21 minute read
Increasing number of Victorian COVID 24 COVID-19
A life put on hold
Regional nurse manager, Gary Clark, told the IRC about the inspirational role nurses have played behind the scenes to construct a barrier to COVID-19 in NSW correctional services. Gary told the Commission that working in prisons “is not a glamorous area of health”, however, it is an area where nurses can make a significant impact on patients and the lives of their families. While it may not be glamorous, overseas experience shows nurses in prisons play a critical role during a pandemic. As of 3 July, the five worst outbreaks of COVID-19 in the United States have occurred in prisons. The hardest hit institution is Marion Correctional Institution in Ohio with 2439 cases. There had been 40 outbreaks of COVID-19 in the United States that involved clusters of 500 or more people. Of those, 31 occurred at correctional facilities. Gary says incarcerated patients are at significant risk of contracting COVID-19 as they are housed in large dormitories or close-contact cells. “Bathrooms are communal and social distancing is almost impossible to maintain,” he says. Away from the public eye there have been thorough preparations to pre-empt COVID-19 outbreaks in Australian jails, with nursing staff at the forefront. These include: • quarantining and testing of all new patients • isolating all patients with symptoms • screening all staff on entry to work • minimising all movements of patients.
Gary was seconded to work with a superintendent from Corrective Services to develop and build a ready-for-operation field hospital should COVID-19 levels become a major issue. There is a contingency to build up to nine field hospitals across NSW, aligned to isolation hubs at regional jails. Gary says staff worked tirelessly, seven days a week over the four weeks, with collaboration with Corrective Services to ensure they were prepared for the COVID-19 pandemic and its possible impact on the correctional system in NSW. “Every area of the nursing community contributed to ensure the commissioning of the field hospital was achieved within four weeks – infection control, HR, educators, unions, management, work health and safety, infrastructure and procurement,” he said.
“My family and friends took a back seat for close to six weeks to ensure the field hospital was built and all the staff were properly trained and educated. “I was proud of what an expert job my colleagues did to work so closely and collaboratively with Corrections to ensure the safety of our patients and staff.” The pay freeze, he said, would have consequences for the retention of nurses who had proven themselves as a bulwark against the coronavirus. “Having no pay rise this year would mean I would have to make difficult decisions such as decreasing the level of my private health coverage and decreased spending on entertainment, takeaway food, dining out and holidays,” he said. “The long-term impact on my superannuation is also of concern after a career of almost 40 years.”
Don’t delay the Super increase
Nurses and midwives stand to lose thousands of dollars a year in retirement income if the Morrison government freezes the superannuation levy.
Is the Morrison government about to take an axe to the retirement savings of workers, including nurses and midwives?
A group of 10 Coalition federal MPs has urged the government to delay or cancel scheduled increases to the compulsory superannuation levy.
They claim employers cannot afford an increase due to the coronavirus pandemic.
Those MPs get superannuation of 15.4 per cent on top of their parliamentary pension and other post-parliamentary benefits.
For the rest of us, superannuation is due to rise from 9.5 per cent to 10 per cent in July 2021 and 12 per cent by 2025.
Freezing the levy at its current rate would cost a 30-year-old worker earning $40,000 a year about $10,000 less each year in retirement, according to former Labor prime minister Kevin Rudd.
Rudd said the Liberal Party was “softening the electorate up” for a superannuation freeze even before COVID-19 struck.
He pointed out that the government commissioned a former Liberal government staffer, Mike Callaghan, to head an inquiry into retirement incomes. Callaghan’s
report was due in late July.
The public intervention by 10 Liberal MPs “dispelled any doubt as to the strategy” Rudd wrote in the Sydney Morning Herald.
“You simply do not get onein-five backbenchers speaking in unison like that unless it has been authorised by the leader, especially when the group includes a gaggle of ministerial aspirants,” he said.
“Using the bushfires and pandemic as political cover, Morrison is determined to fulfil the Liberal Party’s long-held desire to freeze the compulsory super guarantee levy at its current 9.5 per cent rate.”
PANDEMIC POLITICAL PROFITEERING
ACTU Assistant Secretary Scott Connolly described Liberal attacks on superannuation as “pandemic political profiteering”.
