CAMPAIGNESCALATEMEMBERSVOTETORATIOSREGULARSYourrightsandentitlementsatworkp.32 Crossword p.41 Reviews p.43 Nursing research online p.45 PRIVATE SECTOR NURSES Pay rises at Coal Services to match inflation AGED CARE Private profit at root of crisis Print Post Approved: PP100007890 AGED CARE Struggling to plug workforce gaps THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 7 9 NO. 4 AUGUST/SEPTEMBER 2022 page 26page 20 page 22
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The plight of new graduate nurses “thrown in at the deep end” with insufficient training and mentoring was a talking point during the July Special General Meeting.
THE LAMP AUGUST/SEPTEMBER 2022 | 3
The Perrottet government’s promised health sector recruiting drive lacks transparency.
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COVER MembersSTORYvoteto ratios campaign NSW nurses and midwives vote to continue industrial action for shift-by-shift ratios.
COVER STORY NSW falls behind other states in pay and respect The Queensland Government’s pay offer to the state’s nurses and midwives makes a mockery of the NSW Premier’s claim that his deal is the highest in the land.
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COVER STORY Wages cap ignores realities of nursing A 3 per cent wage rise with a possible ‘productivity’ bonus won’t help to keep nurses in the profession or attract new entrants.
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AGED PrivateCAREprofit at root of global aged care crisis: PSI The disaster wreaked upon aged care by COVID-19 is a consequence of policies that have turned aged care into a profit-making opportunity for corporations. StrugglingCARE to plug the workforce gaps COVID is taking an appalling toll on nursing home residents and slashing workforce numbers below the bare minimum.
CONTENTS VOLUME 79 NO. 4 AUGUST/SEPTEMBER 2022 5REGULARSEditorial 6 Your letters 30 What’s on 32 Ask Shaye 36 News in brief 41 Crossword 43 Book Club 44 Your Health 45 Nursing Research Online and Professional Issues 10 COVER
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COVER STORY New grads must sink or swim
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CAMPAIGNESCALATEMEMBERSVOTETORATIOSYourrightsandentitlementsatworkp.32p.43 Pay rises at Coal ServicesPrivate profit Struggling to plug workforce gaps THE MAGAZINE OF THE NSW NURSES VOLUME 9 NO. AUGUST/SEPTEMBER 2022 page 26page 20 page 22 8
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I am also very proud of how the Association has participated in broader union campaigns, nationally and internationally.
I can’t thank all of you enough.
EDITORIAL HolmesBRETT
I believe there is an important lesson to be learnt from these campaigns. Like it or not nurses and midwives have to engage in the political process. Governments hold the keys to unlock the resources needed for the health and aged care sectors to function and flourish.
It has been an honour to lead this magnificent union
What stands out is the passion and engagement of our members. Ten years ago, during that first ratios campaign over 6000 nurses and midwives gathered at Sydney Olympic Park to send a message to the then ALP government that we were not for turning over ratios. It was raucous and energetic. It exuded commitment and determination. It was a wonderful expression of collective power. Fast forward a decade to this year and two momentous strikes –this time against a LiberalNational government. These actions showcased the same fighting qualities, creativity and strength from new generations of nurses and midwives.
Our contribution to the historic Your Rights At Work campaign was widely lauded and respected by our colleagues in other unions, the ACTU and Unions NSW. But it is not just what we have done but who we are that I am proud of: a union with an indomitable spirit and collective strength of character that are intrinsic qualities of our professions.
It gives me a lot of satisfaction to see their heroic activism translate into legislation from the incoming Albanese government to mandate Registered Nurses 24/7 and a pledge to legislate minimum minutes of care time per resident which delivers staffing ratios in private aged care facilities and to significantly improve wages.
When I became leader of the NSWNMA it had 48,000 members and now it has almost 75,000.
When Judith Kiejda and I became leaders of this union, we understood that nurses and midwives’ crippling workloads were a major obstacle to delivering the quality of care patients deserved.
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I depart from this magnificent union with immense pride in what we have achieved and who we are and do so with great confidence about the Association’s future.
Brett Holmes has announced his retirement, having served the Association for 32 years, twenty of those as General Secretary. GENERAL SECRETARY
I leave knowing the union is in capable hands with Shaye Candish as the new General Secretary and Michael Whaites as Assistant General Secretary. Together they make an extremely capable and enthusiastic team. They are dedicated to nursing and midwifery, are passionate about the union and are seasoned campaigners. They have my complete support and Finally,endorsement.Iwould like to thank Judith Kiejda, our former Assistant General Secretary for her loyalty and talented leadership over 19 years, the selfless and dedicated members of council and the Association’s hard working staff. I can’t thank every one individually that has been part of this wonderful journey with me – there are more than 75,000 of you! More to the point, I can’t thank all of you enough. n
In aged care our members have been exemplary in a very difficult environment, standing up for the rights of the elderly.
My predecessors passed on to us an excellent union that was professional, focused and effective. In the subsequent 20 years, together we have built this union into an even greater force that cannot be ignored, which always strives to act for the betterment of the nursing and midwifery professions, and resolutely defends our public and private health systems and aged Therecare.aremany significant achievements to look back on.
Our first steps in what has turned out to be a long journey was to get the very concept of “reasonable workloads” accepted by health management. This morphed into our first major campaign for ratios and a significant initial victory: in 2011 NSW became one of three places in the world to introduce nurse-to-patient ratios delivered through Nursing Hours Per Patient Day (NHPPD). We have continued this fight to this day and the experiences of the last few months has convinced me that we have the strength and fortitude to win a more sturdy framework for staffing with shift-by-shift ratios that will deliver the care that patients deserve.
I am afraid to leave my family members in the care of hospital staff now, as I see the corners we have to cut to maintain basic care without even being able to have a break or leave to go home on time. I am 33 years old, and already I am afraid that I am almost at the end of my career in nursing as I cannot take these atrocious conditions for much longer.
Jessica Moore, RN Shifts are out of control
I am a paediatric clinical nurse specialist. During the Delta wave I was identified as someone with ICU experience and was sent to work in an adult ICU. I’d had six months’ experience as a new grad in the beginning of 2017. You can imagine my shock to be thrown into the deep end like that. I thought I had it bad, but then a few weeks later they brought in nurses from theatres and non-acute wards – many of whom had zero ICU experience. It was neither fair nor safe for patients or staff. The ICU staff were so thankful and helpful, but
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I am afraid I will need to give up years of intensive care training to maintain my own physical and mental health. We are not heroes, as they keep saying – we are highly skilled, highly trained, intelligent healthcare professionals and that’s how we should be treated. We are only asking to be treated this way. Nurses are extremely resilient people – it’s got to make you worry when we are all standing here saying we can’t do it anymore!
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Have Sayyour YOUR LETTERS
6 | THE LAMP AUGUST/SEPTEMBER 2022
At the edge of our resilience
I am a paediatric nurse. During the pandemic, I have seen so many nurses and midwives quit due to poor pay and working conditions. My colleagues are being asked to work in areas beyond their training and scope of practice. All too often, I stop short of walking out from my shift and leaving my patients with nobody to look after them. I stay and try my best – which is not good enough.
Having to apologise to my patients for not being able to provide the care I wish I could has become an increasingly frequent occurrence. Unsafe staffing has gone on for years on a shiftby-shift basis, and the government has refused to hear our pleas for help.
The worst part for me was not being able to provide people the care they deserved. When there were no visitors allowed, many of these patients’ basic needs were neglected. Not out of laziness or lack of caring, but because there were things that all took greater priority. I had one family member allowed to visit and she praised me and the other nursing staff for being “angels”. I smiled and nodded and then avoided her because I couldn’t face the praise when I knew the job I had been able to do was so below any standard I would expect for anyone in a hospital.
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.
I’m sorry to the ICU nurses who tried their hardest to help us and make us feel welcome, even though we were an extra burden they did not ask to bear.
If there’s something on your mind, send us a letter and have your say. The letter of the month will WIN a gift card. The letter judged best each month will receive a $50 Coles Group and Myer gift card. it was not fair on them either, as their workloads constantly increased when they needed to help the temporary staff.
Letter of the month
But most of all I’m sorry that our government undervalues the nursing profession, where caring for people is at the heart of what we do. A government that lies to its constituents and tells them that the health system is coping. We are not coping. Every day we go to work exhausted, physically and mentally, and we try our best to care for your loved ones. But it’s not good enough.
Simone Fisher, RN CNS As an RN prior to COVID, I had to care for six to eight patients per shift on an acute medical ward, where I should have had no more than four. I have worked in emergency and been deployed to midwifery, where staffing has often been so much worse. And since March 2020, this situation has only escalated. Not just because we’ve been caring for patients with COVID, but also because our workforce has been stretched to provide the frontline pandemic response, taking nurses away from the hospital wards. During the Delta wave, nurses from across the health system were redeployed to staff hotel quarantine, airport screening, vaccination hubs and COVID clinics. Despite this, there was more expected of a finite and dwindling pool of staff. As a result, colleagues of mine have moved interstate for better conditions and better pay, or have left the profession entirely. While it feels like the COVID-19 pandemic is in the past, it’s not like that for healthcare workers. Since we took the “living with COVID” approach, we’ve had a constant rotation of staff off sick due to COVID infections, while still caring for patients continuing to present to our hospitals. You only need to consider the number of ambulances sitting outside a hospital emergency department to imagine what the demand may be like.
Nursing hours per patient day is failing us. It is a budgetary calculation that does not provide the nursing and midwifery staffing levels we need, and does not account for ward surging –which is when more beds need to be opened so patients can be moved from ED or ICU to make more space to meet demand on those Imagineareas.running your entire shift, skipping breaks and ignoring a full bladder or your need for hydration, just to ensure that someone doesn’t die. Let alone attempting to meet the basic care needs of your patients, like someone to help them eat, drink or go to the toilet. We have to navigate complex family dynamics, socio-economic situations, consider whether our patients have an appropriate place to go after discharge, and connect them with services to keep them well in the community and address any further psychosocial needs. Inadequate staffing each shift puts an immense amount of pressure on nurses, leading to burnout, and colleagues reducing their hours, or leaving the profession outright. Nurses have been experiencing a higher rate of adverse mental health issues, and we’ve lost many caring and compassionate colleagues due to the increased stress of our roles. Some of those colleagues are no longer with us. Inadequate ratios are dangerous. It puts our registrations, and our patients’ lives on the line, and significantly reduces the quality of care we are able to deliver. As a nurse, I find this incredibly distressing.
Julia Farley, RN LETTER OF THE MONTH Running for a whole shift to ensure someone doesn’t die
I’m sorry to my paediatric colleagues who lost a senior staff member, which left them short-staffed and increased their workloads.
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I’m sorry for my patients and not being able to provide the care they deserved.
So, I am sorry.
So many shifts felt out of control. The acuity, the PPE, being drenched in sweat, being stuck in COVID rooms for hours, not knowing what you were doing or why, and being constantly terrified you would make a mistake that could cost someone their life.
NSWNMA General Secretary Brett Holmes told the meeting that the union leadership “acknowledge the shared frustrations and the ongoing sacrifices being made shift after shift”. “We share in that frustration and remain committed to supporting you, to hearing you and to fighting alongside you every step of the way.”
The meeting authorised NSWNMA Council to initiate industrial action “when necessary, via an e-vote of the public sector membership, at times and locations to be determined in consultation with public sector branches”.
