

PHS CLAIM

It’s time for better ratios and a respectful pay rise After a tumultuous year, it’s appropriate the NSW government prioritises our public health system and the nurses and midwives who have kept our community safe.

A

strong majority of the 200plus public health system branches voted in favour of our 2021 Award Claim which has now been delivered to the Ministry of Health.

“ T he NSW economy ha s benefited from our members’ efforts throughout the COVID-19 pandemic to keep our communities safe. It is nurses and midwives who have kept the health system going,” he said.

Further meetings are scheduled in April and May before the award expires on 30 June.

THE GOVERNMENT CAN AFFORD TO INVEST IN HEALTH

D u r i n g a c omprehen sive c on s u lt a t ive pro c e s s wh i le formulating the claim members told the Association that: • u nderstaffing our hospitals

is

rife

across

• workloads continue to increase, yet there is less support • t here are not enough nurses or midwives which is creating a dangerous work environment.

The claim includes improvements to create a better, more transparent ratios system and a “respectful” 4.7 per cent increase of pay and wage-related allowances per year, plus superannuation (see p21).

In 2020, t he government attempted to freeze wages although the NSW Industrial Relations Commission eventually awarded a small 0.3 per cent increase.

The government has said it will pursue a 1.5 per cent wage cap until 2024.

NSWNMA General Secretary Brett Holmes says this is unacceptable.

The government can afford both a pay rise and further investment in the public health system. In fact, economically it is the right thing to do, Brett says.

“Experts say that pay rises are critical to economic recovery and COVID has shown how important investment in health is to the wellbeing of our economy.”

According to the Australian Bureau of Statistics the Australian economy grew by 3.3 per cent in the September 2020 quarter and by another 3.1 per cent in the December quarter.

The governor of the Reserve Bank of Australia, Philip Lowe said this recovery “reflects the success that Australia has had on the health front”.

Lowe said that “we are now within striking distance of recovering the pre-pandemic level of output”.

The RBA governor has been emphatic about the need for wages to rise to sustain this recovery (see p 22.)

The RBA predicts a strong rebound by the Australian economy in 2021 and 2022. It forecasts economic growth of five per cent in 2021 and 4 per cent in 2022.

THE PUBLIC SAYS NURSES AND MIDWIVES DESERVE BETTER Research by Unions NSW found that the NSW public has a strong appetite for investment in frontline workers such as nurses and midwives and the Public Health System.

The survey found that public sentiment towards nurses and midwives is very positive with strong recognition for the considerable sacrifices they have made and their willingness to go beyond their roles.

There was also strong support for further investment in health and nursing with the pandemic still ongoing.

The community was clearly aware that nurses and midwives have been delivering high quality care despite increased work stress, more responsibilities and a highly fluid environment due to COVID restrictions and guidelines.

The survey also found the NSW public strongly support minimum staffing ratios and recognise their importance to the delivery of high quality care and the safety of patients. n

THE LAMP APRIL/MAY 2021 | 17

PHS CLAIM

Without ratios, rural staffing crisis worsens

Ratios are key to reducing violence

Tumbarumba Multi-Purpose Service in the Snowy Mountains district is so short staffed that nurses who leave the ward to cover an emergency have to call kitchen staff to monitor their patients.

Achieving the NSWNMA claim for ratios would help to reduce the level of violence and aggression in mental health units, says Eliza Wright, secretary of the NSWNMA’s Blacktown City Mental Health Branch.

The NSWNMA’s Tumbarumba branch president, Kristyn Paton RN, gave evidence at a recent hearing of the NSW Upper House inquiry into rural, regional and remote health services.

She confirmed to the inquiry that asking kitchen staff to cover the ward is common practice.

“It’s not an ideal practice but in an emergency, we have no choice.

It reinforces the need for ratios to give us more staff,” she told The Lamp.

Tumbarumba MPS has an emergency department with two beds, an acute medical ward with nine beds and a nursing home with 28 open beds and 40-bed capacity.

Usual staffing is one RN per shift plus a daytime NUM Monday to Friday who doesn’t often work on the floor due to other duties.

Kristyn says it is getting harder to fill rosters because the MPS is losing staff due to heavier workloads and increased responsibilities. “There is often no doctor on call for weeks and months at a time so there is a heavy reliance on the telehealth service and nurses qualified to work in this setting.

“We have nurses living in Tumba who choose to travel 1.5 hours to work at Wagga Wagga Base Hospital or 45 minutes to Tumut Hospital, because they get better support there and don’t feel their registration is being put at risk,” she says.

She says ratios would “give us the capacity to spend meaningful time with our patients and get to know them better, so we can anticipate problems more easily and de-escalate incidents a lot more effectively”.

She says the NHPPD (nursing hours per patient day) system doesn’t adequately take into account the acuity of patients and gives management too many loopholes.

These loopholes regularly leave Eliza’s ward with around one nurse to six patients on morning and afternoon shifts and one to eight at night, which, she says, is seriously inadequate.

The NSWNMA recently went to the NSW Industrial Relations Commission to successfully block a management attempt to cut morning shift staffing at the acute mental health unit of Blacktown Hospital.

Management claimed the shift was overstaffed according to the NHPPD formula.

“We successfully argued that NHPPD was supposed to be the bare minimum level of staffing and a staff cut would be detrimental to both patients and staff,” Eliza said.

“If we had proper ratios the staffing requirements would be clear and that would benefit mental health units across the whole state.

“Nights are particularly volatile, we’ve got a skeleton staff, but we still accept admissions, so anything can happen.

“Only a week ago, a patient assaulted all four nurses on night shift. One of them was punched repeatedly while another

18 | THE LAMP APRIL/MAY 2021

‘ It’s getting harder to fill rosters because the MPS is losing staff due to heavier workloads and increased responsibilities’ — Kristyn Paton

“I sometimes have to call nurses at home to come in on their days off.

It’s really hard because a lot of staff live on outlying farms.

“Under the NSWNMA’s award claim, the MPS would have a minimum two RNs and an EN on every shift, to cover the emergency department and the acute ward and ideally another RN in the nursing home.

“Without ratios, the safety of our community and welfare of our staff are being put at risk,” Kristyn says.

“We often have to do 12-hour shifts and double shifts to plug gaps in the roster.” n

PHS CLAIM

Our ratios claims Ratios applied shift-by-shift and based on the number of patients in each ward, unit or service In charge of shift (however named) will not be allocated a patient load and will be in addition to the ratios claim Staffing for ‘Specials’ to be separate and in excess of mandated ratios or rostered staffing Where AiNs and AiMs are permitted to work in an identified unit or ward, they will not be allocated a patient load and will be in addition to the ratios claim Employ AiNs and AiMs only where clinically appropriate Include the same ratio for all adult inpatient Medical/Surgical wards in all NSW Hospitals to ensure patients receive the same level of nursing care, regardless of where they live or are treated Ratios in EDs, EMUs and MAUs

‘ I have the cost of onsite parking deducted from my pay and it’s over $1000 a year.’

— Eliza Wright was physically held hostage. It was a horrific incident, and those nurses all required time off work. They feel shaken up and overwhelmed.

“Incidents like these leave us feeling unsafe and undervalued at work, especially when it feels like management is more interested in cutting staff to save money. We shouldn’t have to go to work not knowing if we’re going to make it home safe that night.

“Having four nurses on night shift does not even allow us to effectively observe the deescalation guidelines which say you need five nurses to restrain a violent patient.”

Eliza says free parking for nurses is another important aspect of the award claim.

“Most nurses have no alternative other than to drive to work but parking is difficult. Some people have to park in the two-hour zone and keep running outside to move their car.

“I have the cost of onsite parking deducted from my pay and it’s over $1000 a year.” n

Ratios in adult, paediatric and mental health Intensive and Critical Care Units with latest Critical Care Standards to apply Adult inpatient mental health ratios claim for acute and sub-acute wards or units in general and specialised mental health hospitals Extend ratios to all mental health units Ratios in Paediatric and Neonatal Intensive Care Units Skill mix and support clinical supervision for inpatient mental health nurses Latest ACORN Standards to apply to perioperative services across NSW For Community and Community Mental Health the application of a limit of face-to-face client contact hours in any shift. Limit of 4 hours of face-to-face client contact per 8-hour shift, averaged over a week Support clinical supervision for Community Mental Health nurses Ratios for short stay wards – High Volume and 3.5 hours of face-to-face patient care in Day Only Units Ratios for Drug and Alcohol units – inpatient and outpatient Improved claim for Maternity Services Additional principles for maternity services in Birthrate Plus® and non-Birthrate Plus® sites and skill mix for postnatal wards or units Guaranteed staffing arrangements for outpatient clinics Employ 1.4 FTE CNE/CME for every 30 nursing and midwifery staff, rostered across all shifts Ensure there is appropriate skill mix and early career nurses or novice practitioners are not the most senior nurse on shift or allocated in charge New principle for staffing reviews when a new ward/unit/service is created, reconfigured or there is a change in the model of care.

Update Clause 53 to reflect the roll out of 6.0 NHPPD arising from the government’s 5000 commitment over four years.

For Peer Group D and F3 MPS – Minimum three nurses or midwives, two of which must be RNs. Confirm non-maternity patient care is excluded from Birthrate Plus® staffing.

THE LAMP APRIL/MAY 2021 | 19

PHS CLAIM

Award claim aims to protect ICU standards The NSWNMA’s claim for ICU staffing ratios draws on feedback from a statewide ICU nurses’ forum.

Forum member Michelle Rosentreter, who is president of the NSWNMA’s Hornsby Hospital branch, says ICUs are not covered by a NHPPD (nursing hours per patient day) formula.

Instead, Hornsby ICU nurses aim to follow guidelines formulated by the College of Intensive Care Medicine of Australia and New Zealand and the Australian College of Critical Care Nurses.

The guidelines apply to work practice, caseload, staffing and operational requirements for the ICU. “The guidelines are the minimum standards needed to keep our patients and staff safe,” Michelle says.

“Minimum standards are paramount in ICU because of the level of technology we use, the drugs we use and the amount of education we need.

“On average, it takes a nurse about five years to reach a level of competence and confidence needed to deal with the critically unwell in ICU.” Michelle says that in the absence of ratios, ICUs are under pressure from hospital executives to take more patients than is safe.