“If the Liberal Party’s only solution to the problems of the pandemic is to raid people’s super, then they’ve clearly run out of ideas,” Connolly said.
“These backbenchers need to be put in their place by the Morrison government, and workers need to be given reassurance that their retirement savings will go up as currently legislated.”
Until the late 1980s, only highincome earners and public servants enjoyed decent superannuation. Most workers – including almost all women – had no super at all.
From the late 1980s, unions began to win superannuation as a part of enterprise and award bargaining.
Unions set up industry super funds such as HESTA to look after the
retirement savings of their members.
In 1992, the Keating Labor government introduced a compulsory superannuation levy as part of a tripartite agreement between the government, employers and the unions.
The Liberals opposed any levy.
Labor planned for the levy to reach 15 per cent but the Howard government halted it at 9 per cent.
In 2010, the Rudd government a n nou nce d it wou ld incrementally raise the rate to 12 per cent by 2020 but Tony Abbott froze the rate at 9.5 per cent in 2014, citing a “budget emergency”.
According to former prime minister Kevin Rudd, this was “classic Abbott bullshit to advance a long-standing, ideological agenda”.
Rudd disputes the current claim by many Liberal MPs that businesses cannot afford a super increase.
He said labour productivity had risen about 9 per cent since the Abbott freeze, easily outstripping the stalled 2.5 per cent rise in contributions.
“They also conveniently ignore that (Rudd’s announced increase to 12 per cent) was coupled with business-friendly measures including a company tax cut, phased implementation and an instant asset write-off.” n
Fund members face Super ‘double whammy’
About 2.4 million people have applied to withdraw funds from their super accounts under the government’s “early access scheme” put in place during the pandemic. By July, about 500,000 people had already accessed the scheme, which allows members to withdraw up to $20,000 from their super fund. Industry super funds have warned that people who make withdrawals under the scheme face a double whammy if the planned increase in employer contributions from 9.5 per cent to 12 per cent is cancelled. According to Industry Super Australia modelling, if the increase is abandoned, a typical man who draws down the maximum $20,000 allowed under early release rules will lose $180,000 in retirement savings. To make up the difference, he would have to work an extra 6.5 years past retirement age, to 73 and a half. A woman would lose $150,000 and have to work eight years longer, until she was 75, to make up the difference. Experienced business analyst Glenda Korporaal, an associate editor of The Australian newspaper, says the early access scheme has set a dangerous precedent. “The danger for the super industry is that if easier access conditions are continued or not well monitored, they will be seen as a handy ATM to draw down funds for all events of future hardship,” she wrote. “Another severe bushfire season? Allow those affected to draw down their super. People affected by severe flooding or cyclones? Allow them to draw down their super. The list goes on. “Allowing early access to super simply means that there will be no money, or a lot less money, for people – sadly, the more vulnerable in society – once they get to retirement age.”
Nurse death toll soars
Healthcare workers are paying a high price in the global battle against COVID-19.
Br it ish nurse A ndrew Nwankwo spent the last five weeks of his life on a ventilator in intensive care – a victim of coronavirus.
Described as a “big friendly giant”, 46-year-old Andrew worked at Bloomfield Hospital in Chelmsford, north-east of London.
A lack of personal protective equipment at the hospital reportedly forced Andrew to try to buy his own online. “He was being sent to face the danger without being given the adequate protection – that’s the bottom line, and he told me as much,” his brother told the BBC.
A hospital spokesperson denied there had ever been a lack of PPE.
Andrew was among 101 nurses to die after contracting COVID-19 in England and Wales between 9 March and 25 May, according to the Office for National Statistics.
The ONS confirmed that nurses had “statistically significantly higher rates of death involving COVID-19” compared with the general population.
A lack of PPE remains a serious problem for nurses and other healthcare workers (HCWs) in many countries, according to the International Council of Nurses.
It called on governments to systematically record infection rates and deaths amongst HCWs and report the results to the World Health Organization, in order to promote preventative measures.
ICN CEO, Howard Catton, said partial and preliminary figures raised a number of questions, including:
What contributes to the wide
‘Nursing is looking like one of the most dangerous jobs in the world at the moment.’ — Howard Catton, International Council of Nurses
variation of HCW infection rates between countries, e.g. between 1 per cent in Singapore and more than 30 per cent in Ireland?