GOVERNMENT ADMITS
He said the two statewide strikes earlier in 2022 had forced the NSW Government to meet NSWNMA representatives “and contemplate how they could fix the shameful short-staffing crisis”.
The resolution said the government’s announcement of an “additional” 10,148 FTE staff lacked transparency, with “minimal breakdown between health professions or clarity on where they will be allocated”.
The meeting at Sydney Town Hall was also broadcast online and to regional gatherings on the Central Coast, and at Coffs Harbour, Newcastle, Tamworth, Tweed Heads, Wagga Wagga and Wollongong. It coincided with strikes by 81 public sector branches, which had voted for work stoppages of up to 24 hours duration.
PROBLEMS, AVOIDS SOLUTIONS
Between February and May, Brett and other NSWNMA officials, including Assistant General Secretary Shaye Candish, and Director, Strategy and Transformation Michael Whaites, met Premier Dominic Perrottet, Health Minister Brad Hazzard, Finance and Employee Relations Minister Damien Tudehope and Regional Health Minister Bronnie Taylor. “Throughout these discussions,
Members vote to escalate ratios campaign NSW nurses and midwives vote to continue industrial action for shift-by-shift ratios. ‘Brad Hazzard has made it clear he does not believe in ratios.’ — Brett Holmes
8 | THE LAMP AUGUST/SEPTEMBER 2022 COVER STORY
ASpecial General Meeting of NSWNMA members in July voted overwhelmingly to continue the public sector ratios and pay campaign with “sustained and escalating” industrial action.
It welcomed the government’s proposed incentives for nurses to work in regional, rural and remote sites, but noted that “until workloads are safe on every shift, this will not be sufficient to ensure safe patient care and safe professional practice”.
A further 21 public sector branches voted in support of strike action to attend the meeting, but were too short-staffed to safely do so.
A resolution adopted by the meeting said the NSW Government had failed to address systemic workload and workplace health and safety issues, which impacted on patient safety.
He said the ministry rejected payment of on-call allowances for nurse managers, a minimum of three nurses in multi-purpose services 24/7, and a 15-minute break when wearing PPE. The ministry agreed to only three minor variations in the award, “none of which will significantly change what occurs in the Theworkplace”.Ministry agreed to change the definition of “flight nurse”; clarify that parental leave entitlements apply to “subsequent” episodes, not just the second; and ensure the correct NSW Health policies and other relevant Acts are correctly referenced in the Award. n
Whaites told the meeting that the ministry would not even discuss the union’s claims to make existing entitlements – such as two days off in a row and a meal break on night shift – enforceable.
“It appears the ALP is very concerned about looking like they’re going to be profligate spenders of money,” Brett said. “We can’t take anything for granted; we have to continue lobbying, continue to talk to them and convince them that it is in their best interests to have the nurses and midwives saying we want a change of government.”
— NSWNMA president O’Bray Smith
the NSW Government conceded a review of the ‘Nursing Hours Per Patient Day’ model was needed, along with a focus on staffing within emergency departments, intensive care units and maternity services,” Brett said.
“He does understand that the nursing-hoursper-patient-day system needs fixing but he has yet to engage in a real discussion about how to fix “Norit. has he empowered the Ministry of Health staff to engage in a real discussion about how to fix Michaelit.”
Call to lobby ALP
‘We remain committed to supporting you, to hearing you and to fighting alongside you every step of the way.’
— Brett Holmes
Brett Holmes told the meeting that many nurses who are ALP members are getting their local ALP branches to pass resolutions in support of ratios.
At the meeting, Jason Mullavey, NSWNMA branch president at Nepean Hospital, said the NSW Liberal/ National government was clearly opposed to ratios, and nurses were also concerned that the Labor Opposition had yet to commit to ratios.
NSWNMA president O’Bray Smith added: “We need to make sure the ALP is aware we don’t back a party that doesn’t back ratios.”
The Special General Meeting called on all NSW political parties to urgently meet with the NSWNMA leadership to negotiate support for the union’s demand for improved and enforceable ratios “on every shift, and in every ward and unit in every hospital.”
“However, Brad Hazzard has made it clear he does not believe in ratios.
THE LAMP AUGUST/SEPTEMBER 2022 | 9 COVER STORY
‘We need to make sure the ALP is aware we don’t back a party that doesn’t back ratios.’
A further 20 Aboriginal nurse cadetships will be available and a HECS incentive package will be on offer for allied health professionals.
The Perrottet government’s promised health sector recruiting drive lacks transparency.
“Our members want assurances that their excessive workloads will be reduced and they want safe-staffing ratios on every shift, in every ward, in every hospital and every community healthcare setting. “They need staffing numbers that are transparent and accountable when they show up for their shifts.”
“The ministry said it will fund LHDs to employ additional workers, at their discretion.
He said it appears funding will be allocated to Local Health Districts (LHDs) to employ 7674 healthcare workers, including 2756 nurses and 165 Michaelmidwives.Whaites says there is no guarantee that all these proposed nurses and midwives will be employed, as LHDs will have the discretion to determine what employees they need.
COVER STORY 10 | THE LAMP AUGUST/SEPTEMBER 2022
Workforce package no substitute for ratios
In June, the NSW Government announced with much fanfare a $4.5 billion healthcare workforce package over four years. The package would include recruitment of 10,148 healthcare workers, the government said.
The government will offer graduated incentive packages, based on a remoteness index, ranging from $5000 to $10,000 per worker per year of Packagesservice. can include additional leave, relocation reimbursement, professional development and study Increasedassistance.training positions will be offered for nursing graduates, nurse practitioners and medical interns.
“It sounds like a great big number if you’re a government heading into an election in March next year,” the NSWNMA Director of Strategy and Transformation, Michael Whaites, commented.
The cost is $883 million over four years.
— Michael Whaites, NSWNMA Director, Strategy and Transformation
The state government also announced an incentive scheme to attract and retain staff in rural and remote areas.
And, as Maitland branch acting secretary Kathy Chapman asked at the Special General Meeting, “What the hell was the government thinking when they announced only 165 (additional) midwives across MichaelNSW?”saidthe 2756 nurses and 165 midwives includes 966 nurses and 60 midwives promised before the 2019 election but not yet delivered.
Michael Whaites told the Special General Meeting that the union welcomed the announcement but the government had not said what additional healthcare worker ‘We are far from convinced that these numbers are what is needed for safe patient care in NSW.’
“We do not know whether the NSWNMA will be consulted on where positions will be located or at what classification.
“We are far from convinced that these numbers are what is needed for safe patient care in NSW,” he said.
“We also welcome the fact that the government has woken up to the need for nurse practitioners and that more of them are part of answering the needs of regional NSW,” he Hesaid.noted, however, that the Ministry of Health has rejected the union’s Award claim for a minimum of three nurses rostered on every shift, two of which must be registered nurses. Similarly, the ministry has rejected our claims for an allowance for First Line Emergency Care Course (FLECC) qualifications for regional and rural nurses and an additional RN rostered on-call and within 15 minutes travel, for sites without access to medical officers 24/7.
It’s not good and we are worried that someone is going to die,” she said.
She said rural nurses often needed additional qualifications such as FLECC and extended scope of practice to cope with the lack of doctors.
Karen Hart, delegate and vice president of the NSWNMA’s Wagga Wagga branch, said the regional workforce incentive scheme was unlikely to help rural sites where nurses were denied allowances for additional qualifications and had to work without an on-call roster.
Karen said it was “unbelievable” to expect to attract nurses to work at sites with just two nurses and no oncall roster. n
More won’tambulancesfixbedblock
MICHAEL WHAITES, NSWNMA DIRECTOR,
At the Special General Meeting, Tweed Hospital branch member Lesley Ann Stevens said the hospital sometimes had 30 people waiting for ward beds, yet nurses were not allowed to go to code yellow or code brown.
The NSW Government announced $1.76 billion over four years to deliver 1858 extra paramedics, 210 ambulance support staff, 52 nurses and eight doctors.
“Our concern is that without nurse-to-patient ratios, shift by shift, those incentives will not be enough to make sure that new nurses and midwives who turn up in regional and remote NSW will want to stay and will be able to provide safe patient care.”
Michael Whaites said the union was hearing stories like this from every ED across the state.
“Having more ambulances on the roads is desperately needed – but without 1:3 in ED this will mean more ambulances ramped as they hit a bed-block crisis at the door.”
‘Having ambulancesmoreon the roads is desperately needed – but without 1:3 in ED this will mean more ambulances ramped as they hit a bed-block crisis at the door.’
The government also promised to open 52 more ambulance stations.
— Michael Whaites
STRATEGY AND TRANSFORMATION COVER STORY THE LAMP AUGUST/SEPTEMBER 2022 | 11
“The government refuses to recognise the need for shift-by-shift ratios of 1:3 in EDs to help with rising attendances and increased ambulance ramping,” he said.
positions will be created in the regions – nor when and where they will be created.
“We only have 20 acute spaces to assess people anyway, so patients are living in chairs.
— Geoff Hudson, Albury Base Hospital branch
“In 2019 they were brought up to parity with NSW and they continue to get that 3 per cent.
Wages cap ignores realities of nursing
‘PRODUCTIVITY’ INCREASE
Geoff Hudson, president of the NSWNMA’s Albury Base Hospital branch, told the Special General Meeting that members in Albury could “look across the Murray River and see how much better they have it in Victoria compared to us in NSW”.
QUESTIONED
Health executives, senior executive employees and contractors employed by external agencies are not eligible for the “Stubbornly,payment.the government refused to reward the sacrifices made by nurses and midwives in the private hospital sector or aged care sector,” NSWNMA General Secretary Brett Holmes said.
A 3 per cent wage rise with a possible ‘productivity’ bonus won’t help to keep nurses and midwives in the profession or attract new entrants.
After several days of negotiation with the NSWNMA, the government agreed to extend the “thank-you” payment to casual staff, those on temporary contracts and permanent full-time and part-time staff, including: • employees of agencies under NSW awards • some employees of third-schedule organisations (AHOs) • visiting medical officers • junior medical officer locums, and • agency nurses on the NSW Health payroll.
The money will only be paid to staff who commenced employment on or before 1 April 2022 and continue to be employed on 1 July 2022.
Also at the Special General Meeting, NSWNMA member Laura Smith from ‘Albury nurses can look across the Murray River and see how much better they have it in Victoria compared to us in NSW.’
Part-time and casual staff will be paid a pro-rata amount, based on the number of hours worked. Payment was likely to start from July through to August.
He said Victorian nurses “started out worse than us in NSW and they’ve had a minimum 3 per cent pay rise every year since 2016.
pay rates interstate (see p18).
“In addition, they received a $60 per shift COVID allowance during the pandemic worth up to $14–15,000 per year,” Geoff said.
Brett said the government’s wages policy ignored the need for better pay to attract new nurses, and retain those who may be lured by higher
With inflation widely predicted to reach 7 per cent this year, the NSW Government says nurses, midwives and other public sector workers will get an annual pay rise no greater than 3 per cent including superannuation for 2022–23 and 2023–24. A further 0.5 per cent in 2023–24 may be paid if employees make what the government calls “productivity reforms”. To sugar-coat this bitter pill, the government announced a one-off “thank-you” payment of $3000 for NSW Health permanent employees in recognition of their work during the COVID-19 pandemic. The payment includes super-annuation and will be taxable income.
12 | THE LAMP AUGUST/SEPTEMBER 2022 COVER STORY
In reply, Brett Holmes said, “They know full well that there are very few additional efficiencies that can be dragged out of the blood, sweat and tears of nurses and midwives. “If they’re going to award the 0.5 per cent it’s going to be on the basis of what you’ve already done and continue to do rather than anything extra.