“People running hospitals may lack knowledge of what is required to manage patients with life threatening illnesses. It can’t be compared to ward staffing.

“You might hear an executive member say, ‘ICU has got six nurses and only three patients.’

“But those three patients might be hooked up to over 15 infusions, have an artificial airway and dialysis as well as requiring CPR, while you have 20 | THE LAMP APRIL/MAY 2021

‘ We need a fair and reasonable pay increase, shift by shift ratios and better conditions for work – to deliver the care we are trained to do and not to be disregarded.’ —Michelle Rosentreter the primary nurse and another nurse helping to maintain their airway and keeping them haemodynamically stable”.

“I’ve been appalled to learn that some of our tertiary hospitals do not follow the minimum staffing standards developed by these colleges – most notably no free Team Leader/Clinical Coordinator or ACCESS nurse.

“My heart sank when I saw the struggles my colleagues are having at some hospitals, where they are not heard by their executive or their district.

“For instance, at one level 6 ICU – the highest level – the clinical

coordinator running the unit also has to do direct patient care and support junior nurses, while trying to manage deteriorating patients and respond to emergency code blues.

She says it’s time the Berejiklian government and the Ministry of Health listened to nurses and midwives.

“We need a fair and reasonable pay increase, shift by shift ratios and better conditions for work – to deliver the care we are trained to do and not to be disregarded.” n

PHS CLAIM

Pay and conditions claim

Push to overhaul maternity staffing The NSWNMA Award Claim for 2021 seeks to overhaul maternity unit staffing with minimum ratios for postnatal wards and updates and improvements to the Birthrate Plus® tool used to calculate required numbers of midwives.

Campbelltown Hospital midwife Rachel Lown, a member of the NSWNMA’s Macarthur branch, says Birthrate Plus® has some major flaws.

“It does not count babies as patients and fails to take into account the increasing acuity of mothers,” she says.

“We do about 4000 births a year and the acuity of women has increased, so we are taking on many more high-risk cases, which are not factored into your workload.

“For example, I’ve had three ladies immediately after they returned from recovery from caesarean section. Having three post-op women and their babies to look after is very full on.

Rachel says management undertook a major recruitment drive in 2019, which led to a temporary improvement in staffing and workloads.

“However, so many staff have decided to go elsewhere because Campbelltown is so hectic.

“Our main issue isn’t finding staff, it’s retaining staff.”

She says Birthrate Plus® does not adequately provide for “like for like” replacement of staff who are on long-term leave or have taken managerial positions or retired.

4.7 per cent increase in pay and wage-related allowances per year plus superannuation. Next pay increase due July 2021.

Free permanent parking and improved access for all nurses and midwives Extend special allowance for Telephone Counselling

‘ Our main issue isn’t finding staff, it’s retaining staff.’ — Rachel Lown

Update and improve definitions: • New definition of Professional Standard • New definition of Assistant in Midwifery Leave arrangements • Surrogacy Leave • Update parental leave provisions to remove discriminatory references • Access to paid pandemic leave for carers responsibilities

“Some of our senior people have been replaced by very junior staff.

Rachel says nurses and midwives need a fair pay increase after only getting 0.3 per cent last year, when they had to cope with increased workloads due to bushfires followed by the pandemic.

Regarding the union’s claim for free parking for hospital staff, Rachel believes it’s unfair to make hospital staff pay for parking.

“We should get it for free.

It’s the least the government could do for those who serve their communities.” n

Work Health & Safety • Annual fit testing for N95 respirator masks for all nurses and midwives • Safety in outdoor COVID testing clinics Miscellaneous Award improvements • Improve hours of work clause to ensure your genuine agreement, addressing the state-wide problem of waiver forms removing your right to a 10-hour break between shifts.

• Expand Scope of Grading Committee to include Nurse and Midwife Managers • Ensure annual leave and overtime is clear for part-time employees • Ensure overtime wording is clear and applies to overtime prior to shift just as it does at the completion of your shift • Overseas recognition for incremental purposes

THE LAMP APRIL/MAY 2021 | 21

INDUSTRIAL RELATIONS

Wage increases essential for economic recovery: RBA Improved wages remain central to any recovery from the pandemic, according to the Reserve Bank of Australia.

F

or years, the governor of the Reserve Bank of Australia, Philip Lowe, has said wages growth in Australia needs to “have a three in front of it” for our economy to prosper.

His was not a lone voice. The former head of the International Monetary Fund, Christine Lagarde, was similarly outspoken about stagnant wages acting as a drag on economic growth in developed countries like Australia.

The COVID pandemic has not changed this analysis from our central bank.

In an address to the Australian F in an c i al Re vie w Business Summit on 10 March in Sydney, Lowe mentioned wages more than a dozen times.

In the speech, titled ‘Recovery, Investment and Monetary Policy’, Lowe made it clear that wages are central to the RBA’s policy settings.

“Currently, wages growth is running at just 1.4 per cent, the lowest rate on record. Even before the pandemic, wages were increasing at a rate that was not consistent with the inflation target being achieved.

Then the pandemic resulted in a further step-down,” Lowe told the AFR conference.

22 | THE LAMP APRIL/MAY 2021

Wages growth in Australia needs to have a three in front of it for our economy to prosper.

— Phillip Lowe, Governor of the Reserve Bank of Australia,

“This step-down means that we are a long way from a world in which wages growth is running at three per cent plus. The evidence from both Australia and overseas strongly suggests that the journey back to sustainably higher rates of wages growth will take time and will require a tight labour market for an extended period.”

At the same conference, Prime Minister Scott Morrison made a speech on the economy where he had “literally, nothing” to say about wages, Crikey’s political editor, Bernard Keane, pointed out.

“His only proffered ideas around the Australian workforce consist of threatening jobseekers with even more punishment to force them to take underpaid, exploitive jobs,

and hankering for the end of the pandemic so he can let businesses get back to relying on temporary migrants,” he said.

“Both are recipes for pushing wages further down, not lifting them. But the government’s strategy is deliberate wage stagnation, and it leads by example with the imposition of real wage cuts on the public service and an industrial relations bill intended to make it easier to cut wages and conditions.

“Rarely has there been a more stark contrast between what the central bank sees as economically crucial, and the ideological frolics of a business donorcontrolled government.” n

INDUSTRIAL RELATIONS

Aged care wages must rise, says royal commission The aged care royal commission has called on employers and the federal government to work with unions to improve pay for aged care workers.

I

n its final report, the royal com m is sion put s for wa rd t wo re com mend at ion s to bridge the wages gap between aged care workers and workers doing equivalent jobs in the acute health sector.

First, it recommends that the government, employers and unions collaborate on a work-value case and equal remuneration application to the Fair Work Commission.

“If successful, this will increase the wages of personal care workers and nurses in both residential and home care,” it says.

Second, it calls for wage increases to become “an explicit policy objective” of government funding.

The commission wants the government to set up a Pricing Authority to set prices for “highquality and safe” aged care.

It says the authority should price aged care at a level that enables workers to be paid as much as in similar sectors, such as health and disability.

The commission has recommended substantial increases in government subsidies to providers.

However, “merely increasing subsidies … is unlikely to translate into higher wages,” the commission warns.

It note s t hat succe s sive governments have given additional

funds to providers “in the hope that they would be passed on to aged care workers by way of increased wages.

They were not”.

POORLY REMUNERATED AND UNDER-RESOURCED

while professionally engaging with families who themselves may be grief-stricken.”

The three academics say societal values have radically shifted over the past decade.

In a recent article, three academic experts in the field of human resources describe aged care as vital work that is poorly remunerated and under-resourced.

Australians now expect “very high levels of quality care, and there is now an appetite for change in the way we value ageing, and those who work in aged care”.

This “is a grim reality that our society, and our government, need to face,” write Ben Farr-Wharton of Edith Cowan University, Matthew Xerri of Griffith University and Yvonne Brunetto of Southern Cross University.

“At that time, nurses were widely regarded as little more than cleaners and carers who happened to work in hospitals.” n

They say the award rate for a fulltime aged care worker at the start of their career, is $21.09 per hour – slightly less than a cleaner, and only $1.25 per hour more than the minimum wage.

They point out that the job is “substantially more complex and demanding, both physically and emotionally,” than cleaning. “ Work i n g i n a ge d c a re requires someone who is engaged, focused, well-trained and ready to thrive in challenging clinical and social environments.

“Aged care workers also need to contend with the emotional grief associated with end-of-life care and death. They need to do this

They draw parallels with the nursing profession in the first half of the 20th century.

STOP PRESS As The Lamp goes to press the ANMF has asked the Fair Work Commission to add the nursing award to an aged care work value case that was filed by the HSU last year.

This was a recommendation of the Aged Care Royal Commission.

THE LAMP APRIL/MAY 2021 | 23

INDUSTRIAL RELATIONS

Labor’s quest for workplace security Opposition leader Anthony Albanese has promised an ALP government would substantially increase the legal rights and protections for Australians in insecure work.

O

pposition leader Anthony Albanese has announced an ALP indust r ia l relations policy t hat contrasts markedly to the Morrison government’s partly deafeated IR “omnibus” bill.

According to experts, the Morrison government’s bill creates a pathway for employers to cut pay and make work less secure (see The Lamp February/March).

Albanese says changes in the labour market, particularly the rise of the “gig” economy, requires new laws that “ensure more Australian workers have access to employee protections and entitlements currently denied to them by the narrow, outdated definition of an employee”.

The two major parties are now offering significantly divergent econom ic pat hways out of the pandemic.

When announcing the new policy, Anthony Albanese recognised the role of nurses and aged care workers for “shielding us from the horror the pandemic has wrought in the nations across Europe and across the United States”.

“Instead of rewarding you, Mr Morrison is cynically using the pandemic to launch a full-frontal attack on your pay, your conditions and your job security,” he said.

While technological developments and the coronavirus had all 24 | THE LAMP APRIL/MAY 2021

transformed the workplace, workers’ fundamental aspirations remain the same, he said.

“For millions of Australians, the essential prerequisite to raising a family, buying a home and building a future, is a good, secure job and enough super to retire comfortably.