Why are some countries that have high numbers of cases recording low numbers of deaths among HCWs? For example, Germany and Spain.
How do HCW infection rates vary between different clinical settings, such as hospitals, and long-term care facilities, such as care homes?
“Nursing is looking like one of the most dangerous jobs in the world at the moment,” Catton said.
“We need to get this data for every country and work out exactly what is going on that explains the variations that are evident with even a cursory glance at the figures.
“Only then will we be able to learn how best to keep our nurses safe and prevent any repeat of these terrible statistics in the future.”
In the United States, which has the world’s highest number of COVID-19 infections, inadequate access to testing among the general population, a nationwide shortage of protective gear such as N95 masks, and lack of basic supplies like hand sanitiser are driving up the death toll among health workers.
By 1 July, the pandemic had taken the lives of 735 frontline HCWs in the US, according to Lost on the Frontline, a project launched by The Guardian newspaper and Kaiser Health News (KHN).
Lost on the Frontline aims to count, verify and memorialise every US healthcare worker who dies during the pandemic.
They include nurses like Helen Gbodi, 54, who worked at MedStar Washington Hospital Center in Washington DC.
Helen, a single parent, was known for helping elderly neighbours and fellow churchgoers, picking up their medications and groceries and accompanying them on walks.
Rebecca Gbodi said her mother worked long hours to put her three children through college and helped pay school fees for other relatives.
Though Helen did not actively care for patients who had been diagnosed with COVID-19, such patients were being treated on her floor, Rebecca said.
By the time Helen was hospitalised with COVID-19, she was too weak to lift her arm for a virtual handshake with her daughter on FaceTime.
In addition to tracking deaths, Lost on the Frontline reports on the challenges healthcare workers are facing during the pandemic.
It says many have been forced to reuse masks countless times amid widespread equipment shortages. Others had only garbage bags for protection.
“Some deaths have been met with employers’ silence or denials that they were infected at work,” it says. n
Key findings
According to statistics collected by the International Council of Nurses (as at the beginning of June):
7% of the world’s COVID-19 cases are among healthcare workers (450,000 out of 6 million cases) 600 nurses had died of the virus worldwide 101 nurses died from COVID-19 in England and Wales (between 9 March and 25 May) 735 frontline healthcare workers had died in the US (up to 1 July)
More information
Visit Lost on the Frontline https://www.theguardian. com/us-news/series/ lost-on-the-frontline)
‘Little flu’ kills 60,000 and counting
Before being admitted to intensive care with coronavirus in the Brazilian city of Manaus, a 46-year-old nurse named Nicolares Curico wrote to his wife, Deizeane: “Take care of our daughters. I love them.” A week later, Nicolares was dead. Deizeane said her husband loved his profession, but a lack of PPE and staff because so many colleagues were falling ill, had left him overworked and exposed. “He felt unprotected because he didn’t have an N95 mask,” she said. “He was seeing more than 100 patients a day.” Earlier this year, Brazil’s president Jair Bolsonaro described coronavirus as “a little flu” but the country now has the secondworst death toll in the world, behind only the US.
With no social distancing and few lockdown measures in place, it is feared that the death toll – almost 60,000 by 1 July – will continue to spiral. The pandemic is having a particularly devastating impact on Brazil’s nurses. A video from the Rio Nurses Union shows hospital staff sleeping in corridors and bodies covered in bin bags in wards where people are recovering from the virus. Nurses recently assembled in the capital, Brasilia, to mourn the lives of their colleagues and protest a lack of PPE and lack of training in how to use available supplies. During the vigil, they lit candles and laid crosses in memory of those who died from Covid-19.
Increasing number of Victorian COVID-19 outbreaks linked to healthcare sites
Nearly 400 Victorian healthcare workers have caught the coronavirus since the beginning of the pandemic.
When Victoria reached a new height of 428 new COVID-19 cases on 17 July, Victoria’s Chief Health Officer Brett Sutton said positive cases among aged care and health care workers were driving some of the outbreaks.