‘How do they expect us to be more productive when we’ve got six ambulances lining up waiting to offload, 30 patients in a waiting room and no functioning equipment?’
Branches vote again on pay
— Laura Smith, John Hunter Hospital branch
“Any suggestion that you’re going to work harder or could possibly even think of working harder should be rejected outright.” n
THE LAMP AUGUST/SEPTEMBER 2022 | 13 COVER STORY
STOP PRESS Public sector branches have voted and confirm they reject the NSW government’s 2.53 per cent pay offer and want the Association to pursue a 7 per cent pay increase. Following the vote, the Association •will:advise the Industrial Relations Commisssion that the Ministry of Health’s pay proposal is rejected • continue to build for further statewide action, calling for the immediate introduction of shift by shift ratios and for a fair pay increase of at least 7 per cent.
“What measures are they expecting us to go by; what guidelines are they expecting us to meet; and why does it fall on us nursing staff to compensate for their poor planning?”
“Do they have clearly defined measures of productivity and how do they expect nurses to be more productive when they won’t give us the basic resources we need to care for patients?” she “Howasked.dothey expect us to be more productive when we’ve got six ambulances lining up waiting to offload, 30 patients in a waiting room and no functioning equipment?
John Hunter Hospital branch asked how the government would measure the productivity increase needed to get an additional 0.5 per cent pay increase.
The Special General Meeting voted narrowly to amend the resolution and increase the NSWNMA wage claim to 7 per cent – thereby rejecting the government’s offer of a 2.53 per cent wage rise plus 0.5 per cent additional superannuation. The meeting voted 522 in support of the amendment with 513 against. A further 596 members did not record a vote. Given the close outcome of the vote and the reports of voting problems, NSWNMA Council decided to seek clarification from members by asking public sector branches to meet and vote to confirm their intention.
The plight of new graduate nurses “thrown in at the deep end” with insufficient training and mentoring was a key talking point during the June Special General Meeting.
“We do get a lot of a new grads but they’re not getting proper training,” she pointed out. “It’s good to have a lot of new grads but if they don’t know what they’re doing, it is going to be more unsafe.” She said graduate nurses on first rotation were being sent to Liverpool’s trauma centre. “They’re getting culture shock and some have had panic attacks.
‘I feel so sorry for them and I want to help them, but I don’t have time to teach them.’
“Part of that package can be converted into access to training and education, so there is some acknowledgement there, but clearly not enough,” he said.
He said the union was building stronger ties with the Australian College of Midwives, to work together to have the federal government create more training opportunities for undergraduate nurses and undergraduate midwives.
— Melissa Mansell, Liverpool Hospital branch
“A large number of baby boomers are retiring – where are we going to get the training for people to fill these
“I feel so sorry for them and I want to help them but I don’t have time to teach Melissathem.”asked whether the government had agreed to any of the union’s claims regarding education and NSWNMAtraining.Director, Strategy and Transformation, Michael Whaites, replied that the government had rejected the union’s entire ratios claim, including more CNEs. Michael said the only improvement in training offered by the government was included in its incentive scheme for regional and remote workers.
“They (the ministry) fail in their obligation under the Work Health and Safety Act by refusing to identify vacancy rates and making us work under the conditions that we do.” n
Melissa Mansell, president of the NSWNMA’s Liverpool Hospital branch, told the June Special General Meeting that the hospital was losing many highly skilled and experienced senior nurses.
Rhonda-Lea Klenk from Coffs Harbour Health Campus said student nurses were dropping out of university at a “massive” rate. “We have 200 students who apply in first year to be a nurse or midwife and by the time graduation rolls around you’re lucky if you get six to eight midwives graduated,” she said.
“However, they have failed to do that on several fronts, such as not providing education and learning opportunities for new staff, and not providing breaks,” she said.
“We also want to draw your attention to the fact that in the state government’s draft policy on regional, rural and remote incentives for recruitment and retention, allied health workers get HECS-free payments but nurses and midwives do Kaynot.”Burns, branch secretary at Westmead Children’s Hospital said that under work health and safety legislation the government has an obligation to ensure a safe workplace.
COVER STORY 14 | THE LAMP AUGUST/SEPTEMBER 2022
“Within four hours of the teachers’ union striking, the government announced incentives for students with a university entrance rank of 80 or above, but there has been nothing for nursing or midwifery.
Michaelpositions?”Whaites agreed that “people are starting to drop out of the course when they see what it is they are coming into.”
New grads must sink or swim
“Our state desperately needs a transparent nurseto-patient ratios system to improve staffing, reduce workloads and help manage the ongoing demand.”
COVER STORY THE LAMP AUGUST/SEPTEMBER 2022 | 15
Longer wait times point to staffing crisis
“How can the NSW Government continue to call this ‘world class’ care?
Lynette Whitlam , secretary of the NSWNMA’s North Shore Private Hospital branch, has been nursing for 53 years, mostly in the public system. She told the Special General Meeting that she hoped any gains from the union’s public health campaign would flow to private sector nurses.
“I’ve never seen our profession or our patients in a more perilous state than what they are now,” she told the Special General Meeting. “I fully support what the Association and the public nurses are doing.”
‘How can the NSW Government continue to call this “world class” care?’ — Shaye Candish
‘I’ve never seen nursing in a worse state’
Latest Bureau of Health Information data paints a bleak picture of the mounting strain on the NSW public health system. BHI data for January to March 2022 showed that patients waited longer for ambulance transfers, for treatment in ED, and to be admitted to a ward, despite fewer attendances overall than the same quarter in NSWNMA2019.Assistant General Secretary, Shaye Candish, said as the Omicron variant ran rampant in the community, patients requiring triage category 2 “emergency” care waited longer for ED treatment compared to any January to March quarter on record. “The latest hospital data reinforces what we were hearing from members at the time about the incredible pressure they were working under, not long after the NSW Government took their “let it rip” approach in mid-December,” Shaye said. “Members tell us that pressure and the strain on the health system continues today, with the winter peak well and truly upon us. “According to the BHI, barely a quarter (25.8%) of patients who were treated and admitted to hospital spent less than the benchmark of four hours in the ED. Alarmingly, one in 10 of them spent upwards of 18 hours and 29 minutes in ED.
She says all political parties should acknowledge the extent of the staffing problem and undertake to fix it.
“I think it’s even more problematic on the wards, where you can have two RNs responsible for up to 28 to 30 beds, which is dangerous.”
“This is not just about nurses and midwives having difficulties at work –it’s about how we can deliver the best care to our patients.
“We don’t know where recruitment will occur, or how much it will help Westmead, because every unit in every hospital is struggling with staff shortages. “The government’s announcement is not a substitute for the ratios we are asking for – ratios would provide a guaranteed number of staff on the floor.
All political parties should acknowledge the extent of the public health staffing shortage and undertake to fix it, says Westmead Hospital delegate.
COVER STORY ‘The onnumberawouldaskingthenotannouncementgovernment’sisasubstituteforratioswearefor–ratiosprovideguaranteedofstaffthefloor.’
“Personally, I have had a strong commitment to achieving our goals since the start of the campaign.”
“The government and community are taking a more relaxed attitude to COVID, but COVID patients keep coming to hospital and more nurses are going off work sick from COVID than ever before.” She thinks Westmead working conditions are probably similar to many other understaffed NSW hospitals. “A lot of nurses have left Westmead due to poor staffing and the stress that it brings.
“Lack of staff was terrible before the pandemic and COVID made it worse.
“Around 10 people have left my team in recent times and we’ve only hired one part-timer so far this year.
16 | THE LAMP AUGUST/SEPTEMBER 2022
Sofia Santos, a NSWNMA delegate at Westmead Hospital’s F3 Opsuite, says she and her colleagues are “100 per cent committed” to supporting industrial action over ratios and pay. “My unit has turned out to the stoppages 100 per cent, despite the fact that we are giving up a chunk of our pay each time we go on strike,” she says.
“If a government is not looking after its healthcare workforce, it is not looking after its citizens and their communities.” n
Sofia says hospital working conditions have been “appalling” and are getting worse.
The state government says it will recruit about 10,000 additional health sector workers over the next four years, but Sofia says it is not yet known how Westmead will benefit.
“We do a lot of overtime; if we didn’t, we would have to cancel surgeries – and we don’t want to do that to our patients.
“In periop, we are getting by better compared to the wards but we often have to miss one if not two meal breaks in order for us to finish our list.
— Sofia WestmeadSantos,Hospital branch ‘100% committed’ to industrial action
“I don’t think the government understands the extent of the staffing problem in health – they seem to think we can carry on trying to cope with all “Perhapsdifficulties.theydon’t want to admit there is a problem. My fellow union members and I don’t feel they are taking us nurses and midwives seriously.”
COVER STORY
“It’s really scary to think about the future of nursing in this state if this trend Sarahcontinues.”saysPremier
The Perrottet government’s promise to recruit additional nurses and midwives is a step towards easing extreme staff shortages but is no substitute for nurseto-patient ratios, says Sarah Calman, a NSWNMA delegate at Liverpool Hospital’s neo-natal intensive care unit “Even(NICU).ifthe government funds all the promised additional staff, it will only be a matter of time before we run short again – unless we get enforceable ratios,” she says. “We don’t know what new roles will be created. Will they go to where they are needed most? Will they be juniors or people with experience?” she asks.
“No amount of money can take away the pressure and stress of the job if you’re constantly working at unsafe staffing levels.
“People in adult ICU are absolutely exhausted and senior staff are burnt out and leaving. “I spoke to one nurse the other night who told me, ‘This place is just sucking the soul out of me.’
“Staffing across the board at Liverpool is abysmal. It’s very junior-heavy and the new grads often say they can’t handle the “Managersworkload.are receiving resignations every week. They are losing people faster than they are getting them. “How are we going to attract staff when we can’t keep the ones we’ve already got?” Sarah says a “very substantial number” of Liverpool nurses remain committed to the NSWNMA’s ratios campaign, while a few feel “extremely burnt out” and doubtful the union will achieve a Shebreakthrough.believesNSW will eventually be forced to adopt ratios, in line with other states such as Queensland, Victoria and overseas.
gettingthanlosingweek.resignationsare‘ManagersreceivingeveryTheyarepeoplefastertheyarethem.’
“It’s been proven that safe staffing ratios actually save money and improve so many things, such as patient outcomes, safety and nurse job satisfaction. “As far as I’m concerned, ratios are the only priority. I would be more than happy to miss out on a pay rise if we got ratios.
“Since then, the government has been told the real situation multiple times by the union and nurses. Obviously, we wouldn’t go on strike if we were happy in our jobs.” n
“But as far as job satisfaction goes, I would be a lot happier with ratios than I would be with a pay rise and no ratios.
Unsafe workloads will persist without nurse-to-patient ratios, says Liverpool Hospital delegate.
Dominic Perrottet visited Liverpool Hospital last year and met with managers, who told him nurses were coping despite the pandemic.
Ratios vital for safety and job satisfaction
THE LAMP AUGUST/SEPTEMBER 2022 | 17
— Sarah LiverpoolCalman,Hospital branch
“I know that other people have different opinions, especially given the cost-ofliving pressures. Of course, it would be great if we could achieve both ratios and a decent pay rise.
“He didn’t come on the floor to talk to us to see if we were actually coping –because we were not.