“Not being forced into a casual job – but good, permanent work that comes with protections such as sick leave, family leave, annual leave and penalty rates.”

EIGHT YEARS OF SUPPRESSED WAGES Albanese says during their eight years in office, the Liberal– National government has steadily undermined these protections.

“They want to reduce workers’ security to the point where bad employers are unfairly favoured, which then places competitive cost pressure on good employers,” he said.

“After eight years of deliberately suppressing wages, cutting penalty rates and attacking trade unions, the government is now using the pandemic as a cover to cut pay and make work even less secure.”

In contrast, Labor proposes to include “job security” as a key objective of the Fair Work Act. “This will require the Fair Work Commission to bring a sharp focus to job security when making

decisions about your rights at work,” Albanese says.

“L a b or w i l l en s u re t he independent umpire has the capacity to inquire into all forms of work and determine what rights and obligations should apply.”

LEARNING FROM COVID The ALP also plans to respond to one of the most confronting revelations of the pandemic: how many workers – casuals, contractors and gig workers – had no right to paid sick leave.

Workers in casual jobs found themselves very vulnerable to lay-offs. Casuals lost their jobs eight times faster than those in permanent employment and nearly one million casual workers were left out of JobKeeper.

Anthony Albanese says a Labor government would try to introduce more job security in the public sector.

“We will conduct an audit of employment within the Australian Public Service and, as a model employer, take steps to create more secure employment where temporary forms of work are being used inappropriately.

“We will call time on the relentless outsourcing, offshoring a nd shor t-ter m cont rac t i ng that has undercut the capacity of depar tments to do their jobs and undermined the frontline services Australians rely on.” n

INDUSTRIAL RELATIONS

‘After eight years of deliberately suppressing wages, cutting penalty rates and attacking trade unions, the government is now using the pandemic as a cover to cut pay and make work even less secure.’

— Anthony Albanese

Two pathways out of the pandemic The Morrison government and the Anthony Albanese-led opposition have vastly divergent workplace policies as Australia starts to climb out of COVID: Labor’s plan for job security • ‘Job security’ explicitly inserted into the Fair Work Act • rights for gig economy workers through the Fair Work Commission • portable entitlements for workers in insecure industries • casual work properly defined in law • a crackdown on ’cowboy’ labour hire firms to guarantee same job, same pay • a cap on back-to-back short-term contracts for the same role • more secure public sector jobs by ending inappropriate temporary contracts • government contracts to companies and organisations that offer secure work for their employees.

The Morrison government’s IR bill • Suspends the Better Off Overall Test (BOOT) • enables employers to define any employee as a casual with no leave entitlements or job security • allows employers to increase hours for part time employees without an overtime premium • gives employers the power to put part-time employees on the same hours that casuals currently have but at lower pay rates • allows employers to dictate “flexible work directions” to employees to perform new types of work or at new locations • contains penalties for wage theft that are inferior to those found in state laws • allows for Greenfields agreements on new “major” projects (which could be a hospital) that would prevent employees from negotiating better conditions through industrial action for up to eight years.

STOP PRESS As The Lamp goes to print the federal government has been forced to abandon the bulk of its Industrial Relations “omnibus” bill when it was opposed by crossbenchers in the Senate. However, the government hasn’t abandoned it’s IR agenda.

The treasurer, Josh Frydenberg, said the government would continue to advance reforms “where possible”.

THE LAMP APRIL/MAY 2021 | 25

PROFESSIONAL ISSUES

AHPRA warns against anti-vaccine claims There are serious penalties for practitioners who spread COVID anti-vaccination information, including loss of registration.

I

n March, the national medical boards and the Australian Health Practitioner Regulatory Agency (AHPRA) released a joint directive warning doctors, nurses and pharmacists against communicating misinformation about the COVID vaccine, either directly to patients, or via social media.

‘ Nurses have an important role to play in countering misleading and false information’ — Associate Professor Vasiliki Betihavas

Penalties could include losing the ability to practise.

NSWNMA Assistant Secretary, Judith Kiejda, says the AHPRA warning is timely.

“We have all seen the tsunami of pseudo-medical advice floating around on social media during the pandemic. It has never been more important that we, as professionals, provide our communities with sound advice and model appropriate healthpromoting behaviours,” she said.

“The Association is aware that some nurses and midwives are spreading outlandish conspiracy theories from questionable sources on the internet. Nursing and midwifery are professions that are proudly rooted in science. There is no room in our professions for this quackery.”

Experts point out that nurses have professiona l a nd lega l 26 | THE LAMP APRIL/MAY 2021

responsibilities to practice evidencebased medicine.

“Nurses are guided by the ethical and legal requirements of the profession,” says Associate Professor Vasiliki Betihavas from the ACU’s School of Nursing, Midwifery and Paramedicine.

“Policy and procedures are developed from the best available evidence [and] it is a requirement that nurses abide by policy and procedures set by governing bodies and local health districts.

“To promote safe nursing practice, critical reasoning is paramount. Safe nursing practice requires nurses to be guided by evidence with continuous evaluation and ongoing critique.”

BE A ROLE MODEL In light of research suggesting significant levels of hesitancy around the vaccine for COVID-19, nurses have an important role to play in countering misleading and false information, according to Associate Professor Betihavas.

“In Australia, each state has an approved health website. We encourage nurses to refer queries that individuals in the community may have to that website, and to encourage their colleagues to also refer to peer-reviewed literature.”

In a recent interview with the ABC, vaccine hesitancy expert Professor Julie Leask, from the University of Sydney School of Nursing, also emphasised the need to listen to people’s

PROFESSIONAL ISSUES

‘ There is no room in our professions for this quackery.’

— Judith Kiejda

concerns. But she advised to not “go overboard” arg uing every point.

“We can all too easily get bogged down in fact-for-fact debates about safety and the vaccines,” she said.

She said it might be helpful to explain to anyone worried about the testing and approval of vaccines that “the trials are very large and safety issues are being monitored carefully”.

But she says it is important to acknowledge people may have legitimate worries, and it is best to “avoid overconfidence until we learn more from the vaccine trials”.

She suggests nurses consider acting as an example for anyone concerned about immunisation.

“Right now, it might be enough to say, ‘I plan to get one if it’s recommended for me’ and act as a positive role model.” n

Challenging COVID misinformation with the facts Experts say it is better to challenge misinformation where it appears.

“Rather than demanding the deplatforming of the people who post misinformation, we might instead think of it as an opportunity to correct misperceptions in front of the audiences that really need it,” Adam Dunne, associate professor at the University of Sydney wrote in The Conversation.

Here are some useful websites to find empirically-based information about COVID: Therapeutic Goods Administration provides regular updates to keep consumers, health professionals and sponsors informed of the latest regulatory developments on COVID-19 vaccines. https://www.tga.gov.au/ covid-19-vaccines

The World Health Organization website contains a lot of easy-tounderstand information, including the facts behind a number of Coronavirus myths. www.who.int/ emergencies/diseases/ novel-coronavirus-2019 Is it true? This Australian Government Department of Health website provides accurate, evidence-based answers to questions about COVID-19 vaccines. https://www.health.gov.au/ initiatives-and-programs/ covid-19-vaccines/ covid-19-vaccines-is-it-true The NSW Health website – provides information about the COVID-19 rollout in NSW. www.health.nsw.gov.au/ infectious/covid-19/vaccine

Pharmaceuticals are strictly regulated in Australia Medicines and medical devices used in the Australian marketplace are subject to rigorous oversight by the Therapeutic Goods Administration (TGA) – part of the federal Department of Health.

The TGA approves and regulates products based on an assessment of risks against benefits. Lowrisk products may be safely sold through supermarkets, while higher risk products may only be supplied with a prescription.

Before a COVID-19 vaccine is approved for use in Australia, it must pass the TGA’s rigorous assessment and approval

processes. This includes assessment of its safety, quality and effectiveness.

The TGA actively monitors COVID-19 vaccine development, both in Australia and around the world, and is also part of a network of international regulators that meet regularly to discuss the development of COVID-19 vaccines.

The TGA has not approved any medicines for the treatment of COVID-19, including hydroxychloroquine.

The TGA says hydroxychloroquine is “restricted to the following

medical specialties as per the Medical Board list: dermatology; intensive care medicine; paediatrics and child health; physician; and emergency medicine”.

The TGA says it “strongly discourages the use of hydroxychloroquine outside of its current indications”.

There are concerns that the use of hydroxychloroquine outside of its recommended specialties would impact on the health of those who need it to manage existing chronic conditions.

THE LAMP APRIL/MAY 2021 | 27

PROFESSIONAL ISSUES

Nurse Practitioners done over by medical cartel The final report of the Medicare Benefits Schedule Taskforce Review (MBSTR) is “a perverse, offensive and oppressive rejection of nurses”, say experts.

A

rev iew commissioned in 2 01 5 to better a lign Medica re w it h “contemporary clinical evidence, practice and improved health outcomes for patients” has, stunningly, rejected every one of the 14 recommendations of its own Nurse Practitioner Reference Group (NPRG).

The MBSTR had 43 working parties exploring specialty areas, almost all headed by medical doctors, and five reference groups, including a Nurse Practitioners Reference Group (NPRG). The taskforce of 15 mostly medical doctors then deliberated on the recommendations.

The 14 evidence-based recommendations by the NPRG sought to broaden the range of nurse practitioner (NP) services subsidised through the Medicare Benefits Schedule (MBS), in order to encourage the growth of the nurse practitioner workforce.

The recommendations focused on four key areas: • s upporting comprehensive and coordinated care for people with long-term health conditions and Aboriginal and/or Torres Strait Islander peoples

28 | THE LAMP APRIL/MAY 2021

‘ It is unfathomable why the MBSTR should reject all 14 recommendations of a reference group they chose and instructed.’

— Mary Chiarella

• enabling NP care for all Australians • a ddressing system inefficiencies caused by current MBS arrangements and • i mproving patient access to telehealth services.

The taskforce instead proposed t hree recommendations t hat further restrict the practice of NPs who provide services subsidised by the MBS. Two academics, Mary Chiarella – a former NSW chief nursing officer, and Jane Currie – associate professor in Nursing at Queensland University of Technology, slammed the report, describing it as “a decision not to invest in nursing and the health of Australian communities”.