Just three days earlier, an article in the Medical Journal of Australia reported that health worker infections represented six per cent of all infections to date.
I n m id- Ju ly, V ic t or i a’s Department of Health and Human Services announced that 388 Victorian healthcare workers had caught the virus since the pandemic began, and 150 of the cases were still active.
While the department said the “vast majority” of the workers testing positive had been infected outside their workplaces, increasing numbers of Victorian outbreaks have been linked to healthcare sites, including the Northern and Alfred public hospitals, the Brunswick Private Hospital, and the Royal Children’s Hospital. At the time of writing, 27 clusters had been linked to aged care homes in Victoria.
Lisa Fitzpatrick, the Victorian branch secretary of the Australian Nursing and Midwifery Federation, told The Lamp increased community
transmission meant that Victorian nurses, midwives and carers are dealing with uncertainty.
However, she said, “It’s important to remember nurses and midwives are well educated in infection control and know how to protect themselves against the risks at work.
“The Victorian health department’s close-contact tracers are working on understanding the source of infection for each healthcare worker who has tested positive with COVID-19.”
Lisa said that while healthcare workers are contracting the virus in the community and at work, significant numbers are self-isolating and awaiting results of tests. In the meantime, she said Victoria is well prepared in the event a surge workforce is needed.
“There are more than 4000 nurses on the health department’s pandemic surge workforce register, and the federal government has funded critical care education for more than 20,000 nurses, plus refresher education for registered and enrolled nurses who were no longer in clinical practice.”
THE IMPORTANCE OF PPE
The surge in infections occurred as the Medical Journal of Australia published a paper by University of NSW infectious diseases expert Raina MacIntyre and co-authors, calling for all health workers treating COVID-19 patients to be provided with respirators.
They write that a “growing body of scientific evidence around transmission and prevention of SARS-CoV-2 infection” was challenging beliefs that droplet and airborne transmission were distinct modes of transmission.
“Newer studies show that droplets and aerosol particles exist in a continuum,” they write. “Even a single large droplet may reduce in diameter and become airborne during its trajectory, because of evaporation.”
They propose that “N95 respirators offer significantly better protection (96 per cent) than surgical
masks (67 per cent) against SARS, MERS and SARS-CoV-2”.
The authors add: “Our health workers are a precious asset and warrant the highest protection – not simply for their occupational health and safety, but for a functional and resilient health system.”
In mid-July the federal health minister, Greg Hunt, announced five million masks from the national medical stockpile to support Victoria’s response.
Lisa Fitzpatrick says the “state health department has confirmed that delivery of masks and PPE from the national stockpiles to private aged care nurses, carers and other aged care workers will be coordinated through existing Victoria n mecha nisms once approved for release by the Commonwealth Government”.
“Ninety per cent of deliveries are occurring within 24 hours of being ordered.”
‘It’s important to remember nurses and midwives are well educated in infection control and know how to protect themselves against the risks at work.’ — Lisa Fitzpatrick ANMF (VIC)
The crucial importance of PPE was highlighted by Victorian nurse Lisa Peters, who wrote about her experience testing residents of the Flemington and North Melbourne public housing towers for the ABC online.
Going into the towers, Lisa writes: “We were assembled in teams of two nurses and two police officers, and each of us had a trolley containing everything we needed.
“When each floor was completed, we went back downstairs to ‘doff’ — remove our PPE in a particular way so as not contaminate ourselves or others.
“Teams of paramedics were on hand to assist with every step. They possibly thought their job was insignificant, but it was just as important as ours.
Lisa wrote that with both her own safety and that of her immediate family weighing on her mind, “she had never felt so anxious about doffing in all my decades of nursing”.
Scholarship Activism • Campaign • Advocacy
Roz Norman was an outstanding activist, branch official and Councillor of the NSWNMA and ANMF. In honour of her outstanding contributions, the Roz Norman Scholarship was created to further humanitarian, social or community causes.
The 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.
NSWNMA 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.
Applications open 1 July, closing 30 September 2020
Co-operative approach delivers safer workplace
Enhanced dialogue and co-operation between management and staff is bringing improvements to a violence-plagued mental health service.