Until recently, Sarah worked in Liverpool’s adult ICU, where she says the mix of skills sometimes meant there wasn’t anyone around you with the necessary skills to care for an intensive care patient. “It was challenging to take breaks when there was no one able to relieve you.
“The fact is, our hospitals are just not safe without ratios.
irst, there was a decade of wage caps at 2.5 per cent. Then a contemptuous 0.3 per cent pay rise for public sector nurses and midwives in the first year of the COVID pandemic. In the following year, 2021, there was a 1.5 per cent increase. Yet, Premier Dominic Perrottet has the audacity to publicly say NSW is the best paying state. This year the Perrottet government has raised its wage cap to 3 per cent and up to 3.5 per cent in 2023–24 – but only if there are productivity NSWoffsets.will also make a one-off $3000 payment to permanent NSW Health workers “to recognise their work on the frontline of the COVID19 Queensland,epidemic”.
by contrast, has rewarded its nurses and midwives for their stellar efforts during COVID with an offer of an 11 per cent pay rise over three years plus a top-up costof-living payment of up to 3 per cent a Theyyear.will receive 4 per cent in the first year of the agreement, 4 per cent for the second year and 3 per cent for the third year. The cost-of-living top-up payment would be a lump sum equal to the difference between the inflation rate and the base wage increase for that year, up to a maximum of 3 per cent. For example, if inflation increases to 7 per cent – as has been predicted by the Reserve Bank – they would receive a 4 per cent increase plus a further 3 per cent as a lump sum in order to keep their wages in line with inflation.
“We know NSW nurses and midwives have already moved to work in Queensland and Victoria, where they have safer staffing levels in their public hospitals as a result of mandated nurse-to-patient ratios.
NSWNMA Assistant General Secretary Shaye Candish says NSW is falling further and further behind other states, which have implemented ratios and have rewarded their nurses and midwives with higher pay.
The Queensland Government’s pay offer to the state’s nurses and midwives makes a mockery of the NSW Premier’s claim that his deal is the highest in the land.
• Plus a cost-of-living top-up payment that would be a lump sum equal to the difference between the inflation rate and the base wage increase for that year, up to a maximum of three per cent.
• A four per cent increase in the first year of their agreement, four per cent for the second year and three per cent for the third year.
“Now we’re concerned more will follow, as their wages continue to go backwards under a broken wages system.” n
F
In fact, Victorian nurses aren’t even in a bargaining period at this moment and have already negotiated a 3 per cent increase they will receive in December. They also got 3 per cent last December and 3 per cent the December before. That compares with the 2.5 per cent, 0.5 per cent, and 1.5 per cent wage rises “granted” by the NSW Government over the last three years.
• Queensland has already implemented shift-by-shift ratios.
COVER STORY 18 | THE LAMP AUGUST/SEPTEMBER 2022
The Queensland offer also has an increase in Sunday penalty rates from 175 per cent to double time and paid Pandemic Leave of up to 20 days (before the use of personal/sick leave) for COVID-positive nurses, among other gains. Both Premier Perrottet and his deputy Paul O’Toole have claimed that Victorian nurses have only been offered 1.5 per cent “and they’re not going out on strike”.
“The wage rises and ‘cost-of-living payment’ on offer to Queensland public sector nurses and midwives is reflective of a state government that respects and values their nurses and midwives,” she said.
beenmidwivesnursesQueenslandWhatandhaveoffered
NSW falls behind other states in pay and respect
“Our current system means that despite low unemployment, high productivity and record profits, labour’s share of GDP is at a record low,” she said.
COVER STORY THE LAMP AUGUST/SEPTEMBER 2022 | 19
Prime Minister Anthony Albanese agreed the pay rise would help prop up the economy. “If you are on the minimum wage, you are also spending every dollar that you have. Every dollar that you receive will go back into the economy into circulation,” he said. “It won’t go into savings, not an overseas holiday. It will go into food on the table, for kids of people on minimum wages. That is what this is all about.”
National minimum wage goes up 5.2 per cent ‘It will go into food on the table, for kids of people on minimum wages.’
— Assistant General Secretary Shaye Candish
The Fair Work Commission has ruled that minimum wage earners will get a $40 a week pay rise, a decision that was supported in advance by the Albanese government.
“The (minimum wage) review is one tool we have to generate wage growth, but it only affects one in four workers – we need wage growth across the economy.”
— Prime Minister Anthony Albanese ‘The wage rises and payment’‘cost-of-livingonoffer to Queensland public sector nurses and midwives is reflective of a state government that respects and values their nurses and midwives.’
The decision will see the hourly pay rate rise from $20.33 to $21.38. The decision impacts 2.7 million workers on the national minimum wage or awards and came into effect on 1 July.
ACTU Secretary Sally McManus welcomed the increase. She said the lack of wage growth has been and still was “a critical issue for our economy and we need concerted action to address it”.
he PSI reports make it clear that long-term aged care was “already beset by multiple crises stemming from the promotion of profit-making above patient care” even before the arrival of the pandemic.
In 1979, nearly two out of three residential and nursing home beds in Britain were provided by the state; by 2017, this had fallen to one in 20.
20 | THE LAMP AUGUST/SEPTEMBER 2022 AGED CARE T
PSI says a number of investigations have shown that these financial institutional investors extract profits through ownership and business models designed to transform government subsidies and resident fees into other sources of income, including lease agreements, management fees, interest payments to owners, and related-party transactions.
Throughoutemergency.thedeveloped world, including Australia, nursing homes have been at the epicentre of the pandemic, with a disproportionate number of deaths compared to the rest of the population.
The intersection of this financial model in aged care with the arrival of the coronavirus exposed the vulnerability of aged care during a health
TAX EVASION COMMON
The consequences for residents have been Withintragic.thefirst year of the pandemic, four out of 10 of the people who died from COVID-19-related causes were nursing home residents, according to an analysis of 22 OECD countries.
“While the pursuit of market solutions to care has been rationalised as a budgetary costsaving measure, more than ever it is evident that the economic and social costs of reliance on private investment outweigh the benefits,” the PSI says.
‘For-profit providers also engage in a number of strategies to minimise costs, mostly focused on reducing labour.’
At the same time, in most developed countries, government spending on the sector stagnated or fell.
The reports say the sector had “preexisting structural risk factors” that left it vulnerable to the coronavirus.
The two most important factors were a “privatisation juggernaut” and a more hidden trend of “financialisation”, which has led to a flood of private equity firms, hedge funds and banks investing heavily in the aged care sector. Globally, privatisation of the sector has been relentless.
Investors from the finance sector often “deploy tools, techniques and tricks – each quite legal, many highly acquisitive, often involving largescale borrowing – to syphon wealth out of this sector for themselves, instead of investing for better care”.
PSI says aged care is widely seen as attractive for investors because it offers low risk and high returns, rising unmet demand, and a lack of regulation of the quality-ofcare provision. It is low risk with high returns thanks to government funding.
The role of rental income from nursing homes as lucrative real estate assets is especially critical, often in conjunction with complex multinational company structures
Private profit at root of global aged care crisis: PSI
The disaster wreaked upon aged care by COVID-19 is a consequence of policies that have turned aged care into a profit-making opportunity for corporations, according to two new studies by Public Services International (PSI).
PSI says public sector facilities in Australia have been much safer than those run by private organisations during COVID.
The nine largest “not-for-profits” received $4.4 billion in gross income in 2019 from government funding, residents’ fees and other sources, and received an average A$66,000 in government subsidies per care place.
For-profit providers also engage in a number of strategies to minimise costs, mostly focused on reducing labour. Such methods include short staffing, contracting out, wage suppression and erosion of conditions. A key difference that emerges from many studies comparing for-profit, non-profit and public facilities is the adequacy of staffing.
The PSI reports found Australia has a “systemic” aged care crisis where private provision and financial engineering allowed companies to hoover off massive amounts of government funding at the expense of care.
They found that the six largest for-profit providers were running more than a fifth of all residential aged care beds and were getting nearly $2.2 billion in annual government subsidies. They then used complex corporate structures, often via tax havens, combined with internal transactions, to lower reported profits and reduce their tax bills.
THE LAMP AUGUST/SEPTEMBER 2022 | 21 AGED CARE to facilitate tax evasion.
Perverse financial incentives have been found to encourage forprofit providers to limit the care and treatment that could prevent hospitalisation, instead transferring responsibilities back onto healthcare systems. n ‘Investors from the finance sector often deploy tools, techniques and tricks … to siphon wealth out of this sector for themselves.’
The reports found that Australia’s largest for-profit aged care companies are not accountable for the billions in public funding they receive, and instead prioritise financial returns above elderly care.
READ MORE • The Crisis in Long Term Care –Effects of Private Provision • Care Givers and Takers –How finance extracts wealth from the care sector Both reports can be found at:
No accountability in Australia’s aged care system
One company, Opal, paid $2.4 million in tax over two years while paying out an estimated $62 million in dividends. Another company, Allity, told a Senate hearing in 2018 that a loan from shareholders charged at 15 per cent annually was “market rate”.
Australian Financial Review reported in July that of the 35 COVID-19 deaths in care homes in the state of Victoria, all of them had occurred in privately run care homes – even though Victoria has over 180 publicly run care homes. n
“When facilities are in COVID outbreak lockdown, residents have weeks of isolation and restricted mobility. Usual physical activity, social interaction and family contact “COVIDdeclines.alsocauses them to lose their appetite, so they lose weight.
— Glen O’Driscoll, aged care NSWNMA member
Glen says a lot of very experienced RNs and care workers have left the sector due to inadequate staffing, bad working conditions, low pay and opposition to mandatory COVID vaccination.
He says the recent spike in aged care deaths reflects a trend observed in the “COVIDUK. contributes to the burden of disease in frail and aged people who already have multiple chronic health “Whileproblems.COVIDmay not be the single cause of death in the frail and aged, its additional physical burden contributes to a shortened life span and earlier death.” He suspects a reduced quality of care may also be contributing to the increased death rate.
“It might also encourage people to enrol in TAFE and university courses to get their aged care qualifications.
“Until that happens, you can’t begin to work on delivering the standard of care that the Royal Commission into Aged Care Quality and Safety has recommended.”
Glen says the immediate challenge is to get enough care staff on the floor to meet minimum staffing levels and deliver essential care in a timely manner.
‘It’s up to aged care workers to advocate for change.’
He says immigration will have to be part of the solution, but that will create additional pressure on the property market.
“In aged care, most people who get COVID don’t bounce back well.”
22 | THE LAMP AUGUST/SEPTEMBER 2022 For the past seven months, registered nurse Glen O’Driscoll has been a member of a COVID “Flying Squad” – a rapid-response workforce assembled by his employer, a residential aged care provider. The Flying Squad is deployed to facilities with COVID outbreaks, to replace aged care workers who have become ill with COVID and cannot report for work. A resident of the NSW South Coast, Glen is currently posted to Griffith in the Riverina district and has also been sent to the Central Coast and Far North Coast. So severe is the staff shortage that he sometimes works from 7 am to 10 pm.
“Even if existing workers get an immediate wage rise, it will still take time for new grads to fill the staffing gap.”
“Where are the tens of thousands
Struggling to plug the workforce gaps
He thinks a pay rise from the case now before the Fair Work Commission will make the sector more attractive and improve staff recruitment and retention.
AGED CARE
COVID is taking an appalling toll on nursing home residents and slashing workforce numbers to below the bare minimum.