“It is unfathomable why the

MBSTR should reject all 14 recommendations of a reference group they chose and instructed, a set of recommendations that sought to expand the role of NPs and m a ke t hei r s er v ic e s more accessible,” they said.

MEDICAL CLINICIANS “A VESTED-INTEREST GROUP” Chiarella and Currie point out that the NPRG was meticulous in its analysis of MBS data, as well as referencing evidence-based data from the literature, and clinical guidelines from peer-reviewed nursing and medical journals and other sources.

“Research evidence tells us that NPs provide quality care, that patients are highly satisfied with their care and that NPs

PROFESSIONAL ISSUES

A blow to our profession Nurse Practitioner Lesley Salem says she and her colleagues are devastated by the MBS Taskforce Review.

have increased access to health services,” they wrote in the online journal Pearls and Irritations.

“Other studies have demonstrated that NPs prevent presentations to EDs and that their expertise is drawn on significantly by the multidisciplinary teams.”

NPs, they point out, “have been at the forefront of emergency relief work during the NSW bushfires and in front-line acute care, aged care services, quarantine camps and international aid work in the Western Pacific during COVID-19”.

P rofe s sor Ji l l W h ite, a former dean of the Faculty of Nursing and Midwifery at the University of Sydney, was highly critical of the bias in the report from medical clinicians who “are far from independent voices but rather highly vestedinterest groups”.

“Nurses have put up with medical doctors’ organisations presuming to speak on our behalf for too long. Too long have medical doctors been the only health professionals setting policy direction and shaping funding models and controlling access,” she said. n

“In this modern world where evidence is important, it was inconceivable that none of the recommendations were accepted,” she says.

Lesley says the report will impact negatively on the delivery of care to underserved and marginalised communities.

“MBS items are devised for the public to be able to access care.

(The Taskforce) is denying the Australian public a choice in the type of care they can access and who delivers that care.

“As for marginalised groups such as the Aboriginal and Torres Strait Islander people, the homeless and those in remote Australia, they continue to be severely disadvantaged by the rejection of our MBS item requests.

“Many nurse practitioners work with these vulnerable groups. NPs can’t do an MBS health check, which would normally, legally, lead to a care plan that allows for referral to allied health, psychology and other services. An NP’s referral to these services results in the client having to pay for them. Marginalised groups cannot afford to do this.”

NPs will not take this decision lying down, Lesley says.

“The medical model for closing the gap in healthcare disparities has failed thus far. We need other models of care, nursing models of care, to be truly effective.

“We realise we have to be on the front foot and not accept the current discrimination.

“The Australian College of Nurse Practitioners is working tirelessly for us and they have our full support.

We also know we have incredible support from all the other nursing organisations, with over 40

signatures supporting our protest letter to (Federal Health Minister) Greg Hunt.”

“It is time that the government listened to one of the largest workforces in the country.

A blow to us is a blow to the respect of our profession.”

‘The medical model for closing the gap in healthcare disparities has failed thus far.’

— Lesley Salem

THE LAMP APRIL/MAY 2021 | 29

PROFESSIONAL ISSUES

It’s the system, stupid!

Violence in hospitals can’t be tackled without addressing underlying systemic causes, including inadequate staffing levels, poorly designed hospital environments, and lack of communication between different parts of the sector, according to a new report.

A

new study has found that a complex matrix of factors contribute to the creation of violence in the NSW public health system.

The study, Understanding and preventing work-related violence in hospital settings: A systems thinking approach, was funded by SafeWork NSW and carried out by the Centre for Human Factors and Sociotechnical Systems.

‘ This approach gives us an important opportunity to engage with SafeWork NSW on the issue of employer’s responsibilities to provide a safe working environment in a much more systemic way.’

NSWNMA Assistant General Secretary, Judith Kiejda, said the Association welcomes the report.

— NSWNMA Assistant General Secretary Judith Kiejda

“Ensuring safe workplaces for nurses is one of our most urgent priorities. This report demonstrates the multiple and systematic factors that must be addressed to eliminate violence in hospitals,” she said.

“Violence prevention must be given a higher priority by the employers in our sector as well as by our safety regulator,” Judith said.

The 2019 survey of NSW nurses and midwives found that close to half had experienced an episode of violence during the previous week.

The report also cites research that found assaults on healthcare workers have been increasing over the past two decades.

Yet, there have been no WHS prosecutions in a health setting since 2007.

30 | THE LAMP APRIL/MAY 2021

The risks of working in a healthcare setting have been highlighted over the past 18 months: tragically, two nurses have lost their lives at work. Other nurses have suffered injuries such as multiple skull fractures or broken ribs. The NSWNMA has called for the regulator to take a more interventionist approach to ensure employers actively work to provide staff with a safe workplace.

A NEW ROAD MAP WITH AN EVIDENCE-BASED APPROACH This report provides a road map for an evidence-based approach to identifying and addressing the multiple causes of workplace violence. It finds that work-related violence is not a problem solely related to patients, healthcare workers, and security staff.

“Work-related violence in hospital settings is created by an interacting network of contributory factors that spans all levels of hospital systems from the operational front-line (healthcare worker, equipment and environment) all the way up to, and

PROFESSIONAL ISSUES

Read the report Understanding and preventing work-related violence in hospital settings: A systems thinking approach: https://www.safework. nsw.gov.au/resourcelibrary/health-careand-social-assistance/ understanding-andpreventing-work-relatedviolence-in-hospitalsettings-a-systems-thinkingapproach-final-report

including, regulation, government and relevant international bodies,” the report authors write.

“This approach gives us an important opportunity to engage with SafeWork NSW on the issue of employer’s responsibilities, to provide a safe working environment in a much more systemic way,” Judith says.

“For example, we know that forty per cent of the incidents of violence in hospitals happen in a mental health unit. But the reduction in mental health intensive care beds across the state in recent years, from 62 to 50, as well as the lack of appropriate beds and staff settings for high-risk patients in regional areas, are systemic issues that need to be addressed.”

Judith says the report rightly finds that there are systemic communication problems when a patient flagged in one part of the health system isn’t communicated to other parts of the system. In a recent case a patient who was known to be high risk at one Sydney hospital, presented at the emergency department at a second Sydney hospital and injured five members.

“The report highlights systemic issues around communication and lack of responsiveness between and within sectors. The report also gives us the framework for addressing the root problems when, for example, a particular LHD is chronically unresponsive to safety issues and SafeWork notifications,” she said.

Judith says the report highlights the weakness of approaches that deal with workplace violence only when incidents occur, and only by looking at the immediate environment.

“Asking questions such as ‘Who upset the patient who was violent?’ or ‘Do we need to do some extra training in this department?’ or ‘Do we need to install an extra duress alarm?’ can be helpful, but they don’t address the systemic issues that are leading to violence in the first place.”

NOT ENOUGH EXPERIENCED MENTAL HEALTH NURSES One of the biggest systemic issues the report highlights is that there just aren’t enough healthcare workers, particularly experienced mental health nurses, to manage patient care with safety, Judith says.

“We constantly see patients who are known to be high risk, and who are very agitated, in facilities that just don’t have enough staff or the appropriate physical environments.

“The report highlights the need for higher nurse ratios, and funding for those speciality areas.”

Jud it h s ay s t he rep or t recommends that an external multiagency group be convened to look at what needs to happen to implement the report’s recommendations.

“The NSWNMA will be asking to have a seat at the table in any multiagency body, alongside the Ministry of Health, SafeWork, representatives of LHDs, private hospital employers and police.”

Judith says the report is a “significant” improvement on the recently released Anderson report: Improvements to security in hospitals.

“Its main recommendation was increasing the presence of security staff in hospital settings. This completely ignores the causes of violence in the first place, the huge cost of security, and the needs of regional areas and small hospital settings, where security is often just not available.” n THE LAMP APRIL/MAY 2021 | 31

YOUR RIGHTS

Ask

Judith Let’s be kind to one another Easter is here, winter is around the corner, COVID-19 vaccines are rolling out. A sense of relative calm. But International Women’s Day came and went on 8 March – ironically and very sadly drowned out by a backdrop of public debate and media coverage of toxic workplace cultures that ‘tolerate’ sexual harassment and worse, starting at our nation’s parliament. But our own workplaces are not immune.

We await results from the 2020 People Matter Employee Survey, but let’s reflect on the 2019 results. In answer to the question: “In the last 12 months I have been subjected to physical harm and/or sexual harassment or abuse at work”, six per cent of public health workers responded yes! In answer to the question : “In the last 12 months I have witnessed bullying at work”, incredibly 39 per cent stated yes.

21 per cent said they had been subjected to bullying in the previous twelve months.

NSW Health results are worse in these areas than the rest of the public sector and have been for years. Why? Why is it that patients or visitors often engage in such behaviour towards nurses and midwives? Why is it that we or other health colleagues can sometimes treat each other unkindly?

A stressful environment? Patients and families feeling at their worst?

Overworked? Understaffed?

Budgetary pressures? No respect?

A sense of entitlement?

And worse, calling out these behaviours is not so easy. When someone comes forward to make their voice heard, they are often victimised all over again via the “investigation/grievance process”.

We just need to do better.

32 | THE LAMP JUNE / JULY 2020

Vaccination Special Who is responsible for what during the Phase 1a rollout?

The NSW Government, via NSW Health, is responsible for administering the vaccine to identified priority health staff, quarantine workers, COVID clinic staff and testers, emergency personnel including ambulance and the like. The Commonwealth Government is responsible (via contracted providers) to deliver the vaccine to aged care residents and staff.

Do I have to take time off work to get vaccinated?

Public health staff will be scheduled for vaccination appointments during rostered hours. If this is not possible, paid time/award entitlements will apply if outside ordinary hours. As the Commonwealth is delivering the vaccine directly at Aged Care facilities, staff should be able to access these in work time.

If I don’t take up the offer to be vaccinated in Phase 1a, will I be deployed to work in another location?

The Commonwealth Government has to date advised that COVID-19 vaccination is not mandatory.

Therefore, the rights of an employer to compel its staff to be vaccinated are very limited, i.e., there is no public health order legally requiring it.

Accordingly, the Ministry of Health, for example, has said it has no current intention to seek or require staff to be redeployed who do not take up the opportunity to be vaccinated during Phase 1a.