The NSWNMA’s Illawarra S h o a l h a v e n m e n t a l health branch says a joint management–union approach is bringing about a safer workplace and better staff representation in the district’s mental health service.
A combined committee of NSWNMA and Illawarra Shoalhaven Local Health District representatives has overseen the introduction of capital improvements, better equipment and more training this year.
In 2019, after several serious assaults by patients on other patients and staff, SafeWork NSW found the LHD had breached the Work Health and Safety Act and issued it with an improvement notice.
SafeWork said staff were “at risk of psychological injury” due to the way misconduct allegations were handled, which included “potentially intimidating correspondence” sent to workers.
SafeWork directed the LHD to develop, “in consultation with workers, a system to control the risk of psychological injury arising from the process of investigating allegations of misconduct.”
Also in 2019, the NSWNMA launched its own health and safety inspection of the service’s Eloura
— Branch delegate, Chris Scott
East Acute Unit, Eloura West High Dependency Unit and Mirrabook Acute Unit.
The inspection found the LHD had failed to take reasonable steps to protect nurses from exposure to violence from patients and management bullying.
Sixty-two per cent of members in the service said they had been bullied at work in the previous 12 months, mostly by “management or a supervisor”.
NSWNMA Assistant General Secretary, Judith Kiejda, said the inspection found “multiple safety issues that put nurses at significant risk of serious injury”.
PHYSICAL ENVIRONMENT NOT FIT FOR PURPOSE
The inspection report said the physical environment of all three units was not fit for purpose, with poor lines of sight and an inability to separate patients.
CCTV cameras were inadequate, units lacked spaces for de-escalation and separation, windows were made of breakable glass and back-up power supplies were insufficient.
Nurses worked in isolation yet there was a shortage of personal duress alarms.
Regarding patient care, there was a shortage of doctors, poor medical management and a lack of continuity of care.
Understaffing was rife and low rates of anti-violence training were “extremely concerning”.
Management had failed to address serious issues raised by nurses through consultative mechanisms, including assaults on staff resulting in injury, sexual harassment of female staff, high levels of fatigue and low morale.
In a letter to The Illawarra Mercury newspaper titled “Help”, published in November 2019, staff members said “urgent action is critical to instil professional
CHRIS SCOTT, ILLAWARRA SHOALHAVEN MENTAL HEALTH BRANCH DELEGATE
management, systems and procedures” in the mental health service.
The Mercury reported there had been at least six serious assaults on staff by patients between December 2018 and November 2019.
In November, NSWNMA general secretary, Brett Holmes, told ABC News the lack of trained staff was deeply concerning.
“If they can’t recruit sufficient staff then they need to manage the level of service that they can provide otherwise they’re putting the lives of patients and their staff at risk,” Brett said.
He said a shortage of staff was very dangerous for a facility with such a history of violent incidents.
“There need to be adequate numbers of staff to intervene in critical situations and that’s a minimum of six people needed to restrain someone who's physically violent towards themselves or others.”
Brett said a shortage of trained staff gave rise to a high risk of nurses of being involved in a potentially violent incident and then being accused of not practising properly.
“Then staff get investigated, and suspended during that investigation, which only adds to the staffing issues.” n
Catalyst for change
During 2020, there has been “a marked shift in management’s attitude and the issues are being taken seriously and being addressed,” said Chris Scott, a delegate of the NSWNMA’s Illawarra Shoalhaven mental health branch. Chris told The Lamp the union health and safety inspection was “a catalyst for significant change”. Management agreed to close several beds, which was “a relief to staff on workload and safety grounds”, he said. “Previous workloads were unrealistic and unsuited to caring for people with challenging presentations. “The LHD has committed to working through matters with the union including regular joint meetings to implement improvements. “An external HR organisation was brought in to review the culture of the mental health service. That allowed staff to express their concerns without fear of repercussions. “The union and mental health executive are implementing changes which are leading to a safer workplace.” This year has seen improvements to patient access to medical care and staff access to, and sight of areas within units. CCTV coverage and lighting has improved and faulty duress alarms have been replaced. Violence prevention training has significantly improved and patients have more therapy activities and more and safer exercise equipment. Units have been supplied with new weighted chairs and tables that cannot be thrown as weapons. There is also more support for nurse unit managers.