“Current versions of the virus appear to be less pathogenic but more contagious than earlier versions. People are now getting COVID two and three times, and facilities have been getting repeat outbreaks for some time,” he says. “It’s hard and sometimes impossible to keep even a bare-bones workforce on the care-home floor when care staff have to isolate.”
THE LAMP AUGUST/SEPTEMBER 2022 | 23 of immigrant workers needed to fill the staffing gaps going to live?
Glen says the aged care system is based on the “least cost “Themodel”.deepsocial injustices delivered to all participants in the aged care system are a consequence of this model, which is incapable of meeting the staffing crisis.
“The low incomes of existing aged care workers mean they can’t afford to buy into property.” Glen says the current 457 visa is unfair and discriminatory and needs to be changed.
Annie Butler, federal secretary of the Australian Nursing and Midwifery Federation (ANMF) called on the public to wear masks, stay home while sick and ensure their vaccinations are up to date, to help relieve pressure on aged care services. n
“It’s up to aged care workers to advocate for change.” n
“The rental property market is already under severe strain in all regions where aged care staff are needed.
‘Good people I work with every day –Nepalese, Indians, Fijians and many other foreign workers –are effectively indentured workers.’ — Glen O’Driscoll
AGED CARE
Surge in aged care deaths
“Good people I work with every day – Nepalese, Indians, Fijians and many other foreign workers – are effectively indentured workers.
“The standards of care recommended by the royal commission must be adequately funded and staffed by federal and state governments if any meaningful change is to be effected.
The surge in the weekly number of deaths was accompanied by a steep rise in the number of active nursing home outbreaks.
The number dwarfs the death tolls of 231 in 2021 and 686 in 2020.
“They are under strict visa conditions and must work wherever they are deployed.
“They won’t say anything about the injustices in the system, their difficult living circumstances, their poor wages or the extra overtime they’re asked to do, because they hope to eventually obtain permanent residency in Australia and are afraid of jeopardising their chances.
“It cannot and never could deliver the standards of care recommended by the royal commission.
The 2972 COVID-related aged care deaths since the start of the pandemic accounted for 29 per cent of the COVID death toll among the total population, which was Departmental10,190.
statistics also show a sharp upturn in aged care COVID fatalities, with almost 100 residents dying from COVID each week by early July. This was well above the weekly average of 69 since the beginning of March, when the previous Omicron wave ended.
By the first week of July, nursing homes had reported 2055 deaths related to COVID during 2022, Department of Health and Aged Care data shows.
Ms Wells told The Guardian that increasing the care workforce remained a challenge.
Declaring the sector to be “in crisis”, she said Labor had inherited “an absolute mess” from the Morrison government.
She said aged care needs “urgent reform as quickly as possible” alongside an overhaul of the funding model to ensure the sector remains financially viable. n
In surveys conducted for the royal commission, a majority of ANMF members working in aged care indicated they would work more hours if their employer offered them.
n the run-up to the May federal election, Labor promised to mandate RNs on site 24/7, as advocated by the NSWNMA and the Australian Nursing and Midwifery Federation (ANMF), and recommended by the Royal Commission into Aged Care Quality and Safety.
Ms Wells is in talks with the immigration minister, Andrew Giles, about how changes to the visa system could help bring in the workers Australia needs, but she said this was only “one piece of the puzzle”.
Minister ‘confident’ on RNs in aged care
‘We have to get people back into the workforce who have left the workforce; we have nurses working part-time hours who would gladly take on more hours if the money was there to make it justifiable.’’ — Aged Care Minister Anika Wells
“We have to get people who have left the workforce back into the workforce; we have nurses working part-time hours who would gladly take on more hours if the money was there to make it justifiable.”
long border closure for COVID had stopped workers from coming in from overseas, others went back to their home countries during that time, and “a lot of aged care workers are burnt out”.
The ANMF has also pointed out that several hundred nursing graduates are unable to find secure, meaningful employment each year.
The federal minister for aged care, Anika Wells, has raised hopes that every nursing home in Australia will soon have a registered nurse on site 24 hours a day.
The federal minister for aged care, Anika Wells, told The Guardian newspaper in July she was confident the Labor government could meet its commitment on RNs by July 2023.
24 | THE LAMP AUGUST/SEPTEMBER 2022 AGED CARE I
She also confirmed the Labor government would support a pay rise for aged care workers in a case currently before the Fair Work Commission (FWC).
MORRISON LEFT A MESS Labor’s pre-election promises on aged care also included mandating at least 215 minutes of care per resident per day, and supporting and funding a pay rise for aged care workers.
Some states already require at least one RN on site 24/7. Others, such as NSW, require at least one RN on site for morning and afternoon shifts and in some facilities at night.
The 2020 aged care workforce census reported that of Australia’s 2716 nursing homes, 80 per cent already rostered an RN on duty overnight.
The ANMF estimates that just over 750 registered nurses would be needed to ensure at least one RN on site 24/7 in all Australian nursing homes. The ANMF says this number could come from the existing RN Moreworkforce.than80 per cent of RNs working in aged care currently work part time.
“It was in crisis before COVID hit, and COVID has exacerbated all of those conditions, particularly workforce,” she Australia’ssaid.
Unions are seeking a 25 per cent pay increase and Ms Wells said the government would fund whatever increase the FWC decides.
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— Helen Spark, branch secretary and NSWNMA delegate
Coal Services nurses mainly carry out pre-employment and periodic medicals, drug and alcohol testing, fit-testing for masks and hearing protection, and immunisations.
‘Coal Services nurses have been represented by the NSWNMA since 2012 and it’s been very positive for us.’
N
AN IMPRESSIVE DISPLAY OF UNION POWER NSWNMA Assistant General Secretary, Shaye Candish, congratulated Coal Services members on achieving the EBA and setting up a new branch in the same week, describing this as “an impressive display of union power”. Problems surrounding the payment of a $40-per-day on-site allowance to Coal Services nurses was also taken up by the NSWNMA. The allowance has been paid since 2012 to compensate for dust, noise and other conditions.
Pay rises to match inflation
Coal Services members set up an NSWNMA branch, as 5.1 per cent pay increase flows to nurses.
urses providing healthcare services to the coal mining industry have won annual pay increases of 3 per cent or equal to inflation, whichever is Thegreater.pay deal is part of a new enterprise bargaining agreement (EBA) negotiated between the NSWNMA and Coal Services Pty Ltd, which employs about 45 nurses. Under the agreement, their first increase from 1 July this year was 5.1 per cent – in line with inflation as measured by the consumer price index. The union surveyed nurses about their priorities for the new agreement and invited members to take part in a bargaining organising committee (BOC). Six nurses joined the BOC, took part in bargaining meetings with management and reported back to Bargainingmembers. meetings ran from February to June and the new agreement was supported by 98 per cent of Coal Services employees who BOCvoted.members also collected signatures to form a new NSWNMA branch at Coal Services. It covers members at all five office locations: Lithgow, Mudgee, Singleton, Speers Point and Woonona. A sixth office is soon to open at Gunnedah. Branch secretary and delegate Helen Sparke said Coal Services members now had a local union structure to represent them and participate in. “We are scattered across a wide geographical area so we will hold branch meetings by teleconference,” Helen said. “Coal Services nurses have been represented by the NSWNMA since 2012 and it’s been very positive for Sheus.”said an NSWNMA officer helped nurses formulate a log of claims and was involved in discussions with management during the negotiations, “resulting in a good outcome for nurses”. “Having our union’s advice and involvement in our EBA was beneficial and it would have been difficult without that support.”
Helen said management recently adopted a “practice note” with a narrow interpretation of the allowance clause and some nurses believed they were unfairly denied the Afterpayment.negotiations, Coal Services agreed to revise the practice note and consult with industry clients and nurses to determine which sites would give rise to payment of the Theallowance.consultation will include site Heleninspections.saida list of applicable sites would be published to ensure fairness and consistency of payment.
26 | THE LAMP AUGUST/SEPTEMBER 2022 PRIVATE SECTOR NURSES
Coal Services and its subsidiaries are private companies created by statute (the Coal Industry Act 2001 (NSW)), with statutory responsibilities that are administered by the NSW Government.
In February, the branch initiated a petition signed by more than two-thirds of affected nurses, calling on Ramsay to allow all LMPH nurses to wear scrubs. The petition was sent to Ramsay’s chief nurse. In May, Ramsay approved scrubs for nurses across the “Nursescompany.have had some input into the design of the scrubs and we can start ordering them later this year. It is a win for the branch and the nurses who supported the petition,” Bronwyn said. The branch has negotiated other workplace health and safety improvements in recent years. They include routine fit-testing of masks rather than just fit-checking, employing outside staff for front-of-hospital screening rather than taking nurses off the wards and away from direct patient care, and getting workplace health and safety representatives appointed and trained. n
Nurses have long complained about having to wear uncomfortable, ill-fitting and restrictive uniforms in most LMPH wards except the ED, ICU and CCU, where scrubs are Branchpermitted.president and delegate Bronwyn Wratten said when the branch sought their views, almost all nurses indicated a preference for scrubs.
Ramsay Health Care nurses across Australia will finally get to wear scrubs rather than a poorly designed uniform, thanks to an initiative by the NSWNMA branch at Lake Macquarie Private Hospital (LMPH) near Newcastle.
THE LAMP AUGUST/SEPTEMBER 2022 | 27 PRIVATE SECTOR NURSES
EBA NSWNMA members at Coal Services have won: • a 5.1 per cent increase from 1 July 2022. Next year’s increase will be 3 per cent or CPI, whichever is greater • 3 days’ paid natural disaster leave • the right to choose whether overtime is paid out or accrued as time in lieu 3 hours’ employeesengagementminimumforpart-time • the right to use personal leave for self-isolation due to COVID-19 • an increase in family and domestic violence leave from 10 to 20 days. ‘ It’s a win for the branch and the nurses who supported the petition.’
Scrubs for all Ramsay nurses
Highlights of Coal Services
The branch raised the issue with local management, who passed it to Ramsay’s national office.
•
— Bronwyn Wratten, branch president and delegate
28 | THE LAMP AUGUST/SEPTEMBER 2022 forFEENSWNMAWAIVERmembers on parental leave NOTICE DID YOU KNOW, if you’re going on parental leave, paid or unpaid, we’ll waive tountilAssociationyourfeesyoureturnwork? 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 www.nswnma.asn.augensec@nswnma.asn.au Authorised by B.Holmes, General Secretary, NSWNMA
THE LAMP AUGUST/SEPTEMBER 2022 | 29 Contact the NSWNMA if you are: Asked to attend a disciplinary or fact finding interview with your employer Threatened with dismissal Instructed to provide a statement for any reason Contacted by the Health Care Complaints Commission or the Nursing and Midwifery Council of NSW Contacted by police or solicitors in relation to a Coronial Inquest There are some things you shouldn’thandle alone. Call us on 8595 1234 (metro) or 1300 367 962 (non-metro) Email gensec@nswnma.asn.au www.nswnma.asn.au
Wednesday 2 November, 9am to 3pm Aged Care: Disability and Ageing Tuesday 22 November, 9am to 5pm
Friday 16 September, 9am to 4.30pm bit.ly/educationNSWNMA
The Deteriorating Patient
Friday 21 October, 9am to 4.30pm
Tuesday 25 October, 9am to 4pm
Go to the education page of our website to search our face-to-face and webinar CPD options.