Will this approach change?

The approach of not making vaccination mandatory could well be re-considered if the risk of community transmission of COVID-19 changes, or more evidence regarding vaccine efficacy in reducing transmission emerges, especially in high-risk settings. This will be determined based on health advice provided to the Commonwealth Government and/or NSW Government.

Do I need any extra training as a nurse to administer the COVID-19 vaccine?

Core COVID-19 training modules have been developed by the Commonwealth Department of Health in partnership with the Australian College of Nursing. Additional training modules have been similarly developed specifically for the supply and administration of the Pfizer and AstraZeneca® vaccines. These are mandatory to complete prior to any involvement in a vaccination program.

Can I choose which COVID-19 vaccine I will receive?

The type of COVID-19 vaccine offered will depend on a number of variables, including which priority group the person is part of, the person’s work or residential location, and the quantity/supply of vaccine available. It is currently anticipated that the AstraZeneca® vaccine will be the predominant one used. It does not require the same refrigeration requirements of the Pfizer vaccine.

This will make storage and distribution easier and more widespread.

At present, it is recommended that you have two doses of the same COVID-19 vaccine to be adequately immunised.

YOUR RIGHTS

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

What are the postvaccination observation requirements?

All vaccine recipients must be observed for a minimum of 15 minutes post-vaccination. However, for persons with an allergic history or other medical compromise, it would be generally for 30 minutes.

Vaccination clinics/points must have the appropriate equipment and be clinically prepared to manage any case of anaphylaxis.

Will I still need to wear PPE at work after vaccination?

Can I get the regular flu vaccine around the same time as the COVID-19 vaccine?

This is a very topical question as we approach winter. At this stage the expert advice is that the preferred minimum interval between administration of either the Pfizer or AstraZeneca® vaccines and any influenza vaccine is 14 days.

Who falls into Phase 1b?

The Commonwealth Government has announced that the following persons fall into this phase: adults

A on c ppl 31 los ica JU e 5 tion LY PM s 20 21

Vaccination is only one additional layer of protection. So at least in the short term while we monitor and track vaccine efficacy, duration of

effect and impact on transmission, we will still need to continue with all recommended PPE measures in place to control COVID-19.

aged 70 years and over; other healthcare workers not included in Phase 1a; Aboriginal and Torres Strait Islander people older than 55 years; other adults with an underlying medical condition warranting vaccination; other critical or high-risk workers (e.g., defence, police, fire, meat processing).

More information COVID-19: administration of vaccination FAQs https://thelamp.com.au/ professional-issues/covid19/ covid-19-administration-ofvaccination-faqs/

Scholarships for the academic year 2022 Applications for the Edith Cavell Trust Scholarships are being accepted from 1 May 2021, closing 31 July 2021, for studies being undertaken in the academic year 2022.

Members or Associate Members of the NSW Nurses and Midwives’ Association or the Australian Nursing and Midwifery Federation (NSW Branch) are invited to apply.

All grants, awards or loans shall be made to financially assist nurses, midwives, assistants in nursing, assistants in midwifery (including students of those disciplines), and accredited nursing or midwifery organisations, schools and faculties in the furtherance of: (i) accredited nursing or midwifery studies; (ii) such academic research programs as are approved by the Trustees in the theory or practice of nursing or midwifery work; or (iii) clinical nursing or midwifery education programs at graduate, post-graduate and continuing education professional development level; in accordance with a number of categories.

www.nswnma.asn.au CLICK ON ‘EDUCATION’

Full details of the scholarship categories, how to apply and to obtain the official application form is available from the NSWNMA website. Prior to applying, please ensure you have read the Edith Cavell Trust Scholarship Rules.

FOR FURTHER INFORMATION CONTACT: SCHOLARSHIP COORDINATOR, THE EDITH CAVELL TRUST 50 O’Dea Avenue, Waterloo NSW 2017 T 1300 367 962 E edithcavell@nswnma.asn.au THE LAMP JUNE / JULY 2020 | 33

NSWNMA

RS A N I B E W E V LI

bit.ly/educationNSWNMA PROFESSIONAL EDUCATION WEBINARS: Medication Principles Fri 9 April, 2pm Communication: ISBAR & Workplace Communication Tue 13 April, 11.30am Law in Nursing & Midwifery Practice Wed 14 April, 10am Documentation & Report Writing Mon 19 April, 11am Professional Obligations for nurses & midwives Wed 5 May, 5pm Ethics in Nursing & Midwifery Practice Wed 12 May, 2pm Applying Aseptic Non-Touch Technique (ANTT) Tue 18 May, 11am Communication: Clinical Handovers & Assessments Fri 28 May, 11am High Risk Medications & Medication Regulation Fri 4 June, 11am Continuing Professional Development (CPD): Know Your Annual Obligations Thu 10 June, 2pm Nursing & Midwifery Board of Australia (NMBA) Code(s) of Conduct Tue 22 June, 5pm Additional webinars may be added during this period. Keep an eye on the education page and education emails from the Association.

We are resuming face-to-face education in a number of locations. As the situation with COVID-19 continues to evolve in NSW, we will continue to tailor the education we provide.

WATERLOO:

Introduction to Mental Health, Fri 16 April, 9am – 4.30pm, 6 CPD Hours Self-Leadership Experience, Tue 20 April, 9am – 4.30pm, 6 CPD Hours Know Your Annual CPD Obligations, Thu 22 April, 9am – 12pm, 3 CPD Hours The Deteriorating Patient, Thu 6 May, 9am – 4pm, 6 CPD Hours Risk Assessments & Risk Management in Aged Care, Wed 12 May, 9am – 3pm, 5 CPD Hours Know where you stand with Law, Ethics & Professional Standards in nursing & midwifery, Thu 20 May, 9am – 4pm, 6 CPD Hours

BLACKTOWN:

Clinical Communication & Documentation, Wed 28 April, 9am – 4pm, 6 CPD Hours

WOLLONGONG:

Wound Care Essentials, Wed 19 May, 9am – 4.30pm, 6 CPD Hours

June sessions also now available, Waterloo & Newcastle. Numbers in all our face-to-face courses are strictly limited. Cost of face to face education: Sessions 5 CPD hours and over: $95 members / $190 non-members. Sessions 4 CPD hours and less: $50 members / $100 non-members.

Search our upcoming education at bit.ly/educationNSWNMA CPD hours for these courses can be calculated by the time you spend actively learning. This will vary between individuals, as further

34 | THE LAMP APRIL/MAYself-directed 2021 learning can be included (e.g. reviewing the associated resources and completing the reflective questionnaires).

start your career in 2021 A webinar series for early career nurses & midwives

PROFESSIONAL EDUCATION

Critical Thinking, Problem Solving & Situational Awareness The NSWNMA is hosting a webinar series to support nurses and midwives in their first years of professional practice. The topics presented will assist in advancing your career as a nurse or midwife.

The webinars will be held every second month from April 2021 and there will be plenty of opportunities for you to ask questions to the presenters.

Professional Obligations Wednesday 21 April 2021 at 1430 As registered nurses or midwives, you must adhere to the standards, codes, guidelines and frameworks set by the Nursing and Midwifery Board of Australia (NMBA).

This webinar will provide an overview of the professional obligations relating to nursing and midwifery. It will explore professional accountability and responsibility, delegation and supervision, and scope of practice.

Clinical Communication & Documentation Wednesday 16 June 2021 at 1430 The exchange of information needs to be clearly understood by all parties involved. Shared intelligence ensures quality care and patient safety.

This webinar explores the importance of the legal and ethical frameworks around communication and documentation, and how they govern nursing and midwifery practice. It will help you develop the knowledge and resources to understand and communicate professionally, and comprehensively.

Wednesday 18 August 2021 at 1430 During the process of critical thinking, ideas should be reasoned, well thought out and judged.

This webinar will guide you to become an effective critical thinker within the practice setting (using the decision-making framework). It will also help you develop an understanding of how critical thinking and situational awareness are interlinked.

Appropriate Workplace Behaviour & Assertive Communication Techniques Wednesday 20 October 2021 at 1430 Assertive communication is based on mutual respect, targeting problems rather than people.

This webinar will provide you with a clear understanding of how to be assertive in your communication. You will learn how to use these techniques in your practice, to ensure safe patient care.

Self-Reflection & Feedback Wednesday 15 December 2021 at 1430 Self-reflection is an important part of how we develop professionally as nurses and midwives. By implementing self-reflection – and constructive and supportive feedback – you can grow as a practitioner.

This webinar will guide you through the processes of self-reflection, and help you combine this with constructive feedback to overcome learning gaps and build on your successes.

REGISTER NOW bit.ly/KickstartNSWNMA Can’t attend on these days? That’s okay, still register and we will send you the recording afterwards. All nurses and midwives who have recently THE LAMP APRIL/MAY 2021 | 35 commenced employment are encouraged to attend, even if you’re not yet an NSWNMA member. Feel free to invite your colleagues.

NEWS IN BRIEF

AUSTRALIA

Wages to fall say Australia’s top economists The Australian economy will bounce back with robust growth in 2021, but real wages will continue to fall for the next two years.

Even before the COVID pandemic, wage growth had been stagnant and barely keeping up with inflation.

But now, 22 of the country’s leading economists surveyed by The Sydney Morning Herald/The Age predict that wages will deteriorate further even though the economy is set to boom.

These economists expect the economy to grow by 6.5 per cent in 2021 and by 2.9 per cent in 2022.

Inflation is expected to average 2.7 per cent to the June quarter this year, and then 1.7 per cent over the following 12 months.

But the collective view of the 22 economists is that wage growth – already at a record low of 1.4 per cent – will drop to 1.2 per cent this year and lift to 1.6 per cent in 2022.

The alarming outlook for wages will be compounded by the Morrison government’s industrial relations bill, according to an analysis by a group of independent labour law academics that was submitted to a Senate inquiry.

One of the academics, Prof Andrew Stewart from Adelaide’s law school, said the overall impact of the Coalition’s IR bill was “to put downward pressure on wages and conditions”.

“That’s sending a message to employers that the way in which businesses should be getting through the pandemic and the recession is to cut wages and conditions,” he told The Guardian.