Wednesday 14 September, 9am to 4pm
Law,WollongongEthicsandProfessional Standards in Nursing and Midwifery
The Deteriorating Patient Wednesday 30 November, 9am to 4pm
Face to face education opportunities for the reminder of 2022
PROFESSIONAL EDUCATION
AgedGosfordCare:Reactive Behaviours
Thursday 27 October, 9am to 4pm Dee Self-Care,WhyResilience and Self-Leadership Training
Aged Care: Care Planning Friday 7 October, 9am to 3pm Self-Care, Resilience and Self-Leadership Training
Wednesday 7 December, 9am to 3pm Law,GraftonEthicsand Professional Standards in Nursing and Midwifery
CPD hours for these courses can be calculated by the time you spend actively learning. This will vary between individuals, as further selfdirected learning can be included (e.g. reviewing the associated resources and completing the reflective questionnaires). Planning for 2023 is due to commence soon and we intend to visit more regional areas throughout the year! We also have our wide range of live webinars relevant to nursing and midwifery practice, all free!
Aged Care: High Impact, High Prevalence Incidents
ClinicalWaterlooCommunication and Documentation
Thursday 18 August, 9am to 4pm
Aged Care
DiversityBlacktowninResidential
SupportingNewcastlePeople Living with Dementia Tuesday 20 September, 9am to 5pm Medications: How we do it better Wednesday 9 November, 9am to 4pm Medications:Penrith How we do it better
Thursday 8 September, 9am to 4pm
Thursday 25 August, 9am to 4pm
REFERENCEEDUCATION GROUP
MORE INFORMATION + EXPRESSION OF INTEREST: email education@nswnma.asn.au
CLIMATE CHANGE ACTION REFERENCE GROUP
The NSW Nurses and Midwives’ Association is seeking members to join the Education Reference Group. The group will meet 4-6 times per year to discuss current issues and challenges facing education within the nursing and midwifery professions. Meetings are held in a blended Zoom/face-to-face format to allow members to be involved regardless of geographical location.
The NSW Nurses and Midwives’ Association is seeking members to join the Climate Change Action Reference Group. The group will meet 4-6 times per year to discuss current issues and challenges the climate crisis has on the nursing and midwifery professions. Meetings are held in a blended Zoom/face-to-face format to allow members to be involved regardless of geographical location.
Current NSWNMA members who work in, are involved with or have an interest in climate action are invited to join.
Being a member of the Climate Change Action Reference Group gives you the opportunity to: be a voice for the climate issues impacting nurses, midwives and the profession assist in the development and reviewing of policies be a link between members and the Association
Being a member of the Education Reference Group gives you the opportunity to: be a voice for educational issues impacting nurses, midwives and the assistprofessioninthe development and reviewing of policies be a link between members and the Association
MORE INFORMATION + EXPRESSION OF INTEREST: email education@nswnma.asn.au
THE LAMP AUGUST/SEPTEMBER 2022 | 31
Current NSWNMA members who work in, are involved with or have an interest in education are invited to join.
Whilst the Ministry of Health initially sought some feedback from public health unions on this initiative after the NSW Government’s announcement, unfortunately without further consultation or receiving answers to the many questions we posed, the Ministry released the policy directive.
When it comes to your rights and entitlements at work, NSWNMA Assistant General Secretary Shaye Candish has the answers.
Categorisation of the bush
Budget announcement Where did this new scheme come from?
The usual political speak about a system being under pressure but coping. A fear to be honest and confront the reality of the situation – equal parts hubris and ignorance. Have we learned nothing? Care cannot be delivered if nurses and midwives are not there, or staffing accountability on a shift-by-shift basis is not present. Regardless of the health or care setting, more nurses and midwives are needed. Governments of all persuasions and their bureaucracies need to admit we have reached rock bottom. If we are open and honest about that fact, then maybe we can really start to rebuild.
New Health policy
32 | THE LAMP AUGUST/SEPTEMBER 2022 YOUR
There is absolutely no doubt that the sustained pressure of Association members, and the damning findings of the Upper House Inquiry into health and hospital services in rural, regional and remote New South Wales, meant the NSW Government could no longer avoid this longstanding and endemic problem.
Positions included What roles will potentially be included in any incentive?
Union input Did the Association have any input to this new policy?
locations may be deemed rural and remote by the Ministry of Health considering unique location attributes that present challenges to attraction and retention of the health workforce.
Firstly, it will only apply to roles undertaken by employees of the NSW Health Service, and excludes contractors, agency nurses, Visiting Medical Officers or contingent workforce who are not paid through the NSW Health payroll. Secondly, to have the incentives applied (recruitment or retention) to a specific position or class of role, they will need to be identified as being hard to fill or a critical vacancy as defined under the policy directive. – Rural Health Workforce Incentive
The Ministry of Health recently released the Rural Health Workforce Incentive Scheme (PD2022_025). This sets out the broad framework of the scheme, along with its key features.
Special edition
How will this scheme to be applied in the NSW Health Service?
The lack of logic and public alarm is disturbing Early August 2022, and we have COVID-19 and influenza cases reaching peak levels. Two and a half years of preparation, awareness and lived experience should have been enough to ensure readiness. But what has been delivered? Record numbers of COVID-19 cases, hospitalisations and, sadly, deaths. Influenza case numbers not seen for years. All-toopredictable levels of staff being absent – either unwell or in isolation, or simply crushed under the weight of work demands. Our public health system lies near broken. Aged care facilities are being ravaged by outbreaks in numbers beyond even last year. We continue to break records, but all the wrong ones. And what is the response?
It will only apply to locations in NSW outside the metropolitan and regional city centres and their immediate surrounds. Rural and regional hospitals and services will be classified using the Commonwealth Department of Health’s Modified Monash Model, with the incentives potentially available to those identified as being MM3 to MM7. For example, Wagga Wagga would be classified as MM3, Mudgee MM4, Lockhart MM5, Nyngan MM6 and Bourke OtherMM7.
Timing Why now after all these years?
Leading up to the NSW Budget, the NSW Government announced it would commit $883 million over the next four years to attract and retain staff in rural and regional NSW. However, the release was big on headlines and light on detail.
RIGHTSAskShaye
Where will the incentive schemes be applied?
Package makeup Who decides the makeup of any incentive package?
Next steps What happens next? Members should check out the policy directive whilst the Association seeks to have the many unanswered questions clarified by the Ministry.
IncentivesRIGHTS
Transfer incentives
New grads get things done Aged care win Hope for change Out now! Listen on NSWNMA’s fortnightly podcast
THE LAMP AUGUST/SEPTEMBER 2022 | 33 YOUR
Leaving the scheme Can I leave an incentivised placement early? Certain constraints are applied if one was to leave an incentivised position prior to its term concluding, with repayment requirements possible. However, it may be possible to transfer to another incentivised role and maintain the incentives in place.
family travel assistance; transfer incentives (see below); study assistance; or a cash bonus.
What are the transfer incentives mentioned?
What is the value of the incentives? The value of the incentive that could be applied to a position or a class of role will be either $5,000 or $10,000, depending on the MM rating and whether the position is hard to fill and / or critical to service delivery. Additional benefits over and above this amount can be considered in certain circumstances.
This includes a right to return to your substantive position (or like position) if only undertaking a fixed temporary secondment. However, it does also include consideration of a priority transfer to a preferred location nominated by the worker at the conclusion of the secondment. This would need to be agreed prior to commencing the incentivised engagement and have Ministry of Health approval.
A range of options may be used to tailor the recruitment or retention package that suits the individual ie it is not necessarily intended to be a one size fits all approach (as understood by the Association). You should have a say in how you would like the incentive used.
Monetary incentives What type of things could the incentives be used for? Examples used in the policy directive (noting some are dependent on the MM rating applied) include: professional development; salary;personalreimbursement;computer/internetadditionalleave;additionalbasereimbursementofutilities;
34 | THE LAMP AUGUST/SEPTEMBER 2022 We’re looking after your benefit rewards We’ve joined forces with Member Advantage, Australia’s leading loyalty program, to bring you a membership benefits program that offers you hundreds of savings every day. As a member of The NSW Nurses & Midwives’ Association, you can enjoy: • 4% off groceries at Coles and Woolworths • 7% off purchases at over 10,000 pubs and bars • 25% off a pair of glasses at Specsavers • 5% off petrol at Caltex • Up to 60% off hotel bookings • Discounted movie tickets • Commercial pricing at The Good Guys Plus much, much more! Log in today to start accessing your rewards. online.nswnma.asn.au Terms and conditions apply to all offers. customercare@memberadvantage.com.au1300853352 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
THE LAMP AUGUST/SEPTEMBER 2022 | 35 LIONS NURSES’ SCHOLARSHIP Looking for funding to further your studies in 2023? The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships. Nurses eligible for these scholarships must be resident and employed within the State of NSW or ACT. You must currently be registered with the Nursing and Midwifery Board of Australia and working within the nursing profession in NSW or the ACT, and must have a minimum of three years’ experience in the nursing profession – the last 12 months of which must have been spent in NSW or the ACT. Details of eligibility and the scholarships available (which include study projects either within Australia or overseas), and application forms are available from: oror50LionsAdministrationwww.nswnma.asn.au/educationLiaisonNurses’ScholarshipFoundationO’DeaAvenueWaterlooNSW2017contactMattWeston1300367962education@nswnma.asn.au COMPLETED APPLICATIONS MUST BE IN THE HANDS OF THE SECRETARY NO LATER THAN 31 OCTOBER THE LIONS NURSES’ SCHOLARSHIPS OPEN ON 1 AUGUST AND CLOSE ON 31 OCTOBER EACH YEAR
The
Roz Norman was an outstanding activist, branch official and Councillor of the NSWNMA and ANMF. honour of her outstanding contributions, the Roz Norman Scholarship was created to further humanitarian, social or community causes. scholarship covers fees for an approved course promoting activism and the development of campaigning skills or public advocacy, including ongoing financial support for reasonable costs associated with campaigning for a period of one year, up to a maximum of $5,000. Branch Officials or highly active members who can demonstrate leadership qualities are encouraged to apply. Successful recipients are required to report back to Committee of Delegates (COD) at the end of the scholarship period.
In
NSWNMA
Applications open 1 July, closing 30 September 2022 ScholarshipActivism•Campaigning•Advocacy To apply go to bit.ly/RozNormanScholarship Further enquiries Email: education@nswnma.asn.au Metro: (02) 8595 1234 • Rural: 1300 367 962
UNFPA, the UN’s sexual and reproductive health agency, said it feared that if women faced greater barriers to getting terminations, more unsafe abortions would occur, particularly in low- and middleincome countries.
UNITED STATES US abortion bombshell has international ramifications
A study published in The Lancet Infectious Diseases modelled the spread of the disease in 185 countries and territories between December 2020 and December 2021.
It found that without COVID vaccines, 31.4 million people would have died, and that with the vaccines, 19.8 million of these deaths were avoided.
Many more deaths could have been prevented if access to vaccines had been more equal worldwide. Nearly 600,000 additional deaths – one in five of the COVID deaths in lowincome countries – could have been prevented if the World Health Organization’s global goal of vaccinating 40 per cent of each country’s population by the end of 2021 had been met, the research found.
“The United States now is out of step with the rest of the world, and fails to take into account the overwhelming global medical evidence that supports abortion as essential health care,” she said.
The move by the US Supreme Court to reverse the historic Roe v. Wade decision – which recognised that a pregnant woman’s right to choose an abortion was protected under the constitution –has global implications, health experts say. Health organisations are concerned that the decision could increase pressure on healthcare workers who perform abortions, and threaten hard-won gains in countries where stigma around terminations is still strong.
‘The inequitable distribution of vaccines prolonged the pandemic.’
Critics say the US Supreme Court’s decision to overturn abortion rights was dictated by politics rather than evidence-based health opinion.
“The saving of more than 19 million lives by the unprecedented rapidity of development and rollout of COVID-19 vaccines is an extraordinary global health feat.”
36 | THE LAMP AUGUST/SEPTEMBER 2022 NEWS IN BRIEF
“The fallout from this calculated decision will also reverberate worldwide,” said Dr Alvaro Bermejo, director of the International Planned Parenthood Federation (IPPF).
“The justices who put their personal beliefs ahead of American will, precedent and law will soon have blood on their hands, and we are devastated for the millions of people who will suffer from this cruel judgment.” Dr Jeanne Conry, president of the International Federation of Gynaecology and Obstetrics (FIGO), said the impact of the decision would be “felt on a global scale”.
‘The justices who put their personal beliefs ahead of American will, precedent and law will soon have blood on their hands.’ — Dr Alvaro Bermejo, International Planned Parenthood Federation WORLD COVID vaccines saved 20 million lives in first year
The unprecedented rapidity of development and rollout of COVID-19 vaccines is hailed as “an extraordinary global health feat”.
The researchers, from the Imperial College London, said: “The inequitable distribution of vaccines prolonged the pandemic, and exacerbated the probability and frequency of the emergence of variants of concern.”
The study highlighted lessons to be learned from the pandemic: improvements in vaccine supply, cold-chain operations, and public confidence.
“Provision of vaccine doses from high-income to lowerincome countries is therefore not only moral but also pragmatic,” they said.
Prof. Margaret Hellard from the Burnet Institute told a Victorian parliamentary inquiry in June that Australia could record as many as 15,000 COVID deaths in 2022 alone. Federal health minister Mark Butler says authorities are expecting a further wave of the virus over the next few months from the BA.4 and BA.5 “We’vesubvariants.seenoverseas that there is a greater risk of reinfection, so if you have had COVID earlier this year in the first wave over summer, there is a risk that you are open to reinfection,” he said. “I do encourage you to go out and get that booster –it will provide further protection against the possibility of reinfection with these new subvariants over the coming months.” many as COVID deaths 2022 alone.’
THE LAMP AUGUST/SEPTEMBER 2022 | 37 NEWS IN BRIEF CROSSWORD SOLUTION
Call the NSWNMA on 1300 367 962 and find out how you can access this great service Quality NSWNMAadvicelegalformembers • 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 Offices in Sydney and Newcastle with visiting offices in regional areas (by appointment)
15,000
Ten thousand dead and counting
AUSTRALIA
‘Australia could record as
The number of deaths in Australia from COVID has passed the 10,000 mark. The first death occurred in March 2020. By August 2021 there had been 1000 deaths. There has been a steep escalation in the number of deaths from COVID in Australia over the last year.
COVID deaths have reached a sobering milestone in Australia and new variants suggest there are more waves of the virus to come.
in
The arrival of the Omicron variant in Australia at the end of 2021 (which coincided with the let-it-rip policy by authorities) saw the death count rise steeply to 5000 deaths in February of this year. The 10,000-death mark was passed on 3 July.
Productivity is growing at almost twice the average rate over the past decade and profits are increasing at more than 20 per cent, but the labour share of GDP has hit an all-time low, according to figures released by the Australian Bureau of Statistics.
— ACTU President Michele O’Neil
“Work-related mental health conditions are the fastest growing injury type in Australia. Our work must include eliminating psychological risk factors, including high workloads, poor work support, as well as gendered violence and harassment, if we want to continue making work safe and healthy.”
It is estimated that in the Asia–Pacific region there are more than 1.1 million deaths each year from work-related trauma or Indisease.Australia, 200 workers die at work each year. A further 5000 workers will die from occupational diseases, including asbestos-related disease and silicosis. ‘Health and safety at work goes health’psychologicaltoincludesinjuriesphysicalbeyondandrisksworkers’
— ACTU Secretary Sally McManus
The right to a safe and healthy work environment has been enshrined in the International Labour Organization’s Declaration on Fundamental Principles and Rights at Work.
“Productivity and profits are at record-high levels, while workers are experiencing both real wage cuts and a cost-of-living crisis,” said ACTU Secretary Sally “ActionMcManus.mustbe taken to ensure the over 13 million working people of our country are sharing in our nation’s prosperity.
After years of campaigning by workers globally, the right to a healthy and safe workplace has been adopted as a new fundamental right at this year’s International Labour Conference in Geneva. This principle now sits alongside the right of freedom of association and the right to collective bargaining, the elimination of forced labour, the abolition of child labour, and the elimination of discrimination in respect of employment and ACTUoccupation.President Michele O’Neil, who spoke at the ILO conference, said that although this was an incredible achievement, more work needed to be done to improve occupational safety and health.
“The ABS data reveals that businesses can easily afford fair wage increases that would stop further real wage cuts and address the cost-of-living crisis. It’s time for action to end years of low wage growth and real wage cuts.”
AUSTRALIA Health and safety recognised as a fundamental right by ILO
38 | THE LAMP AUGUST/SEPTEMBER 2022 NEWS IN AUSTRALIABRIEF
Productivity and profits are up, but workers aren’t getting the benefits.
The economy grew at 3.3 per cent over the last year. Productivity grew 2.8 per cent in the year to March, almost triple the average of about 1 per cent over the past decade. Business profits doubled to reach 21.6 per cent for the year to March, while the labour share of national income fell to the lowest on record at 45.1 per cent.
“Health and safety at work goes beyond physical injuries and includes risks to workers’ psychological health,” she said.
The ACTU says urgent action is needed to ensure that working people share in the wealth of the economy and in the recovery from the pandemic.
Workers’ share of GDP hits all-time low
‘ Businesses can easily afford fair wage increases that would stop further real wage cuts and address the cost-of-living crisis.’
Research finds global heating is reducing people’s sleep, especially among women and older people, with serious health impacts.
“In Europe, chronic liver disease has a substantial impact on young and middle-aged individuals in their prime working years, with the peak age of death occurring in the late 40s and early 50s. This contrasts with mortality from smoking-related and other obesity-related illnesses, such as lung cancer or type 2 diabetes, for which deaths typically occur in the 60s and 70s,” he Expertssaid. were unanimous on the two key tools needed to reduce alcohol consumption: raise the price and reduce the marketing.
The researchers used data from sleep-tracking wristbands used by 47,000 people over a total of 7 million nights and across 68 countries.
UNITED KINGDOM
The sleep loss per degree of warming is about a quarter higher for women than men, twice as high for those over 65 years old and three times higher for those in less affluent Women’snations.bodiescool
“It’s well documented that the price of alcohol matters. Wales and Scotland put a minimum price (on alcohol) and overnight it lowered consumption,” said Aleksander Krag, Vice-Secretary of TheyEASL.also recommend a complete social and digital media ban on the marketing of alcohol.
The lead researcher, Kelton Minor from the University of Copenhagen, Denmark, said: “Growing numbers of people in many countries around the world do not sleep enough.”
The healthiest amount of alcohol consumption is zero
Experts on liver disease advocate less consumption, less advertising and higher prices for alcoholic beverages.
THE LAMP AUGUST/SEPTEMBER 2022 | 39 NEWS IN BRIEF
That was the key message from a conference held by the European Association for the Study of the Liver (EASL) and The Lancet Prof. Nick Sheron, a clinical adviser to Public Health England, told the conference that in general, liver disease impacted on a younger demographic.
‘Chronic liver disease has a substantial impact on young and middle-aged individuals in their prime working years.’
Previous studies have shown that rising temperatures damage health, including increased heart attacks, suicides and mental health crises, and accidents and injuries, as well as reducing the ability to work.
earlier in the evening than men’s when going to sleep, meaning higher nighttime temperatures may have a bigger impact on women.
“In this study, we provide the first planetary-scale evidence that warmer than average temperatures erode human sleep.”
The study found that the average global citizen is already losing 44 hours of sleep a year, leading to 11 nights with less than seven hours’ sleep, a standard benchmark of sufficient sleep. Some groups are affected much more than others.
DENMARK
The largest study to date has found that rising temperatures driven by the climate crisis are affecting people’s sleep across the world, reports The Guardian.
‘ Growing numbers of people in many countries around the world do not sleep enough.’
If you want to look after your liver and you can’t completely abstain from alcohol, you need to have at least three consecutive days a week alcohol-free. Even then, only by taking alcohol in moderation for the other four days, combined with a healthy diet, will avoid damage to your liver.
More sleepless nights on a hotter planet
40 | THE LAMP AUGUST/SEPTEMBER 2022 Recruit a new member and go into the draw to win a rejuvenating holiday in Experience the ultimate private pool villa luxury at the award-winningAgata Villas in Seminyak, Bali Secluded tropical bliss awaits at Agata Villas Seminyak – your own private paradise. Discreetly tucked away from the hustle and bustle of Seminyak yet within easy reach of the beach clubs, restaurants and boutique’s Seminyak is known for. SeminyakBali $5,000Valuedatover THE 2022 – 2023 NSWNMA MEMBER RECRUITMENT SCHEME PRIZE You and a friend will experience: • 1 x BBQ Seafood dinner at Melati Seafood Restaurant, Jimbaran (up to four guests) • Daily afternoon tea • 1 x Full Day Tour per stay (private charter) • Welcome seasonal fruit basket and drink each guest on arrival • The NSWNMA will arrange return flights for two to Bali • 5 nights’ accommodation in a two-bedroom pool villa • Inclusions valid for up to four guests (NSWNMA will arrange for two return flights only as part of this prize)* • Return airport transfers • Daily breakfast served in your villa • 2 x a la carte lunches and 2 x dinners per stay Recruiters note: Join online at www.nswnma.asn.au Every member you sign up over the year gives you an entry in the draw! 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. The prize will be drawn on 1 July 2023 and must be redeemed by 30 June 2024. Subject to room availability. Block out dates 24 December 2023 – 3 January 2024. Accommodation package and inclusions (excluding flights) is valid for up to four guests. NSWNMA will arrange and pay for flights for two to Bali. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. Prize drawn 1 July 2023
THE LAMP AUGUST/SEPTEMBER 2022 | 41 CROSSWORDtestKnowledgeyour ACROSS 1. Separation of the neurosensory retina from the pigment epithelium layer (7.10) 9. Disincentive (10] 12. Above, overhead (4] 14. The symbol for aluminium (2] 15. Became less acidic (10] 16. A painful sore or swelling around a fingernail or toenail (6] 17. Symbol for iron (1.1) 18. Inflexible; rigid, unchangeable. (8] 19. Of equal tension (8] 21. The death of a newborn (8.9) 25. Ethyl (1.1) 26. The entrance into a canal or hollow organ (9] 27. Utilisation (5] 28. Understanding gained through experience or study (9] 31. Left eye (2] 33. Capable of distinct and connected speech (10] 35. Lured, tempted (7] 37. A natural body chemical made during melanin making process (4] 38. A genetic disorder where the body produces red blood cells that are unstable (6.4.7) DOWN 1. Systemic condition seen after nuclear explosions or accidents (9.8) 2. Giant (5] 3. A flammable, toxic and carcinogenic liquid, which is absorbed through the skin, lungs and GI mucosa (13] 4. Energetical (9] 5. A type of martial arts (9] 6. Gallbladder (11] 7. Felt jealous (6] 8. Involuntary movements of facial muscles and tongue, usually caused as a neurologic side effect of certain drugs (7.10) 10. A fibrous protein similar to collagen (7] 11. Symbol for chlorine (1.1) 12. Edible viscera of a butchered animal (5] 13. Ethinyl Estradiol (1.1) 20. Incision or seizure with the teeth (4] 22. Relating to the study and treatment of defective binocular vision (9] 23. Skilled (9] 24. Make laws (9 27. Resembling a scar (5] 29. Anaesthetic that numbs a particular area of the body (5] 30. Symbol for gallium (1.1) 32. Contempt, disdain (5] 34. Raise (2] 36. An antiviral HIV drug (1.1.1) 91 10 12 13 16 18 2019 2122 23 25 26 27 28 29 30 32 33 34 3835 36 3731 2417 14 15 11 2 3 45 6 7 8
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ALL OFFERS: For full t&c’s go to https://travelbenefits.ubookdirect.com Queensland offer: valid for travel 9 October 2022 until 31 March 2023. Rate based on 2 adults, minimum 3-night stay & subject to availability. Sydney offers: valid for travel until 31 March 2023. Rate based on 2 adults & subject to availability. Bali offer: Valid for travel until 30 June 2023. Rate based on 2 adults, minimum 5-night stay and subject to availability.