“And every shred of hard economic evidence we’ve got is that the route to recovery should be coming from the opposite direction, from wage rises.”

‘ Every shred of hard economic evidence we’ve got is that the route to recovery should be coming from the opposite direction, from wage rises.’ — Professor Andrew Stewart, Adelaide Law School

36 | THE LAMP APRIL/MAY 2021

AUSTRALIA

Billionaire “bandits” Billionaire wealth in Australia has grown by an “eye-watering” 25 per cent to a record high of $357 billion during the pandemic.

According to the Australian Financial Review, there were 48 more billionaires in 2020 than there were three years earlier – a doubling of billionaires in the last three years.

The Greens leader, Adam Bandt, has called for Australia’s widening inequality to be at the centre of the next federal election. He says the pandemic has meant ordinary people have suffered while “billionaires and big corporations are making out like bandits”.

“Before the pandemic, workers’ share of income in Australia had sunk to the lowest level in history, while corporate profits reached record highs.

“Since then, the pandemic has not just hit our health and our freedom of movement; the pandemic has made inequality worse,” he said.

According to figures released by the Australian Bureau of Statistics, in mid-February over two million Australians were unemployed or underemployed.

The ACTU described the figures as “alarming” and warned they will worsen with the termination of JobKeeper and with JobSeeker payments reduced to $40 a day.

“JobKeeper and JobSeeker have been the backbone that held our economy together during the pandemic and to cut them while entire sectors are still feeling the effect of the crisis is short-sighted and dangerous,” said ACTU President, Michele O’Neil.

“Genuine recovery from the pandemic recession will require comprehensive support, job creation and wage growth.”

‘The pandemic has made inequality worse.’

— Greens leader Adam Bandt

Advertise in The Lamp and reach more than 70,000 nurses and midwives.

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

NEWS IN BRIEF

AUSTRALIA

IR bill “an immediate threat to public health” The attack on casual workers’ leave will exacerbate a weakness in Australia’s COVID-19 response, say experts.

The Morrison government’s industrial relations bill will increase the casualisation of work, impacting workers who are most vulnerable to the coronavirus, and undermining Australia’s COVID strategy, say health specialists.

The ANU Research School of Public Health, in a submission to a Senate inquiry, notes that Australia already has one of the highest rates of individuals without leave entitlements among OECD nations, with estimates ranging from 25 per cent to 37 per cent of the workforce.

“Casual workers are twice affected by the pandemic, due to the absence of leave entitlements, and by being among the lowest paid and insecure workers,” they said.

The public health experts cited modelling that paid leave, including for flu and other infectious diseases, can reduce workplace infections by at least 25 per cent.

They argue casual workers are already at risk of infection and transmission, citing healthcare workers, personal care attendants, cleaners, security guards, abattoir workers, delivery workers, supermarket staff, public transport and taxi drivers, and childcare staff.

STOP PRESS Despite having to retreat on most aspects of it’s Omnibus bill, the government was successful in ramming through its changes to casual work, the very changes that will undermine our COVID-19 response.

CROSSWORD SOLUTION

One of the researchers, Professor Kamalini Lokuge, said “all the evidence shows the changes proposed in this act pose an immediate threat to public health”.

“The proposed changes will undermine our world-class response to COVID by increasing casual employment and insecure working conditions. They will also lead to inadequate protections and lack of access to paid sick leave.”

Quality legal advice for NSWNMA members • Workers Compensation Claims • Litigation, including workplace related claims • Employment and Industrial Law • Workplace Health and Safety • Anti-Discrimination • Criminal, including driving offences • Probate / Estates • Public Notary • Discounted rates for members including First Free Consultations for members

Call the NSWNMA on 1300 367 962

and find out how you can access this great service

Offices in Sydney and Newcastle with visiting offices in regional areas (by appointment) THE LAMP APRIL/MAY 2021 | 37

NEWS IN BRIEF

WORLD

WHO calls for vaccine equity COVID will not be beaten without global solidarity.

The World Health Organization (WHO) has called on political leaders worldwide “to accelerate the equitable rollout of vaccines in every country, starting with health workers and those at highest risk for COVID-19”.

WHO says this requires the scaling up of vaccine manufacture and “rejecting vaccine nationalism at every turn”.

“Due to unprecedented scientific efforts, vaccines are now being distributed in more than 70 countries across the world, with health workers in those places rightly among the first groups to receive them.

“In the majority of low- and middle-income countries, vaccination has not even started, which is a catastrophe as hospitals fill up.

“We must act swiftly to correct this injustice,” it said.

WHO is championing two initiatives – the COVAX facility and the COVID-19 Tools Accelerator.

The COVAX facility is a COVID-19 vaccine and procurement initiative, which aims to ensure poorer countries are able to access doses.

The COVID-19 Tools Accelerator aims to spur the development and distribution of vaccines, treatments and diagnostics. It has a financing gap of $27 billion for 2021.

“This is a fraction of the projected global economic cost of up to $9.2 trillion if governments do not ensure developing economies have equitable access to COVID-19 vaccines,” said Tedros Adhanom Ghebreyesus, director-general of WHO.

‘In the majority of low- and middleincome countries, vaccination has not even started which is a catastrophe as hospitals fill up. We must act swiftly to correct this injustice.’

— World Health Organization 38 | THE LAMP APRIL/MAY 2021

UNITED STATES

US COVID deaths exceed 500,000 Another grim milestone in the world’s richest country as encouraging signs appear elsewhere.

By mid-February, the COVID-19 virus had claimed more than 500,000 lives in the United States after a devastating winter surge, but with signs suggesting that the death rate was beginning to decrease.

The Lancet COVID-19 Commission noted that the US could have averted 40 per cent of the deaths from COVID if the country’s death rates had corresponded with other developed countries.

At the same time, the number of new cases reported worldwide fell 16 per cent in a week, according to the World Health Organization.

The number of new deaths reported also fell 10 per cent over the same period.

Five of the six WHO regions of the world reported a double-digit percentage decline in new cases in February, with only the Eastern Mediterranean showing a rise, of 7 per cent.

“This shows that simple public health measures work, even in the presence of variants,” WHO director-general, Tedros Adhanom Ghebreyesus, said. “What matters now is how we respond to this trend.

The fire is not out, but we have reduced its size. If we stop fighting it on any front, it will come roaring back.”

‘The fire is not out, but we have reduced its size. If we stop fighting it on any front, it will come roaring back.’

— WHO director general Tedros Adhanom Ghebreyesus

NEWS IN BRIEF

AUSTRALIA

Burning down our Super house Allowing super to be used to fund house deposits would inflate prices, make housing affordability worse and drain retirement savings. The only winners would be big banks and property developers.

A “fundamentally flawed” proposal by a group of Coalition MPs to bust open super for first home buyers’ housing deposits could hike the nation’s five major capital city median property prices by between 8–16 per cent, a preliminary analysis from Industry Super Australia (ISA) shows.

According to the ISA analysis, allowing couples to take $40,000 from super would send property prices skyrocketing in all state capitals, but the impact would be most severe in Sydney, where the median property price could lift a staggering $134,000.

“Throwing super into the housing market would be like throwing petrol on a bonfire – it will jack up prices, inflate young people’s mortgages and add billions to the aged pension, which taxpayers will have to pay for,” said Industry Super Australia chief executive, Bernie Deans.

AUSTRALIA

The people speak: “We want action on climate change”

The biggest ever opinion poll on climate change has found two-thirds of people think it is a “global emergency”.

The survey was conducted by the UN Development Programme (UNDP) and questioned 1.2 million people in 50 countries.

The poll found the highest proportion of people saying there is a climate emergency was in the UK and Italy, both at 81 per cent. Australia was at 72 per cent and the US at 65 per cent, the same as Russia, and India was at 59 per cent. Even the lowest proportion, in Moldova, was 50 per cent.

While younger people showed the greatest concern, with 69 per cent of those aged 14–18 saying there is a climate emergency, 58 per cent of those over 60 agreed, suggesting there is not a huge generational divide.

Even when climate action required significant changes in their own country, majorities still backed the measures.

In nations where fossil fuels are a major source of emissions, people strongly supported renewable energy, including the US (65 per cent in favour), Australia (76 per cent) and Russia (51 per cent).

Where the destruction of forests is a big cause of emissions, people supported conservation of trees, with 60 per cent support in Brazil and 57 per cent in Indonesia.

“The voice of the people is clear – they want action on climate change,” said Cassie Flynn, the UNDP’s strategic adviser on climate change.

‘In nations where fossil fuels are a major source of emissions, people strongly supported renewable energy.’

Workers should not have to choose between a home or retirement, says ACTU Assistant Secretary Scott Connelly.

“The government should tackle the causes of unaffordable housing – insufficient supply and low wage growth … rather than force young people to empty their super to compete against each other in the property market,” he said.

‘ Throwing super into the housing market would be like throwing petrol on a bonfire.’

— Industry Super Australia chief executive Bernie Deans

THE LAMP APRIL/MAY 2021 | 39

LUED be Vital VA e b

ANNUALCONFERENCE

e s be Acco g be Knowledg b tive rou ing b m be eO be Conf plished be Ac be gene spiring Moving P b e E R L dent be Courageous B E n A e P a T K I S IMISTIC be pst PEC be ing b be REMAR TE e ble t be Hap eU D be s py be Honoura tiva gressiv pecial b o Pro M be LEGENDARY be be d be Powerful be Prou

ICC, SYDNEY

21–23 JULY 2021

e Intuitive ative b be k nov ind n I e Nurtur

os ab l i nd tive e in

OUR

Moment MAKE IT HAPPEN

COUNT TOWARDS CPD HOURS

9am – 5.20pm

NSW NURSES & MIDWIVES’ PROFESSIONAL DAY ICC Sydney, Pyrmont Theatre & online

SPEAKERS Professor Joseph Ibrahim • Head of the Health

Law & Ageing Research Unit, Monash University Professor Ibrahim is the lead author of Recommendations for prevention of injury-related deaths in residential aged care services.

His work has informed approaches for protecting residents from abuse and poor practices and ensuring proper clinical and medical care standards are maintained and practiced. He was the Sydney Morning Herald Good Weekend’s “People Who Mattered 2019: Health”.

Prof Debra Jackson • AO, RN, PhD, SFHEA,

FACN, University of Sydney • Racism & social justice

Prof Jill White • Professor Emerita, Faculty of

Nursing & Midwifery, University of Sydney & Faculty of Health, UTS • International Year of the Nurse & Midwife

Rob Bonner • Director Operations & Strategy,

ANMF (SA) • Aged care staffing and skills mix report More speakers to be announced

40 | THE LAMP APRIL/MAY 2021

Wednesday 21 July

COST

Early-Bird Rate Full Rate (until Friday 11/6)

(12/6 – 11/7)

Members

$110

$160

Non-members

$160

$240

Retired associate members $75 and student members

$100

Branch Officials

Free

Free

Online conference registration

$60

$120

Register now! nswnma.info/profday21 REGISTRATION CLOSES Sunday 11 July PROFESSIONAL DAY IS GOING ONLINE! Online conference registration closes 5pm, Tuesday 20 July.

NURSING RESEARCH AND PROFESSIONAL ISSUES The Australian Journal of Advanced Nursing (AJAN) is the peer-reviewed scholarly journal of the Australian Nursing and Midwifery Federation (ANMF). The mission of AJAN is to provide a forum to showcase and promote a wide variety of original research and scholarly work to inform and empower nurses, midwives and other healthcare professionals, to improve the health and wellbeing of all communities and to be prepared for the future.

“Taking our blindfolds off”: acknowledging the vision of First Nations peoples for nursing and midwifery Juanita Sherwood, Roianne West, Lynore Geia, Ali Drummond, Tamara Power, Lynne Stuart, Linda Deravin “You need to take your blindfolds off and come back to the fire.”

These were the words of a First Nations Elder and a custodian of the sacred fire speaking to Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) delegates and educational researchers during a recent visit to the Aboriginal Tent Embassy in Canberra.

These words called to us to remember and to acknowledge our ways of knowing, doing and being as First Nations health professionals and researchers. They also called to all who were present to critically reflect on our professional stance and practices as nurses, midwives and researchers in the light of the fire.

These words are a reminder of the importance of our shared role and responsibility to continue to challenge racism and oppressive practices in Australian healthcare for transformation and for better health outcomes for First Nations Peoples.

Decolonising nursing and midwifery research and education is a clear transformational reform process to address oppressive practices and racism, including attitudes, ignorance and bias, generalisations, assumptions and uninformed opinions, and commit to developing and embedding cultural safety in the nursing and midwifery professions. https://www.ajan.com.au/index. php/AJAN/article/view/413/94

Identifying barriers and facilitators of full-service, nurse-led early medication abortion provision: qualitative findings from a Delphi study Caroline de Moel-Mandel, Ann Taket, Melissa Graham A lack of skilled abortion providers, particularly in regional and rural areas, is globally one of the most critical barriers for women accessing safe abortion services.

Using medication rather than surgical abortion methods, the pool of abortion service providers can potentially be expanded, in particular within the primary healthcare (PHC) sector. However, in Australia, where medication abortion has been available since 2012 for abortions up to 63 days’ gestation, the uptake of medication abortion provision among regional and rural general practitioners (GP) remains low.

In Australia, most abortions are costly and are provided in metropolitan-located private practices, which limits the access to abortion services for women residing in regional and rural areas. The provision of medication abortion in the PHC setting within the legal gestational timeframe of 63 days could improve this situation.

While EMA has been widely available in Australia since 2012, to date, only a small number of regional and rural GPs are certified prescribers. Increasing the tasks of associate health workers in the EMA provision process would not only address the shortage of EMAproviding GPs and the multi-phase, time-consuming aspect of the EMA process, but also remove the need for women to travel long distances to specialised abortion clinics.

This public health strategy is endorsed by the World Health Organization and is currently applied in a number of countries.

Qualitative determination of occupational risks among operating room nurses Ülfiye Çelikkalp, Aylin Aydın Sayılan Due to their different working conditions, hospitals are classified as very dangerous workplaces in terms of personnel safety under the Turkish Workplace Health and Safety Directive. The International Council of Nurses has also drawn attention to safety at work in hospitals.

By the nature of their occupations, health sector workers experience occupational health problems for reasons such as exposure to various biological, chemical and ergonomic risks arising from close contact with patients, antineoplastic agents, and iodising radiation.

In addition, particular concerns have been raised concerning staff health and safety due to high levels of occupational hazards faced by health staff and compensation demands. As in all workplaces, knowledge of existing or anticipated risks, and the planning and application of preventive measures, must constitute the basic approach in the operating room.

One of the most important and severe risks faced by health workers is needlestick and sharps injury (NSSI), reported at levels ranging between 23 and 68.5 per cent in different studies.

Other hazards include the risks associated with contact with patient blood or body fluids as a result of such injuries, including contracting Hepatitis HCV and HBV or Human Immunodeficiency Virus (HIV). In that context, health workers appear to be a susceptible/vulnerable occupational group in terms of exposure to occupational diseases and associated risks. https://www.ajan.com.au/index. php/AJAN/article/view/104/89

https://www.ajan.com.au/index. php/AJAN/article/view/144/88 THE LAMP APRIL/MAY 2021 | 41

The 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, midwives and assistants in nursing/midwifery through further studies and research, made available through scholarship. The knowledge and expertise gained by nurses, midwives and assistants in nursing/ midwifery, supported by the Edith Cavell Scholarships, is an asset to the care of their patients and clients. Bequests to the Trust continue to support this important work.

Edith, a British nurse serving in Belgium in WW1, is a hero to most nurses and midwives. She helped some 200 Allied soldiers escape from German-occupied Belgium. Her actions saw her arrested, accused of treason, found guilty by a court-martial and sentenced to death. Despite international pressure for mercy, she was shot by a German firing squad.

NAME ADDRESS

EMAIL

Cavell Edith

TRUST BEQUESTS

PHONE

BEQUEST/ DONATION AMOUNT

$

PREFERRED METHOD OF PAYMENT Electronic Fund Transfer Account name: Edith Cavell Trust Bank: Commonwealth Bank BSB: 062-017 Account no: 10017908 Credit Card I authorise the Edith Cavell Trust (processed via NSWNMA) to debit my credit card for the amount of Mastercard

$

Name on Card

Visa

Card no

Expiry Date

/

Signature of Cardholder

NSWNMA

Hoodies $50

Keep warm with NSWNMA hoodies – stylish, comfortable, affordable and sold at cost to members

Red or navy Sizes: ladies 10, 12, 14, 16 unisex S, M, L, XL, 2XL, 3XL 80% cotton/20% poly brushed fleece, kangaroo pocket with full lining hood

$10

FREE POSTAGE

$60

Spend $60 and over to receive

42 | THE LAMP APRIL/MAY 2021

er

po

st d ag e for rders un o

ORDER VIA

MEMBER CENTRAL

LOGIN @ WWW.NSWNMA.ASN.AU

CROSSWORD

test your

Knowledge 1

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ACROSS 1. Any of several types of lymphoma characterized by formation of malignant large lymphocytes in a diffuse pattern (5.4.8) 9. A curved bone forming the wall of the thorax (3) 10. An alkaloid used to treat erectile dysfunction (9) 12. A round edible seed (3) 13. Gluteus maximus (4) 14. A unit of radioactivity (1.1.1) 15. Arrogance (13) 18. Became powdery by losing the water of crystallization on exposure to a dry atmosphere (11) 19. Parturition (5)

20. A bluish mottling of the skin evoked by low temperatures (6.11) 23. An intestinal disease with symptom resembling those of appendicitis, occurring chiefly in children and young adults (11) 26. Set up, establish (7) 27. Dried leaves which contain nicotine (7) 30. The central organ of the body (5) 31. A gene that encodes angiogenin (3) 32. Anterior opening to the nasal cavity (5) 33. Thrix (4) 34. Huntington disease is a type of this gene disorder (9.8)

DOWN 1. A voice disorder which chokes off words as uttered, resulting in strained and strangled speech (9.8) 2. Tularaemia (6.5) 3. Reddish in colour (9) 4. Epidural Hematoma (1.1.1) 5. Specialised white cells concerned in the body's immune system (11) 6. Having not yet learned to speak: (9) 7. Adversary, opponent (7) 8. A physician trained in administering anesthetics during surgery (17) 11. Ochratoxin A (1.1.1) 16. Take or consume (3) 17. Indecisiveness, irresolution (10) 21. Any of various aerobic bacteria that can fix atmospheric oxygen (9) 22. An area outside of cities (5.4) 24. Cuts with a knife (7) 25. A large, often destructive, sea wave (7) 28. Treated by heating to a high temperature but below the melting point (5) 29. Umbilicus (5)

THE LAMP APRIL/MAY 2021 | 43

INSURANCE BENEFITS

For NSWNMA Members

Insurance protection when you need it most The NSWNMA is committed to protecting the interests of nurses and midwives by purchasing a range of insurances to cover members.

Journey Accident Insurance provides cover for members who are injured as a result of an accident while travelling between their home and their regular place of employment.

Professional Indemnity Insurance provides legal representation and protection for members when required.

Make sure your membership remains financial at all times in order to access the insurance and other benefits provided by the NSWNMA.

Unsure if you are financial?

It’s easy!

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

www.nswnma.asn.au 44 |

IMPORTANT NOTE From 1 December 2018 the insurance benefits have changed as follows: • Journey Accident Insurance: the waiting period for benefits is now 14 days • Professional Indemnity Insurance: the limit per claim is now $5 million THE LAMP APRIL/MAY 2021

REVIEWS

book club

All books can be ordered through the publisher or your local bookshop. Call 8595 1234 or 1300 367 962, or email library@ nswnma.asn.au for assistance with loans or research. Books are not independently reviewed or reviewed using information supplied by the publishers.

C

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Rachel Clarke Hachette Australia: RRP: $32.99 ISBN 9781408713778

INTE IAL

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Breathtaking

Rising Heart Aminata Conteh-Biger with Juliet Rieden Macmillan Australia RRP $34.99 ISBN 9781760784966

One woman’s astonishing journey from unimaginable trauma to becoming a power for good.

Brutally kidnapped from her father’s house by rebel soldiers.

Resettled in Australia as a refugee.