42 | THE LAMP AUGUST/SEPTEMBER 2022 TRAVEL Take a look at these fabulous holiday offers Never pay full price for a holiday again
UBOOKDIRECT is giving members a $20 voucher to use on any already discounted member package when booking through the Concierge. To book one of these fantastic destinations log on to https://travelbenefits.ubookdirect.com and click on the ENQUIRY tab or call 1300 959 550.
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Stay 3 nights and only pay for 2 in a Spa Room for as low as $270 with the following inclusions: free parking and WiFi. Use your $20 voucher to save even more.
• Daily breakfast and afternoon tea • Return airport transfers • 2x free lunches and 2x free dinners / stay • 1x full day private charter tour per stay (7 nights+) • 1x BBQ seafood dinner / stay at Melati Seafood Restaurant Jimbaran Beach (7 nights+) • Welcome drink, tropical fruit basket and Wi-Fi
Ubookdirect offers all NSWNMA members discounted rates on 1000's of hotels Australia wide. Fill in a quote request today to save on your next getaway. Book your school holidays now to get the best discounted rates.
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Escape to the blissful tropical paradise that is Silkari Lagoons Port Douglas. Long stretches of white sandy beaches, blue waters and tropical weather. You deserve it! Silkari Lagoons Port Douglas, Queensland OFF!55%
Deals start from $132 per night for a Premium Room with kitchen, in the heart of Sydney’s CBD with the following inclusions: late checkout and free WiFi. Use your $20 voucher to save even more.
Many of us dream of staying as young as possible as long as possible whether we're in our 30s, 40s, 70s or even 80s, and there's a growing Conga line of products and people offering you just that dream. The dilemma is, which of the pills, mental and physical exercise programs, diets and superfoods actually work? S INTERES T INTEREST
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.
THE LAMP AUGUST/SEPTEMBER 2022 | 43
Issac And The Egg Bobby Palmer: Hachette Australia RRP $32.99: 9781472298638ISBN Find hope in friendship.griefnoveldebutunforgettableinunexpectedthethisaboutand
Dr Norman Swan Hachette Australia RRP $34.99: ISBN 9780733648342
Fourteen-year-old Tilly’s world is torn apart when her single mother dies suddenly and she is sent a million miles from everything she has ever known to a small country town and a guardian who’s a total stranger. She doesn’t believe she can ever be happy again.
The ultimate guide on what you can do at any age to stay young and healthy longer, from Australia's trusted, straighttalking doctor and broadcaster, Dr Norman Swan, bestselling author of So You Think You Know What's Good for You?
PECIAL
Sometimes, to get out of the woods, you have to go into them. Isaac and the Egg is one of the most hopeful, honest and wildly imaginative novels you will ever read.
Megan Goldin Penguin Random House 9781760897222$32.99:RRPISBN
A young man walks into the woods on the worst morning of his life and finds something there that will change everything. It’s a tale that might seem familiar. But how it speaks to you will depend on how you've lived until now.
The Happiest Little Town
Barbara Hannay Penguin Random House RRP $32.99: ISBN 9781760899431
REVIEWSbook club
So You Want To Live Longer?
thriller that unfolds at a breakneck speed, Stay Awake will keep you up all night. Megan Goldin’s Stay Awake is an electrifying novel that plays with memory and murder. Liv Reese wakes up in the back of a taxi with no idea where she is or how she got there. When she’s dropped off at the door of her brownstone, a stranger answers—a stranger who claims to live in her apartment. She reaches for her phone to call for help, only to discover it’s missing. In its place is a bloodstained knife.
SPECIAL
The Abythehasauthorthethrillerstoppingheart-newfromAustralianwhotakenworldstorm.complex
Stay Awake
The uplifting new novel by the bestselling author of The Garden of Hopes and Dreams. Happiness has a way of catching up with you, even when you’ve given up trying to find it.
• On your exhale: – Push through front heel; – Lock front leg out; – Lean forward slightly so that you’re not loading lower back; – Squeeze your glutes together Repeat 5 times each side to progress work up to 20 each side
44 | THE LAMP AUGUST/SEPTEMBER 2022 YOUR HEALTH fitness+wellbeing
• Step back with one large step. You may almost feel a loss of balance, but thankfully this exercise also assists with balance.
Note: If you can’t perform full range, you can elevate your front foot.
• On your inhale: – Rotate hips outwards as much as possible; – Go as far as you can your end range, before where the knee starts to collapse.
• Place your feet hip width apart
• Stand on one leg and hinge forward placing hands on a wall, bench, chair or sink for support. Have your other foot in the air (having a bent back leg makes this exercise easier to complete).
• On your exhale: – Rotate hips inwards as much as possible; – Continue until the foot rolls out or is blocked by your standing hip Repeat 10 times each side.
Two movements to help your hips that can be done at work Karl from Vitruvian Health shares two movements you can do to improve your posture that you can do at work: Split Squat and Assisted Aeroplanes
How to perform Assisted Aeroplane
To progress this exercise, reach your hands outwards like you have wings. Congrats you’re now an aeroplane! Want to follow along to this exercise? Check out this video with Karl.
Now don’t worry you don’t need to be able to do the splits for split squats and you don’t need to get on an aeroplane to do assisted aeroplanes - though it’s always fun to make the sounds while you’re doing these Theseexercises.awesome movements are ones you can do anywhere! The beauty of this exercise is that you don’t need any equipment to do it and you can perform it at any time of the day when you have a spare few minutes. If you're finding it difficult though, using a step or a wall can make it easier. You can follow this workout on channel.InstagramHealth’sVitruvian
• On your inhale: – Bend front knee; – Push back hip forward; – Bring your chest up to the sky as you go down.
How to perform Split Squat
Wendy Foster, Lois McKellar, Julie-Anne Fleet, Linda Sweet Across the world, midwives are considering leaving the profession. Midwives have cited reasons such as excessive workload allocations and inappropriate staffing levels, increasing levels of administrative duties, non-family friendly rostering and clinical hours, traumatic workplace events and Nationally,burnout.it has been identified that almost half of Australian midwives surveyed had considered leaving midwifery practice in the subsequent six months. The primary reason given for considering leaving included both dissatisfaction with the organisational structure of midwifery and an inability to practice in accordance with their practice Midwiferyphilosophy.isunderpinned by a philosophy that places women and their families at the centre of care, with a commitment to ethical practice and evidencedbased care.
The International Confederation of Midwives’ International Code of Ethics for Midwives states: “Midwives have responsibilities to themselves as persons of moral worth, including duties of moral self-respect and the preservation of Asintegrity”.anethically informed profession, there is a high likelihood that midwives experience morally challenging situations. When unable to protect professional and personal values in the workplace, midwives have reported psychological trauma, primary and secondary traumatic stress, burnout, anxiety and depression. The concept of moral distress may be one factor that has been largely overlooked when evaluating the psychological wellbeing of midwives. The purpose of this paper is to explore Australian midwives’ experience and consequences of moral distress.
Moral injury involves a deep emotional wound and is unique to those who bear witness to intense human suffering and cruelty. This article aims to synthesise the very limited evidence from empirical studies on moral injury and to discuss a better understanding of the concept of moral injury, its importance in the healthcare context and its relation to the wellknown concept of moral distress. Some cases of moral distress may turn into moral residue and end in moral injury with time, and in certain circumstances and contexts. The association between these concepts needs further investigation and confirmation through empirical studies; in particular, where to draw the line as to when moral distress turns into moral injury, leading to severe consequences. Given the very limited research on moral injury, discussion of moral injury in the context of the duty to care, for example, in this pandemic’s settings and similar situations warrants some consideration.
We have talked a lot over the years about the risk of burnout for nurses and midwives. Since the pandemic there is recognition of a more severe form of psychological distress affecting healthcare workers: moral injury.
Moral injury in healthcare professionals: a scoping review and discussion
This guide to moral injury during COVID-19 has been developed as a practical resource for healthcare workers and organisations to better understand the range of moral emotions arising from the COVID-19 pandemic, and to develop organisational and individual strategies to mitigate risks of lasting harm. Since the onset of the COVID-19 pandemic, there has been a flood of articles, commentary and media published regarding the mental health effects it has had on healthcare workers.
Anto Čartolovni, Minna Stolt, P Anne Scott, and Riitta Suhonen Moral injury emerged in healthcare discussion quite recently because of the difficulties and challenges healthcare workers and healthcare systems face in the context of the COVID-19 pandemic.
articles/PMC8366182/https://www.ncbi.nlm.nih.gov/pmc/
In addition to basic emotional reactions such as fear, we’ve seen reports of a range of responses that involve moral emotions such as shame, guilt and demoralisation during both the COVID-19 pandemic and previous mass-disease outbreaks. When we seek to understand the emotional responses to COVID-19, and consider what we can do to support people, we need to have the full range of moral emotions in mind. Our approach reflects the importance of recognising the interaction between individual and environmental factors in understanding moral emotions and moral injury.
NURSING RESEARCH AND PROFESSIONAL ISSUES
S1871519221001578?via%3Dihubcom/science/article/abs/pii/https://www.sciencedirect.
THE LAMP AUGUST/SEPTEMBER 2022 | 45
Moral stress amongst healthcare workers during COVID-19: a guide to moral injury
Exploring moral distress in Australian midwifery practice
Phoenix Australia – Centre for Posttraumatic Mental Health and the Canadian Centre of Excellence –PTSD (2020)
Guide-to-Moral-Injury.pdfStress-Healthcare-Workers-COVID-19-wp-content/uploads/2020/07/Moral-https://www.phoenixaustralia.org/
46 | THE LAMP AUGUST/SEPTEMBER 2022 www.nswnma.asn.auUnsure if you are It’sfinancial?easy! Ring and check today on 8595 1234 (metro) or 1300 367 962 (rural) Change your payment information online at www.nswnma.asn.au ForBENEFITSINSURANCENSWNMAMembers 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 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. needwhenprotectionInsuranceyouitmost 1/ 3/ 4/ 5/
Recently moved house or changed jobs? Changed your classification or email? Everyone who uses our online portal from 1 April 2022 –30 March 2023 to update their details will automatically be entered in the draw to win. * The winner must be a financial member of the NSWNMA. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. Log on to online.nswnma.asn.au and update your details to go into the draw. Win an APPLE WATCH
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