Now helping mothers and babies in Sierra Leone.

‘The best and the worst of our shared humanity … breathtaking and heartbreaking.’ The Hon. Dame Quentin Bryce AD CVO.

Old Seems To Be Other People Lily Brett Penguin Random House RRP $24.99 ISBN 9781761042348

Sparkling with wit and wisdom, Old Seems to be Other People is a collection of essays by Lily Brett that explores the hilarity, challenges and poignancy of getting older. In this disarming and gently self-deprecating collection of vignettes about ageing, Lily Brett gives us snapshots of her everyday life in New York. After waving enthusiastically to a tall, greyhaired woman she has mistaken for her husband and avoiding a large dog that turns out to be a fire hydrant, Lily has to concede that her ophthalmologist is right: she does need cataract surgery.

While at a café with her husband, she’s transfixed by a speed-dating dinner in progress at the other end of the café. She moves closer and watches. The event manager tells her they also have speed-dating dinners for seniors.

R

IA When the once-in-a-century pandemic struck, it didn’t L IN T E matter that it was predicted and expected. We ambled, halfasleep, into disaster. Economies nosedived. Whole societies shut down.

As a palliative care doctor, Rachel Clarke found herself spending less time in the hospice and more in the hospital. Unable to convey the intensity of her days on the wards to friends and family, by night, she wrote about what she and her colleagues were going through. Breathtaking is her inside story of how the health service responded. But when she looked back over her writing, she found that what she had thought was an unrelenting stream of death and darkness was in fact illuminated by pinpricks of light. The curtailing of human contact, it seemed, was a reminder of precisely how precious it was, and just how far a little of it could go.

The Chase Candice Fox Penguin Random House RRP $32.99 ISBN 9781760896799

The new novel by New York Times #1 bestselling Australian author Candice Fox is an electrifying cat-and-mouse thriller set in the Nevada desert.

Candice Fox has been described by the Sydney Morning Herald as “one of the finest new gen crime writers” and her latest is another thrilling ride, as a mass prison breakout lets loose 650 of the country’s most dangerous prisoners.

THE LAMP APRIL/MAY 2021 | 45

46 | THE LAMP APRIL/MAY 2021

REVIEWS

at the movies

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EMBER

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It is deep autumn and Sam (Colin Firth) and Tusker (Stanley Tucci), partners of twenty years, are on holiday. They are travelling across England in their old campervan visiting friends, family and places from their past.

Since Tusker was diagnosed with young-onset dementia two years ago their lives have had to change. Jobs have been given up and plans put on hold. Their time together is now the most important thing they have. As the trip progresses however, their individual ideas for their future begin to collide.

Secrets are uncovered, private plans unravel and their love for each other is tested like never before. Ultimately, they must confront the question of what it means to love one another in the face of Tusker’s irreparable illness.

In cinemas April 15.

Email The Lamp by 12 April to be in the draw to win one of 10 double passes to Supernova thanks to Madman Entertainment.

Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

IE

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GIV E

In June Again, a twist of fate gives family matriarch June (Noni Hazlehurst) a reprieve from an ongoing illness.

Much to their amazement, June re-enters the lives of her adult children, Ginny (Claudia Karvan) and Devon (Stephen Curry), and learns that “things haven’t gone according to plan”. With limited time but plenty of pluck, she sets about trying to put everything, and everyone, back on track. When her meddling backfires, June sets out on a romantic journey of her own and discovers she needs help from the very people she was trying to rescue.

In cinemas 6 May. Email The Lamp by 30 April to be in the draw to win one of 10 double passes to June Again thanks to StudioCanal.

Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

It’s 1981, the start of a new decade, and Ritchie, Roscoe and Colin begin a new life in London. Strangers at first, these young, gay lads, and their best friend Jill, find themselves thrown together, and soon share each other’s adventures.

EMBER AY

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Supernova

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But a new virus is on the rise, and soon their lives will be tested in ways they never imagined. As the decade passes, and they grow up in the shadow of AIDS, they’re determined to live and love more fiercely than ever.

Released to DVD on 23 April.

Email The Lamp by 30 April to be in the draw to win one of 10 dvds of It’s a Sin thanks to Acorn.

Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

THE LAMP APRIL/MAY 2021 | 47

NOTICE

NSWNMA FEE WAIVER for members on parental leave DID YOU KNOW,

if you’re going on parental leave, paid or unpaid, we’ll waive your Association fees until you return to work?

You’ll still be entitled to access advice and receive The Lamp.

Contact the Association and let us know when you plan to take parental leave so we can set up your waiver.

PHONE 8595 1234 • 1300 367 962 EMAIL gensec@nswnma.asn.au 48www.nswnma.asn.au | THE LAMP APRIL/MAY 2021

Authorised by B.Holmes, General Secretary, NSWNMA

TRAVEL

Take a look at these fabulous holiday offers CONCIERGE SERVICE Save time and money when you book through members only Concierge Service.

NSWNMA members have access to thousands of hotels across Australia and New Zealand. UBOOKDIRECT is giving members a $20 voucher to use on any already discounted member prices when booking through the Concierge. UBOOKDIRECT will beat any hotel you can find on Expedia by a minimum $20 (min 2-night stay).

29% OFF

23% OFF

Leisure Inn Pokolbin Hill – Hunter Valley, NSW

Melbourne Hotel CBD – Melbourne, VIC

Leisure Inn Pokolbin Hill is located within walking distance to Hunter Valley Gardens. The hotel offers studio, and self-contained 1 and 2 Bedroom Apartments featuring private patios with peaceful views of hotel grounds, river and vineyards.

Just a 5-minute walk from Southern Cross Station and a 10-minute walk to Melbourne Central, Marvel Stadium, and Melbourne Aquarium.

The Melbourne Convention and Exhibition Centre and Flinders Street Station are both less than a 20-minute walk.

Studio Spa Queen Room – 2 Nights $214* (2 ADULTS)

Standard Queen Room – 1 Night $95* (2 ADULTS)

• Flexible booking options – cancel or reschedule your travel dates permitted up to 3 days prior to travel • Free WiFi – limits apply

• Free upgrade from Standard Double Room to Standard Queen Room • Complimentary WiFi during stay • Late check out of 12noon

20% OFF

Sydney Hotel Harbour Suites – Sydney, NSW Sydney Hotel Harbour Suites provides accommodation with a restaurant, private parking, a fitness centre and a shared lounge. It is located just 5 minutes from Town Hall Station and Darling Harbour. The hotel features an indoor pool, sauna, 24-hour front desk, and free WiFi. Spacious self-contained apartments with city views for only $121 per night!

Premium Queen Room with Kitchen – 1 Night $121*(2 ADULTS) • 12pm late checkout • Free WiFi during stay

* All travel deals are subject to availability. For black-out dates, high season and peak season surcharges and rates and full T&C’s go to unionshopper.ubookdirect.com • Leisure Inn Pokolbin Hill: valid until 31 March 2022. Rate based on 2 adults and subject to availability • Sydney Hotel Harbour Suites: valid for travel until 31 August 2021. Rate based on 2 adults and subject to availability • Melbourne Hotel CBD: valid for travel until 31 August 2021. Rate based on 2 adults and subject to availability.

CAN’T FIND WHAT YOU’RE LOOKING FOR?

Contact the Member Concierge desk to discuss thousands of hotel deals on offer across Australia and New Zealand. To book one of these fantastic packages email bookings@ubookdirect.com.au or call 1300 959 550.

For all other packages, head to unionshopper.ubookdirect.com THE LAMP APRIL/MAY 2021 | 49

NEW MEMBER BENEFIT

Access to online Professional Education ers!

b m e FREE for NSWNMA m

1/

Meeting your Continuing Professional Development (CPD) obligations* is now even easier with this great new offer for NSWNMA members. As a financial member you’ll have access to 61 online courses absolutely free.

FEATURING Access to over 20 hours of FREE CPD* 61 topics including those modules that are deemed mandatory annual competencies by large health organisations and nursing agencies* Free professional development portfolio to provide evidence to the Nursing and Midwifery Board of Australia (NMBA) of participation in CPD annually 3/

4/

Access free webinars on a range of topics

LOGGING ON MEMBERS: New users create a ONE-TIME login to the website.

NON-MEMBERS: Join the union at www.nswnma.asn.au and receive access to your 20 hours of FREE CPD!

bit.ly/NSWNMAMemberCentral * Nurses and midwives have various obligations in relation to CPD, which you can read more about on the NMBA website or here. The NMBA outlines that CPD must be relevant to your context of practice, and recommends nurses and midwives complete a range of CPD activities, e.g. – 5/ face-to-face, simulation, interactive e-learning, self-directed learning. The ANMF Education is developed for nurses and midwives working across ForAPRIL/MAY nurses and midwives practicing in NSW, it is important to ensure you follow relevant governance and legislative requirements.

50 Australia. | THE LAMP 2021

Recruit a new member and go into the draw to win A luxury

holiday in

Vanuatu Valued at over $5,000

The 2020 – 2021 NSWNMA Member Recruitment scheme prize Tamanu on the Beach Resort & Spa is a peaceful, private and secluded boutique resort located on its own private white-sand beach, just 20-minutes from Port Vila. Voted as Vanuatu’s luxury resort of the year, you will enjoy luxurious, ocean-facing villas and some of the best cuisine on the island. You and a friend will experience the following: • 7 nights’ accommodation in a beach-view villa at Tamanu on the Beach • Welcome fruit cocktail or chilled coconut on arrival • Daily a la carte breakfast for two adults • Free daily shuttle to Port Vila • Free in-house movies • Complimentary use of the resorts island facilities • Complimentary Wi-Fi. The NSWNMA will arrange return flights for two to Vanuatu Every member you sign up over the year gives you an entry in the draw!

21

Prize drawn 1 July 20

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, so you will be entered in the draw.

Conditions apply. Prize must be redeemed by 30 June 2022 and is subject to room availability. Block out dates include 1 July - 30 September 2021 and 1 December 2021 - 31 January 2022. The prize will be drawn on 1 July 2021. 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/20/05518.

Search “Ausmed” in the app store.

Authorised by B. Holmes, General Secretary, New South Wales Nurses and Midwives’ Association, 50 O’Dea Ave, Waterloo NSW 2017